Rhonda Patrick
👤 PersonPodcast Appearances
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Now let's dive into today's special AMA preview.
Hi, everyone.
Welcome to Q&A number 72.
Nice to see people from all around.
I see people saying hi from their location.
Excited to be here.
Today, we're going to do things a little differently.
I'm going to start with the rapid fire questions that I usually end with.
And then after the rapid fire questions, I'll kind of get into some deep dive questions today.
But I did mention in the chat that I was going to get my exogenous ketones.
And I see some questions already in the chat about exogenous ketones and the different types of ketones, when to take them and why.
And some of you may be wondering why I'm taking it right now.
I didn't get to do any of my high-intensity interval training this morning, and that usually gives me a pump of lactate.
And that lactate gets into the brain, and it really sort of gives me a little extra pump so that I can feel cognitively ready to do this Q&A.
And so I took my exogenous ketones because beta-hydroxybutyrate, which is the major circulating ketone, and it's the one that's found in all these exogenous ketone products.
acts very similar to lactate in a sense, where it activates a lot of the same genetic pathways, including brain-derived neurotrophic factor.
It's also anxiolytic.
So what I find when I take some exogenous ketones is that I feel it's not the same as like drinking a cup of coffee, but I feel focused, but a very calm focus.
So
It seems to calm me a little bit and allow me to focus better.
And I really like that.
So when it comes to the type of ketones right now, I don't have any affiliation with any brands.
But I've been experimenting with Delta G. And this is what's known as the Oxford ketone.
It was developed by Dr. Richard Veach and Kieran Clark, who is at Oxford.
It's the real deal.
It's the ketone that was sort of developed with funding from DARPA.
And it was really – the aim was to kind of help military personnel be able to be cognitively on their game during very stressful periods where they're sleep-deprived, perhaps not eating under a lot of just stressful conditions.
And so –
That is the ketone I'm doing.
And the reason I'm experimenting with that one is because it's the only... Actually, the Oxford ketone is the only ketone out there that actually is the beta-hydroxybutyrate ester.
That one and also...
KetoneAid, which was started by Richard Beach, that one also uses the same ketone ester.
So what that is is the beta-hydroxybutyrate, and it's esterified to 1,3-butanediol.
What that is is it's
It's an ester that your liver does get, your liver converts into beta-hydroxybutyrate eventually.
So what happens is when you take a product like Delta G, and I'm using their Delta H product because it's the, I don't really need the really, really high ketones.
So this is about 11 grams of ketones in a serving size of a bottle.
And they have higher dose ones that's like 25 grams.
And I don't really need that.
So you feel the effects immediately because it does have beta-hydroxybutyrate in there without having to be converted into beta-hydroxybutyrate by your liver.
So you feel the effects immediately within like minutes.
And then because it's esterified to the 1,3-butanediol over the course of an hour to 90 minutes, you're also converting that 1,3-butanediol into more...
beta-hydroxybutyrate.
And so it's sort of, not only do you have an immediate effect, but you have this sort of long tail effect as well.
Now, someone asked about Ketone IQ.
That product only uses the 1,3-butanediol.
So there's no actual beta-hydroxybutyrate in that product.
It's a much lower dose.
I believe it was five grams.
And it's also...
Slow acting.
So if you want that, if you're using that for something like in my case where I'm giving, you know, doing a Q&A or let's say I was, you know, I'm doing a podcast or a talk, then I would take it at least an hour beforehand because it takes a while to convert the 1,3-butanediol into the beta-hydroxybutyrate.
You can kind of think of it as like a precursor, ketone precursor.
Whereas the one I'm taking right now, I can just take, boom, right away.
I'll feel it immediately.
And then I continue to feel it over the next couple of hours.
It's also given me a little bit more motivation to revisit my experimentation with ketogenic diet, certainly cycling.
I like the way I feel.
I like the calming effect.
And that largely has to do with, I had a podcast with Dr. Mark Mattson a few years back, and
And he was explaining, you know, when you're in ketosis and your body is making beta-hydroxybutyrate in ketones, the beta-hydroxybutyrate appears to – it gets into the brain and it sort of shifts the balance between GABA, a neurotransmitter, inhibitory neurotransmitter, and glutamate, which is more of an excitatory neurotransmitter.
And it tips the balance more towards GABA.
And that sort of has this anxiolytic effect where you feel calmer and you're less anxious.
So for me, that is hugely beneficial because I do sometimes have an amount of background anxiety, particularly if I have to perform well.
And so I like that sort of calm focus that I feel when I have – when I'm either in ketosis because I have experimented with ketogenic diets and I do remember that being one of the most profound effects that I noticed when I was doing a ketogenic diet –
And also I've been in ketosis from fasting, same thing.
And then I've tried exogenous ketones.
And so they all sort of replicate that feeling of sort of calm focus, which I do really like.
I see people in the chat asking, Faisal's asking about advice on sleep and shift work.
We are going to do a little bit of a deep dive on sleep today.
So we'll talk more about that later.
I want to go ahead and get some of the rapid fire questions.
I love how a lot of people asked questions, follow up questions on my recent coffee episode that I that I released.
I don't know, a few weeks ago.
So Ruby asks, a follow-up on a great coffee episode, do coffee filters have any sneaky chemicals or glue in them?
Yes, some of them can.
I use the Chemex unbleached coffee filters.
Those are the ones that I use.
I really like them.
If you want to try them out, great.
A related question from Michelle was, loved your deep dive on coffee.
What brand and type of coffee maker are
filter and coffee do you use?
And are you saying that a paper filter does remove all the bad stuff that you mentioned?
Okay, so the coffee that I have been on or been using right now, I've tried a
Honestly, right now I'm on a bit of a decaf coffee kick because my creatine is amazing.
And now that I take 10 grams a day instead of 5 grams a day, I find that I'm not having that afternoon crash.
I don't necessarily want to call it a crash because I wasn't really crashing.
But I would often get a little sleepy, you know, two, three o'clock in the afternoon.
I no longer have that with my higher dose of creatine.
And so I've also gone down to decaf.
And the brands that I use for both decaf and also regular caffeinated coffee are
Because I'll cycle back on.
And the great thing about cycling off of coffee and then going back on is that when you go back on, the coffee is so effective.
And so you kind of, I like to use it for those moments when I really need it.
I use the Purity Coffee brand.
I really like their organic coffee.
For the decaf, I use their Calm decaf, which is great.
They have regular coffee, which is also great.
And so right now, that's kind of like my brand that I've been using.
I already mentioned the filters I use, the Chemex unbleached coffee filters.
And then for a coffee maker, I like doing the pour over.
And so I do Chemex pour over glass coffee maker.
So it's like a big glass coffee maker.
And then you put the filters inside and the coffee and then you pour the hot water in and there it goes.
It drips through.
When it comes to the filter, it does filter out a lot of the oily substances, the diterpenes, which I know I kind of painted a bad picture of in the episode because they raise LDL cholesterol and that could be a concern sometimes.
Particularly for people that already are higher risk for dyslipidemia, perhaps they have higher LDL cholesterol, they have higher, maybe they have LP small a. There's a ton of reasons why someone may want to really just be very anal about making sure that they eliminate all the things that can raise their LDL and try to keep that down.
Yeah.
But the diterpenes also, there is at least some in vitro evidence.
So this means these are just cells in a Petri dish.
It's not the strongest type of evidence, but it is still something to talk about.
That there can be some anti-cancer effects with the diterpenes.
So they're not all, it's not like they're just like villain and there's nothing good about them.
There is potentially something beneficial, although we don't have a lot of evidenced
To support that, it does seem like there's a possibility that there's some benefits there as well.
In other words, what I'm saying is if you like your French press coffee, by all means keep making your French press coffee, particularly if your LDL and lipids are looking great.
And we're going to talk about lipids as well today.
A related question from Freda Vera.
They ask, what's the best overall company to purchase organic beans for cognitive protection?
Again, I'm turning to Purity Coffee because one of the reasons I really like their brand is they have a lot of testing and data posted on their site.
They sort of validate the organic beans.
They do independent analyses on beans.
You know, they're the polyphenol content.
So this would be the chlorogenic acid.
And it seems to be pretty much like, you know, really high, high amount of the chlorogenic acid.
In fact, their light to medium roast preserves around 65% more of these polyphenols than other organic brands do.
And they also have third-party testing showing that they're free of pesticides and heavy metals and other contaminants.
So I like that brand.
And again, the polyphenols are really what is beneficial for brain health.
Again, caffeine itself also appears to be beneficial.
So I'm on my decaf kick right now, but I will shift back to my caffeinated coffee eventually.
Okay, and then another related question on coffee was from KRD, who says, Hi, Rhonda, on the subject of coffee, what does the research say about coffee causing loss or malabsorption of minerals such as iron or zinc or copper?
Also, does coffee cause dehydration?
In what way can we drink coffee to prevent nutrient loss?
So with respect to nutrient loss, coffee, really, most people are fine.
I would say it's very minor.
And the biggest minor effect would be iron.
So even most people that have normal amounts of iron don't have to worry about this.
But
it can cause a little bit of an absorption issue with iron.
And so if you are eating a meal, you probably want to make sure it's like the coffee spaced out by like an hour so that you're not inhibiting the absorption of iron from your meal.
When it comes to dehydration, it's totally like it's just not it's kind of unfounded, basically, especially for people drinking normal amounts of coffee.
And you start to get into like the really high dose.
Maybe you can cause some issues.
But there was a study showing that, you know, for 200 mil cups of coffee per day.
So this is about four milligrams of caffeine per kilogram body weight per day.
Over the course of 72 hours, there was no difference in terms of water, total body water and urine, osmolarity, just all that stuff.
So there's really just not a lot of evidence that it's causing dehydration in most normal circumstances.
Another rapid fire question from Farid Gargour.
They ask if there's any issues of drinking coffee on an empty stomach.
Not that I'm aware of.
I mean, obviously, like maybe some people do, but I don't, there's not like an overall thing.
It's not like a thing.
And then another question about dairy.
So the question is regarding the dampening of
dampening effect of dairy, if my goal is general long-term health, is there still a benefit to avoiding dairy in order to maximize immediate absorption of polyphenols?
Would it in fact be better to add dairy and slow the absorption rate?
So what this question is hinting at is the fact that
Coffee, when you add dairy to your coffee, the bioavailability of the polyphenols is dramatically slowed.
In fact, there was a crossover study that gave people 609 milligrams of chlorogenic acids.
Those are the major polyphenols found in coffee, plus whole milk.
And they found that basically...
The metabolites that are the polyphenol metabolites, they fell from 68 to 40.
And it was about 40% relative drop in the first day of recovery.
So essentially, you're not going to get all those polyphenols out.
popping like immediately, but eventually they catch up.
So over long-term health, it's fine.
But if you're wanting that immediate polyphenol boost to your brain, then you probably should not add dairy.
You should do something like MCT powder or, you know, some kind of plant milk, like almond milk, for example.
And if you like to have your coffee with cream, don't use dairy.
And then there was another related question about protein doing something similar to
And, yes, it does do something similar, and you can essentially just time your protein 30 minutes before or after your coffee if you're concerned about the delay in release and bioavailability of the polyphenols.
And there was another, this is the last question on coffee.
This question was submitted by Sam.
And Sam says, for those of us who have the gene for slow metabolism of caffeine, should we do anything differently?
Your gene data notes that slow metabolizers should limit or avoid caffeine altogether.
Is this still valid?
I would say that for people that are slow metabolizers, obviously, you need to kind of self-experiment.
But typically, you want to limit your caffeine to morning use.
And taking it in the afternoon may be the issue because if you're a slow metabolizer, it may take 10 to 12 hours before you're metabolizing all that caffeine.
And so there may be this residual effect on your sleep.
However, you should be able to mostly notice that.
So if your coffee consumption protocol is not causing any issues with your sleep, then whatever you're doing should probably be fine.
Okay, there's a few more rapid fire questions we're going to get to before, but I want to look at the chat to see some coffee related questions here.
Myrna is asking about my thoughts on decreased blood flow from vasoconstriction from coffee to the brain.
In fact, the polyphenols do the opposite.
They actually increase the blood flow to the brain.
So whatever minor vasoconstrictions probably just canceled out.
Bodhi's asking about Nespresso Virturo.
Sorry, I don't know how to say that.
But the Nespresso capsules.
And they're asking where this falls on the health spectrum.
Unfortunately, those pods, those capsules, they all have lined plastic in them.
And so...
My biggest concern with those isn't the coffee type.
It's the hot liquid going through plastic, which as we have talked about several times, rapidly accelerates the breakdown of microplastics into your beverage as well as their associated chemicals like BPA into your beverage.
Unfortunately, I don't think those are a good choice for that reason because you're actually going to be consuming a lot of microplastics and plastic associated chemicals.
Alyssa's asking about the meter I use for my ketone to measure my ketones.
I actually don't use the meter that's sold with any companies.
I use a Precision Extra, which allows me to measure my blood glucose with a finger prick or ketones or I don't know if they do lactate.
I use a different meter for lactate, but I really like the Precision Extra.
I've been using it for like almost 10 years.
It's a really great product.
Mike is asking when I cycle off caffeine if I notice any lowering in my resting heart rate.
I actually do not.
Monica's asking about coffee pot makers that are not made of plastic.
That's why I mentioned the one I use, which is the glass key mix.
And it's a pour over.
And so it's basically you just put the filter on the top of it and then the coffee drips through.
And then, of course, there's some percolators that you can buy that are not made of plastic.
And there's the French press, of course, as well, if you're not concerned about drinking unfiltered coffee.
Allie's asking about coffee pods that are compostable and made of paper.
As long as you can confirm there's no plastic lining inside the paper, then sounds great.
Okay, let's finish up some of these rapid fire questions that were submitted.
Chris Hall asks, you recently mentioned the potential benefits of ubiquinol, berberine, and alpha lipoic acid in Synergy.
Can you speak about appropriate dose ranges?
So for people that are really wanting to not only affect their glucose regulation, but also their lipid
panel their i would say you know their lipids they're wanting to optimize their lipids in general then i would say that the literature really suggests berberine in a higher dose is more beneficial and it has to be split up so the studies really do um
highlight that berberine should be taken at about 600 milligrams three times a day and it's taken with meals.
If you're wanting it to really affect the glucose response it needs to be taken with a meal.
And so that's a total of about 1.8 grams a day of berberine.
Alpha-lipoic acid is anywhere between 600 to 1200 milligrams a day.
And the ubiquinol is a reduced form of CoQ10, CoQ enzyme 10.
And essentially, the ubiquinol is a more bioavailable form.
So, and I talk about this in a minute in the context of fertility, which is a little bit of a higher dose.
But in this regard, you know, 100 milligrams could be fine.
Okay, here's the related question about ubiquinol and the optimal dosage for a woman in their mid-30s that's preparing for egg freezing or improving mitochondrial health.
So those studies actually show...
600 milligrams a day of CoQ10 in the form of ubiquinone, which is the oxidized form of CoQ10, and it's less bioavailable.
So modifying the dose here, if you're looking at the more bioavailable form, the ubiquinol, 400 milligrams a day of that is also something that would be more equivalent to the 600 milligrams a day of the CoQ10.
Some other things to add for women that are looking to improve their egg quality, they'd obviously want to add a prenatal vitamin that has all those important B vitamins in it and the methylated ones as well.
You want to add vitamin D, 5,000 IUs a day.
You want to add omega-3, about 2 grams a day.
Also some evidence that melatonin, 3 mg a day, has antioxidant effects as well on eggs.
And then myo-inositol, about 4 grams a day as well.
And this leads into a related question by Ivana about myo-inositol and what the dose is and the reason I'm taking it.
So I was taking it, again, four grams a day.
And mostly it was for sleep, but also for ovarian reserve.
And then Karen says, in your June supplement update, you didn't mention taking
Benfotamine, collagen, lutein, or zeaxanthin, are you still taking these?
If so, when do you incorporate them?
I do take collagen every morning in my coffee.
Lutein and zeaxanthin are in my multivitamin, so I don't feel like I need to take those really separately.
And then benfotiamine I haven't been taking lately.
There's another question from Matthew Tanner asking about homocysteine.
I don't seem to talk about taking extra methylated B vitamins.
So yeah, my homocysteine is great.
I don't really take extra methylated B vitamins because I get it in my multivitamin.
In other words, it takes a lot of these methylation groups to make creatine.
And so...
that sort of takes away from the other roles that it could play, like lowering homocysteine, because you need methyl groups to convert homocysteine back into methionine, right?
And so if you're freeing up methyl groups because you're giving your body exogenous creatine, then what happens is those methyl groups can then be used to methylate homocysteine and then thus converting it into methionine.
Not a lot of people talk about this, but there is some evidence on it.
And again, I do take 10 grams of creatine a day.
Stas asked what vitamin K2 supplement I'm taking.
I'm actually taking the, I'm now taking the Pure Encapsulations.
They didn't always have this.
Pure Encapsulations, vitamin D plus K2.
That's my new supplement.
So it's all in one, which is great.
And you guys know I don't have any affiliation with Pure Encapsulations.
Okay, we're almost done with these rapid fire questions.
Kathy asks,
My question is that Rhonda told us a lot of great things about moringa powder by Cooley Cooley a while back, but she's now saying there's a lot of lead in powder green supplements.
Is there lead in moringa powder?
Is Rhonda still taking moringa powder?
So I do not currently take moringa powder.
I have switched to supplementing with Avmacol.
I think I told you guys this.
I take the Extra Strength Avmacol.
It's really fantastic.
It's helped my mom with her tremors.
It's kind of amazing.
I've moved away from any sort of green powder supplements because I do think that they're just a high risk for heavy metals.
You can test this.
There's a variety of blood tests that you can do.
Add back in some green powders and you might see that your heavy metal burden goes up.
So that's kind of what I'm doing right now.
And then this is the last rapid fire question from Ted Ham.
And Ted asks, what are the best options for choline supplementation if one has
SNPs for poor phosphatidylcholine absorption or levels given the risk increase in TMAO levels.
Now, keep in mind, choline deficiency also leads to non-alcoholic fatty liver disease.
And so you want to be careful with that as well.
So the free choline salts...
are the forms that the microbes in the gut can actually ferment into TMAO.
Well, it actually ferments it into trimethylamine, and then that gets converted into TMAO, which is pro-atherogenic.
And that's what people are wanting to avoid.
So essentially, the goal would be to not have choline in this salt form.
You'd want choline in its already sort of pre-formed membrane-ready form.
part.
So in this case, you'd actually want to supplement with the phosphatidylcholine because the microbiome, the bacteria in the colon, wouldn't really be able to use that phosphatidylcholine, that colon that's already in this membrane, as a substrate to make the precursor for TMAO.
So in fact, there was a study that looked at phosphatidylcholine capsules
for four days, sorry, for four weeks.
And essentially, the TMAO was unchanged.
So it wasn't increasing the TMAO, whereas the same dose of choline bitartrate, so that would be the choline salt, did increase TMAO quite sharply, actually.
So I think the solution here really is you want to do phosphatidylcholine.
Another potential form would be the citicholine.
So this is CDP choline, and this is basically, it's a nucleotide.
It's a nucleotide-bound choline.
And I don't think it's very... It's much more less prone to converting the choline into the TMA or the TMAO.
So that's another form of choline.
I've actually been experimenting with that recently because it's a little bit of a nootropic because choline is a precursor for acetylcholine, which is a neurotransmitter that is involved in cognition, memory.
So...
Acetylcholine would be another form, but I would say for the purposes of wanting to get, you know, not the nootropic effect, but wanting to get like adequate amounts of choline, phosphatidylcholine would be the way to go.
Matthew's asking if I have any concerns with the choline bitartate in the multi.
No, because it's such a small amount.
We're talking about levels that are much, much higher, 250 to 500 milligrams.
So it's a very, very different amount that we're talking about here.
When it's a super small amount, it's just sort of non-significant.
Faisal is asking if I have any opinion on Thorne products.
I use a lot of their supplements.
I use their creatine.
I use their glutamine.
I use a lot of their supplements as well.
I think they're a good brand.
Daisy's asking if we take CoQ10 and not looking to get pregnant, do we need 600 milligrams a day?
No, you do not.
The 100 to 200 is fine for mitochondrial health.
The 600 milligrams is an excessive amount and it's solely for the purpose of
increasing the egg quality, the ovarian reserve.
So really, it's a very specific outcome that people are looking to achieve when they're supplementing with a high dose of CoQ10 and or ubiquinol.
Let me get to the deep dives.
Okay, so the first question, this was a top voted question by Alina.
And the question is, what are the most common causes of fragmented sleep and nighttime awakenings that last over an hour?
And which strategies or nutrients do you recommend to improve sleep continuity and continuity and depth?
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Welcome back to the podcast.
Today, we're doing a deep dive into one of the most well-researched and widely used supplements, creatine.
And joining me is Dr. Darren Kanda, one of the world's leading experts on creatine, muscle physiology, and aging.
Dr. Kandao is a professor and director of the Aging, Muscle, and Bone Health Laboratory at the University of Regina in Canada.
He's also the director of research for the Athlete Health and Performance Initiative and has published over 140 peer-reviewed papers on how nutrition, particularly creatine, and resistance training impact muscle, bone, and brain health.
Most people associate creatine with strength and power, but its effects extend far beyond that.
In fact, in this episode, Darren and I discuss how research now suggests creatine supplementation may play a role in cognitive function, particularly under stress or sleep deprivation, muscle and bone health, especially in aging populations, endurance performance and HIIT adaptations.
It reduces inflammation and improves recovery.
We talk about metabolic and cardiovascular health with potential benefits for cholesterol, triglycerides, and even vascular function.
We even discuss mental health conditions like depression.
We also get into a lot of specifics regarding creatine supplementation, including how creatine supplementation works.
The best ways to take creatine, should you cycle it, is timing important.
Does it work better if you take carbohydrates?
We talk about dosing strategies.
Standard recommendations are three to five grams per day, but the question is, should some people take higher doses?
We discuss creatine and whether or not we need a loading phase for it, or if you can just start with a daily dose.
We also talk about different forms of creatine.
Monohydrate is the gold standard, but what about HCL or other formulations?
And we also discuss a lot of different common concerns.
Does creatine cause bloating, GI distress?
Does it interact with caffeine?
Does it cause baldness?
Is it bad for the kidneys?
And many other concerns.
We also dive deep into the emerging research on creatine and sleep, including whether creatine actually improves sleep or if it's just helping the negative effects of poor sleep.
So by the end of this episode, you'll have a comprehensive understanding of creatine, how it works, how to use it, and whether it makes sense for you.
Thank you so much for having me.
Thank you so much for joining us.
We've compiled a comprehensive set of resources for you.
Head over to foundmyfitness.com forward slash topics where you'll find a deep dive into all the current evidence-based research on creatine.
Just scroll through the alphabetical listing until you'll find the letter C.
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And now on to the podcast with Dr. Darren Kandow on all things creatine.
Darren, I'm super excited to have you here today to have this conversation with you to go deep into the science of creatine.
I've read several of your studies.
I'm a huge fan.
A lot of really important and interesting research to talk about.
Maybe we can start where it's most popular.
I mean, a lot of people think about creatine.
In its role in exercise performance.
However, there's been a lot of emerging research in other areas.
Maybe you could give people just a quick snapshot.
Well, let's talk about the resistance training and improving performance, muscle health.
And how is it going to benefit you?
Is it going to improve your training volume?
Is it going to make you stronger?
Yeah.
So, okay, to go back, you just gave a total information dump, which is awesome.
Let's go back first to the explosive power you were talking about.
It seems to really help benefit in that explosive power, like you're talking about doing a squat.
Yes.
Or, I don't know, maybe the first few seconds of an interval, something where you're going, you know, using all that power.
Yeah.
Is creatine benefiting... Is that how it's benefiting...
increasing the training volume or is there something else that's happening?
Does it affect the recovery time in between sets?
And I think this is really important.
We're talking about here, I mean, we were talking about squats, these explosive types of power, types of training.
And this is a really important field because you often hear about people talking about the loss of muscle mass as we age.
You talked about losing type two types of muscle fibers more readily than the type one.
So these are the types of muscle fibers involved in that explosive type of power type exercise.
And, you know, people don't think about how power decreases with age, how strength decreases with age and how that affects our quality of life, how it affects our physical independence, our fall risk.
And so I think just focusing on this type of training, I mean, the creatine is the icing on the cake, right?
Yeah.
But just focusing on doing these types of multi-joint compound types of lifts, which is something that I, in the past, I would say year, a good year now, a solid year of doing CrossFit type of training where I'm doing strength training.
I'm doing resistance training, strength training, and high-intensity inner training.
That's including the types of stuff that I'm used to doing, biking and rowing, but also adding in doing some drop sets with front squats with the barbell and things like that.
So the improvements in the muscle strength presumably are coming because you're increasing your training volume, right?
Or is there a direct effect on strength?
You mentioned some of the anti-inflammatory effects of creatine, particularly in the context of more endurance type of training.
People that are perhaps running marathons or just clocking in a lot of hours of running or cycling per week.
Is that...
I think that goes to some respect in the recovery sort of bin, right?
And I'm wondering if that also plays a role in recovering from doing your resistance training, strength training, like on a recovery day.
So, I mean, do you think it plays a role just broadly in recovery?
So when people hear catabolic or, you know, they'll think of muscle breakdown, right?
And certainly, you know, there's a big component to sarcopenia, inflammation in sarcopenia, which is age-related muscle breakdown.
Is there a role for creatine in preventing the breakdown of muscle?
Does creatine have a general anti-inflammatory effect in both males and females?
And circling back to people that are supplementing with creatine and it improves their training volume, improves their strength, why do people have to supplement with creatine?
So from a perspective of a vegan who is not getting any almost amount of dietary creatine, they're relying on their liver to make it.
What's going on in their brain?
You mentioned the brain makes creatine.
During development, is the developing brain making its own creatine?
So creatine is mostly found in animal foods, meats, poultry, fish.
Yes.
None in plants at all.
So if we're producing between, you know, one to two grams.
At best.
At best, yeah.
Just in our liver.
Correct, yeah.
And that presumably then is being transported to muscle.
Okay.
And then if – let's say you're getting – I think I was reading some NHANES study where on average people get – younger adults, not older adults, get anywhere between one to two grams a day from their diet.
Right.
But older adults are getting on that lower end even – not even necessarily even at one gram.
So older adults are getting even less.
But then –
Is there more to be consumed by the muscle or does it get spread around?
Well, let's talk a little bit about that.
So in some of these, you know, the strength training, resistance training studies, what's the common dose that's taken?
And maybe we can talk a little bit about, I mean, there's the loading phase, which I've never done.
So I actually take five grams a day.
And although I might start taking more after this podcast.
So I'd love to know, like, what is the average dose that's taken to improve, you know, your strength training, your resistance training, your training volume?
And then we can go from there.
Yeah.
I definitely want to get into some of these, you know, potentially negative effects of the high, high dose.
But let's talk a little bit about your new emerging data on bone health.
And so you're talking about, so I mentioned five grams a day.
And well, maybe before we get to that.
Mm-hmm.
How long does, if I'm taking, like if someone's taking five grams a day and, you know, how long does it take to get your muscle stores saturated?
And then let's say your resistance training, right?
So you're working, let's say your resistance training and endurance training.
I mean, you're working out five to six hours a week.
I'm just talking about my schedule here.
Yeah.
And I'm doing five grams a day, right?
Am I just constantly saturating my stores even though I'm pulling down from them as I'm working out?
Or how does that work?
Well, let's talk about bones.
So one of the best things you can do for bone health is weight-bearing exercise, these compound lifts, the things that we were talking about with improving your explosive power and your strength, right?
Right.
How is creatine adding to that?
So you think just supplementing with creatine by itself, even if you're doing eight grams, isn't really going to necessarily affect your bone health if you're not doing any weight-bearing exercise?
Yeah.
Even considering preventing the activation of these osteoclasts that are breaking down the bone?
Right.
Yeah.
What about someone who is, let's say, a postmenopausal woman who's experiencing some perhaps osteopenia?
Yes.
Do you think before trying some of these other standard of care treatments like bisphosphates, for example, you mentioned doing the weight-bearing training and the creatine, perhaps 8 grams or 10 grams a day would be a good first line of defense to try before trying some of these other drugs that do have negative side effects?
Well, prevention is obviously, I think, the key, right?
If we can encourage people before they're experiencing massive breakdown of their bone or osteoporosis, osteopenia.
Yeah.
Yeah.
Yeah.
It is.
You know, when you...
When you hear the word creatine, you think about like the gym bro, right?
Like, I mean, it's like you're taking the creatine and trying to get, you know, their muscles bigger.
And the reality is, is that, you know, women, women are also very susceptible to, I mean, they were susceptible to, you know, losing muscle mass and strength, but bone is a big one.
I mean, it seems like it'd be very important for that population of people in particular.
Yeah, and we'll definitely dive a little more into the supplementation, but I'm interested in the brain.
And we've gone from the role of creatine, it seems to have multiple roles, anti-inflammatory, anti-catabolic.
Right.
It's obviously important for producing ATP, regenerating the ATP.
What about the brain?
So the brain is stressed.
So brain aging.
Brain aging.
Older adults.
Aging is a stress on the brain.
It is.
So supplementing with how much creatine can improve cognition in, let's say, older adults.
OK, so let's if you're if you're someone like myself who's been supplementing with five grams a day for a year.
OK.
Okay.
So you just mentioned the best studies showing any improvement in.
And when we're talking about improvement, we're talking about cognition.
We're talking about like memory.
Okay.
You said 20 grams, right?
Which is definitely what I don't want.
The swelling part of that, which happens around 20 grams.
So have there been studies looking at 10 grams?
Is that like a sweet spot?
You went to another area that I definitely want to talk about.
But, like, before that, so 20 grams then you're saying acutely when you're in this sleep-deprived state, jet lag, you know, let's say fill-in-the-blank type of, you know, extreme stress.
Right.
Is that immediate?
So let's say like you miss, you're like up late, you're up late one night and you have something to do the next morning or the next day, you have to be like on your game.
If you take that 20 grams either at night, would you take it at night like before you go to sleep or in the morning or does it matter and will it have an effect immediately?
I wonder if there's any effect just because it was sort of a triaging of like it's helping with the energy.
And so it's like freeing up other people.
Energy, you know, for like other, you know, taking care of oxidation.
So TBI, I mean traumatic brain injury, the way I think of it is like real-time brain aging.
Yes.
It's like all of a sudden you just get a knock to your head and it's like accelerated aging.
So what would be a protocol for someone that, you know, let's say they take a blow to the head or they get hit with a ball, a soccer ball or, you know, whatever, the football, whatever sport that they're doing, would it be like they should be taking high dose immediately?
Yeah.
And they shouldn't be taking it for the benefits on muscle and explosive power and those high-intensity moments.
You mentioned earlier about 0.1 grams per kilogram body weight.
So how would you adjust, let's say, you're taking 10 grams of creatine per day and you're wanting the benefits of muscle, bone, brain, as do I. However, I do not weigh as much as you do.
So would you, is there a scalable amount per kilogram body weight you think would be something that, or is it hard?
That makes sense.
And it really does seem like there's this sort of triaging where it's like, okay, the muscles consuming it.
It's like the greedy one.
And then whatever's left over, maybe the bone.
But if the brain's stressed, maybe, you know, it's funny how the body can figure that out.
Like, no, the brain needs it.
So.
There's some interesting research that you also published kind of in the brain area is sleep, right?
And I'd love for you to talk about that study.
I thought it was so interesting, these resistance training females, and you gave them creatine, and it really seemed to help improve their sleep on training day.
And it's almost kind of the opposite of what we were just talking about.
We were talking about if you're in this context where you're jet lagged, you're sleep deprived, and you take the creatine and it kind of helps you get over that brain fog that like, you know, you're not quite on your game.
You know, the other thing I was thinking about, Darren, was, I mean, so adenosine.
Is there a role?
Because, I mean, it's downstream of ATP, right?
So I'm wondering if there's any role, because adenosine is something that does make you sleepy.
Well, let's go back to the brain and talk about another.
So we talked about brain aging, you know, traumatic brain injury, which is stress.
We talked about lack of sleep, you know, and things that's...
stressing the brain.
I guess neurodegenerative disease is a very stressful thing on the brain as well.
It would be interesting to see if creatine can help in that regard.
Although, again, prevention is always better, right?
Okay, well, what I was going to get to was the other part of brain disorders, neuropsychiatric disorders.
You have depression, anxiety.
Those are also unfortunately very common nowadays, even in younger adults and adolescents.
So there's been some interesting research with creatine and depression.
And there's also a big inflammatory component in depression.
There's the inflammation.
In fact, there have been studies just in healthy young individuals where they induce inflammation, so like LPS, it can cause depressive symptoms.
Well, what's interesting is, you know,
Activated lymphocytes, T cells, consume just enormous amounts of energy to basically become active and fight off pathogens.
And so I'm wondering if creatine is taken up by these immune cells and it maybe helps in some way.
I mean, you're saying it reduces cytokines.
I mean, a lot of these T cells are producing cytokines to fight off things.
But who knows if they have that potential?
energetic boost, how that could affect, you know, just I would say like the broader, like not having this huge kind of war going on, right?
I wonder if there's any.
Has anyone ever looked at creatine?
you know, creatine's role in helping prevent infectious, you know, disease or respiratory illness, fighting off pathogens.
Like just anecdotally, I supplement with glutamine and create my five grams of, it's about 5.6 grams of glutamine I take a day and with creatine, five grams of creatine.
And it has made a insanely big difference in my susceptibility to respiratory illness, which
I have a little seven-year-old who brings home everything.
Yeah, it's like a vector.
Yeah.
And it's made a really big difference.
And glutamine also is just, it's consumed by activated T cells.
Right, right, yeah.
Yeah, so it would be interesting to see if there's any effect of
both of those, but even just looking at creatine as well.
I know glutamine's been shown in endurance athletes who are very prone to respiratory illness, like these marathon runners.
It's really like they're really just getting to that catabolic state, right?
Are you familiar with any of that workup of the long distance runners and glutamine?
There's like a few studies showing that these marathoners and stuff, they don't get as many respiratory illnesses if they're taking glutamine.
Well, there certainly doesn't seem to be any shortage of interesting things to study with creatine.
And it's like, you know, the field is exploding.
So maybe someone out there will be looking at that at some point.
Another really interesting area is the vascular health.
Mm-hmm.
And I mean, there's just like we were just chatting about a recent study coming out.
Yeah.
Endothelial cells have transporters for creatine.
I've also come across some other like cardiometabolic health benefits.
So glucose, but also triglycerides.
Was cholesterol in there too?
Can you talk about that?
Is that maybe some mixed data?
I'm not sure if everything is showing the same.
So creatine decreases body fat in combination with resistance training compared to resistance training alone.
Well, going back to this loading phase and this higher dose, I mean, when I say higher, I mean 20 grams.
All these studies doing that, I mean –
barring the brain stuff, is it really just to, like, kind of get their store saturated quickly because the study is you're not going to wait 30 days?
So it's really, you know, all these other people trying to do this loading stuff, just kind of following the studies, but really they don't have to do that unless they, like...
tomorrow when I hit the gym and have that explosive power benefit.
You just brought up a point that I was thinking of, and that is surgery or injury.
Because that's a stressful situation.
We're talking about really creatine shining in that background of some sort of stress, whether it's training or sleep deprivation, but also you can have something like an injury or a surgery where you're...
planning a stressful event?
And what's the dose on some of those?
So the 20 gram a day loading phase and then the maintenance phase being?
About five grams.
Okay.
Yeah.
And if someone's already taking, let's say, 5 or 10 grams a day and then they're going to have a surgery, do they still need to do the loading or should they just continue on?
Okay, so it sounds like, you know, in most cases, you know, the creatine plus the training, resistance training or endurance training is the key.
But in some situations when there's just a massive amount of stress from, you know, perhaps an injury or surgery or sleep deprivation, creatine can shine on its own.
Is that correct?
Yeah, exercise is definitely the most important thing.
But I know I'm going to ask you to speculate a little bit here, but let's say you do have an older adult who is sedentary, and just getting up out of a chair is hard.
It can be challenging.
Do you think that even supplementing with creatine in that –
maybe help them a little bit more?
So another question of mine, you were talking about where creatine transporters are, where it's synthesized.
You mentioned it's created in the liver and the brain.
But you mentioned it goes to the testes.
And that was going to be my question.
Is it affecting fertility?
It seems like it improves it.
Well, good.
Yeah, well, let's get into those myths.
But before we get into those, I kind of wanted to, we've talked a lot about adults, we've talked about older adults, the effect of creatine on many different tissues in those populations.
But at the start of this podcast, you said something that caught my attention.
And that was, you said children and you said pregnancy.
Yeah.
And, you know, I'm a mother of a seven-year-old who's quite active, you know, plays soccer and tennis.
And I've often wondered, you know, can children take creatine?
I mean, obviously, weight adjusted.
But is there any – has there been any, you know, evidence in children?
Has anyone looked at children?
Besides the TBI study.
Wow.
I mean, so...
A few things here.
So with respect to the dose with children, so you said 2 to 3 grams or 0.1 gram per kilogram body weight?
Or is that applicable to the children as well?
And vegan kids probably even more so, right?
And then pregnancy...
Has there actually been any human data looking at women supplementing with creatine being safe?
Yeah, and again, coming back to the vegans, that comes to mind because you're talking about women who are pregnant who are only relying on their liver ability to make creatine, right?
So that would be phenomenal to get a study like that done.
But do you think it'll be approved?
I know I'm jumping all over the place here, but going back to the kids, you mentioned the creatine supplementation was shown to improve agility.
Now, why is that?
Is that because of the type 2 muscle fight?
Okay.
Well, getting into some of the supplementation questions, and I think we've kind of touched on quite a few, but I want to kind of dive a little bit deeper.
You first mentioned, of course, I think a lot of people that are familiar with the creatine field know creatine monohydrate.
Creatine monohydrate.
Is that still...
the gold standard for supplementing with creatine?
If so, why?
Well, why do people turn to these other forms?
Is it because of GI distress that can be experienced with monohydrate?
It seems as though, like, I get mixed reviews.
I'll talk to, like, almost, like, 50% of people say, hey, like,
I get GI, like, stomach distress, GI problems if I take creatine monohydrate.
Some people have to go to another form or they have to lower their dose.
Why does that happen?
Are there any ways around that?
Is there, like, any tricks to improving, you know, the ability of your stomach to digest it?
Well, the question is, like getting back to what you said, if it's not increasing intracellular water, then it may not be doing what it's supposed to do.
And ultimately, that's the whole point.
So the question is, if you're taking creatine HCL or there's liposomal creatine or there's a GNC brand that's like it's an AMP creatine HCL.
So it's like at the end of the day, the bulk of the research is done using monohydrate.
Well, aside from the marketing, I think some people...
I know some people personally that even taking like a five-gram dose of creatine monohydrate experience like stomach issues.
Yeah.
So what can those individuals do?
So that would be an interesting experiment for someone to try that's experienced GI problems.
Correct.
To try taking it with food and carbohydrates seems like it might be... Really good.
Really good.
Okay.
And then the other thing is you're talking about like lower dose, micro dosing and spreading it out.
Is that something you'd have to do like forever or is that like to kind of get your gut used to it or is it...
Well, you said these smaller doses were more effective at what, at...
Well, this kind of goes to a...
Another question I had, which was, we've been talking a lot about dose, but it's also about, you know, if you're taking the cycling of it.
So, you know, some people like to slam their protein shake right after a workout.
Yeah.
Is there any reason to worry about that with creatine?
Because you're talking about saturating the stores.
It seems like it's a, okay, well, you're trying to saturate the stores.
I don't know that cycling around, that's going to do anything.
So do you think it's better to take creatine, like you taking it in the morning if you're going to work out in the morning?
But what if you work out in the evening?
Do you want to take it in the evening?
Okay, so some of the other questions are interaction with other supplements, other compounds.
For a very, very, very, very long time, I put creatine in my coffee.
I put everything in my coffee because it just masks everything.
I just didn't do it in one.
I've never really had any GI problems with creatine supplementation myself.
But I'm not sure that I'm supposed to be doing that.
Yeah.
Okay.
Is creatine heat sensitive?
So if you are putting it in your coffee...
OK, so you don't have to worry so much about it being in like a hot liquid.
Yeah.
Okay.
Well, this is all really good information.
I think addressing some of these, the myths and questions, the misconceptions, I mean, all those things, because you've published a couple of meta-analysis or review articles, I guess, or review articles on this.
And so you talked about, let's talk about the fat gain, right?
So that was kind of one you touched on a little bit.
I mean, especially women.
Is it really just because of the lean mass increase?
Okay.
So it's doing the opposite.
Yeah.
The hydration myth.
So what about you here?
I've heard some people talk about cramps.
It causes cramps or dehydration.
Ooh, that's super interesting.
Has anyone directly looked at that?
therefore my cells must be exploding or muscles and therefore it was causing cramping and we just don't see any evidence behind that yeah okay so it was like a correlation thing yeah it was the opposite and then sort of went with you um okay we've talked a lot about the kidneys and you're talking about creatinine and i'd love to talk about that's that's one that i hear a lot um that it can it's bad for the kidneys it's bad for the liver can can you address that it's probably the
Okay, well, this is really important.
I've had a few people reach out to me and tell me that their creatinine was elevated.
And I don't think they told their GP that they were taking creatine.
And so the idea here is that it's the metabolism of the creatine to creatinine that's being excreted through urine.
I see.
So it's really good to talk to your physician about that.
Baldness.
That's one.
That's one.
It was that rugby.
Was it rugby players?
And that was going to be my next question.
I mean, first of all, has anyone replicated this study?
It sounds like no.
No.
And second, has anyone directly looked at hair follicle?
And no rodent studies?
Is there any other really, I think, prevalent misconceptions or myths that you want to talk about?
Are you familiar with any of the research of Dr. Carrie Cornier?
I just had him on the podcast and he was, you know, he has a lot of exercise, the role of exercise in cancer treatment.
And, you know, not just not just aerobic, but resistance training.
So that would be interesting for you guys to have a discussion.
Yeah.
The other thing that came to my mind that I now remember I've heard a lot of people talk about is creatine supplementation increasing their urination, particularly during sleep, like having to go urinate frequently.
Okay.
Well, that's good to know.
I think we've covered a lot.
There's one area I did want to talk about.
And we talked about kind of saving at the end because there's more speculation here.
And this is just an interest of mine.
I remember several years ago, a former colleague of mine, Mark Shigenaga said,
um, was talking to me about, you know, creatine production in the liver being one of the biggest, biggest, um, sort of sinks for methylation.
And that's because you need, you need methyl groups to produce it.
Yes.
And as a byproduct, you also make homocysteine.
And so, um, he was talking about some, at the time, I think it was pretty preliminary, but some evidence showing that if you did supplement with creatine, that, um,
The enzymes in the liver that do produce creatine, there was a feedback, and they sensed that, and they didn't use so much of them.
The methyl groups were being shunted to other methylation pathways.
And so I'm just wondering if you've come across any evidence looking at creatine supplementation and homocysteine levels, for example?
So the question is, like, maybe you need to start with a population that has elevated homocysteine.
Because it's hard to detect small changes when you already have.
Well, maybe someone will look at it.
Right.
Well, if you talk to any researchers doing vascular health research with creatine, it would be great.
I will, for sure, yeah.
So I think we've covered pretty much just a lot of ground, really interesting stuff.
Did we miss anything?
There's anything that you wanted to discuss?
Are there any other interactions with other?
I'm glad you brought this up because to clarify, maybe some people were confused when we were talking about this earlier, the timing of the creatine around exercise was to improve the uptake of creatine into muscle.
And that can be done before or after, like in close proximity to the exercise.
But if you're looking for the benefit in terms of improving or increasing your training volume and the explosive power, the strength, it doesn't necessarily have to be timed around the exercise, right?
It sounds like there's no reason not to take it.
I mean, there's a lot of benefits, the muscle, the bone, the brain, very, very convincing.
Third-party testing, you can look for companies that have been vetted, that are reliable brands, and that's always like a...
Yeah, and that's a good point because we were talking about taking, you know, 10 grams a day, which is your sort of go-to and now soon will be mine.
You don't want to take 10 grams a day of some, you know, mixture of things, right?
You want it to be just creatine.
Now, you mentioned creatine pure.
That's very pure.
What about microionized?
Is there any reason to believe it wouldn't work?
It's because it's monohydrate, right?
So it should do the same thing.
Okay.
Well, excellent.
We've just covered so much wonderful information.
And thank you so much for taking time to talk about all this research with me today.
And thank you for doing all this research.
I mean, really, you've just done an amazing job covering so much important ground in terms of the effects of creatine on human health.
Thank you to Dr. Darren Kandow for coming on the podcast.
After this episode was recorded, a new study was published suggesting that creatine supplementation was not effective for increasing muscle mass.
But that study is not what most people think it is.
Dr. Kandow, who was actually one of the co-authors of the paper, joined me to break down what the study actually showed, what the data support, what they don't, and how to interpret the findings in context.
You can watch that full breakdown on the Found My Fitness Clips YouTube channel.
Thank you so much for your support for the podcast.
Your enthusiasm and engagement really do mean a lot to me.
If you've already subscribed on YouTube, Apple Podcasts, or Spotify, or perhaps even all three, thank you.
If you haven't yet, I would greatly appreciate if you took a moment to do so.
On Apple Podcasts, you can leave a five-star review if you think we've earned it.
And if you can write a comment letting us know your thoughts, that would be great.
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Thank you so much for listening, and I'll talk to you guys soon.
Thank you so much for having me.
Thank you so much for having me.
where we wanted to distill a lot of the cutting edge research that was discussed on the Found My Fitness podcast from these leading experts into a guide that not only was evidence-based, but had actionable insights for people.
It's called the How to Train According to the Experts Guide.
So I think the result is we have this really great roadmap that people can follow looking for how to improve workouts,
whatever the end goals that they're looking for, whether that is optimizing their cardiorespiratory fitness or their hypertrophy training or perhaps even body recomposition.
So in this training guide, we cover a lot of different aspects of exercise, including training protocols to improve cardiorespiratory fitness, training protocols to delay heart aging and improve the cardiovascular structure of the heart,
We also have a lot of information in there on how to train to improve metabolism, mitochondrial metabolism, glucose metabolism.
And we also get into resistance training protocols, whether you're interested in improving strength, bone mass, bone density, muscle hypertrophy.
or losing fat at the same time while you're gaining muscle.
So that would be body recomposition.
In addition, we have some supplemental information in there on sauna use, other protein intake and other supplements like omega-3 and creatine.
So a lot of really great information in this guide.
You can find that guide and download it for free in howtotrainguide.com.
So that being said, today's episode will serve as a companion to that guide.
Brady and I will discuss a lot of the information you'll find in the free guide, and we'll probably give some of our personal takeaways as well.
Also one of your areas of expertise.
I agree that when Dr. Ben Levine came on the podcast, while I was doing a lot of background information research on his work, so reading his publications, and then after the podcast episode, I felt like I learned just a tremendous amount of information that I had no idea about.
which is really like the cardiovascular structure and what role the heart, the structure of the heart plays in cardiovascular health.
But I do think before we get started, we should probably mention that it's important, I think, for people to identify what their goals are with respect to training.
So are you someone that's interested in becoming an elite endurance athlete like yourself?
Or are you interested in improving your performance
your health metrics, so maybe increasing your health span, so to speak, reducing your cardiovascular disease risk, reducing your dementia risk, reducing your risk of cancer, all the while, you know, improving mental health, improving muscle mass, maintaining independence with age.
These are all things that are my personal goals.
And I do think the guide covers a lot of those bases.
But again, you know, some people might be training for different goals.
Brady is being a bit modest.
Not only is he elite from a cardiorespiratory fitness standpoint, if not strictly a competitive standpoint, he also has a master's in science, a research background, and is wicked smart.
Well, with a VO2 max of what, 75?
I mean, that's why I would say you're elite.
Well, speaking of cardiorespiratory fitness, I think that that would be a good place to start.
It is something that we've covered quite a bit on the podcast.
And Dr. Ben Levine, when I had him on the podcast, really, he was discussing just...
an eye-opening study for me that he was a part of.
It was a study that was done over the course of 30 years.
It was two separate studies known as the Dallas Bedrest Study.
And the study involved, first of all, Dr. Lean's mentor, Jared Mitchell, who was studying a group of men and looking at the effects of being sedentary on their cardiorespiratory fitness and other cardiovascular health parameters.
And when I say sedentary, I mean...
full-on sedentary.
They underwent bed rest for three weeks.
So what that study found was, lo and behold, when you're actually not moving for three weeks, not even getting up to go to the bathroom.
So, I mean, they had catheters.
This was extreme bed rest.
They really wanted to look and see what happened to cardiovascular function, cardiorespiratory fitness, after just not moving for three weeks.
Of course, lo and behold, cardiorespiratory fitness declined.
Not so surprising, as well as a lot of the other parameters they measured.
But what was really eye-opening to me was, you know, fast forward 30 years, Dr. Levine is now in Gerard Mitchell's lab, and they find those same group of men, and they wanted to see what 30 years of aging had done to their cardiorespiratory fitness, which does naturally decline with age.
And what they found was that their cardiorespiratory fitness after 30 years of aging was
was no worse than their cardiorespiratory fitness after three weeks of bed rest 30 years ago.
So essentially, three weeks of bed rest is worse for your cardiovascular health, for your cardiorespiratory fitness, than 30 years of aging.
And when you put it like that, it's like, wow, being sedentary is so detrimental on our cardiovascular health.
So maybe you can, Brady, just kind of recap, highlight, talk about what cardiorespiratory fitness is, how you measure it.
I guess we'll get into some ways to improve it.
But I mean, this is something that you have a lot of experience in as well.
Yeah, it's something that in the past, I would say, two to three years, it kind of came on my radar as an important biomarker for longevity, right?
There's a variety of biomarkers that can be looked at.
And as you mentioned, even compared to something like grip strength, cardiorespiratory fitness seems to really shine in terms of being a good indicator of your overall health status.
When Levine was on the podcast, Dr. Lean was talking about, you know, it takes a certain amount of
Oxygen, like your cardiorespiratory fitness has to be a certain level just to sit down and have a conversation like we're having, right?
And if you're a sedentary person that really hasn't tried to improve their cardiorespiratory fitness, like at all, as you get older, because it does decline, like even maintaining that just...
Even above and beyond that, there's been just numerous studies that have looked at the correlation of VO2 max, cardiorespiratory fitness, and all-cause mortality.
One I've talked about, and I talked about with Levine as well, was a published study in JAMA Medical Journal in 2018, where I think it was like...
Participants that were involved in some, they were previous veterans.
And so they were sort of looked at according to their cardiorespiratory fitness.
And the people that were in the highest group had a five-year increased life expectancy compared to people in the lowest cardiorespiratory fitness group, which is pretty profound.
I mean, you're talking about five years.
But also, even if you looked at the people in the very highest group and you compared them to people in the high normal, so they were still like on the high normal end or doing good, like those people in the highest group had a 20% lower all-cause mortality.
So they were still doing better than the people that had a high normal cardiorespiratory friendliness.
But I think also what was really surprising to me in that study was that the people in that low cardiorespiratory fitness group had a mortality risk that was comparable or even worse than people with diseases that we know are clearly bad for your health, like type 2 diabetes, like heart disease, hypertension, even smokers.
So in other words, again, going back to this Dallas bedrest study as well, where being sedentary for three weeks was worse on your cardiovascular health than 30 years of aging.
It really drives home that point that when you're sedentary and your cardiorespiratory fitness is falling, you're
But it is a disease.
Being sedentary is a disease.
And I do think that low cardiorespiratory fitness should be considered kind of like a disease marker as well.
A lot more can be said about VO2 max and cardiorespiratory fitness.
You kind of mentioned a little bit about athletes being interested in VO2 max and improving their VO2 max.
Can you talk a little bit about why maybe athletes think about training explicitly for VO2 max or maybe why they don't?
Well, you alluded a little bit to, you know, you said high-intensity interval training, and that's, you know, one way that you can improve VO2 max.
And I think we're going to get into that in a minute, talking about Dr. Martin Kabbalah's research.
But I'm interested.
So let's say, you know, you want to improve your lactate clearance, one that you mentioned.
Like, what kind of training, how do you train differently than doing, like, high-intensity interval training?
How would you improve your lactate clearance more?
Well, so high intensity interval training workouts, like Dr. Martin Gabalo is on the podcast and he's really an expert in high intensity interval training.
And there's there are a lot of people that are interested in the time efficiency of it.
So high intensity interval training workouts.
I guess there's a lot of ways to define it.
Marty likes to talk about it being like when you're doing it, doing the interval, that you're doing vigorous exercise.
And that could be different for a lot of people depending on your fitness level.
But essentially, you're working harder than you can't really have a conversation when you're doing that interval.
So you're going really hard.
Most people are about 80 to 85 percent, at least maximum heart rate for the interval.
And then, you know, they have these periods of recovery and they go back to the working part, the interval again.
What was really interesting to me with respect to improving cardiorespiratory fitness, when Marty came on the podcast, he was talking about a meta-analysis that had looked at a variety of different studies where people were meeting the requirements for moderate intensity exercise.
So they were doing about 150 minutes a week of
what is called moderate intensity exercise.
So they're probably doing, you know, something more like a zone two where they're, or maybe even a little bit less than that, but, you know, something like 60 to 80% their max heart rate.
And about 40% of those individuals didn't see improvements in their cardiorespiratory fitness.
And last year,
some high-intensity interval training or some more vigorous exercise was sort of added to the equation.
So can you talk a little bit more about, like, you mix in high-intensity interval training into your workouts, but, like, why do you think there's this sort of non-responder effect?
Or there's probably multiple reasons for it, but, like, what's the rationale for adding in more vigorous type of exercise or high-intensity interval training into a workout to improve cardiorespiratory fitness?
Yeah, actually, Dr. Levine also mentioned something similar where he was saying, you know, you have to continually stress your cardiovascular system to have the adaptations, the beneficial adaptations.
And so if you keep doing the same thing without ever adding an additional stress or stimulus, then you're only going to stay the same, maybe.
You're not really going to improve, right?
And so it does make sense from that aspect as well.
Since we're talking about vigorous intensity and adding more of a stressor and a more stronger stimulus, maybe you can recap some of what Dr. Levine, Dr. Kabbalah talked about on the podcast when they were sort of defining the various training zones and what these zones are, because there is a lot of information out there on that, which can be quite confusing to people.
I really like the talk test.
way of defining it because I as you were sitting here talking about this I was thinking about my my whole exercise protocol and I'm like okay oh yeah that's actually what I thought was more zone two is really more zone three what I'm doing here with respect to heart rate monitors do you I know Levine mentioned there can be a lot of error with using some like a smart watch and is there more accuracy in using something like a chest strap like a maybe a polar strap versus
a smartwatch versus like the talk test.
So let's say you don't have a chest strap.
Should you be using a talk test or can you still use your smartwatch?
Is it still, what's more accurate?
I usually am not wearing, I do have a chest strap.
I have a Polish chest strap.
I have used it before, but I'm not typically wearing it when I'm doing a workout.
And so I think using my smart, my Apple Watch along with the talk test, because I often have someone with me when I'm working out, is like, okay, well, maybe it's not entirely accurate as I'm getting into my zone three, perhaps zone four, but I know I can't talk more than a word.
So it's clearly like it's good to combine them both.
So I want to there's there's a lot of interest in zone two training.
I talked about zone two training with Dr. Martin Kabbalah a little bit with Dr. Ben Levine.
And I want to ask you, maybe you can talk a little bit about what.
are the benefits of zone two training unique are there unique benefits of zone two training metabolically cardiorespiratory health-wise and as as you were explaining and defining some of these zones i was thinking to myself even what's the real difference between zone two and and what you would call zone three right this this threshold type of training as well right so um i'd love to hear
Well, you mentioned a pretty daunting number here.
You said 20 to 30 hours of exercise a week, which is far beyond what I myself do.
I'm more in the six to six and a half hours a week.
And so, you know, the question is,
If you are not doing 20 to 30 hours, let's say you're doing maybe five or even less than that, you're getting like two and a half.
This is where Dr. Gabala on the podcast was talking about high-intensity interval training being really time-efficient and having many of the same benefits as even like a Zone 2 type of training with respect to mitochondrial benefits, cardiorespiratory benefits, if not even better, if the same volume of exercise is performed.
In other words, if you're doing 30 minutes of Zone 2 and then a 30-minute high-intensity interval training workout, that you're going to have even...
more improvements in cardio-respiratory fitness than you would zone 2.
You would have better improvements in even mitochondrial density, for example, than you would.
So it's kind of interesting to look at the benefits of doing something like high-intensity interval training.
Now, you're not going to do 20 hours of HIIT.
I mean, that's impossible, right?
And like you were saying, burnout and things like that are also an issue, and you have to be able to space them out with
But there are a lot of benefits to doing high intensity interval training, time efficiency, you get improvements in cardiorespiratory fitness.
We talked about that with even people that were doing regular, you know, low to moderate intensity exercise for 150 minutes a week.
They needed to really stress their system a little bit more above and beyond that to get improvements.
Not everyone, but a large percentage of them did.
And then there's also some brain benefits that are also really
I don't want to say uniquely associated with high-intentional interval training or vigorous exercise, but also the benefits are associated with the lactate that you're producing, which does come with increasing exercise intensity, right?
So if people are time-limited and they want to combine some zone 2 training with
With HIIT, like, can you combine them in one session?
Like, can you, I was talking about, you know, with you the other day, like, sometimes I'll go for, I'll do some, my jog, or I'll do like a zone two workout.
And then I'll add in some intervals, right, where I'm like going, going pretty hard for a certain amount of time.
And then I kind of go back to a slower pace where I can have a talk test after my heart rate comes down a little bit.
Well, going back to our goals, you know, I did mention brain health and lowering dementia risk.
I often also just, a lot of my workouts are geared towards like brain health and not even just thinking about long-term brain health and, you know, delaying dementia, delaying brain atrophy, delaying all those, you know, brain age-related diseases, but also just like mental health, like how I feel and feeling good.
And it's clear to me, like after I do a
you know, a hit, either a hit or also a very long, if I do a much longer, more steady state sort of run, I also get a lot of really great feelings from that as well.
Structuring the amount of, let's say, low to moderate intensity or zone two, I know we're not measuring lactate directly, but let's call it that, versus your high intensity interval training
A lot of people out there, you'll see on a lot of platforms, people say 80-20, right?
80% of your exercise workout should be like low to moderate.
20% should be high intensity.
Dr. Kabbalah talked a little bit about this, the distribution, the weekly training volume.
You know, how someone who is not like yourself, you know, endurance athlete, do they need to follow this 80-20 rule?
Or how should that distribute?
Does that distribution change?
Yeah, maybe we should, that's a good segue into some of the high-intensity interval training protocols that are evidence-based in terms of improving cardiorespiratory fitness, for example.
And a lot of these protocols also improve other parameters, which we're going to get into as well, like mitochondrial density, as well as other metabolic benefits.
But the Norwegian 4x4, so this is probably one of the
It's a very well-studied protocol where Dr. Levine talked about it.
Dr. Kabbalah talked about it.
People are doing four different intervals.
So they're doing for four minutes.
They are exercising typically on a stationary bike, perhaps a rowing machine.
You could do it on a treadmill as well.
But a lot of the protocols were on a bike.
And you're doing for the four minute interval, you're going at an intensity that you can maintain for that entire four minutes.
That's pretty hard.
So it's pretty much a sustainable, hard intensity for four minutes.
It's obviously not going to be maximal, but you're going as hard as you can for and as hard as you can sustain for that four minutes.
And then you follow that by a three-minute recovery period, which is very light, right?
You want your heart rate to come down.
You want to clear your lactate.
And then you go back into the four-minute interval.
So that's a four by four.
You're doing it four times.
That's a very good protocol to improve cardiorespiratory fitness.
There's a variety of other protocols out there Dr. Kabbalah mentioned.
So there's the
one minute on, one minute off, and you do that 10 times so that the 10 minute workout, well, it's actually 20 minutes, but 10 minutes of more high intensity training, where again, for that entire minute, you're going as hard as you can sustain for that minute, right?
It's not going to be all out, but it's as much as hard as you can go and sustain that for a minute.
And then you rest and recover for a minute, a very, very low intensity exercise.
And then there's things like even Tabatas.
So Tabata would be a 20-second on, 10-second off.
You do that eight times.
The 20 seconds, you're really going as hard as you can because, I mean, 20 seconds is, it's not long, although it seems long when you're going as hard as you can.
It actually seems quite long.
And there's a variety of other protocols out there as well.
But we were talking a lot about even just adding a little like higher intensity workout at the end of a run.
Do the intervals necessarily have to be 85% of your max heart rate?
And again, going back to what we were talking about earlier and what Dr. Levine and the Kabbalah were mentioning about, just mixing it up and giving that little extra stressor so that you get those adaptations, right?
You don't want to keep doing the same thing.
So sometimes even just doing something a little bit harder in your, you know, normal sort of low to moderate intensity workout is beneficial, right?
Yeah, for sure.
Mixing it up.
That's something I do as well.
Although I do have wonderful coaches that work with me and they're very great at mixing up my routine and it's very nice.
But if it's just me left on my own device, I usually get on my Peloton and I'll do a Tabata.
And it's the same, almost the same exact class that I have been doing for years.
But, you know, sometimes we're just creatures of habit, you know, and it's easy to kind of go back to the thing that you know.
So this, I think, is a good
transition point.
So we talked a lot about improving cardiorespiratory fitness and the benefits of that and the different types of training to help improve cardiorespiratory fitness based on a lot of what the experts have talked about in the podcast and their research.
I want to remind people that they can find
All of that information, along with a variety of protocols for improving cardiorespiratory fitness in our How to Train Guide, according to the experts.
And you can download that right now at howtotrainguide.com.
We are going to move on to the next section, which...
is very interesting as well and is also related to cardiovascular health.
But it really is an area that is kind of neglected in a way, and I would say in popular media with respect to cardiovascular health, and that is the youthful structure of the heart and maintaining that youthful structure of the heart, which is really important for its function.
It's important for preventing cardiovascular disease.
It's even important for performance, being able to have a good aerobic capacity as you as you're getting older.
So Dr. Ben Levine is really, I would consider him one of the world's leading experts in this area.
And it was just a great privilege having him on the podcast.
I just learned a tremendous amount of information.
You know, I didn't even really know much about how...
How the structure of the heart changes with age.
And until I was diving into his research and had him on the podcast and he was he was talking about how as we age, our heart becomes stiffer at around early middle age.
This is like around I guess it was it's more like 35 to 50 years of age.
Crazy to think about that as being early middle age.
Your heart starts to get stiffer, stiffness, and that affects cardiac compliance.
It affects hypertension.
And part of that reason that it gets stiffer has to do with glucose regulation.
And so when we're eating a variety of foods, particularly foods that are refined carbohydrates, refined sugars, and there's an elevation in our blood glucose levels that can be sustained for longer periods because perhaps there's a refined sugar or something that we're eating a lot and maybe we're not exercising.
That's the key for sedentary.
That glucose stays around in your vascular system.
And it reacts with proteins, including collagen, which is lining our blood vessels.
It's lining our myocardium, our pericardium, right?
This is where our heart is.
And that collagen, when it reacts with glucose in the maillard reaction, it causes the protein, the collagen, to become stiffer.
And so that affects the stiffness of our vascular system, of our heart, and also our blood vessels.
As we start to get into late middle age, this would be like 50 to 65, in addition to our heart getting stiffer, our heart shrinks.
So it atrophies.
And so our heart is getting smaller and it's getting stiffer.
And these sorts of structural changes are affecting our cardiovascular health and our cardiovascular performance, right?
Dr. Levine has done a whole lot of research, lots of different studies trying to identify...
how much exercise, what exercise is doing to the structure of the heart, for one, and how much exercise is really needed to help really stave off a lot of those changes, those structural changes with age.
And he had one of the studies that he had done early on, which were done in master's athletes.
They are physically active every single day, and they're competing at a national level in many cases.
So they're doing a lot of cardiovascular and aerobic exercise.
Their hearts, structurally, so we're talking about seniors, so these are people that are older, their hearts looked like healthy 30-year-olds.
So 30-year-olds that don't have any identifiable diseases like cardiovascular disease or type 2 diabetes or hypertension, right?
And so that's pretty profound when you're talking about, you know, a 50-, 60-year-old person's structure at least looking very similar to what a healthy 30-year-old would look.
But we're not all going to be
endurance athletes and masters athletes throughout our lives.
So the next question is, well, what is the exercise dose that's really needed to get you most of the way there to maintain that youthful cardiovascular structure?
And that's where some of Dr. Levine's follow-up studies have looked at some of that research.
Maybe you can talk a little bit about that.
And yeah, I'll tell you, this study was a bit surprising to me because probably for that reason where, you know, you think the 150 minutes a week or even just three days a week of exercise
aerobic exercise, oh, you think you're doing really good, you know?
And I absolutely increased my frequency of aerobic exercise after hearing about this because, I mean, I was like, oh, wow, I need to be doing more.
I can do more.
I should do more.
And now I have evidence of why I need to do more, right?
But it was a bit surprising where it's like, okay, if you do four to five days a week of aerobic exercise, then you're not quite at the master's athlete level in terms of your heart.
structure, but you're mostly there.
And I do think four to five days a week is pretty sustainable for most people.
It should be.
Yeah, it should be.
It is a part of both of our profiles.
I mean, when you wake up in the morning, what's the first thing you do?
Do you, I mean, I'm not the first thing, but like in terms of work versus exercise, do
Exercise is the first thing I do.
I mean, I brush my teeth and yeah, I eat a little bit, but, but I do before I work in most cases, I exercise and, um,
that wasn't always the case for me, even, even dating back to when I was been, have been very interested in my health span and lifespan.
It was like, okay, I'm working, you know, we're going to four days a week or no, now it's, you know, six days.
It's, it is, it is every morning.
And, and if I, if I don't get to, if I take off an hour of what would be my work time, so be it because that's, what's going to happen.
I'm going to exercise.
Well, let's talk a little bit about some of Dr. Levine's research on getting into that, starting into that late middle age, age 50.
And this was a very...
He calls it one of the most cited or viewed at, I guess, viewed on the website in journal circulation studies of all time.
And rightly so.
I think it's a pretty astounding study.
It was a two-year intervention trial where he took 50-year-olds.
Him and his colleagues took 50-year-olds that were otherwise healthy but sedentary.
I would argue that's not healthy if they're sedentary.
It is a disease.
But they don't have any other identified diseases like cardiovascular disease or hypertension, for example.
But they had been sedentary.
And he put them on a two-year exercise protocol, which maybe you can discuss in a minute, that was pretty intense.
They looked at the structure of their heart before starting this protocol.
And then two years after this exercise protocol, they looked at their hearts again and found that in many aspects, like the cardiac compliance and a variety of different parameters that they looked at, the size of the heart and the stiffness, right, the stretchiness of the heart.
in many aspects had reversed in terms of their aging.
In fact, it was comparable, their hearts were comparable to looking more like 30-year-olds.
So they had essentially started this program and they had these 50-year-old looking hearts.
And with respect to the size and the compliance.
And then after this two-year exercise protocol had reversed 20 years of cardiac aging, which is pretty astonishing and inspirational in many respects.
So the protocol wasn't necessarily easy, though.
Yeah, for me, it would for sure.
Especially with respect to your cardiorespiratory fitness.
Well, a lot of this research, so this intervention study, you know, we're talking about the master's athletes looking at identifying, you know, I called it the dose, but it really...
is in terms of frequency, how many days a week you have to work out to kind of help maintain that youthful cardiac structure has led Dr. Levine to have what he calls his prescription for life with respect to exercise.
He does add a little bit of resistance training into that prescription for life.
Maybe we can talk a little bit about that and then talk about our own sort of our prescription for life, like what our protocols are.
Well, you're doing what's your total hours?
Well, I'm so I'm not clocking in quite as many hours.
I'm doing more like six, six to six and a half hours a week, depending on on the week.
So I end up doing a more high intensity training and a little bit more.
I would say of that zone three is probably a big, a big part of my training.
So I do three days a week.
It's more like a CrossFit type of training where I'm doing a combination of... Well, two of those days I do strength training for about 30 minutes each.
So it's about an hour of strength training a week.
And then I do a little bit of hypertrophy training as well.
And then followed by like a 15-minute high-intensity interval training that includes some aerobic as well.
So it'll be something like I'll do like the rowing machine or the bike or jumping rope.
And then I'll add in something like, you know, lighter weight squats or pushups or dips or lunges.
And, you know, so it's like a combination of and that's for the remaining like 30 minutes.
So that would be like an hour a week of that.
And then I do another hour of something kind of similar, but includes a little bit more aerobic exercise.
So it's a combination of things as well where I'm also doing things like lunges and I'm doing weights and I'm doing hypertrophy training.
I'm not as much strength training, but then I'm combining it with a rowing machine.
I'm doing a salt bike.
I'm doing the skier or jumping rope.
So it's a very efficient way for me to get that strength training, my resistance training, and also some high intensity interval training in there.
In addition to that, I'll do about an hour a week of, I do some zone two into zone three runs, probably more zone three-ish where I'm not really talking.
I mean, it's very breathy of a talk, right?
And then I'll do some sprinting towards the end of that.
And then one day a week.
So that's like, this is all like, that's twice a week I do that.
And then on my sixth day, which is typically a weekend, I'll do hiking for like one and a half hours to two hour hike with my family.
And we're walking, of course, and it is hiking.
So we walk up hills, but sometimes we do some sprints like and race each other and stuff in the middle of that.
But it's not like really super intense.
I do consider it more of a recovery day because the walk is just
very long and it's over an hour so it meets that box with what dr devine said he should do something once a week that is at least an hour long he doesn't care what it is as long as it's fun and you enjoy it i enjoy the hikes and you know he said you could even be walking it could be a walk so um that's kind of my my uh typical my week's workout um as well
For me also,
accountability is important.
So I do work with coaches.
I have a really great coach that comes and works with me on my strength training and CrossFit type of training.
And then I go and work out with friends as well.
And there's, again, there's that fun group aspect to going to a gym, maybe that has classes.
I mean, that's another way.
It's something that's going to keep you going back, right?
So it does have to be sustainable.
It has to be something that you
I don't necessarily enjoy strength training.
And we can talk a little bit more about this when we get into that part.
I mean, it's very hard and there's a lot of surprising aspects of it that I didn't quite expect after I really started engaging in that.
But it helps to have a coach or certainly even just going to a class, right, where there is a coach.
It doesn't have to be a personal trainer, but whatever it is that you have decides best for you.
With that said, I would like to move on to some of the metabolic effects and adaptations that occur with aerobic exercise.
So fundamental to metabolic health is mitochondrial health and mitochondria.
For most people who aren't aware of what these are, they're little tiny organelles that are inside of our cells.
Most of our cells, with the exception of red blood cells, that are creating energy from the food that we eat, carbohydrates, fatty acids.
They're very important for a variety of metabolic functions and everything from neurotransmitter synthesis, brain function, to muscle function, to cardiac function, or mitochondria at the center of everything.
So you really want to do what you can to preserve and improve mitochondrial health.
There's a lot of interest in improving mitochondrial health and what types of training protocols are best for improving mitochondrial health.
And when Dr. Martin Kabbalah was on the podcast, I was asking him about high-intensity interval training and how that compared to more of a Zone 2-like continuous exercise type of training in terms of improving mitochondrial health.
And he basically said that when the volume of exercise is kept the same,
That mitochondrial density, so this is mitochondrial biogenesis, which is the creation of a new mitochondria, was actually better after high-intensity interval training than more zone 2, low to moderate-intensity type of training, when the volume of exercise was the same.
Now, again, as we mentioned earlier, you're most of the time going to be doing a larger volume of exercise of the zone 2 type of training versus high-intensity interval training.
So it becomes a more time-efficient way of getting some similar benefits, metabolic benefits and mitochondrial benefits, as a Zone 2 type of training would get.
So with respect to mitochondrial biogenesis, mitochondrial density, also a process known as mitophagy.
So this is the...
clearing away of damaged mitochondria.
As we age, our mitochondria become damaged.
We don't have a repair system for, like, we don't have a DNA repair system.
We have DNA in our mitochondria, but we don't have the same types of repair systems as we do in our nuclear genome.
So mitochondria repair themselves through a variety of mechanisms.
One of them is mitophagy, where a
portion of the mitochondria will be recycled or perhaps even the entire mitochondria if the entire mitochondria is damaged.
It seems as though the more vigorous the exercise, the more intense the exercise, the increased prevalence that you have of mitophagy happening.
So again, it doesn't mean that zone two type of training isn't having that happen as well, but you probably just have a larger volume of that before you get there.
So then there's this whole area of fat burning.
And you discussed this a little bit earlier and Dr. Kabbalah discussed this.
where what type of exercise is better for fat burning, right?
Well, mitochondria are at the center of burning fat, right?
So fatty acids are oxidized in the mitochondria.
So you hear a lot about zone two training and how zone two training is really ideal for optimizing fat burning.
Maybe you can talk a little bit about, maybe recap a little bit about what Dr. Gbala was saying with respect to how high intensity interval training affects fat utilization and how that compares to perhaps a low to moderate intensity type of training like zone two training.
It comes down to that adaptation, right?
When you're pushing beyond the capacity of your body's ability to bring nutrients and oxygen to the mitochondria to be oxidized for energy, and you start going into that zone three, zone four, where you're using glucose and producing lactate as a byproduct, your body's going, oh, I need to...
I need to increase my mitochondrial density so that I can start using my mitochondria, right?
It's an adaptation.
It's a response to that stressor.
And I think the other thing that people often think about is always like this black and white thinking, right?
There's this bin and that bin, to use Dr. Lane Norton's analogy, where people think if you're doing high-intensity interval training, you're just burning glucose.
and producing lactate.
And that's just not the case.
In fact, the majority of the time, even when you're doing a high-intensity interval training workout, you're doing both, right?
You're not just burning.
I mean, unless someone's doing like an all-out Wingate, which I don't know many people that have done that.
I certainly haven't ever done one.
But you're not really going to be just only burning glucose, right?
There's a gray area.
So you're also still using your mitochondria to some degree as well.
Why do people, why is there a, you can see it circulating around on social media and the blogosphere, podcasts.
If you're doing zone two training, you're going to be a better fat burner.
Like I'm doing, you ask someone why I'm doing zone two training because I want to be a better quote unquote fat burner.
What does that even mean?
Is that even true?
And I've also seen studies where it seems as though doing more high intensity interval training, more vigorous exercise, people end up burning more fat after the exercise, you know, if they're doing that type of exercise versus low to moderate intensity training.
Metabolic flexibility.
I mean, there's definitely longevity benefits for that.
And to get that metabolic flexibility, it sounds like, you know,
you don't necessarily have to be just a zone two trainer.
Like you can do high intensity interval training.
Again, you're increasing your mitochondrial density.
There's a lot of different ways to get there in terms of aerobic exercise.
It doesn't have to necessarily just be zone two, which is where some of that, like you hear some people and they think they, I think there's a misconception where it's like, oh, I have to be
in the zone two where I'm only burning fatty acids and not shifting into that more intense zone where I'm burning glucose as well in order for me to become a fat burner.
And I don't know that that's necessarily the case.
Well, shifting gears and talking a little bit about glucose regulation.
I mean, this is also a very important area for cardiovascular health.
I mentioned that glucose dysregulation, if you're constantly having elevations in blood glucose levels.
That can lead to the stiffening of your myocardium, of your pericardium, right?
These have collagen in them and they react with glucose and that leads to a lower cardiac compliance.
Essentially, your heart is less stretchy.
You want to have, you want to maintain and improve your glucose regulation throughout your life.
It's very important.
This is where my conversation with Dr. Martin Kavala was really important.
I think, shed some light into the benefits of high-intensity interval training on glucose regulation.
Now, there's no doubt that aerobic exercise improves glucose regulation, like, full stop.
Like, you're going to have improved glucose regulation if you are engaging in aerobic exercise.
But if you're, again, comparing the volume of exercise being the same and comparing sort of a continuous lower-to-moderate-intensity exercise with high-intensity interval training or a more
you're going to have more improvements in glucose regulation with the higher intensity exercise.
And that somewhat has to do with the utilization of glucose, which produces lactate as a byproduct.
It's not necessarily a byproduct.
We know it's not a byproduct anymore.
It's an active metabolite that is not only an energy source for mitochondria, it's also a signaling molecule.
So in other words, it's a way for your muscles to communicate with glucose
your muscles and proteins in your muscles.
It's also a way for your muscles to communicate with other organs like the brain and the heart and the liver and your kidneys.
And so that lactate actually is a signaling molecule to the muscle cells, the glucose transporters in the muscle then come up.
It's called translocation.
They come up to the cell surface of the muscle and they're open and primed and ready to take in a lot of glucose.
And lactate's really key in that process.
So if you're producing lactate by having a more intense workout, you're going to have more GLUT4 transporters that are translocating up to the muscle cell surface where they're ready to take in the glucose.
So high-intensity interval training is definitely a good way to improve glucose regulation.
But the lactate isn't the only reason for that.
You're talking about engaging the muscles.
There was a study that was published, oh gosh, not a few months ago.
I mean, it was less than a year ago that had compared doing 10 body weight squats to 30 minutes.
So the 10 body weight squats over the span of an eight hour work day, basically.
So you're doing it every 45 minutes.
So every 45 minutes, you do 10 body weight squats over eight hours.
And that was compared to a 30 minute continuous walk.
And the bodyweight squats were more potent at improving glucose clearance than the continuous walk.
Again, probably because lactate is being produced and you're engaging, like you're talking about the muscles are being engaged more robustly than perhaps a walk would do.
But also, Dr. Gvala talked about walking and continuous walking versus interval walking as well.
I like to do that again, like I mentioned with my hikes, you know, we'll stop and we'll do some interval sprints.
And of course, like throughout the day, it's nice.
We'll talk a little bit about exercise snacks, but that's another way to kind of break up the sedentary part of your day.
I want to shift gears and talk a little bit about I'll just talk briefly about brain health.
We cover a little bit in this guide as well.
And Dr. Gabal and I talked a little bit about this as well.
In fact, he just sent me a systematic analysis yesterday, a new study that came out on high-intensity interval training and how it improves brain-derived neurotrophic factor.
So brain-derived neurotrophic factor is a growth factor.
It's a neurotrophic factor.
It's produced in the body, in the muscle, but also in the brain.
In the brain, it plays a very important role for – it helps the growth of new neurons in certain parts of the brain, like the substantia nigra, for example, the hippocampus.
And it helps with the connections between neurons so that your synapses and your connections and your long-term potentiation, things that are forming long-term memory are more solidified.
It plays a role in neuroplasticity, the ability of your brain to sort of adapt to the changing environment and a variety of other things.
things that's doing in your brain that's hugely beneficial for brain aging, for cognition.
So you really want to increase brain-derived neurotrophic factor in the brain.
There's been a variety of exercise protocols, high-intensity exercise protocols, vigorous exercise.
It seems as though the more vigorous the intensity of the exercise, the more robust the brain-derived neurotrophic factor effect is.
And again, this comes down to lactate as well as other mechanisms.
Lactate's one mechanism because lactate has been shown to cross over to the blood-brain barrier and in the brain activate brain-derived neurotrophic factors.
So it's one of the ways your muscle communicates with the brain and tells the brain, you know,
You're also stressing your brain at the same time.
And so it's a way, it's a response, an adaptation, the way your body is adapting and going, okay, I need to make sure I can handle this stress.
Let's make more brain-derived neurotrophic factor so that I can handle that stress.
high-intensity interval training workout has been shown to improve cognition.
I often like to do a 10-minute Tabata before I do something that I need to be sharp or focused on, like a podcast, for example, because it's a 10-minute workout.
I mean, you have 10 minutes and you can do it.
And I often feel really good after that.
So we do cover some of that in the training guide as well.
I think that the bottom line with protocols to improve brain-derived neurotypic factor is
is intensity and also volume.
So, you know, even if you're doing a 20-minute workout and you want to be at least like 80% your max heart rate for those 20 minutes, more like a zone three-ish kind of workout, right?
That's been shown to robustly increase brain drive neurotrophic factor.
If you double that to 40 minutes, then you get an even more robust increase.
I deliberately structure those short 10-minute HIIT workouts around times like this, like a podcast I'm going to do or a presentation I'm going to give and I'm in a hotel and it's like I got to do my 10-minute high-intensity workout.
I'll often go to the gym and get on the bike and do something.
I think this is a good segue into these sort of exercise snacks.
Now, some people would consider a 10-minute workout even on the longer end of an exercise snack.
So exercise snacks, they can be structured or unstructured.
And I talked about this with Dr. Martin Kabbalah a lot.
He's been involved in a lot of studies involving the unstructured type of exercise snacks.
But the structured type of exercise snack is something where you're getting –
your heart rate really high, at least 80% of your max heart rate, right?
You're getting more into that vigorous intensity zone.
And it could be anywhere from one minute to nine minutes, perhaps 10 minutes, where you're doing intervals, right?
If you're doing a 10 minutes, not like the entire 10 minutes you're in that, but you're doing intervals.
But if you're doing a one minute or two minute or three minute workout, then you can be in a pretty high 85% your max heart rate zone, right?
So some examples would be something like
Like body weight squats or you do high knees or burpees or jumping jacks for some people.
Lunges, right?
Something where you're engaging multiple muscle groups and you're also just getting your heart rate up as well.
So those would be the structure types of exercise snacks.
There's also the unstructured type where people just throughout their daily activities that they're doing will engage in an exercise snack.
So these are called vigorous intermittent lifestyle physical activity or VILPA.
And this is typically someone who, let's say their office is on the third or fourth floor of a building and they sprint up the stairs.
They go fast up the stairs, maybe not technically sprint because a coach would be like, no way.
And you're right, but no way.
But they're going fast.
They're not just walking.
They're going fast.
Their heart rate's getting up.
And they do that multiple times a day.
Or they walk.
And instead of just walking, they're really briskly walking.
They're going really fast, right?
And there's other examples of this sort of unstructured type of, you know, house cleaning sometimes, right?
People are like going around and vacuuming and they're kind of fast.
Like, you know, I've seen that being the case as well.
So there's a lot of types of unstructured exercise that can be done.
And there's a variety of benefits that are associated with this sort of these exercise snacks.
And with Dr. Gabala, when he came on the podcast, he was talking a lot about these VILPA studies where
Researchers give people that are engaging in this type of unstructured exercise an accelerometer.
So this is measuring their heart rate, and they're able to see their heart rate and also, I guess, the distance as well.
But it's also measuring their heart rate, and they're seeing how high their heart rate goes.
And then they've looked at a variety of outcomes, all-cause mortality, cardiovascular-related mortality, cancer-related mortality.
And what these publications, which Dr. Gabala has been a part of, have shown is that people that are engaging in this type of vilpa exercise, this unstructured exercise for one to two minutes, three times a day.
So you're getting up to the nine minute a day range.
They have a 50% reduction in all-cause mortality, cardiovascular-related mortality, and a 40% reduction in cancer-related mortality.
And these are benefits that are even found in people that identify as non-exercisers.
So in other words, they don't consider themselves, they don't go to the gym, they're not doing tennis or dance class or whatever.
They consider themselves like not doing physical activity.
So I think that that data really kind of drives home that even these small sort of bursts of physical activity can be beneficial for health.
Then there's also a lot of psychological benefits that Dr. Kabbalah talked about as well.
It also helps with the midday slumpiness, where you're feeling kind of sleepy.
And I cannot drink caffeine afternoon.
For me, it affects me.
I'll be up too late in the evening.
So I will get up and do some bodyweight squats.
Usually it's bodyweight squats.
Sometimes I'll do some pushups or something.
But something that just gets my heart right up and blood flowing.
What do you know?
I feel better, right?
I'm more focused, ready to get back to work as well.
And the other thing that's really good with the exercise snacks is to time them around meals.
And there's also been some evidence on this published looking at mostly people with metabolic dysfunction, like type 2 diabetes, metabolic syndrome, and how even doing something timed around a meal, and it doesn't have to be long.
It can be a short, again, you're doing some body weight squats or burpees or jumping jacks, whatever.
it improves glucose regulation, right?
And so it's something that you can, I typically will do it if I'm going out to dinner, certainly when I'm on vacation and I don't eat the way I usually eat on my usual discipline type of diet, where I was like, okay, we're in Italy and we're having gelato.
I'm like next to the gelato station and I'm doing body weight gelato.
It's like, so, I mean, it's something that can be used as a tool for, like you mentioned, improving cardiometabolic health and also timing it around times when maybe
you're cheating a little bit more as well.
Very good point.
And also that psychologically feels good, right?
Like I'm checking that box, right?
All right, so I think that wraps up our section on aerobic exercise training.
We really covered a lot of ground here.
This is all covered in our How to Train According to the Experts guide, along with a variety of protocols, more detailed information.
Again, you can find that at howtotrainguide.com.
We're going to move on to resistance training.
This is another area that
very important for longevity and also an area that I've actually focused a lot more on in the last year.
You know, it really happened after I started having experts in this field of muscle protein synthesis, muscular health, professors like Dr. Stuart Phillips, Dr. Brad Schoenfeld, even experts like Dr. Lang Norton as well.
Having them on the podcast and just hearing about all the important aspects of maintaining strength, maintaining mass with age really was eye-opening for me.
And so I became...
I dedicated a lot more effort and time into resistance training over the last year.
Really, some of the statistics that Dr. Stewart had called out on the podcast were kind of scary.
First of all, he mentioned that your peak muscle mass occurs between the age of 20 and 30.
For me, it was quite a while ago.
I mean, you're reaching that point, but that's your peak.
And then after that peak, you start to decline on average about 8% per decade.
So this age-related decline in muscle mass is...
is often referred to as sarcopenia.
And there's a lot of elements that can contribute to that, which I will not get into.
But so 8% per decade.
And then as you reach the age of 70, that goes up to 15% per decade.
And then strength actually declines even quicker than muscle mass.
So strength declines annually for men about 3% to 4% per year.
And then for women, it's about 2.5% to 3%.
Your strength decreases per year on average.
Now, if you're engaging in resistance training, strength training, then you're...
skewing that right in a positive way you're not going to be declining as much and that's that's kind of the goal one of the goals of resistance training but it's also very important for maintaining functional independence so your muscle mass your muscle strength
These are very important for as you're aging to have functional independence, to make sure you're lowering your risk of a fracture, a fall.
That's also very important as well as when you're doing the resistance training.
A lot of the exercises that are engaging, you know, multiple muscle groups are also improving bone density as well.
And that's another aspect that's very beneficial with respect to resistance training.
But there's also another part of this equation that's muscle power.
Yeah, it's not something that's talked about as much either, right?
So yeah, we're going to cover a lot of aspects of resistance training, including training for strength and hypertrophy, body composition as well.
But I want to start with when I had Dr. Lane Norton on the podcast, he had some really good general principles that people can follow about
for resistance training.
Most people can follow these general principles.
And I thought they were really, they were just really, it was really good information that was just, I think, accessible and applicable for a lot of people.
Yeah, for me, like I mentioned, I've really engaged on this journey in the last year of really being committed to my resistance training.
And all of these principles that Lane discussed, I...
So the consistency for me really involved having a coach and a group of friends that I work out with as well.
We do resistance training together.
And both of those, for me, help tremendously with consistency.
Other people might be different.
Some people, I mean, I think generally speaking, accountability does help with consistency.
So having a coach or a class you go to or some friends that you work out with routinely, like you have this day per week, you guys are doing this workout together, really helps with consistency.
Progressive, the progressive overload.
So working with a coach, this is obvious, probably why I'm able to, but I learned how important it was, where it's like, I don't just...
Right out the bat go and like I'm doing a back squat with 80 pounds.
I'm working my way up there.
And in many cases, you can consider that like a warm up.
But, you know, I start with just bodyweight squats and then I just do the bar and then we progressively load the weight.
And so that's also a really important aspect as well as recovery.
And we're going to talk a little bit about recovery even between sets and also recovery days.
What's interesting is now I've been doing so much of the strength training, resistance training, that my recovery days are my Zone 2 runs, which I never would have thought of as recovery days back when I was only just doing running or running in my Peloton.
But it's kind of funny how sometimes you call that a recovery, but it really, you know, you're engaging in exercise.
You're just letting, you know, it's not so hard on your muscles, right?
I also find that doing runs seems to help with the soreness, big time.
And then mindset, another one.
That's a big one.
And for me, sometimes I just do it, like, especially when I'm doing strength training, when I, if I know what, how heavy I got, you know, like, what was my, what was my one rep max, so the maximum amount of weight that I could lift for just one rep.
What did I get to last time?
Or what was my reps in reserve?
Like, what was I, what was I at for that?
I don't think about those things.
I'm just, I'm just doing it.
And it really helps to not be a perfectionist because that can get, that can really get in your mind and kind of stress you out.
I think the stress, and that's another thing, when I am under a lot of stress,
I kind of just do something a little bit lighter, you know, not quite as intense.
I think it becomes more important when you're lifting heavy, like for strength training.
So let's talk about strength training.
We're talking about training for strength and even bone density, bone mass as well, because there's a lot of overlap there.
And Dr. Brad Schoenfeld came on the podcast and really did a lot.
was so knowledgeable in this area and talked quite a bit about strength training and the best types of exercises for strength training.
And I think one of the take-homes here was the multi-joint exercises.
These are the compound type of exercises.
They're engaging multiple muscle groups and joints simultaneously.
It really are the best exercises
type of exercise for improving strength.
And ultimately, they're more time efficient as well.
So these are exercises like squats or deadlifts or lunges, rows of any type of variation, presses, overhead presses, all the variety of types of presses that you can do.
These are the multi-joint compound types of exercises.
They're essentially improving function.
Again, I'm going to improve bone density more because you're putting more force and you're putting more of the force and stressing your bones more with those types of exercises.
And that causes the adaptation of bone remodeling.
So you're going to have improvements in bone mineral density and bone mass as well.
So a lot of the overlap between those multi joint exercises.
When it comes to strength itself, so I guess I should contrast that to the single joint exercises, which are more like bicep curls, tricep kickbacks.
What are some other ones?
Do you know?
Well, when you're so strength training in general is mostly is mostly where you're lifting heavier and doing the lower volume.
So I think Dr. Schoenfeld mentioned that.
When you're doing strength training, you're going to get up to about an 85% or more of your one rep max, which again is the maximal amount of weight you can lift for one rep.
And that's the strength training.
And so oftentimes you are going to do fewer reps than
than you would if you were not strength training, and you're going to require a longer recovery.
So Dr. Schoenfeld mentioned between two to five minutes, depending on the weight that you're lifting, depending on how you feel.
So I know for me personally, with my strength training, you know, yesterday I was doing strength training with back, I did back squats,
And I got up to 85% of my one rep max.
So that's where I ended at that weight.
Sometimes I go to an actual where I just do one rep, but I was doing 85% of my one rep max and I did five reps.
And I would rest about three minutes between that.
Typically I rest between two to three minutes between my sets.
And every person's sort of different.
And if you're lifting heavier, you're gonna require more rest.
And it's really important sometimes
And I've learned this where my cardiorespiratory system feels ready to go pretty quickly after I finish my set and I have to like wait and go, wait a minute.
Like if I start to engage again, I'm not going to get the five in because my muscles haven't had enough time to recover.
You mentioned the central nervous system and that rusting being important for your central nervous system to recover.
And I'll say that for me, it's been one of the most surprising aspects of strength training in particular, is how...
stressful it is on my central nervous system.
Lifting heavy is scary to me.
And I don't know, I mean, I'm sure as I become stronger, it won't be as scary because I'm more experienced.
I've been doing strength training now for, I would say it's been 11 months.
So I started last February.
So almost a year.
And of course, I've been making my progressively getting to where I am now.
But it's hard.
mentally on me.
And I find that it's physically hard too, for sure.
But I find that, I mean, just that moment before I'm about to lift, like do a clean or squat down or deadlift, whatever it is,
I'm anxious, you know, and it's very stressful for me.
In fact, one of the very surprising benefits to strength training for me was the effect on my ability to handle stress throughout the day.
Because I do exercise, you know, it's pretty much what I do before I eat and, you know, take care of my family and stuff.
But then I exercise.
I'm doing my strength training before I work.
And I have found that doing the hardest thing for me mentally in the day, first thing in the morning, makes everything else a lot easier.
And that was very surprising for me because, you know, I do a lot of stuff that's hard.
boy, but getting that barbell and doing that clean or, you know, lifting that really heavy weight, it's very hard.
So it's important, again, to let your central nervous system rest as well.
And that is also going back to what we were talking about with Lane.
If you're under a very stressed state, it's probably not the time to try to do your
your personal PR on lifting weights.
I think I need to get some more loud amping music on when I'm strength training because I don't have any on while I'm doing my strength training.
And I'm wondering if that'll help me a little bit with being a little more mentally prepared for it.
So talking about failure, that's another area that both Dr. Schoenfeld and Dr. Lane Norton have discussed on the podcast in terms of do you have to go to failure to improve your muscle strength or even mass?
I would say a long time, a lot of people thought that going to failure was really the ultimate necessary thing to really get those gains in strength.
And in fact, it seems as though, at least according to a lot of the published research that have come out, Dr. Schoenfeld talked about that it's actually not necessarily – it's not necessary and also may even potentially be problematic in some cases, particularly if you're doing like a multi-joint type of exercise because you can increase your injury risk.
And also, as you mentioned, like if you're going to failure –
then you kind of like if you're going to do it, you can't really do another next set without like you're going to affect your performance.
So what are some other things that that Dr. Norton and Dr. Schoenfeld mentioned with respect to failure?
What about... So...
When you're engaging in a lot of compound lifts in particular, deadlifts, squats, your heart rate gets very elevated.
I mean, you're pushing like high intensity training workouts for sure.
And there are some people that
only strength training, only resistance training.
And they think because their heart rate's getting really elevated, they're filling that cardiovascular aerobic exercise bin because their heart rate's getting elevated.
But Dr. Levine came on the podcast and said that really wasn't the case.
It was fascinating to me to hear Dr. Levine's explanation of that and for that, basically why your heart rate elevates so much when you're doing a strength training.
And especially given my anecdote, right, where I was just talking about how surprised I was how much my central nervous system was involved in strength training.
I wonder if there is some connection there as well.
I just had, you know, I had no idea that it was like there's so... It's mentally...
But let's shift gears and talk a little bit about hypertrophy training.
So this is there's a lot of overlap with strength training here.
And Dr. Schoenfeld on the podcast was talking about hypertrophy training.
So this is the type of training that people are interested in with the goal of increasing their muscle size, their muscle mass, right?
Hypertrophy, muscle hypertrophy.
And essentially, the biggest difference that he was mentioning is the...
weight, right?
So you're not lifting as heavy and you're increasing the volume, right?
So you're lifting lighter and you're increasing the volume.
So typically I mentioned with strength training, people are getting up to about 85% of their one rep max.
With hypertrophy training, it's more like 60 to 80% of your one rep max.
And so you're doing more reps rather than doing like, you know, up to five reps for what you'd be doing with strength training.
So this is, I would say, one of the biggest general principles that Dr. Schoenfeld talked about in the podcast with respect to training for muscle hypertrophy.
Resting is also a little bit lower.
It's shorter.
You don't have to rest quite as long because you're not lifting as heavy.
So you're resting for one to maybe two minutes between your sets versus two to five minutes.
So that's also seems like a big difference.
And then when it comes to like exercise selection, Dr. Schoenfeld mentioned, I mean, it really depends on what you're interested in, right?
So you're always it seems best to do these multi-joint exercises, right?
So you're doing deadlifts, you're doing squats, you're doing presses, rows, because not only are you
Getting gains in muscle hypertrophy, strength.
You're also getting functional, you know, you're improving your functional, your function, your muscular function and power.
A lot of power is in things like squats or lunges or things that are causing you to use muscular power.
Although you can get some of that with bicep curls as well.
But some guys are interested in their bigger biceps.
And so focusing on bicep curls obviously would be something that they'd be interested in.
For myself, I do a lot of compound exercises with, you know, some bicep curls and tricep kickbacks and stuff as well.
But the majority of my training is definitely compound exercises.
Yeah, it's pretty straightforward.
I like that.
You know, like it's it's not it's not a very complicated concept to understand.
I think the one question I wish I had asked him back then when I wasn't engaged in so much of resistance training was, yes, hypertrophy.
But, you know.
Functional independence, right?
Like reducing fall risk, being able to get in and out of a chair.
I wonder how much of that you're going to get with machines versus doing Olympic lifting or like a squat, deadlifts, things like that with a barbell.
And I don't know.
I think I maybe talked a little bit about this with Lane.
And I think he said you might get a little bit more.
bang for your buck with using like a barbell or doing a squat with a barbell versus like a, is it a hack squat?
But at the end of the day, if you are increasing your muscle strength and your muscle mass, you're definitely going to be reducing your fall risk as well.
You need to do what you like, what you're going to be consistent with.
I mean, that's like paramount, right?
The most important thing.
Training for body composition.
So Dr. Schoenfeld, Dr. Lang Norton, both of them talked quite a bit about training for body composition on a podcast.
So a lot of people are interested in losing fat and simultaneously gaining muscle, so body recomposition.
And Dr. Schoenfeld talked about, and this is a common thing with weight loss in general.
So when people are on a weight loss diet, which most of the time involves caloric restriction to some degree, they end up losing some muscle mass, right?
It's not just fat that's being lost.
And he cited a study that even up to 30% of the weight that's lost can come from muscle or lean body mass.
So I think that's important to consider because if you're not engaging in some form of resistance training, then you are at a higher risk for losing muscle, even though you may be losing fat.
And so I think there's a variety of ways
Take homes here that were talked about on the podcast in terms of like the best sort of template to follow with respect to body recomposition.
So obviously engaging in resistance training, number one, right?
I think the other thing that Lane had mentioned is that, you know, most people don't even really know how many calories they're eating in a day, which is so true.
You know, so you kind of have to be able to...
track that at least for a couple of days and get an average to know how much to cut out, right?
And then again, if you want to like, if you're going to increase the amount of protein, you know, making sure it's not really fatty protein either, right?
Like this is where something like a protein powder comes in.
It's very handy because you can increase that protein without
a lot of calories, right, as well.
Yeah, sleep is important for brain health, your immune system.
I mean, just cardiovascular health, everything.
I think another aspect that a lot of people are interested in, and certainly myself, is time-efficient protocols for resistance training.
And this is certainly like we were talking about time-efficient protocols for aerobic exercise and high-intensity interval training being at the top of the list there.
Dr. Schoenfeld has actually published a couple of studies on...
time efficiency and how to be efficient with your resistance training workout.
He talked about it on the podcast.
I really liked a few of the principles that he had covered.
Going back again to multi-joint exercises, they are the most time efficient.
You are going to be training multiple muscle groups at once.
So squats, deadlifts, lunges, rows, presses, those are really great types of exercises to do if you are pressed for time.
And then he also talked about using supersets and dropsets.
And so this is something I also use in my workouts.
Supersets are typically when you are engaging back-to-back different exercises that are working different muscle groups without any rest.
And so you're doing back-to-back ones.
So for example...
You're doing bicep curls and then you, you know, after your bicep curls, you go straight into tricep kickbacks.
Then you go into lateral raises or frontal raises and you go back and then you, you know, hammer curls and then you go back to the some sort of tricep kick.
And you're doing them like back to back, right?
Like, so those are the super sets and you really get fatigued.
And it is a very time efficient way that you can get a really good workout in 10 minutes, doing 10 minutes nonstop, just switching from muscle group to muscle group, doing these sort of supersets as well.
And then drop sets is another type of training that involves basically, I do a lot of drop sets on the tail end of my strength training.
So it involves like reducing the load and then performing another set.
You increase the volume, you reduce the load and increase the volume, and then you perform another set back to back.
So let's say you did a squat workout, strength training squat workout.
You then drop the weight way down.
You're at like 60% of your one rep max, and then you do 10 of those, rest for a minute, and then 10 again.
So that would be an example of drop sets.
And that's also a very – and there's a lot of different ways you can do drop sets.
I just talked about the way I do it.
Dr. Schoenfeld talked about a variety of other ways to do it.
We also cover that in the guide as well.
But I do think that's another really time-efficient way to involve – engage in resistance training.
And then you can combine, you know, a lot of different types of training, right?
You can do your strength training and then do some hypertrophy training within that same exercise session.
You can avoid a lot of warming up.
In fact, the warm up, rather than like stretching for like doing all these like stretches where you're like, I don't know, is this really that important?
Maybe you can stretch for like three minutes or
four minutes or whatever or less and then you're you're you're warming up is actually just like progressively loading right so you're you're like i said you do body weight squats or you do your squat with the barbell and then you get to your weight right like like the much more productive way to warm up because you're actually warming up your muscles
Was there any other time efficient protocols that were important?
I think if anything, Dr. Schoenfeld talked about, there might even be a benefit to combining because the increased blood flow to muscle, you're getting more nutrients there, you're getting more oxygen.
So it actually improves recovery time.
It decreases the amount of time you need to recover.
So you might even get some benefits there as well.
The microsets, it's funny that I forgot that one because my husband does a lot of that type of resistance training work.
He does a lot of microsets throughout the week.
And it really does depend on someone's schedule and what suits them best as well.
But it's nice to have all these options.
And I think this kind of is a good segue into the minimum amount of time required.
required, in quotes, to basically get some strength and hypertrophy benefits.
And I think Dr. Schoenfeld talked a little bit about this as well.
And you also mentioned the micro dosing as well.
So it doesn't necessarily have to be two 30 minute sessions.
You can do that.
The more sessions of like 10 or 15 minutes sessions that you're doing multiple times, as long as the total time is the same.
So again, all of this is in our How to Train Guide.
You can find all these protocols and information.
Download that copy, howtotrainguide.com.
We're going to move on to the last section that is covered in our guide.
And this really is sort of supplemental to this.
the exercise protocols.
We're going to cover a lot of supplemental protocols like deliberate heat exposure, for example, using a sauna, some nutrition, protein intake, and then also some supplements like omega-3 fatty acids and creatine.
So starting with
Deliberate heat exposure, drawing from some of the leading experts in this area of sauna research, Dr. Yari Laukanen being one of the world's experts on how the sauna is affecting cardiovascular health.
I've had him on the podcast many years ago, and he has published just numerous studies on how the sauna affects cardiorespiratory fitness, how it's affecting blood pressure, cardiac compliance, arterial compliance, just a lot of different cardiovascular health parameters.
And his research has shown in a couple different ways.
So there's been observational data showing people that exercise and use the sauna have a lower all-cause mortality than people that exercise and don't use the sauna.
But he's also done some interventional studies where he's taken two groups of people and put them on an exercise protocol, aerobic exercise on a stationary bike.
And then only half of that group then went into a sauna after the
exercise, and he measured cardiorespiratory fitness and found that people that use the sauna in addition to aerobic exercise improve their cardiorespiratory fitness even more than people that only did the exercise.
And there were other cardiometabolic parameters that were also improved.
Cholesterol was improved.
Blood pressure was improved more as well.
So it seems as though adding the sauna in addition to an exercise routine is another way to improve some cardiometabolic
endpoints and also cardiorespiratory fitness.
There's also some endurance benefits as well, something that I've talked about before on the podcast.
In fact, you, Brady, use the sauna in your exercise protocol.
I do the same.
I get in the sauna after both aerobic exercise training as well as doing my strength training, resistance training exercise.
You know, and a lot of the data that Dr. Laukonen has published has been observational data looking at people that are routinely using the sauna and the effects of that on people.
cardiovascular-related mortality, all-cause mortality.
And it seems as though the minimum effective dose to get some benefits is really two times a week of sauna use.
If you get up to four times a week, then you're really getting maximal benefits of four to seven times a week.
People are getting reductions up to 50% in their cardiovascular-related mortality, 40% related to reductions in their all-cause mortality.
And this sauna doesn't have to be so hot.
I mean, this isn't like the 250
something degree temperatures that you often hear people cite that they're using.
In fact, I think that's a little bit too hot.
I mean, these people are using 100, on average, 175 degrees Fahrenheit.
Often there is a little bit of a humidity, you know, 30, up to 30% humidity as well, but they're in there for about 20 minutes.
And so I find it is nice to get into the sauna after a workout and extend that sort of aerobic exercise mimicking capacity a little bit further.
Another area that using deliberate heat exposure could be beneficial is composting.
Combining it with resistance training or even using it during perhaps an injury when you're not able to work out.
And I would say a lot of this evidence is preliminary and more needs to be done.
But going off the preliminary evidence and just knowing that there's benefits for cardiovascular health as well, why wouldn't you?
There has been at least some preliminary evidence in one small study that people that got in the sauna after the resistance training protocol increased resistance.
signaling molecules that are involved, anabolic signaling molecules that are involved in muscle hypertrophy.
There's also been another trial in humans that underwent, I mean, it was experiments that are done where they mobilize a muscle for a period of time and they look at atrophy after that, right?
Disuse atrophy is what it's called.
And it seems as though heat exposure, at least at the local level in this regard for this study, people that had the heat exposure were about almost 40% less likely to lose.
They lost 40% less of their muscle mass, which is quite a bit.
So a lot of potential reasons there.
Heat shock proteins have been shown to be activated.
A lot of disuse atrophy studies done in animal models with heat exposure.
And then you're getting a variety of endocrine effects as well.
Growth hormone is elevated when you get in the sauna, and that can have aspects for recovery as well.
So there's a lot of reasons to combine deliberate heat exposure with also resistance training workout.
And I would say that is not the case for deliberate cold exposure.
And Dr. Luke Van Loon, who was a guest on the podcast as well, had done some, he has done some research on that, in fact, showed that doing deliberate cold exposure, like a cold bath, immediately after resistance training workout does blunt hypertrophy.
Kind of going back, circling back to the disuse atrophy, you know, that's something that's obviously very relevant for people if they're injured or perhaps they're traveling somewhere and they don't have the same, they're working their muscles out the same way that they usually do.
And so there's a case to be made, you know, where it's like, okay, well, I'm not going to be...
engaging my muscles as much.
And you're kind of like, you don't use it, you lose it, right?
And this is where a supplement that I'm quite fond of for a variety of reasons, omega-3 fatty acids seem to be beneficial.
So Dr. Chris McGlory came on the podcast and talked about some of his research using high dose omega-3s.
It was about five grams a day, which is a little bit higher than what is prescribed for some people for different cardio metabolic reasons.
was able to prevent or cut disuse atrophy almost by 50%.
In this case, it was in women.
So omega-3 fatty acids might be another sort of tool for recovery, right?
Use during perhaps illness, injury.
I think they should be used every day.
There's a lot of benefits, cardiovascular benefits as well, anti-inflammatory benefits.
Again, going down to the recovery and omega-3 fatty acids being beneficial for inflammation.
For someone like yourself, it might be even more useful, right, where you're really running, you're running, what, 20 hours a week almost.
There's a lot of stress on your muscles and a lot of inflammatory cytokines and molecules that are generated during that kind of training.
Yeah, I think it was three grams a day, and it decreased the troponin levels, which is a marker of cardiac stress.
Okay, so we're also going to kind of transition to some of the nutritional aspects of this guide.
starting with protein, which is probably, I guess, the most important when it comes to muscle mass, muscle hypertrophy, anything and all things muscle.
Dr. Stuart Phillips was on the podcast.
Dr. Brad Schoenfeld talked quite a bit about protein intake.
Dr. Luke Van Loon, Dr. Lang Norton, quite a few experts have been on talking about the importance of protein intake, how the RDA for protein, which is 0.8 grams per kilogram body weight,
does not appear to be enough for maintaining muscle mass, particularly if you are engaging in resistance training.
In fact, Stu Phillips was a author on a study that was a meta-analysis of multiple randomized controlled trials
that found that people that on average were taking in about 1.2 grams of protein per kilogram body weight and were engaged in a resistance training protocol, if they upped that to about 1.6 grams per kilogram body weight, they had a 27% increase in muscle mass and a 10% increase in muscle strength compared to people that were resistance training but only doing the 1.2 grams per kilogram body weight, so a protein intake.
So I think that's a pretty easy lever we can pull in terms of increasing our muscle mass and strength with not as much effort, right?
It takes a lot of effort to lift weights, but to increase your protein intake isn't quite as much effort.
All this information and more I recently covered in an episode on the science of protein.
For those of you that haven't checked it out, make sure you check it out if you're interested in protein and the effects of protein on aging, muscle mass, strength, all things considered.
Definitely check that out.
I kind of want to move lastly to the last sort of aspect in the training guide, and that has to do with creatine supplementation.
And Dr. Stuart Phillips and also Dr. Lane Norton both mentioned creatine as one of their top-tier supplements that they take.
Lots and lots of evidence on safety and efficacy.
You take it.
Maybe you can talk a little bit about...
you know, just summarize briefly for people, what are some of the benefits of creatine supplementation, how people should start, dose, you know, some of the best practices?
I take about five grams a day.
I thought about experimenting with 10 grams.
I mean, it's hard to sometimes notice differences, subtle differences like that, especially when you're taking so many other things and doing so many other things, right?
But I've also thought about kind of increasing the dose just to see like, oh, can I lift a little bit heavier?
Is it going to affect my strength as well?
Yeah, that's good to know.
Yeah, I've definitely not taking it on vacations before, especially because my my container is like this big of it.
I often wonder that sometimes when I'm aliquoting like powders and stuff.
I'm like, oh, is this going to get my bag flat?
That is to say, all of this wonderful information, very useful, practical information, protocols, everything can be found in the How to Train According to the Experts Guide.
You can pause now, download that at howtotrainguide.com.
Wonderful training guide that Brady was a big part in working on.
Thank you so much, Brady, for sitting down.
First of all, for working on the guide and for sitting down with me to discuss it.
I do want to plug your book you have, VO2 Max Essentials.
You also have a Substack page you can tell people about.
And you're very active on Twitter, X. I follow you there.
You post a lot of really great stuff on exercise, physiology, fitness.
So maybe you can tell people where to follow you up on those platforms.
All right.
Well, thank you so much, Brady.
Plastics are everywhere.
Every week, without even realizing it, we are consuming the equivalent of an entire credit card in plastic.
We are unknowingly ingesting and inhaling millions of plastic particles every year.
And these tiny particles aren't just passing through, they're accumulating in our organs and our tissues.
In early 2024, human brain samples were found to have, on average,
0.5% plastic by weight.
In the reproductive system, higher levels of plastic like PVC have been linked to lower sperm counts.
And it doesn't stop there.
These microplastics are often made from or contain harmful chemicals like BPA, BPS, phthalates.
These are widely used to harden plastics, make them more durable.
And these chemicals are known to disrupt hormones.
They alter metabolism.
They've been linked to a range of health issues from reproductive problems to neurodevelopmental diseases.
But how are these microplastics entering our bodies?
And why are they so pervasive?
The primary roots of exposure are oral ingestion and inhalation.
We're consuming them through bottled water, through tap water, packaged foods, and even fresh produce that's contaminated by polluted soil and water.
We're inhaling these microplastic particles suspended in the air, especially in urban environments where synthetic clothing fibers and degraded plastic waste become airborne.
And they don't just pass through us, they are accumulating.
They've been detected in the lungs, liver, heart, brain, reproductive organs, and even in the placenta.
This widespread presence raises critical questions about what these microplastic particles might do to our health.
Could they be disrupting our cells, altering our brain function, contributing to chronic disease?
In today's episode, we're going to dive into the reality of microplastic exposure.
We're going to discuss how these particles get into our bodies and what it might mean for our long-term health.
We're going to explore how plastic could be influencing everything from our brain health to our reproductive health.
And importantly, we're going to talk about actionable steps to reduce our exposure to them and help our bodies get rid of them whenever possible.
Microplastics are everywhere and they're small.
They're really small.
We're talking about particles ranging from five millimeters in size, so that's like the size of a grain of rice, all the way down to a hundred nanometers, which is about a thousand times smaller than a grain of sand.
When they're that small, they're called nanoplastics.
And these particles are the result of larger plastic items breaking down over time through a process called oxidation.
So this is a slow but relentless breakdown process.
Actually more than 70% of microplastics come from this breakdown from larger plastics, while the rest are intentionally added to everyday products like microbeads and cosmetics, fibers in our synthetic clothing,
and also industrial plastics used in manufacturing.
But here's the real issue.
We're exposed to these microplastics almost constantly, and it's happening through two primary routes, oral ingestion and inhalation.
So think about that.
When we're drinking water, eating food, or simply just breathing,
We're taking in microplastic particles, and the numbers are actually staggering.
The average person inhales or ingests up to 120,000 microplastic particles per year from sources like tap water, bottled water, and packaged foods.
And it's not just the obvious items.
Microplastics have been detected in seafood, in fruits and vegetables, because they're contaminated in our water, in our soil, and also in the air around us, which lands on the fruits and vegetables.
Also, we have utensils, cups, baby bottles, like plastic items that we're using every day.
And these things are shedding microplastics directly into the food and drinks that we consume.
Tap water alone can account for the ingestion of anywhere between 220,000 to 1.2 million microplastic particles per year, depending on the source.
Studies show that people who drink bottled water exclusively could consume up to 90,000 more
additional plastic particles per year compared to those who only drink tap water.
So the contamination in bottled water is often due to that breakdown of plastic through the oxidation process itself.
Why does this matter?
Because while tap water contamination often comes from environmental sources, bottled water brings an additional layer of plastic leaching from the packaging itself into what we're drinking.
So what can we do about it?
Well, one solution we'll dig into later is using a reverse osmosis water filter, which can filter out not just microplastics, but also nanoplastics and other contaminants.
It's actually one of the most effective tools we have
for cutting down our exposure to microplastics and nanoplastics in our water.
But before we go deeper, I wanna highlight another really unsettling aspect of microplastics, their role as carriers for harmful chemical additives.
So plastics often are infused with chemicals such as BPA,
BPS, phthalates, and the PFAS, these are the forever chemicals, and they're infused with them to enhance the durability and flexibility of the plastics.
And so these chemicals come with significant health risks, which we're going to cover in more detail in a moment.
But take BPA, for example, or even its counterpart, BPS.
These compounds can mimic estrogen in the body, leading to hormonal imbalances that affect everything from reproductive health to brain function.
Actually, a study published in the Journal of Hypertension found that drinking from aluminum cans lined with BPA-containing resin can increase blood pressure within just a few hours, which is really a clear indicator of immediate impacts on our cardiovascular system from these endocrine-disrupting chemicals like BPA.
Phthalates are another group of chemicals that are commonly used to make plastics more flexible.
They've been linked to endocrine disruption, reproductive issues, and developmental problems in children.
Research actually has reported that higher levels of phthalates correlate with decreased testosterone levels in males, affecting everything from muscle mass to mood.
Then there's the PFAS.
So these are the per and polyfluoroalkyl substances.
They're often called forever chemicals.
I'm going to refer to them as PFAS throughout the podcast.
But the reason they're referred to as forever chemicals is because they resist breaking down in the environment and they accumulate in our bodies over time.
So PFAS are used to make products resistant to water, oil, stains.
They appear in things like nonstick cookware,
water-repellent clothing, and even food packaging.
Exposure to PFAS has been associated with immune system suppression, thyroid dysfunction, and increased risk of certain cancers.
But what's even more alarming is how easily these chemicals can leach out of plastics, especially when they're heated
when they're in contact with acidic or fatty foods.
So think about that hot takeout container, you pour soup in it, or plastic water bottles that are left in a hot car on a sunny day.
Many paper cups are lined with plastic, and when we pour hot coffee or hot water to make tea into the cup,
We're not just getting our caffeine boost.
We are ingesting microplastics that are breaking down from the heat, which accelerates the oxidation process.
And we're also getting a slew of chemicals like BPA.
So one study found that heating polycarbonate bottles to just 100 degrees Celsius can increase the release of BPA up to 55 times.
And it doesn't stop there.
Most canned foods and beverages are stored in cans lined with plastic that can leach these chemicals out.
like BPA and phthalates into our food, especially when that food is acidic or fatty.
So a recent study found that microwaving food in plastic containers can release over 4 million microplastic particles into a meal in just three minutes, along of course with the chemicals they carry.
Have you ever microwaved popcorn?
I have.
That bag is often lined with the forever chemicals PFAS to prevent oil from soaking through the bag.
When heated, these chemicals migrate into the popcorn, adding, of course, a chemical burden to our popcorn without us even realizing it.
Remember, PFAS are called forever chemicals because they are very resistant to degradation.
In fact, the half-life in our bodies is from two to five years.
It's the cumulative effect of these exposures that's a growing concern.
These chemicals don't just pass through our bodies.
They accumulate over time, potentially leading to long-term health consequences.
So understanding the sources of exposure is really important for us to be able to take proactive steps to minimize them whenever it's possible, whether that means choosing products that are packaged in glass or avoiding microwaving plastic or using popcorn bags or even just bringing our own reusable to-go coffee mug to the coffee shop.
So we'll get into this more later when we cover mitigation strategies.
But I do want to mention, unfortunately, microplastics are not confined to contaminated food and water.
They're also present in the atmosphere, in the air we breathe.
This allows them to enter our respiratory system where they can then lodge themselves deep within our lungs.
In fact, this raises significant concerns about potential chronic lung inflammation and other health issues associated with long-term exposure.
But also breathing in microplastics is one way to get them into our circulation.
And once they're in our circulation, they can make their way to organs and tissues.
A major source of airborne microplastics is actually synthetic textiles used in clothing.
This is polyester, nylon, acrylic fibers.
Every time these fabrics are washed, they shed tiny microfibers, microplastic particles that can enter waterways and eventually end up in our tap water and our oceans.
But it's not just about water contamination.
These microfibers become airborne as well, meaning we inhale them during our regular wear, especially when handling laundry.
Indoor dryers can exacerbate this issue if not properly ventilated to the outside, although ventilating merely does just shift the microplastic exposure to the environment and contributes to broader air pollution.
Another significant contributor to airborne microplastics is tire wear and the degradation of synthetic soles on our shoes.
So each time we drive or we walk or we run, tiny particles of rubber and plastic are worn away and they're released into the air.
And these particles become part of the ambient dust we inhale every day.
In urban areas with high traffic density, this can represent one of the most substantial sources of airborne microplastic exposure.
And it's important, I really want to note this, that air pollution, including particulate matter like microplastics, has been increasingly recognized as an environmental risk factor for neurodegenerative diseases like Alzheimer's disease.
In fact, I've discussed this in great detail in a previous episode, episode 79 with neuroscientist Dr. Axel Montaigne.
Make sure you check that out if you want to dive more into the role of air pollution in Alzheimer's disease.
Understanding these sources of microplastic exposure, again, is really important because it helps us develop strategies to mitigate our exposure.
And we are going to discuss those mitigation strategies later in this episode.
But first, it's essential to address a pressing issue that often goes unnoticed.
Microplastics don't just pass through our bodies.
They bioaccumulate.
So every breath we take, every bite we eat, every sip we drink introduces these tiny microplastic particles into our system, and they don't just vanish.
They're settling into our lungs, into our livers, our kidney, our bloodstream, and even into our brains.
And along with them, they're carrying these harmful chemicals like BPA and phthalates, right?
These might be altering our health in ways we're only beginning to understand.
So let's start with the lungs.
There was a study published in 2022 that examined lung tissues from surgical patients and found microplastics in every single sample.
And what's striking is that these patients had no significant environmental exposures beyond just daily life.
Researchers identified various types of microplastics, including polyethylene, polypropylene, and PET.
the same plastics that are found in everyday items like bags, bottles, clothing fibers.
In the lungs, microplastics can cause inflammation and oxidative stress, and they can contribute to respiratory issues like asthma and COPD.
One study found that microplastics could reach the lower regions of the lungs, which was previously thought to be unlikely due to the body's natural filtration mechanisms.
This discovery suggests that inhalation is a more significant route of microplastic exposure than we previously understood.
But the lungs are just the beginning.
The liver, our body's primary detoxifying organ, is another critical site where microplastics accumulate.
Research has shown that liver cells exposed to microplastics exhibit significant disruptions in functions.
So specifically, they have mitochondrial damage and increased oxidative stress, both key drivers of conditions like non-alcoholic fatty liver disease.
A study compared liver tissue samples from individuals with liver cirrhosis compared to those who had healthy livers.
The cirrhotic livers contain significantly higher levels of microplastics compared to normal healthy livers, suggesting these microplastic particles could play a role in liver disease progression.
This is alarming because it implies that microplastics aren't just innocent bystanders accumulating our organs.
They may be playing an active role in damaging our organs.
But what's most concerning is the brain.
In both animal studies and also preliminary human studies, microplastics have been found to cross the blood-brain barrier.
This is a highly selective membrane designed to protect the brain from harmful substances like microplastics.
Once microplastics are inside, they can activate microglial cells.
These are the brain's resident immune cells.
Activated microglia can trigger neuroinflammatory responses, which over time may contribute to neurodegenerative diseases like Alzheimer's disease, like Parkinson's disease.
In fact, a study using mice exposed the mice to microplastics.
And it found that increased levels of pro-inflammatory cytokines were found in the brain along with behavioral changes that were indicative of neurological impairment.
While more research is needed to fully understand the implications for humans, I do think these findings are a significant cause for concern.
And the reproductive system isn't spared either.
A study discovered microplastics in human placentas collected after birth.
The microplastic particles were found on both the maternal and fetal sides of the placenta as well as within the amniotic membranes.
So this suggests that microplastics can cross the placental barrier, potentially exposing the developing fetus to these particles during critical periods of growth.
And in males, the situation is equally troubling.
Human studies have detected microplastics in testicular tissue, in sperm, and even in the blood testes barrier.
This is a protective layer that shields the developing sperm cells from harmful substances.
In animal studies, exposure to microplastics led to decreased sperm count, reduced motility, and alterations in sperm morphology.
These changes raised serious questions about fertility and reproductive health in humans.
One of the most significant and efficient transport systems for microplastics to reach our organs, like the brain, like the sperm,
is our bloodstream.
So one study published in 2022 was the first to detect microplastics in human blood samples.
Researchers found that 80% of the participants had measurable levels of microplastics in their blood with an average concentration of about 1.6 micrograms per milliliter.
This finding confirms that once the microplastics enter our bodies, whether through inhalation or ingestion or even dermal contact, they can circulate in our bloodstream and then deposit in various tissues and organs.
What I'm getting at here is that every time we drink from a plastic bottle
or drink tap water contaminated with microplastics or eat food packaged in plastic or breathe air contaminated with microplastic fibers from synthetic clothing or tire wear.
We are potentially introducing these particles into our bloodstream.
The blood then acts as a highway delivering microplastics to organs where they not only take up residence,
but they accumulate over time.
And this is the concern, bioaccumulation.
Microplastics don't degrade easily within the body.
A study involving cardiac surgery patients found that the number of microplastics in their blood increased after surgery compared to before surgery.
This suggests that microplastics persist in the body and are not readily eliminated, leading to bioaccumulation.
This could have potential long-term health implications.
But it's not just the plastics themselves that we need to worry about, right?
It's also the chemicals they carry.
Many microplastics act as vectors for endocrine-disrupting chemicals.
like BPA, BPS, phthalates, and the PFAS.
These are substances that can leach out and accumulate alongside microplastics in the body.
We're gonna discuss some of these health consequences in just a minute, but I wanna drive home how important it is to understand this concept of bioaccumulation of microplastics.
So far, it does not seem like microplastics have a way out once they make their way into our organs.
This is key to understanding and grasping the health risk associated with them.
Now let's discuss how microplastics and their associated chemicals like BPA, BPS, phthalates are impacting our endocrine system.
This is not just a minor concern.
It's a significant area of research because endocrine disruption means that these substances are interfering with hormone signaling in our bodies.
And hormones, as many of you know, regulate everything from metabolism to reproduction to brain function.
So let's start with BPA and BPS, which are classified as endocrine-disrupting chemicals because they can mimic the body's natural hormones.
Specifically, they act as xenoestrogens.
These are foreign compounds that imitate estrogen by binding to estrogen receptors.
When BPA or BPS binds to these receptors, they can either activate or block normal estrogen activity.
This miscommunication leads to abnormal hormone signaling affecting reproductive health, brain development, and so much more.
For instance, one study found that adults and adolescents with higher urinary BPA levels had lower testosterone levels and altered estrogen metabolism.
This suggests BPA isn't just mimicking estrogen, but it's also disrupting normal hormonal pathways, throwing off this delicate balance of our endocrine system.
Phthalates are another group of endocrine disruptors, and a certain metabolite of phthalates called DEHP in particular interferes with the HPG axis.
This is essentially the command center for hormone production and regulation.
By disrupting this access, phthalates can then lead to reduced levels of critical hormones like testosterone and estradiol.
And this doesn't just impact reproductive health.
It has downstream effects, muscle mass, bone density, even mood.
On the thyroid front, BPA and phthalates can interfere with thyroid hormone receptors.
This disrupts the normal feedback mechanisms that regulate T3 and T4 thyroid hormone levels.
These hormones are vital for metabolism, for energy levels and cognitive function.
Disruption here can lead to symptoms like fatigue, weight gain, cognitive impairments.
Human observational studies have provided some evidence of these effects.
So data from the National Health and Nutrition Examination Surveys, this is NHANES data, has repeatedly shown that higher urinary levels of BPA correlate with disruptions in sex hormone levels and thyroid function.
In one study, pregnant women with higher BPA levels, they had children with altered hormone levels, particularly affecting thyroid function.
Since thyroid hormones are critical for brain development, both in utero and throughout life, this finding does raise significant concerns.
Now, conducting long-term randomized controlled trials in humans to assess the impact of these chemicals is ethically problematic.
We can't knowingly expose people to potentially harmful substances.
However, some short-term intervention studies have been insightful.
For example, one study had participants consume canned soup daily for five days, which led to a 1,200 increase in urinary BPA levels compared to those who consumed fresh soup.
This acute exposure of BPA led to measurable changes in their hormone levels, including decreased testosterone
and altered thyroid function.
When we turn to animal studies, the data becomes more supportive.
Chronic exposure to BPA and phthalates in mice has shown not to just disrupt hormones, but also leads to physical changes.
Male rodents exposed to BPA exhibited reduced sperm count, impaired sperm quality, and alterations in testosterone synthesis.
And female rodents showed disrupted ovarian function, earlier onset of puberty, and irregular estrous cycles.
A particularly interesting study involved exposing pregnant mice to BPA.
The offspring of these mice showed behavioral changes such as increased anxiety and altered social interactions, suggesting that BPA exposure can have transgenerational effects impacting brain development and behavior.
In terms of thyroid function, animal studies demonstrated that microplastics like polystyrene and chemicals like PPA disrupt thyroid hormone signaling.
This leads to reduced levels of TSH, T3, T4.
These hormones are critical for regulating metabolism.
What was the result?
Well, animals exhibited signs of hypothyroidism, including weight gain and lethargy.
So what does this mean for us?
The cumulative evidence suggests that even low dose chronic exposure to these endocrine disruptors could impact our hormonal health in meaningful ways.
The endocrine system doesn't just operate in isolation.
It's interconnected with virtually every system in our body.
So disruptions here can contribute to a cascade of health issues from infertility to metabolic disorders to cognitive impairments to increased cancer risk.
I want to take a moment now to shift gears and talk about BPA and reproductive health, starting with how it affects pregnant women and their developing babies.
A study published in 2022 looked at BPA exposure in pregnant women and found that those with higher levels of BPA in their urine were more likely to give birth to boys who had slower growth rates during their early years.
So what's happening here?
Well, BPA is an endocrine disruptor.
It's messing around with our hormones.
And during pregnancy, hormones are very important for keeping everything on track for fetal development.
BPA, which mimics estrogen, can throw off that balance.
And so the study actually did find that BPA exposure disrupts estrogen signaling in the placenta.
This interference might explain why boys had delayed growth.
I think it's pretty unsettling when you think about how something as ubiquitous as BPA is found in everything, all these plastic food containers, in our drinking water, everything, how it could have such a profound impact on early, early development.
And it's not just BPA that's causing concern.
Phthalates, another class of chemicals that are everywhere in plastic bottles, food packaging, personal care products, on and on and on.
What's troubling is how consistently
Phthalates interfere with male reproductive development, and it's really getting worse as our exposure to plastics increases.
Multiple studies have now shown that higher phthalate levels during pregnancy are linked to a significant shortening of the anogenital distance in male boys.
This is a key marker for reproductive health.
So shorter anogenital distance in boys has been linked to a higher risk of birth defects like hypospadias.
This is where the urethra doesn't develop property, and also undescended testicles.
And these aren't just cosmetic issues.
They can lead to serious complications later in life, including infertility, hormonal imbalances, and even increased risk of testicular cancer.
And it's not just high levels.
Phthalate exposure, even at low concentrations, can disrupt the development of male reproductive organs.
So what's the reason?
Phthalates act as antiandrogens, meaning they block the action of testosterone, which is critical for male development.
Studies have shown that phthalates disrupt hormonal signals during these crucial windows of fetal development, essentially hijacking the very process that shapes the male reproductive health.
So the result is there's long-term impacts that can persist into adulthood.
Fast forward and you see similar issues in men exposed to higher levels of phthalates.
Research has shown that men with elevated phthalate levels have lower sperm quality and reduced testosterone levels, directly impacting fertility and overall hormone balance.
And it's not just boys and men who are affected.
In women, exposure to higher phthalate levels is associated with irregular menstrual cycles and a higher risk of endometriosis, which is a painful condition that can lead to fertility issues.
The mechanism here is similar.
Phthalates disrupt estrogen pathways, which are crucial for regulating the menstrual cycle and maintaining reproductive health.
We're talking about chemicals that have made their way into our bodies through the products we use every day, through the water we drink every day, through the air we breathe every day.
And phthalates don't need to be at high concentrations to wreak havoc.
They're quietly causing this insidious damage to our hormonal systems that's building up over days and days and years and years and decades and decades.
And they're affecting everything from development, including neurodevelopment.
And I wanna talk about this now.
So there's a potential link between BPA and autism spectrum disorder.
There are multiple human observational studies that suggest a connection between maternal BPA levels and an increased risk of neurodevelopmental disorders, including autism spectrum disorder.
For example, one study from Harvard School of Public Health found that higher BPA levels in pregnant women were associated with behavioral problems in their children, particularly boys.
So these included issues like anxiety, aggression, impaired social functioning.
These are traits that overlap with autism spectrum disorder symptoms.
Another large cohort study followed pregnant women and their children over several years
and found that higher maternal BPA exposure during pregnancy was associated with poor neurodevelopmental outcomes in children, including several behavioral problems.
And again, these effects were more pronounced in boys.
While the study didn't specifically diagnose autism, the behavioral impacts they observed align, again, with traits that are seen in autism spectrum disorder.
There's also a meta-analysis that reviewed several studies on maternal BPA exposure and neurodevelopment.
And although it didn't conclusively prove a direct link to autism, it did find consistent evidence that prenatal BPA exposure increased the risk of behavioral issues
like hyperactivity and inattention, which are common in children with autism spectrum disorder and also other neurodevelopmental disorders.
And when you pair that with the animal data, it becomes harder to ignore this potential connection.
Animal studies have consistently shown that BPA exposure during pregnancy
causes offspring to have deficits in social behaviors, increased anxiety, and altered brain structure in key areas like the prefrontal cortex and hippocampus, the same brain areas that affected in humans with autism.
And it's not just about BPA exposure during pregnancy.
There's actually another layer to this.
So one study found that children with autism spectrum disorder actually struggle to metabolize BPA.
So their bodies aren't detoxifying the chemical as efficiently, so it builds up, especially in its active form, free BPA, which means it's circulating in their systems longer and potentially affecting brain development throughout childhood and adolescence.
This is important because estrogen receptors in the brain play a key role in things like cognition, memory, social behavior, areas that are often impacted in autism.
Some research actually suspect that this impaired metabolism of BPA in kids with autism spectrum disorder could be disrupting those key neural pathways, which could explain some of the cognitive and behavioral challenges that are seen in autism.
It's almost like this one-two punch.
First, you've got maternal exposure during pregnancy, which affects the structure and development of the brain.
Then if that child is less able to metabolize BPA efficiently, it sets up this prolonged exposure to a chemical that's known to interfere with brain development.
So animal studies consistently show that early life exposure to BPA disrupts neuronal circuits
responsible for learning, attention, behavior, and this could explain some of the cognitive and social deficits seen in children with autism spectrum disorder.
But the effects of BPA on the developing brain don't end with autism.
There's also evidence that prenatal exposure to BPA is linked to a higher risk of behavioral problems like anxiety,
attention disorders, and even ADHD.
So a study published in 2017 found that kids who were exposed to higher levels of BPA during pregnancy were more likely to develop ADHD along with anxiety and depression later in childhood.
So how does BPA do all this damage?
Well, it seems like it interferes with the key neurotransmitter systems, specifically dopamine and serotonin, that affect brain function.
So these chemicals are crucial for regulating mood, attention, cognitive function.
And during development, serotonin actually plays a key role in shaping the structure and function of the brain.
It's actually called a brain morphogen during development.
So it's shaping...
the growth and differentiation of neurons during early life.
It acts as a growth factor during embryonic development, influencing the development of key brain regions like the cerebellum by promoting dendritic growth and synapse formation and stabilization.
These are critical processes for proper neural circuit formation and coordination between brain regions.
Disruption of the serotonin system during this very critical period could absolutely affect brain development.
In fact,
vitamin D deficiency during pregnancy may also disrupt serotonin production, which could affect autism risk.
I actually published two studies on this very topic a few years ago.
So the fact that BPA is linked to autism and it disrupts the serotonin system and vitamin D deficiency
also is linked to autism during pregnancy and also disrupts the serotonin system, to me, strengthens the connection because when you start to see different environmental factors that are all sort of aligning and converging on a similar mechanism, it's really hard to ignore.
So on top of that, BPA also induces oxidative stress in the brain.
So this means it's generating harmful free radicals that damage brain cells.
It impairs their ability to communicate and to adapt.
This is what we call synaptic plasticity.
That oxidative stress can also trigger inflammation, which just sort of amplifies the damage, especially in developing neurons.
Now I want to get on to something that we touched on earlier in the podcast that also is pretty concerning.
It's the idea that microplastics could actually be making their way
into the adult brain.
So when we think about how the body protects the brain, we usually think of the blood-brain barrier.
This is a highly selective shield that's supposed to keep harmful substances out of the brain.
But there's emerging evidence suggesting that microplastics, especially the smaller nanoplastics, so these are less than one micrometer,
can actually cross the blood-brain barrier.
And once they're in, they could cause some real damage.
For example, one study found that polystyrene microplastics were accumulating in critical brain regions like the hippocampus and the prefrontal cortex.
These are areas responsible for memory, for learning, for emotional regulation.
When these microplastics settle into brain tissue, they can trigger an inflammatory response.
They spike levels of pro-inflammatory cytokines like TNF-alpha, IL-6.
These are markers that are associated with chronic brain inflammation.
And we know chronic brain inflammation is linked to neurodegenerative diseases like Alzheimer's disease, like Parkinson's disease, and even just normal cognitive decline.
If you want to learn more on how neuroinflammation plays a major role in the development of neurodegenerative disease, please check out my previous episode, episode number 79 with Dr. Axel Montaigne on the blood-brain barrier and Alzheimer's disease.
And it's not just animal studies that's showing this connection.
There's emerging human data showing accumulation of microplastics in brain samples taken from human autopsies.
In one study, research examined tissues from livers, kidneys, and brains of autopsied individuals.
While all organs contained microplastics, that's concerning, the brain samples alone were particularly concerning because on average of the 91 brain samples studied,
They contain 10 to 20 times more plastic in the brains than other organs.
And these findings are even more disturbing when you consider their implications for neurodegenerative diseases.
Among the brain samples studied, 12 were from individuals who had died with dementia, including Alzheimer's disease.
These samples contained up to 10 times more plastic by weight compared to those people who had plastics in their brains without dementia.
While this doesn't yet prove causation, I think the correlation is enough to raise serious concerns about the role of microplastics in cognitive decline and diseases like Alzheimer's disease.
What's also striking is the increase in microplastic concentrations over time.
So human brain samples from 2024 had about 50% more plastic than similar samples dating back to 2016.
This trend mirrors the rising level of microplastics found in the environment, suggesting that as our environmental plastic pollution increases,
so does the plastic accumulation in human tissues like the brain.
So the question becomes, what does long-term low dose exposure look like for humans, especially in urban environments where microplastic air pollution is high?
And what about kids?
So we already discussed this somewhat.
During early development, the blood brain barrier is even more permeable, which means that pregnant women and young children
could be at a greater risk for neurodevelopmental issues like autism or ADHD if exposed to microplastics.
And observational evidence seems to suggest that this is the case for chemicals associated with them as well, like BPA.
So the implications are that we could be looking at higher risk of neurodegenerative diseases, cognitive impairments, and even neurodevelopmental issues if exposure starts early in life.
This is something we absolutely need more research on, but the early signs are not good.
Let's shift gears and talk about fertility.
BPA is something I really want to emphasize here because its impact on fertility is pretty alarming.
There's a lot of research out there that shows just how much BPA exposure can interfere with women's reproductive health.
Let's start with egg quality.
So there's a study that looked at women going through IVF, and what was found was kind of shocking.
Women with higher levels of BPA in their urine had half as many viable eggs as women with lower BPA levels.
And that's huge.
Imagine your chances of a successful pregnancy being cut in half just because of your exposure to a chemical found in everyday plastics.
But it doesn't stop there.
BPA also messes with ovarian function by disrupting the hormonal balance that's crucial for regular ovulation.
It interferes with estrogen and progesterone, which are basically the key players in regulating our menstrual cycle.
This means even if you're not trying to conceive right now, BPA could be impacting your ability to ovulate consistently and prepare your body for pregnancy when you're ready.
And then there's implantation.
This is the process where the fertilized egg attaches to the uterine wall.
Even if everything else is in order, BPA can affect the uterine lining and make it harder
for a fertilized egg to implant.
One study showed that women with higher BPA levels had lower implantation success during IVF, which makes it clear that this isn't just a hypothetical concern.
BPA is affecting the body's natural ability to support early pregnancy.
And BPA may also play a role in puberty as well because of its ability to mimic estrogen.
So studies have shown that exposure to BPA at critical stages of development, such as early fetal life, infancy, or even early childhood, is linked to early onset of puberty in girls.
A study published in 2016 found that girls with higher prenatal BPA exposure had earlier breast development and menarche, which is the first menstrual period.
which can have long-term health consequences, including increased risk for breast cancer later in life, earlier menopause later in life, et cetera.
And for men, BPA exposure is also a concern when it comes to fertility.
Now we've known for a while, again, BPA can act like estrogen in the body, which can disrupt hormone balance, but its effects on sperm are really alarming.
So a study published in 2020 found that men with higher levels of BPA in their systems
had lower testosterone levels, and unsurprisingly, their sperm quality was also significantly reduced.
So think about this, they had lower sperm count, reduced motility, and even structural abnormalities that were found in their sperm.
And these are men who otherwise would seem healthy.
Testosterone, as we know, is crucial not just for reproductive health, but for overall health.
And when BPA gets into the body, it can start to mess around with the endocrine system in ways that affect all these areas of male fertility.
What was also interesting about this study is that researchers found that this decline in sperm quality was found at relatively moderate levels of BPA exposure, which really highlights, again, how pervasive this issue is.
BPA is everywhere, plastics, food containers, canned goods, receipts.
So this exposure adds up quickly.
And this is where we start to see these systemic effects that have very real consequences on health and fertility.
But honestly, BPA is just the tip of the iceberg when it comes to what's going on here.
Microplastics are also playing a pretty significant role.
And this is where it can get even more concerning.
There was a study that looked at semen samples from 40 healthy young men, men who should be in their prime reproductive years.
And get this, every single sample had microplastics in it.
On average, there were two particles per sample.
And these weren't just harmless specks.
We're talking about plastic particles ranging in size from 0.7 micrometers to 7 micrometers.
So they're small, but they're definitely there.
And the most common type that was found was polystyrene.
This is the stuff that's found in packaging.
It's in containers.
That made up around 31% of the total.
But what's really troubling is that what is this doing to sperm?
These microplastics were linked to abnormal sperm shape and impaired motility, meaning their sperm couldn't move as efficiently.
And one of the worst culprits was PVC.
This is the same plastic used in things like water pipes.
This is where our tap water is coming from.
So small particles from PVC can break down and leach into our water supply over time.
So tap water is a huge source of microplastics.
So here we are.
Microplastics aren't just an environmental issue, they are a human health issue.
We've got them inside our bodies, even affecting fertility, which is something that feels so fundamental.
And it raises the question, if microplastics are doing this to healthy young men, what else are they doing to our overall health?
It's something we really need to pay attention to.
Okay, now let's discuss how microplastics and their associated chemicals like BPA, phthalates, could play a role in cardiovascular disease.
Much of the focus has been on how these substances affect hormones and metabolism, but there is some growing evidence that they could have an impact on the heart and also on blood vessels.
So BPA doesn't just mess with our hormones.
It actually directly affects our heart's ability to function properly.
One of the key mechanisms here is how BPA disrupts calcium signaling in heart cells.
So calcium is essential for the electrical activity of the heart.
It helps regulate things like heart rate, contractile function, and even how blood vessels dilate.
Studies have shown that acute exposure to BPA can inhibit voltage-gated calcium channels, which impairs how cardiomyocytes, these are the cells in our heart, handle calcium.
And this disruption can affect how the heart contracts, and it can trigger abnormal activities in the heart muscle.
What's interesting is that these effects seem to hit men and women differently, likely due to BPA's interaction with estrogen, which is a hormone that plays a key role in regulating heart function in women.
Another set of chemicals that we've been discussing, phthalates, can act as cardio depressants, meaning they slow down the heart rate and they interfere with the way electrical signals move through the heart.
This not only weakens our heart's ability to contract, but also slows blood flow down.
It makes it harder for our hearts to do its job efficiently.
And these effects can build up over time.
They can contribute to chronic heart problems.
In rodent studies, exposure to a metabolite of phthalate called DEHP has been shown to decrease coronary flow and reduce the heart's ability to contract properly.
Phthalates slow down heart rate and the speed at which electrical signals travel across the heart muscle.
So this means phthalates are directly suppressing cardiac function.
Now let's talk about microplastics themselves.
Microplastics have been found embedded in arterial plaques.
A study published in the New England Journal of Medicine found that patients with microplastics lodged in their arterial walls were 4.5 times more likely to experience a major cardiovascular event like a heart attack or stroke within three years compared to patients that did not have microplastics in their arterial walls.
Microplastics were detected in 58.4% of patients undergoing surgery for heart disease.
This suggests that chronic exposure to these particles could be playing a significant role in cardiovascular events.
What's happening here is likely twofold.
First, microplastics can promote chronic inflammation, which is a key driver of atherosclerosis or the buildup of plaque in the arteries.
Second, these particles carry harmful chemicals like PPA and phthalates directly into the arterial walls.
So these chemicals may further contribute to the formation of plaque
and may also increase the risk of heart attack or stroke.
Another concern is the link between BPA exposure and hypertension.
In a randomized controlled trial, researchers found that participants who drank from BPA line cans experienced a significant spike in blood pressure, about 4.5 millimeters of mercury increase
in systolic blood pressure within hours.
So the lead researcher of this study warned that repeated exposure to BPA could be contributing to chronic hypertension.
This is a condition that's already affecting nearly a third of the global population.
High blood pressure is a major risk factor for heart disease and stroke.
A study that analyzed NHANES data from over 9,000 participants followed people for about nine years and found that those people with the highest urinary BPA levels were 1.76 times more likely to die from cardiovascular disease.
Interestingly, these effects were far more pronounced in women.
So women in the highest exposure group had about a 2.8 times higher risk of a cardiovascular death compared to women in the lowest group for BPA levels.
For men, there was still an elevated risk, but it was not as extreme.
So this isn't just about BPA raising our blood pressure in the short term.
We're talking about a serious long-term risk of dying from heart disease.
And it appears that women are especially vulnerable.
And again, it's not just BPA, but also the microplastics themselves accumulating in the arterial walls and possibly increasing heart attack risk.
This really highlights the critical importance of reducing microplastic exposure, of reducing our exposure to BPA in everyday life, whether that means we're making more informed choices about choosing glass over plastic or avoiding canned foods, which are lined with BPA, or even just filtering our tap water.
We'll get to more on that in just a minute.
But first, I want to shift gears and talk a little bit about what we know about microplastics and their associated chemicals when it comes to cancer risk.
So this is a topic that's gaining more attention as new data emerges.
As we've been discussing, one of the key concerns with microplastics is not just the particles themselves, but the chemicals they carry, including phthalate and BPA, both which are endocrine disruptors.
Because these substances interfere with our hormonal systems, there could be an effect on cancer risk.
Let's start with phthalates.
So a study published in 2022 looked at about 1.3 million children in Denmark over a 20-year period.
The study found that childhood exposure to phthalates was associated with a 20% higher overall risk of childhood cancer.
But it didn't stop there.
The study highlighted specific cancers showing that children exposed to phthalates had nearly a threefold higher rate of osteosarcoma.
This is a rare bone cancer.
And they had a twofold higher rate of lymphoma.
So this is a blood cancer.
What makes this study particularly robust is the data set.
So Denmark has a universal healthcare system that provides very detailed records, allowing researchers to track medication-associated phthalate exposure with more precision.
So the findings are very significant because the phthalate exposure here wasn't just environmental or dietary.
It was actually tracked through medication fills
containing phthalates.
So it represented a higher exposure than normal, typical environmental levels.
But still, I think these results should make us question what background exposure from our everyday environment could be doing, especially over time.
The connection between phthalates and breast cancer is also emerging.
A meta-analysis pulled data from nine case-controlled studies involving over 7,800 participants across multiple countries, and it found that specific phthalate metabolites were positively associated with breast cancer risk.
These are the kind of details that matter.
We're not just talking about vague associations here.
These are metabolites.
from specific phthalates showing a clear connection to cancer risk.
So the question becomes, how much cumulative exposure are we really getting?
And more importantly, how does this cumulative exposure build up over years or even decades to affect our cancer risk?
Because cancer really does take decades to develop.
There's also a growing body of research linking BPA exposure to breast cancer.
So BPA acts by mimicking estrogen, which plays a central role in the development of breast cancer.
Studies have shown that even low dose exposure to BPA can promote the growth of estrogen sensitive breast cancer cells in laboratory settings.
And we know from population level studies that chronic low dose exposure, the kind we're getting from everyday contact with BPA in plastics or canned food linings,
even receipts, can accumulate.
And so the question is, is it possible this cumulative exposure over decades can increase breast cancer risk, particularly in women that may already have a higher risk for genetic or other lifestyle factors?
One of the reasons microplastics are so concerning is they act as a carrier for these chemicals.
The plastics themselves can accumulate harmful chemicals like BPA, phthalates, and even heavy metals, transporting them into our bodies again via the air we breathe, the water we drink, and the food we eat.
And once they're in the body, microplastics can be bioaccumulative, meaning they're building up in our tissues over time.
Microplastics have also been found in human tumor samples.
In a study that was conducted on patients with lung cancer,
Researchers found microplastic particles in tumor tissue, suggesting that these foreign particles might play a role in cancer development or progression.
The presence of microplastics in tumor tissue is alarming because of their ability to cause chronic inflammation and potentially carry these harmful chemicals like BPA and phthalates directly into the tumor microenvironment.
While it's not yet clear whether these particles are directly playing a role in causing cancer, the fact that they can infiltrate tumor tissue highlights their potential to influence tumor biology, possibly by exasperating inflammation or even interfering with immune responses.
There's obviously a lot to be learned here, but I do think the preliminary data is cause for concern and more research needs to be done in this area.
Now I want to talk about practical strategies for reducing our exposure to microplastics and their associated chemicals.
And let's start with water.
The most straightforward action is to minimize drinking water from plastic bottles and cans.
Plastic bottles can leach microplastics and chemicals like BPA and BPS into water.
And cans are often lined with plastic coatings containing these substances.
Even if you're opting for water in glass bottles, there's another layer to consider, and that is the quality of the water itself, especially when it comes to carbonated water.
This is where the forever chemicals enter.
These are the per- and polyfluoroalkyl substances, PFAS.
As we discussed earlier, they are referred to forever chemicals.
They are particularly troubling because they have half-lives that are several years long.
meaning they persist in the body and accumulate over time.
So PFAS have been linked to a range of health issues, including hormonal disruptions, immune system effects, even certain cancers.
In 2020, Consumer Reports conducted third-party testing and they published data on several popular brands of sparkling water,
to measure PFAS levels.
The findings were eye-opening.
Topo Chico topped the list with PFAS levels at 9.76 parts per trillion.
To put that into perspective, Perrier registered at about 1.1 part per trillion and San Pellegrino, which was even lower at 0.31 part per trillion.
Both Perrier and San Pellegrino are often available in glass bottles, which is an added advantage for reducing plastic exposure.
And I do think it's encouraging that multiple brands did achieve PFAS levels below one part per trillion, which demonstrates that it's entirely feasible to provide safer options.
But this raises a critical question.
Why do some brands like Topo Chico have such high levels of PFAS?
In 2023,
Coca-Cola, which is the parent company of Topo Chico, claimed they had reduced their PFAS levels by about half.
However, without any actual transparent empirical data to confirm this, and even if it was accurate, that would still leave their PFAS levels at around 4.88 parts per trillion, which is significantly higher than many other brands that have less than one part per trillion of PFAS levels in their sparkling waters.
So I think this situation does underscore a very important point, which is that we can't always rely on bottled or canned water, even from brands we trust, to be free of contaminants.
So how do we ensure that the water we're consuming is safe?
I think the answer lies in taking control of our water quality at home.
And one of the most effective ways to do this is by installing a reverse osmosis filtration system.
So reverse osmosis filters can remove up to 99.9% of microplastic particles from water.
It's really one of the best solutions for obtaining clean drinking water.
Beyond microplastics, these systems also filter out a wide range of contaminants, everything from heavy metals to bacteria, and even chemicals like BPA and the PFAS, forever chemicals.
Now, it is important to note that reverse osmosis filters don't just remove the bad.
They also strip away beneficial minerals and trace elements.
So this is everything from calcium, magnesium, potassium, sodium, phosphorus, a variety of others, zinc, iron, copper, and selenium, iodine, manganese, and on.
and on, there's more.
These minerals are essential for various functions in the body, obviously everything from bone health to nerve signaling, but there are practical solutions to this issue.
Many reverse osmosis systems now come with a remineralization filter option that can add back these essential minerals and trace elements back to the water after they're purified.
Alternatively, there's high quality mineral drops that can be added back to the filtered water or people can just supplement with mineral supplements.
I do think that an added benefit of having a reverse osmosis home filtration system is its versatility because not only can you use this water for drinking, but you can use the purified water to wash fruits and vegetables and a variety of produce, which can be contaminated with microplastics on their surface from soil, from contaminated water, from air exposure where
these particles settle on the surface of the produce.
So washing produce with filtered water can help remove some of these microplastic particles that cling to surfaces, particularly waxy surfaces on certain produce.
When it comes to food, opting for fresh over packaged food is another obvious impactful choice.
So packaged foods often come wrapped in plastic,
Those can shed microplastic and leach chemicals like BPA into our food.
So by choosing fresh produce, fresh meats, bulk items, we can minimize exposure, which is good for our own health, but also promotes environmental health as well.
Similarly, we should consider reducing our consumption of canned foods and canned beverages.
So many aluminum cans are lined with plastic coatings.
These codeines contain BPA, or they have alternatives like BPS, which carry similar health risks.
So whenever possible, it's better to select products that are packaged in glass versus cans.
We can also reevaluate our food storage habits, so opting for glass or stainless steel or ceramic containers instead of plastic ones.
Avoid heating food in plastic containers.
Remember, heat can accelerate the leaching of chemicals like BPA.
into our food, into our beverages.
It also accelerates the oxidation process, which then causes more microplastics to be shed from the larger plastic itself.
And remember, microwave safe simply means the plastic won't melt.
It doesn't guarantee that it's free from chemical leaching.
Also try to avoid cooking with nonstick pans, which are coated with some of these chemicals, like the forever chemicals.
So try to opt for options like titanium, ceramic, cast iron.
These are all other options that we should be using for cooking our foods because, again, heat is causing these chemicals to be leached into our foods at an even higher and accelerated rate.
Which brings me to another crucial point, and I wanna talk about this myth of BPA-free products.
There's a lot of these BPA-free products which sound like they're safer alternatives, but they're not.
Manufacturers frequently replace BPA with chemicals like BPS,
which also can disrupt hormonal activity in much the same way.
And studies have shown that BPS may not be a safer option than BPA and potentially causing adverse health effects on fetal development, brain health, cardiovascular function.
Some BPA-free plastics even contain phthalates or other harmful plasticizers.
So the term BPA-free merely means the product lacks BPA and not that it's free from all other toxic chemicals.
I also want to again highlight and bring your attention to a common daily exposure to microplastics and their associated chemicals, and that is disposable paper, coffee, and teacups.
These convenient paper cups are typically lined with plastic to prevent leaks.
Here's the issue.
When you pour that hot beverage into them, the heat causes the plastic lining to break down.
You're getting microplastics into the beverage.
You're leaching chemicals like BPA into your beverage at a much higher level.
I already talked about a study where
heat can cause the leaching of VPA up to 55 times higher compared to cold liquids.
So a simple solution really is just to bring your own reusable to-go mug to a coffee shop.
If you're enjoying a drink at the cafe, ask for a ceramic cup.
If you're on the go, just bring your own mug.
And most baristas are actually happy to fill your own travel mug.
Some shops actually even offer a discount for doing so.
When it comes to oral consumption of microplastics and their
hidden source of microplastics, and that is salt.
It may or may not surprise you, but salt can significantly contribute to our microplastic intake.
Estimates suggest that consuming salt can add around 7,000 microplastic particles to our diet each year, and that's a conservative figure.
So sea salt generally has the highest levels of microplastic contamination due to the ocean pollution.
One study found that sea salts contained anywhere from 550 to 681 microplastic particles a
per kilogram, making them some of the most contaminated sources of salt.
Lake salts come next, followed by rock salts, which have the least amount of microplastic contamination.
So rock salts include commonly used varieties like Morton's iodized salt or pink Himalayan salt.
So these salts do still contain some microplastics, but the levels are significantly lower than what's found in sea salts.
So whenever possible, opting for rock or mined salts can reduce microplastic intake.
Okay, now let's turn our attention to the air we breathe.
This is another significant yet often overlooked source of microplastic exposure.
Reducing the amount of microplastics we inhale is crucial.
And fortunately, there are a few practical steps that we can take to minimize this risk.
First and foremost, let's consider our indoor environments.
This is where we spend the majority of our time.
One effective strategy is to use a HEPA filter.
This is a high efficiency particulate air filter.
Using these in our homes can be highly efficient at trapping airborne microplastic particles.
They can capture particles as small as 0.3 microns, making them pretty suitable for removing the vast majority of microplastics found in indoor air, many of which range from 10 to 100 microns in size.
A significant portion of airborne microplastics originates from synthetic textiles
from carpets and other household materials.
Every time we walk across a synthetic carpet or we sit on a polyester couch, tiny plastic fibers can become airborne.
By using a HEPA filter, especially in areas where synthetic materials are prevalent, we can significantly reduce the number of microplastics floating around in our indoor air.
Moreover, many modern vacuum cleaners actually now come equipped with a HEPA filter.
So this feature allows them to trap microplastics effectively when they're cleaning floors or carpets, and it prevents these particles from being redistributed back into the air.
So regular vacuuming with HEPA filters can also make a substantial difference in indoor air quality as well.
Now let's address the source of many of these airborne microplastics, our clothing.
Synthetic fibers like polyester, nylon, and acrylic are ubiquitous in today's fashion.
These materials offer benefits like durability and affordability, but they also shed microplastics into the environment, both into the air and also through washing.
One impactful change is to opt for clothing made from 100% natural fibers
So this is cotton, bamboo, linen, hemp, wool, or silk.
These materials do not shed microplastics.
But it is important to note that even blends containing synthetic fibers can still release microplastics.
So aiming for pure natural fibers is really key here.
I understand this might be challenging, especially for people that have specific fashion preferences or budget considerations, but even gradual shifts in our wardrobe can make a significant difference over time.
For those of us not ready to 100% part with our synthetic garments, there are ways we can also still mitigate the impact.
Installing a microfiber filter on our washing machine is an effective method.
So washing synthetic clothes is a major, major source of microplastic pollution in the ocean, in our waters.
And so installing a microplastic filter can actually trap microplastic fibers released during washing of our laundry and prevent them from entering our waterways.
There's also brands like Guppy Friend that offer these laundry bags that are designed to catch microfibers during washing.
So these bags really offer a straightforward and cost-effective solution for people that are not really ready to install a microfiber filter on their washing machine just yet.
I also wanna highlight another pathway through which microplastics and their associated chemicals like BPA can enter our bodies, and that is through the skin.
So dermal absorption isn't as significant as ingesting contaminated food or water or inhaling polluted air, but it is still a route worth paying attention to, especially because it involves everyday items we might not suspect.
So consider thermal paper receipts.
These are things that we're getting from the supermarkets, gas stations, ATMs.
These receipts often contain BPA, which is used as a color developer in the thermal printing process.
So when we handle receipts, BPA can transfer into our skin and potentially enter our bloodstream.
Now here's where it gets more interesting and concerning is that the use of lotions or sunscreens or hand sanitizers can dramatically increase the absorption of BPA through the skin.
These products can enhance our skin's permeability, which allows BPA to pass through the skin more so than it normally would.
In fact, studies have shown that using hand sanitizer before handling receipts can significantly boost BPA absorption into our bloodstream.
What can we do about this?
When possible, opt to decline paper receipts or request a digital version, have it sent to your email or phone.
Many retailers offer this option and it reduces BPA exposure to ourselves, but it also reduces paper waste, so it's a win-win.
If your job requires you handling receipts frequently, such as if you're in a retail or food service, consider wearing nitrile gloves.
So nitrile gloves are effective barriers against chemicals like BPA.
unlike some latex glove, which may not offer the same level of protection.
Okay, lastly, I wanna cover some excretion methods.
I wanna talk about how our bodies handle the influx of microplastics and the chemicals associated with them, including BPA, BPS, phthalates, and the forever chemicals
the PFAS.
So once these chemicals enter the body, whether it's through ingestion or inhalation or through skin contact, they are quickly absorbed and processed primarily by the liver.
The liver is equipped with a variety of enzymes.
Part of these enzymes are called phase two detoxification enzymes.
These are enzymes that convert these chemicals into more water soluble forms
making them easier for our body to excrete them mostly through urine.
For example, BPA is cleared relatively fast within about six hours under normal conditions.
Phthalates take a bit longer, ranging between 12 to 24 hours, depending on the specific compound.
While that might sound reassuring, the problem is we are exposed to these chemicals almost constantly.
So our bodies are in a near continuous state of processing them.
But this is where it gets even more complicated.
So PFAS, again, these are forever chemicals, do not break down easily.
So unlike BPA or phthalates, the PFAS have a half-life of two to five years, meaning they accumulate in our organs like the liver and the kidneys, and their persistence in the body makes them
much harder to eliminate.
They stick around and they build up over time.
Then there's microplastics themselves.
Microplastics do vary in size.
Larger particles could pass through the gut and be excreted in feces, but the smaller nanoplastics, these are the really, really tiny particles, these are crossing biological barriers and they're entering the bloodstream.
Once they get into circulation systemically, we don't really fully understand how or if
they're ever excreted efficiently.
What we do know is that they are accumulating in our organs, in our tissues, and this is a growing concern when we talk about long-term health implications.
So how do we help our bodies clear out chemicals like BPA, BPS, and phthalates more efficiently?
One promising strategy revolves around tapping into our body's natural detoxification systems.
And we can do that through dietary and lifestyle interventions.
One compound that really stands out here is sulforaphane.
You've probably heard me talk about this before.
It's a powerful molecule found in broccoli sprouts and other cruciferous vegetables.
Sulforaphane activates a key pathway called NRF2.
Think of NRF2 as a master regulator of detoxification.
It controls the production of enzymes that helps our body clear out many, many toxins.
It boosts the phase two detoxification enzymes.
These are enzymes that bind to harmful chemicals and make them more water soluble so we can excrete them through our urine.
Animal studies have shown that when rodents are exposed to BPA and given sulforaphane, their phase two detoxification enzymes go into overdrive and they experience less overall BPA-related toxicity.
Now, while there's not a lot of direct evidence on sulforaphane's ability to clear BPA and phthalates specifically,
I think the mechanism here is very solid, and we do have compelling human data in other areas.
For instance, studies show that sulforaphane can increase the excretion of toxins like benzene and acrolein, which we get exposed through air pollution and food.
by up to 60%.
So in my view, incorporating sulforaphane-rich foods into our diet, like broccoli sprouts, which contain up to 100 times more sulforaphane than mature broccoli, or considering a high-quality supplement of stabilized sulforaphane or its precursor, glucoraphanin, could be a viable strategy for helping detoxify BPA, BPS, and phthalates.
And by doing so, we do boost our body's natural detoxification pathways that has been shown in human studies that could help us more effectively eliminate some of these microplastic associated chemicals.
Another avenue worth exploring is the role of dietary fiber in helping our bodies eliminate chemicals associated with plastics and perhaps even some microplastics themselves.
Consuming fiber-rich foods can bind to lipophilic chemicals like BPA and phthalates in the GI tract and reduce their absorption into the bloodstream, promoting their excretion via feces.
So feces is another way our bodies detoxify BPA, phthalates, and even microplastics.
Some animal studies support this mechanism, indicating that higher fiber intake leads to increased fecal excretion of these compounds.
But what about microplastics themselves?
While research is still emerging here, I think there's a reason to believe that dietary fiber could aid in the excretion of some larger microplastics.
So since microplastics can be trapped within the gut lumen, a fiber-rich diet could potentially help encapsulate these particles and facilitate the removal through regular bowel movements.
Essentially, fiber might help sweep the gut clean and reduce the residence time of microplastics
therefore limiting their chances of causing harm and getting into the bloodstream.
This means incorporating foods that are high in fiber like legumes, fruits, vegetables, whole grains could serve a dual purpose.
Not only do they provide essential nutrients and micronutrients and phytochemicals and fermentable fiber that supports overall health and gut health, but they also could enhance the elimination of both harmful chemicals and microplastic particles.
Let's talk about another powerful tool for eliminating some of these microplastic associated chemicals.
Physical activity and practices that induce sweating.
So exercise, things like sauna, hot tubs, even hot yoga.
Sweat, it's not just about cooling down the body, it's also a way to eliminate harmful chemicals and compounds from the body.
So sweat does can trace amounts of BPA and phthalate metabolites.
Now, while most of these chemicals are excreted through urine, studies have shown that sweat can help too.
One study published in the Journal of Environmental and Public Health found measurable levels of phthalates in sweat of participants.
I think this tells us that regular sweating, whether through exercise or sauna or hot yoga, can be a viable route for excreting some of these harmful substances.
So while the amounts of BPA and BPS and phthalates that are excreted in sweat are smaller compared to urine,
I think consistent sweating could really still play a meaningful role in lightening the toxic burden load on our body.
And lastly, I do want to make one last mention that these excretion strategies that we've been discussing are less effective for the forever chemicals, the PFAS, because of their
resistance to metabolic breakdown because their half-life in the body is two to five years.
So really the best way to avoid PFAS is to avoid the exposure in the first place.
And reducing our exposure to plastics does remain the most effective way to reducing our burden of PFAS chemicals.
So this means avoiding plastic chemicals, avoiding mineral waters with high concentrations of PFAS,
and really just trying hard to reduce our use of plastics.
So this wraps up our deep dive into the pervasive issue of microplastics and their associated chemicals.
So I want to leave you with this.
Microplastics and their associated chemicals are not just an environmental concern.
They're posing a significant human health challenge that's impacting us at multiple biological levels.
These microplastic particles infiltrate our bodies.
They're accumulating in vital organs like our brain.
They're disrupting hormonal balance.
They're impairing fertility.
They're posing substantial risk to our neurological and cardiovascular systems.
But there is a constructive path forward by educating ourselves and making deliberate informed choices such as implementing effective water filtration systems to reduce our microplastic intake, opting for fresh foods over packaged ones, choosing clothing made from natural fibers instead of synthetic ones when possible.
Supporting our body's natural detoxification processes through proper nutrition and things like cruciferous vegetables and broccoli sprouts.
Sweating, exercising, using the sauna.
These are all ways that we can actively reduce our microplastic exposure and their associated chemicals.
I also hope that by raising awareness and advocating for systemic changes, we can contribute to a global effort for policy changes aimed at reducing plastic pollution.
Remember our individual actions when they're multiplied across communities, they can lead to a significant impact.
And I do think that
If we work together, we can have the capacity to not only protect our own health, but that of future generations as well.
Thank you for joining me in this important conversation today.
If you're interested in learning more, make sure to check out my microplastics topic article.
You can find that on my website at foundmyfitness.com.
Go to the topics tab in the toolbar and scroll down to M.
where you can find the microplastics article with references.
You should also consider becoming a FoundMyFitness member, where you get to ask me questions in a live and recorded Q&A every month.
I very often answer questions related to the topics discussed in today's episode.
things like microplastics and plastic exposure and BPA and reverse osmosis filters and which ones are the best and HEPA filters and all those kinds of questions.
You can find that information on my website at foundmyfitness.com.
Thank you so much and I'll talk to you guys soon.