Huberman Lab
Dr. Casey Means: Transform Your Health by Improving Metabolism, Hormone & Blood Sugar Regulation
06 May 2024
Chapter 1: What is discussed at the start of this section?
Welcome to the Huberman Lab Podcast, where we discuss science and science-based tools for everyday life. I'm Andrew Huberman, and I'm a professor of neurobiology and ophthalmology at Stanford School of Medicine. My guest today is Dr. Casey Means. Dr. Casey Means did her undergraduate degree at Stanford University and her medical degree at Stanford University School of Medicine.
She is one of the world's foremost experts in metabolic health. Today, we discuss how metabolic function and dysfunction impacts our health.
In particular, we discuss mitochondria, which are involved in energy production within our cells and the various things that we can each and all do to ensure proper mitochondrial function, which is essential, not just for things like body composition and physical and mental energy, but also our ability to regulate hormones, blood sugar, and much more.
We discuss how exercise, even simple exercise like walking, as well as sleep, as well as more vigorous exercise, and in particular nutrition, including the types of foods we eat, the timing of food intake, and the sources and quality of those foods impact our mitochondria and other aspects of metabolic function.
We also discuss how particular micronutrients within specific foods can directly impact mitochondrial and metabolic health. Dr. Means explains how mitochondria, inflammation, and reactive oxygen species, which are the byproducts of metabolism in our cells, can combine to create conditions of obesity, as well as ways that we can manage those things
or even reverse mitochondrial inflammation and reactive oxygen species dysfunction in order to reverse obesity, reverse diabetes, and enhance our health in myriad ways. By the end of today's discussion, you'll have a clear picture of the cellular processes that occur in the brain and body that underlie metabolic disease and metabolic health.
And most importantly, you'll have a very clear picture of the actionable items that we can each and all carry out every day and every week in order to ensure metabolic health, proper mitochondrial function, and indeed that can also impact body composition and overall feelings of wellbeing. I would also like to share that Dr. Casey Means has a terrific new book coming out.
I know it's terrific because I've read it. It is entitled Good Energy, The Surprising Connection Between Metabolism and Limitless Health. If you're interested in the book, we provided a link to the book in the show note captions. Before we begin, I'd like to emphasize that this podcast is separate from my teaching and research roles at Stanford.
It is, however, part of my desire and effort to bring zero cost to consumer information about science and science-related tools to the general public. In keeping with that theme, I'd like to thank the sponsors of today's podcast. Our first sponsor is Element. Element is an electrolyte drink that has everything you need, but nothing you don't.
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Chapter 2: How does metabolic function impact our overall health?
Drinking element dissolved in water makes it extremely easy to ensure that you're getting adequate hydration and adequate electrolytes. To make sure that I'm getting proper amounts of hydration and electrolytes, I dissolve one packet of Element in about 16 to 32 ounces of water when I wake up in the morning, and I drink that basically first thing in the morning.
I also drink Element dissolved in water during any kind of physical exercise that I'm doing. They have a bunch of different great tasting flavors of Element. They have watermelon, citrus, et cetera. Frankly, I love them all. If you'd like to try Element, you can go to drinkelement.com slash Huberman Lab to claim a free Element sample pack with the purchase of any Element drink mix.
Again, that's drinkelement.com slash Huberman Lab to claim a free sample pack. Today's episode is also brought to us by Waking Up. Waking Up is a meditation app that includes hundreds of meditation programs, mindfulness trainings, yoga nidra sessions, and NSDR, non-sleep deep rest protocols.
I started using the Waking Up app a few years ago because even though I've been doing regular meditation since my teens, and I started doing yoga nidra about a decade ago,
My dad mentioned to me that he had found an app, turned out to be the Waking Up app, which could teach you meditations of different durations and that had a lot of different types of meditations to place the brain and body into different states and that he liked it very much.
So I gave the Waking Up app a try and I too found it to be extremely useful because sometimes I only have a few minutes to meditate, other times I have longer to meditate. And indeed, I love the fact that I can explore different types of meditation
to bring about different levels of understanding about consciousness, but also to place my brain and body into lots of different kinds of states, depending on which meditation I do. I also love that the Waking Up app has lots of different types of yoga nidra sessions. For those of you who don't know, yoga nidra is a process of lying very still, but keeping an active mind.
It's very different than most meditations. And there's excellent scientific data to show that yoga nidra and something similar to it called non-sleep deep rest, or NSDR, can greatly restore levels of cognitive and physical energy, even with just a short 10 minute session. If you'd like to try the Waking Up app, you can go to wakingup.com slash Huberman and access a free 30 day trial.
Again, that's wakingup.com slash Huberman to access a free 30 day trial. And now for my discussion with Dr. Casey Means. Dr. Casey Means, welcome.
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Chapter 3: What role do mitochondria play in metabolism?
relatively low time investment, certainly don't have much financial cost in the sense that they could be done in gyms and with fancy equipment, but they don't require that. Again, I want to point out that these are not like strict prescriptives, but if you had a magic wand
And because you are interested in the health of humans, let's talk about a few of these things that can improve glucose disposal and mitochondrial function, mitophagy, the removal of dead or dysfunctional mitochondria so they can be replaced. Let's talk about the walking one first. You said 7,000 steps a day. I don't track my steps. What are we really talking about there?
We're talking about taking the stairs and trying to walk as much as possible. Maybe we were going to just give a really crude prescription. You're a doctor, so you can prescribe things. What would you tell people to do? How many short walks per day? Is it three? Is it five? What are we talking about?
I would say at least three. I would say aiming for more than that is good, though. So to sort of just give a sense of the picture of walking, if walking were a pill, it would be the most impactful pill we've ever had. in all of modern medicine. There was a paper in JAMA, 6,300 participants followed for 10 to 11 years.
And the people who simply walked 7,000 steps per day compared to less than that had in up to 70% lower risk of all-cause mortality in the follow-up period. So not causality, but it's pretty incredible.
They've done follow-up research with slightly different numbers showing, again, though, like many thousands of people in the study followed for about 10 years, 8,000 to 12,000 steps per day was associated with 50% to 65% lower all-cause mortality. And this has been played out in many studies showing about a 50% reduction in Alzheimer's
dementia, obesity, type 2 diabetes, depression, cancer, gastric reflux, just all across the board. And I think the key thing is that it's not about the steps. It's about the fact that muscle contraction is medicine. When we contract our muscles, even in a very like low-grade way, like walking or doing a couple air squats, you know, we're activating AMPK and we are
essentially causing that cell to have a stimulus to push glucose channels to the cell membrane. Most of the time, the glucose channels are like in vesicles, in little bags inside the cells. They're not on the cell membrane. So of course, that's going to keep the glucose in your bloodstream not being processed by the mitochondria.
So when we think about steps, it's a proxy metric for just moving more throughout the day. So let's take two people. You have a person who's walking for one to two minutes every 30 minutes throughout the day. Maybe they're exercising at the end of the day or the beginning of the day. Maybe they're not. is stimulating glucose channels to be at the membrane all day.
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Chapter 4: What are the key factors affecting metabolic health?
The study makes a. somewhat wild claim that if this were extrapolated to a year, we anticipate that we could see a loss of 44 to 66 pounds.
Assuming it's linear progression. Exactly. Which is not the case, folks.
But that's why I'm saying it was a pretty – but that was there in the discussion. But I think that short period is quite interesting because So that's pretty significant. And that's just for two and a half hours a day. So I think now that they're about $150 on Amazon, these under-desk treadmills, I think for anyone who's a knowledge worker, it's a good thing to have at your house.
And the way I use it is I basically just force myself to start my day on the treadmill desk. And I say to myself, if I don't like it after five minutes, I'll sit down. But I'll start and just see how it feels. And then an hour goes by. And I've forgotten I'm even on it.
Is that right? So you're able to work without thinking about having to treadmill.
I am putting it at such a slow speed. I think I'm usually walking at like one mile per hour. I mean, it's very, very glacially slow. I do put my aura ring on my second toe when I do this because otherwise it doesn't count my steps. Because if your hands are at your desk, it won't count your steps.
Because the aura rings measuring hand. Accelerometry, yeah.
But it's incredible how even at a 1.0, one mile per hour speed after two to three hours, you're easily going to get six, seven, 8,000 steps and then throw in a couple other short walks throughout the day and you're getting there easily. So it's just a great way to build back in what modernity took away. And that unfortunately is unavoidable, that regular movement for good physiology.
So I'm a big fan. of them. And the data suggests that for a couple hours a day, they can actually have an impact on body composition, which I think is a great, easy, inexpensive thing for people to do. But if you don't want to buy one, just set those timers and build in the walks throughout the day outside.
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Chapter 5: What are the effects of ultra-processed foods on calorie intake?
inpatients at the NIH and every had ad lib, you know, unlimited access to food during each of those two week interventions. So it's two weeks of ultra processed food, two weeks of unprocessed or mentally processed food, and they could eat whatever they wanted. as much as they wanted in both groups, and then they would weigh every single bite that was left on their trays.
So they knew exactly, exactly how many calories they ate. And literally just giving people this ultra-processed food, which is devoid of what our bodies need and therefore will drive people to eat more, they ate uh, 500 calories more per day for a total of 7,000 calories more in that two weeks.
And they gained about two pounds and then lost two pounds in the unprocessed group, which makes sense, of course, because a pound is about 3,500 calories. And so we have to do these kind of crazy studies just to prove what we kind of know is true, which is that this ultra processed food environment that's cropped up for the past 50 years is is an experiment that has failed. It has failed.
Close to 45% of kids are overweight or obese now. It's not working. And that really is the root cause. So I think a lot of food is about quality and how do we actually really meet the needs of the cells so that our satiety hormones get secreted and we naturally stop eating. Because just telling people eat less calories but eat whatever you want, that just doesn't work.
we have to inspire the body to not want to eat excess calories which we do by stimulating satiety hormones you know helping the microbiome support that process and then change our reward circuitry which is done with nutrient-rich the most nutrient-rich food we can possibly get and that's why i mentioned the soil because our food is drastically depleted of nutrients so when we look at that 70 metric tons of food we're eating in the lifetime
It's just fascinating. That's the information for our body, what it's going to be built from, how it's going to function.
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Chapter 6: How do satiety hormones influence our eating habits?
Well, right now, 60% to 75% is ultra-processed. So we slash the value because the ultra-processing just slashes the nutrients. We slash the value of that 70 metric tons. And then we have crappy soil because our industrial agriculture system, which means the food in some cases has 70% less of key micronutrients in it.
So that 70 metric tons, what's actually useful for our body becomes so much smaller. So what we want to do is basically expand the value of that substrate we're putting in the body. And that means real food, unprocessed from good soil, meet the needs of the cells, naturally don't be hungry, maintain a healthy weight.
and you know, something I talk about is that we could, I mean, we could talk about nutrition, the biochemistry of nutrition all day, but in my review of sort of the biology and the biochemistry, like there's five main things I think we can strive for in our food that can really help meet the needs of ourselves.
And when it really comes, there are obviously more things our body needs, but if we strive for these five things, we will ultimately, I think eat a really healthy diet. And that is nutrition, Fiber, omega-3s, adequate healthy protein, a good amount of probiotics, and high antioxidant sources.
And if we build our diet around knowing a few things in each of those categories that we really love and stock our kitchen with it and make our meals a mixing and matching of each of those components and we get a good amount of those, we will give the body a lot of what it needs to have mitochondrial health, reduce chronic inflammation, reduce oxidative stress.
It's interesting for me to take a step back from nutrition as it's typically presented and think about the brain, the hypothalamic circuitry that drives hunger and satiety and things like that. And to map that onto what I've heard, and I believe to be true based on my view of the literature, which is that we are largely – meaning these circuits in the brain make us –
largely amino acid foraging machines because we need those amino acids in order to carry out metabolic processes and reconstruct any tissues that need repair and recovery, not just from exercise, but just daily turnover, removal of waste, et cetera. So we're foraging for amino acids.
unconsciously we're foraging for micronutrients and of course we need macronutrients we need enough energy from proteins fats and carbohydrates or some either combination of the three i feel like i'm sort of in the dying category of omnivores right i'm neither you know i'm not meat-based and i'm not uh plant-based i'm omnivores i think most people are omnivores actually but
omnivores aren't discussed quite as much as the other categories, at least not on social media. But that, you know, we think of ourselves as getting hungry and wanting to eat. And I think eating the food, some of them that I listed off before, like meat and fish and eggs and vegetables and fruits and some – I do like starches like rice, oatmeal, some pastas, some sourdough breads and things.
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Chapter 7: What role does cold exposure play in metabolic health?
So I feel like highly processed food is polypharmacology. Whereas when you are eating foods that create a more pure experience of micronutrients, amino acid content, calories, and taste, those four things map to one another that intuitively we can start to understand, oh, I like this food and it's good for me and this is enough of it, right? I don't know anyone...
who of reasonable size that that eats like four ribeye steaks you know they eat one i mean i'm sure there's some freaks out there that do that but you know one you know even small piece of quality meat is very satiating yeah you will self-regulate because the body like every other animal in the world is exquisitely designed to regulate hunger on a very intuitive level
if we eat natural food. I think it's almost ridiculous to talk about calories in isolation because the reason we're eating more calories is because we're eating ultra-processed food. But I love what you just said, Andrew, about the brain and the polypharmacy. I've never heard that said. And I think it's like processed food is like polypharmacy of food.
It is the definition of processed food, which I know you talked about with Rob Lustig, the NOVA4 criteria is literally it's breaking down foods into these constituent parts that were never meant to be separated from each other, like the endosperm of a wheat kernel separate from the bran and the, you know, the germ.
And then take that and like a little science experiment, pair it up with all these other individual components and synthetic chemicals that are made in a factory and put them together to create this thing that the body, I truly think our insatiable hunger, again, we're eating ourselves to death in the United States. That's the reality.
Our insatiable hunger and our chronic disease epidemic fundamentally is a lot of, it's mass cellular confusion. And when you think about what chronic inflammation is, chronic inflammation is biochemical fear.
on the cellular level well when you put this stuff into the body that's never seen before obviously that's going to generate some confusion and you know you could you could trace that back to what that really means with leaky gut and you know all the sorts of the real physiology of that but um there's a wonderful book that is called the end of cravings by mark schatzer he also wrote the dorito effect but he talks a little bit about what you're talking about which is this ideal that processed food is actually the ultimate
sort of food-based variable reward. So in the way that it – like things that – I mean, I'm speaking expert here, but things that the body can't predict what the outcome is going to be are going to kind of get you in that dopamine motivation pathway. And that's actually what processed food is doing is it's –
Every time we eat a different – we think we're eating a tortilla, but it's like completely different than all the other weird tortillas, ultra-processed tortillas on the shelf. So every time we eat tortilla, and our brain is this incredible prediction machine, and as it's coming towards our mouth, we're predicting what the load is going to be. But we have no idea. Is it a Coke Zero?
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Chapter 8: How does mindset affect metabolic health and cravings?
Whereas every time you eat a ribeye, your body's pretty much getting a similar thing each time. And so the prediction matching is going to be more conducive to getting off the motivation treadmill for more, which I think is so important.
fascinating um but i think backing up a little bit one one concept i have for food that really helps me is really thinking about the body's always trying to help me be satiated and trying to help reduce my cravings i literally just have to give the body what it needs i have to stimulate the body in a way that it will serve me and giving me satiety hormones to basically regulate my hunger and
again, with visuals, I think it's so helpful. I think about these cells lining our small intestine that literally have nutrient sensors and literal receptors on the cell membrane in the luminal side of the gut that's facing all the food that are just sitting there waiting to bind with these things in our food that will stimulate the cell to make the satiety hormone that
poof, effortly makes us not hungry, gets rid of that grip of attachment to cravings that all of us are so plagued by. And like, I think, you know, we have this intense conversation happening in society right now about GLP-1 analogs and Ozempic and Minjar and all these things, GLP-1 agonists, but like,
we rarely talk about the fact that we have nutrient sensing cells of the gut, the L cells of the gut, that when stimulated appropriately will make GLP-1. And when stimulated the way they want to be, will secrete hordes of GLP-1 for us. And so how do we actually think about just literally giving the body what it needs to stimulate the satiety hormones?
And the processed foods aren't giving us those things. The things that are going to stimulate those cells Well, the things that will, I mean, this is kind of fascinating if you don't mind going down a little road.
No, please, please.
With the GLP-1 conversation, I feel like so missing from the conversation is the idea that like from a first principles perspective, there's three ways our body could make more GLP-1. We make more cells that make it, L cells of the gut, Each of those cells makes more GLP-1. And importantly, we can also inhibit the inactivator of GLP-1, which is an enzyme called DPP-4.
So GLP-1 actually gets rapidly degraded by DPP-4 in the body. So if we can figure out how to inhibit DPP-4, we can raise our GLP-1 levels.
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