The Essential Guide to Dr. Rhonda Patrick – A 2018 Summary

This exclusive post covers the following series of podcasts:

  1. The Joe Rogan Experience – Dr. Rhonda Patrick (December 2017)
  2. The Wild Ideas Worth Living Podcast: Dr. Rhonda Patrick
  3. Found My Fitness with Dr. Rhonda Patrick – Dr. Charles Raison on Depression, the Immune-Brain Interface & Whole-Body Hyperthermia
  4. The Art of Manliness: Dr. Rhonda Patrick on How to Optimize Your Body With Micronutrients, Genetic Nutrition, and Intentional Stress
  5. The Peter Attia Drive – Dr. Rhonda Patrick
  6. Found My Fitness with Dr. Rhonda Patrick – Exploring the Fasting Mimicking Diet with Dr. Valter Longo
  7. The Joe Rogan Experience #1178 – Dr. Rhonda Patrick (October 2018)
  8. Found My Fitness with Dr. Rhonda Patrick – Dr. Dale Bredesen on Preventing and Reversing Alzheimer’s Disease

As 2018 comes to a close, we here at Podcast Notes are busy compiling the many takeaways and tidbits learned throughout the year. Perhaps you’ve heard Dr. Rhonda Patrick (@foundmyfitness)? If not, it is our pleasure to introduce you to our (and soon to be your) favorite scientist. Without further ado, we present a comprehensive summary of Dr. Rhonda Patrick’s 2018 podcast appearances, as well as some tidbits and learnings thrown in from her own podcast, Found My Fitness.

Diet, Nutrition, and Supplements

The Microbiome

  • Bacteria in the microbiome eat the fermentable fiber we don’t digest (from things plants, seeds, nuts, and legumes)
    • If you don’t eat enough fermentable fiber, the bacteria in the microbiome start eating the carbohydrate lining in the gut, called mucin, which separates the immune cells in the gut from the bacteria (this is bad)
  • The microbiome regulates the immune system – “It’s the major source of inflammation in the body”
  • Probiotics
    • For probiotics to work, you either have to take them constantly, or there needs to be space in your gut for them to take residence (like after a a heavy course of antibiotics)
      • So, you can’t just eat a shitty diet, then take a probiotic
    • Rhonda will take VSL#3 and Visbiome occasionally
    • Some studies show probiotics improve anxiety and depressive symptoms
  • Artificial Sweeteners/Other Additives and Their Impact on the Gut Microbiome – There is no free lunch
    • Stevia:
      • It’s a non-nutritive sweetener that changes the composition of the gut so that the bacteria that are really good at harvesting glucose will increase in number, causing some people to become obese
    • Aspartame
      • Found in diet sodas, has an adverse effect on the gut microbiome
    • Xantham Gum:
      • Not all that bad, but other emulsifiers in hot sauces for example, can disrupt the gut microbiome
  • Many healthy older people in their 90s, have microbiomes that look very much like that of a younger person in their 30s

Refined Sugar

  • The easiest thing you could do, to have the biggest impact on their health, would be to cut out refined sugar
  • Refined sugar has been shown to increase inflammatory biomarkers as well as small dense LDL particle number (which is a bad thing)
  • There is little difference between drinking a glass of orange juice and a glass of soda (OJ is NOT part of a healthy breakfast)
  • Refined sugar decreases testosterone

Micronutrients

Micronutrients – The Background

  • There are ~30-40 micronutrients
    • These are essential vitamins and minerals like magnesium, vitamin, C, and vitamin K that our body cannot make – we have to get them from food
  • Recommended daily allowances (RDAs) for micronutrients are set by making animals deficient in a certain micronutrient, and once a certain deficiency level causes an animal to die, the RDA is set a few standard deviations above that
    • Thus, you can’t really go by the RDAs
    • We don’t really know what levels are needed to stave off disease and aging
  • SpectraCell Labs offers a micronutrient test to see your levels and where you might be deficient
  • 22% of the enzymes in your body require a micronutrient as a cofactor in order to work

What are some of the essential miconutrients?

  • (All products linked are from Thorne, one of Rhonda’s go to supplement companies):
  • Magnesium – found in leafy green plants
    • Magnesium is a required cofactor for an enzyme which repairs damaged DNA
      • Enzymes require certain cofactors to make sure they run properly
    • DNA damage is a precursor to mutations that can lead to cancer and accelerate the aging process
    • Beef liver is a great source of magnesium
    • 45% of the U.S. population has inadequate levels of magnesium
  • Folate – also found in leafy green vegetables
    • Folate is needed to make a precursor which is required to make new DNA
      • This is important when you’re making new cells, and thus need new DNA
  • Vitamin D
    • About 5% of the human genome is regulated by vitamin D
    • About 70% of the U.S. population doesn’t have adequate levels of Vitamin D
      • Adequate levels of vitamin D are considered to be between 40-60 ng/mL
      • Generally 1,000 IU of vitamin D will raise blood levels by 5 ng/mL
  • Vitamin E 
    • Vitamin E helps recycle vitamin C, and vice versa
    • It’s an antioxidant, but it’s also important for maintaining cell integrity – it’s located inside the cell membrane and prevents normal oxidative processes from happening there
    • The RDA is 15 mg
    • Nuts are the best source (almonds) of vitamin E, as well as sardines
    • 60% of the U.S. population doesn’t have adequate levels of vitamin E (found in nuts, avocados, and olive oil)
  • Vitamin C
    • Important for making collagen, converting dopamine to norepinepherine (important for the fight or flight response)
    • It’s also an antioxidant
  • People that are obese/overweight have the most micronutrient deficiencies

Triage Theory

  • This theory states that metabolic processes that are required for short term survival will get their share of the micronutrients first
    • The metabolic processes more concerned with long term maintenance would get neglected
  • So, here’s an example of what might happen if you lack a certain micronutrient:
    • There are enzymes that are required to prevent and repair DNA damage, and then there are enzymes that require a micronutrient to prevent short term disease
    • If there’s only so much of a micronutrient around, it will be used for the latter. The DNA damage just isn’t as important right now
      • We evolved to live long enough to make babies, not for optimal health when you’re 80

What does Rhonda’s diet look like (circa July 2018)?

  • Rhonda follows a time restricted eating based diet
  • She tries to fast for ~15 hours each day
    • Usually, depending on her activity levels, she can obtain a blood ketone level of 0.7-1.0 mmol using a Precision Xtra after 15 hours of fasting
    • Typically, she only eats breakfast and an early dinner
  • What does she eat?
    • Salmon with salad/sauteed vegetable in olive oil
    • Smoothies with blueberries, avocado, and kale
    • Some watermelon in the summer time
    • Nuts as a snack – usually walnuts, almonds, macadamia nuts, cashews, and pistachios

Supplements

  • What is Rhonda supplementing with?
    • Life Extension PQQ
      • Rhonda takes 20 mg a day
      • PQQ is made by bacteria in the soil, plants then absorb it
      • It’s been shown to improve mitochondrial function, and lower markers of inflammation
    • Thorne Vitamin D
    • Thorne Vitamin K
    • Rhonda takes capsulized fish oil from a friend who makes it in Norway – she takes 5-6 grams a day
      • It’s not available in the U.S. yet
  • Rhonda says the supplement company Thorne, is usually a safe bet
  • Some Tidbits on Fish Oil
    • DHA is found in both fish oil and fish
    • Rhonda advises to consume DHA supplements in the phospholipid form for increased absorption (that’s why she recommends this brand of fish oil)
      • Only ~1% of a fish’s DHA is in the phospholipid form
      • In the roe of a fish (aka fish eggs) – 40-70% of the DHA is found in the phospholipid form
    • Fish oil increases dopamine in the prefrontal cortex
      • Some schizophrenics are prescribed a very high dose (3-6 grams a day) of fish oil because their dopamine is lower in the prefrontal cortex, which is associated with he negative symptoms of schizophrenia
    • On one of her podcasts with Joe Rogan, Joe mentioned he takes Carlson’s fish oil – he takes 3 tbsp. a day 

Sulforaphane

  • What is it?
    • A compound in raw broccolli sprouts (the biggest source), but it’s also present in brussel sprouts
  • What are the benefits of sulforaphane?
    • Sulforaphane activates a variety of enzymes which help get rid of potentially harmful compounds in the body
    • Humans given sulforaphane extract show an increase of glutathione (a master antioxidant) in the brain – it plays a huge role in preventing brain aging
    • Sulforaphane has been found to improve symptoms of autism
  • To grow your own broccoli sprouts (which are high in sulforaphane) use this kit with these seeds
    • Freezing your broccoli sprouts increases the sulforaphane content
    • You can’t cook the sprouts – the enzyme that converts the precursor into active sulforaphane is heat sensitive
    • You can put mustard seed powder on brussel sprouts, sauteed kale (kale also contains some sulforaphane), or broccoli sprouts to help increase the absorption of the sulforaphane
      • The mustard powder has the active enzyme that converts the precursor in the sprouts/kale into sulforophane
  • Sulforaphane Supplements
    • Avamacol – this is a “sulforaphane like supplement”
      • Rhonda calls it “The best in the U.S.”
    • Rhonda says Prostaphane is better, but it’s hard to get in the U.S. (it’s made in France)
      • Rhonda has been taking 3 pills/day (each pill is 10 mg) with food

The Ketogenic Diet

  • Rhonda has tried the ketone ester from HVMN
    • She experienced a decrease in anxiety (it got her to a blood ketone level of ~4.5 mmol in about an hour) and a feeling of “being present”
      • Perhaps the glucose in her brain is being spared for other things besides “worrying”
        • Sulforaphane also does this for her
        • In one of her podcasts with Joe Rogan , Joe suggested “the perfect pre-podcast meal” – the HVMN ketone ester and a salad contain broccoli sprouts (which are loaded with sulforaphane)
    • She’ll often take the HVMN ketone ester before doing a podcast, or a big talk
    • It lowers her blood sugar levels pretty dramatically, so once the ketones ware off (after a couple of hours) she crashes, since she doesn’t follow a ketogenic diet regularly
      • If she was already in ketosis, this wouldn’t happen
      • Perhaps the crash could also be mitigated by consuming the HVMN with a higher carb meal
  • Rhonda finds it hard to go full time ketogenic, due to the many benefits of eating lots of plants/fibrous vegetables
    • Certain micronutrients have a higher density in plants – like folate, magnesium, vitamin k1
    • Fermentable fibers are also good for the gut, which helps regulate immune function
      • It is possible to get the necessary fiber on a ketogenic diet, it’s just more difficult

Genetics and the Ketogenic Diet

  • (As a reminder, 23andMe works great for genetic testing)
  • PPAR-alpha
    • Predominantly found in the liver – involved in fatty acid catabolism and in the production of ketone bodies
  • PPAR-gamma
    • Predominantly found in adipose tissue – involved in taking up free fatty acids into adipose tissue
  • People with certain SNPs (pronounced snips – these are basically single gene variants) on PPAR-alpha and PPAR-gamma, just don’t do well with saturated fat (typically consumed in abundance on a ketogenic diet)
  • People with these SNPs, should consume a higher ratio of poly and mono unsaturated fat to saturated fat, in order to lower their type 2 diabetes risk – (
  • These people, will typically see the following happen while on a traditional ketogenic diet, if they consume too much saturated fat:
    • Their LDL particle number will go up, despite the fact that their triglyceride levels go down
    • Their levels of C-reactive protein (CRP) will rise (this is a marker of inflammation)
    • Their markers of cholesterol biosynthesis will go up (because their bodies are making more cholesterol)
    • Their phytosterols will go up (which typically go down on a ketogenic diet)
      • Phytosterols are a group of naturally occurring compounds found in plant cell membranes
      • Side note – Cholesterol is the sterol from an animal. Phytosterol is the cholesterol equivalent from a plant.
    • —> One of Dr. Peter Attias patients (described in these Podcast Notes) experienced something like this. What did Dr. Attia do?
      • He cut his patient’s saturated fat intake to very low levels (20-25 grams a day)
      • When the patient did this, 65% of his fat calories were being consumed from mono unsaturated fat (this is very hard to do, an easy way to get this much mono unsaturated fat is to consume lots of olive oil)
      • After 8-12 weeks, with the same macronutrient distribution (so the same overall levels of protein, carbs, and fat – just with different types of fat – much less saturated fat), their LDL particle number dropped tremendously, inflammation dropped, and their sterol biomarkers returned to normal

The Carnviore Diet

What is the carnivore diet?

  • The diet entails eating nothing but meat
  • Some people are a little more lenient, and eat only animal products (so in addition to meat, they may eat eggs)
  • Many people report staying in a state of ketosis, while following a carnivore diet, due to all the saturated fat that’s consumed

In summary, what are Rhonda’s thoughts about it?

  • “The diet could be dangerous without any long term evidence or scientific studies”
  • “At the end of the day, there’s no data” – Going on a carnivore diet may be harmful long term

What are the supposed benefits of the diet?

  • The diet does seem to improve autoimmune disorders
  • Why does it work?
    • The diet mimics calorie restriction and fasting – these have been shown to allow for significant improvements in autoimmune diseases
      • People eat less when they eat a high protein diet
        • You have less insulin production, which changes your leptin and ghrelin levels (the satiety and hunger hormones, respectively), which causes you to eat less
      • Studies show that when people are given the same food every single day, naturally they start to eat less, and calorie restrict themselves
    • It replenishes the immune system through apoptosis
      • While fasting, or just calorie restricting to very low levels, entire cells are cleared away through a process known as apoptosis
      • During a 72 hour fast, animal studies show you can clear away about 30% of the immune system and replenish it with brand new healthy immune cells
      • Autoimmune cells may be selectively killed off first, and replenished with non-autoimmune cells
    • It produces changes in the microbiome
      • The microbiome has been linked to autoimmunity in things like arthritis and multiple sclerosis (MS)
        • One study showed that when people with MS fasted every other day for 7 days, they experienced profound changes in the gut microbiome
      • People who follow a carnivore diet tend to grew gut bacteria which produce more butyrate (this is a short chain fatty acid which gut cells love – it’s good for them), which helps the immune system produce for T-regulatory cells

But aren’t there other ways to cure or help autoimmune issues, without going on such a restrictive diet? – Yes!

  • Do a prolonged fast once per quarter, depending on how severe the issues are
  • Do a fasting mimicking diet (FMD) once per month
  • One study showed that going on a ketogenic diet for three months, also improved symptoms of autoimmunity

Other Negative Microbiome Changes That Occur When Following a Carnivore Diet

  • People that go from a high fiber, to a high protein (or carnviore diet), will tend create an environment in the gut that allows for the presence of more bacteria that ferment amino acids (like putrefactive bacteria)
    • Why is this not desirable? – Some species of putrefactive bacteria have been linked to colon cancer
      • These bacteria create genotoxic agents known as putracine and cadaverine which damage the DNA inside colon cells
    • By eating fiber/vegetables along with meat/protein – this promotes the growth of lactic acid producing bacteria (bifiodo, lactobacilius etc.), which limits limits the growth of putrefactive bacteria

What are Rhonda’s main concerns with the carnviore diet?

  • The possible micronutrient deficiencies
    • We know by now (assuming you’re reading this in order) that micronutrients (30 particular vitamins and minerals) are essential
      • They run our metabolism, are involved in making neurotransmitters, etc.
      • 22% of all enzymes in your body require a micronutrient to function
      • You don’t make micronutrients in your body, so you have to get them from your diet
      • Many micronutrients are much more concentrated, and easy to get, from plants
    • The biggest one micronutrient deficiency concern is vitamin C
      • Vitamin C is an antioxidant that’s important for making collagen and converting dopamine to norepinepherine (important for the fight or flight response)
        • Scurvy happens when you don’t have enough vitamin C for collagen production (this is thought to be about only 10 mg/day – it doesn’t take much)
        • So people on a carnivore diet are probably getting enough Vitamin C to prevent scurvy, but perhaps not enough to cover all the other things that vitamin C is required for
    • Vitamin E is also a concern
      • Vitamin E helps recycle vitamin C, and vice versa
      • It’s an antioxidant, but it’s also important for maintaining cell integrity – it’s located inside the cell membrane and prevents normal oxidative processes from happening there
      • The RDA is 15 mg
      • Nuts are the best source (almonds) of vitamin E, as well as sardines
    • Folate too…
      • Folate plays an important role in making new DNA
      • So low levels of folate, can lead to DNA damage – this is very hard to measure, and you don’t even know it’s happening
    • And magnesium
      • Enzymes that repair DNA damage require magnesium
  • By not eating vegetables, you’re missing out on key fiber that the gut needs
    • “We evolved eating plants”
    • There are all these other things present in plants that people following a carnivore diet are missing out on – falvonoidspolyphenolsphytochemicals, etc.

Exercise

Exercise – The General

  • It seems to be that exercise is the single most important thing you can do to preserve brain health
  • Exercise has been shown to change the microbiome in a positive way, independent of diet
  • Rhonda finds exercise improves her anxiety levels and decision making ability
    • She loves to go on a very long run if she’s struggling with a decision
  • Strength Training
    • There’s been studies showing people who strength train have a 23% lower all cause mortality and 30% lower cancer related mortality
    • Leg strength has been linked to massive improvements in cognitive function
  • Aerobic Exercise (things like running and cycling)
    • Increases neurotrophic factors in the brain (30 minutes increases this 2-3 fold)
      • These cause your brain to make new neurons in areas involved in learning/memory
      • These neurotropic factors also repair damaged neurons
    • VO2 Max – the ability of the body to transport oxygen during exercise, it’s improved with high intensity interval training
      • Once you hit 25, this declines about 10% per decade – muscle mass declines at the same rate
      • You’ll likely live longer if you can keep your VO2 Max up, or improve it

IGF-1

  • This stands for Insulin-like growth factor 1
  • IGF-1 is activated potently when we consume amino acids and protein
  • Humans that have gene polymorphisms, that raise  IGF-1 levels, have a higher incidence of cancer, and vice versa
  • Check out the images below (image credit) relating all cause mortality, cancer mortality, and cardiovascular disease mortality with serum IGF-1 levels
    • It seems like only very high levels of IGF-1 are problematic
    • Most of the uptick in mortality above the 70th percentile of serum IGF-1 levels, is driven by cancer
    • KEY- From Rhonda’s podcast with Dr. Peter Attia (check out the Podcast Notes) the general consensus seems to be that maybe the best thing to do is cycle high and low IGF-1 levels
  • The older you get, the better IGF-1 seems to be for you, due to it’s ability to help preserve lean tissue
    • So as you age, it makes sense to start incorporating more protein into your diet

Exercise and IGF-1

  • The boost in neurogenesis (the creation of new neurons), via brain-derived neurotophic factor (BDNF), after exercise requires IGF-1
  • IGF-1 plays an important role in the repair/growth of muscle
  • People who are exercising, are putting IGF-1 to the places it’s supposed to go (muscle and brain tissue)
    • If you’re going to eat a high protein diet (and refined carbs), you should be active and exercise often

The Ties Between Exercise and Depression

What You Need To Know

  • Aerobic and strength training exercise can serve as potent forms of antidepressants
    • Exercise elevates inflammatory processes acutely
    • BUT – Then there’s an anti-inflammatory response, that is much more powerful than the initial stressor that occurred

The Similarity Between Exercise and Illness

  • When you get sick, two primary pro-inflammatory cytokines are activated – Interlukin one beta (IL-1B) and Tumor necrosis factor alpha (TNFa)
    • IL-1 activates another cytokine called interleukin 6, or IL-6
      • IL-6 is a “bad guy” – it’s most consistently elevated in depressed people
      • High IL-6 levels are associated with heart attacks, stroke, and cancer
      • IL-1 also activates IL-10, which is anti-inflammatory
  • Exercise also activates IL-6 (also IL-10) like crazy, but doesn’t activate IL-1 or TNFa – this same thing happens in hyperthermia treatments (like using the sauna)
    • IL-6 plays a key role in exercise’s ability to induce insulin sensitivity
    • If you block IL-6, you block the beneficial metabolic effects of exercise
      • So by exercising, and taking a nonsteroidal anti-inflammatory agent afterwards, you block the effects of IL-6
      • There’s been studies showing taking high dose antioxidants (like vitamin C) suppressed the insulin sensitivity effects of exercise, possibly by suppressing IL-6
    • KEY – When you exercise, IL-6 rises briefly, but over time your base levels will drop, as the anti-inflammatory response, is much more potent than the initial rise in IL-6

Kynurenine Pathway and Exercise

  • Chronic inflammation changes serotonin metabolism
    • Chronic inflammation activates an enzyme called indoleamine 2,3-dioxygenase
    • This enzyme takes tryptophan (which should be converted into serotonin) and shunts it away from serotonin, into something called kynurenine
    • Looking at the ratio of kynurenine to tryptophan tells how active this enzyme is, and thus how inflamed you are
  • Exercise helps treat depression through this pathway
  • Kynurenine is a byproduct of tryptophan metabolism, when your immune system is activated in the case of chronic inflammation
    • You’re not converting tryptophan into serotonin, you’re converting it into kynuerenine
  • Kynurenine can form quinolinic acid and kynurenic acid
    • Kynurenic acid is a NMDA antogonist (it inhibits it’s effects)
    • Quinolinic acid is a NMDA agonist and causes neurotoxic effects – this has a powerful association with depression
  • KEY – when you exercise, muscle cells take up kynurenine, preventing the formation of quinolinic acid, and thus reducing depression

Fasting

Depression, Food Intake, and Inflammation

  • Inflammatory markers (like cytokines) are elevated in depressed people
    • The heavier you are, especially around the mid section, the more likely you are to be depressed
    • Fat cells are big producers of inflammatory markers
  • One of the major risk factors for chronic low-grade activity of the immune system is frequent and abundant food intake
    • Postprandial inflammation (inflammation after you eat) increases with meal size, and meal frequency
    • Food is a foreign substance and can be hard on the gut – the gut barrier is compromised with every meal, you’re releasing a little bit of endotoxin into the blood stream because your immune system is activated
  • Every time you eat, your body temperature elevates
    • Hyperthermia has antibiotic effects – think in terms of evolution, when we didn’t know how safe our food was

Fasting and Time-Restricted Eating

Insulin Sensitivity

  • We are most insulin sensitive in the morning, so it makes sense to consume most of your calories then, rather than late at night
    • Your metabolism is weakest at night (so this is really when you want to consume the least amount of calories)

What are some of the benefits of prolonged fasts?

  • Prolonged fasts cause whole organs to shrink, and then regrow with new/healthy cells after the fast upon refeeding……how?
    • Stem cells are activated by low IGF-1 (IGF-1 levels drop when you fast)
    • When you refeed, IGF-1 levels rise. IGF-1 is used to then proliferate those stem cells into new tissues/organs
  • Fasting causes many cells that are damaged to be selective killed off
  • In healthy cells – more antioxidants and anti-inflammatory molecules are made
  • Fasting has powerful anti-inflammatory effects
    • One study looked at the effects of a 24 hour fast on the NLRP3 inflammasome (activates inflammation) – It was found that the gene expression for that complex is dramatically reduced

What are some of the benefits of intermittent fasting (IF)?

  • IF has been shown to improve metabolism, but won’t really increase stem cell production/allow for the clearing away of damaged cells
  • “Time restricted eating is like vacuuming your carpet every day, prolonged fasting is like doing a deep carpet steam clean”

To Conclude – A Great Thought on Fasting

  • “Maybe fasting represents the opportunity to ‘fix’ the inside”
    • Think about it on a evolutionary scale – there were often periods, thousands of years ago, where food was just not available
    • Now we eat all the time – we’ve lost this “auto-repair” mode

Calorie Restriciton vs. Fasting

  • Rhonda used to believe that the best way to increase health span, was through caloric restriction…but not anymore
  • When you calorie restrict, you see a major drop in insulin-like growth factor 1 (IGF-1)
    • However, periods of growth (or periods of higher IGF-1 levels) are important – if you’re constantly calorie restricting, you won’t have this
    • Remember – IGF-1 levels shoot up during the refeeding phase after fasting
  • A recent study on lemurs, showed caloric restriction increased median and maximum life span, as well as delayed the onset of various degenerative diseases
    • However, there was a massive atrophy (gradual decline/wasting away) of grey brain matter, in regions of the brain that didn’t occur in control animals
      • So sometimes, some of the modalities we think are really good for increasing health span, have other effects
  • Periodic prolonged fasts, are a better way of regulating IGF-1 levels long term

The Fasting Mimicking Diet

What does a FMD entail?

  • 5 days of eating low protein, low sugar, vegan, lots of good fat (about 800 calories a day in total) – repeated monthly (or less) depending on the need

What happens while on a FMD?

  • It’s very similar to a prolonged fast
  • While on a FMD, organs shrink. When you refeed, they expand back to their normal size. 
  • A FMD causes cells that are preferentially damaged to be cleared away by apoptosis
    • Damaged cell parts (DNA, mitochondria etc.) are also killed off
    • Protein aggregates are also cleared away

How does this all happen?

  • IGF-1 levels are reduced by going on a FMD (this causes organ systems to shrink)
    • Stem cells are activated when this happens
  • Upon refeeding, IGF-1 levels rise again and causes the same organ systems to re-expand to their original size
    • The stem cells are transformed into new/healthy tissues/organs
    • (During the refeeding phase, for this reason, you need to eat a sufficient amount of protein to raise IGF-1 levels)

The FMD and Autoimmune Disorders

  • The FMD has the capability of reversing many autoimmune disorders
    • In animal models involving Multiple Sclerosis (MS), the formation of stem cells (and their subsequent proliferation into new/healthy cells) has been shown to restore autoimmune cells, to a non-autoimmune state – resulting in a reduction in clinical severity, or in some cases a complete reduction of MS symptoms

The FMD in Healthy Subjects

  • Three cycles of the FMD, done 1x a month for 5 days – for 3 months, was shown to affect biomarkers related to aging in a positive way, as well as risk factors for diseases
    • The FMD seems to have a knack for returning people with elevated IGF-1, cholesterol, triglycerides, fasting glucose, systemic inflammation, and systolic+diastolic blood pressure to normal levels
  • Three cycles of the FMD, 5 days each – once per month, is expected to lower risk of a variety of diseases
  • Fat loss during the FMD seems to be concentrated to visceral fat around the abdominal area
    • Muscle also tends to shrink, but upon refeeding, is rebuilt to normal levels

The FMD and Cancer

  • Studies have shown that that following a FMD prior to chemotherapy allows cancer cells to be much more prone to cell death
    • Why? – Healthy cells increase their stress response pathways when you’re fasting (more heat shock proteins, more antioxidants etc.), and cancer cells can’t do this
    • Therefore, healthy cells are more resilient to the cancer treatment

How often should you do a FMD?

  • Dr. Valter Longo (in his podcast with Dr. Patrick – Podcast Notes here) recommends doing the FMD on a “need-to-do-it basis”
  • If you’re an athlete, and eat right – do it once or twice per year
  • People in a problem state (someone who is obese, with high cholesterol, blood glucose, and triglycerides) – do it more often (once a month or so)

Heat and Cold Stress

The Sauna and Heat Stress

Heat Stress is a Hormetic Stressor

  • This means exposing the body to small amounts of stress, which trigger cellular responses that exceed what is actually needed to compensate for that little bit of stress you exposed your body to
  • Also includes exercise, cold stress (like taking an (ice bath), and fasting

Benefits of Using the Sauna

  • Decreased anxiety
  • There are studies that show endurance athletes who use the sauna 2-3 times per week have performance enhancements (runners, cyclers)
    • Using the sauna results in increased blood flow to the heart (this allows the heart to do less work per beat – you’re pumping out blood easier and allowing fatty acids and glucose to travel more freely to muscles)
  • Men that use the sauna 2-3x a week (for ~20 minutes at 170-180 °F) have a 27% reduced risk of developing cardiovascular disease, 24% lower all cause mortality, and a 20% lower risk of developing Alzheimer’s disease – compared to men who only use the sauna once a week
    • If you raise these numbers to 4-7 times a week – those men have a 50% reduced risk of developing cardiovascular disease, a 40% lower all cause mortality, and a 66% lower risk of developing dementia/Alzheimer’s disease
  • Heat stress increases plasma blood flow and takes work off the heart, it lowers cardiovascular strain
  • Heat Shock Proteins (HSPs) are activated when the body is exposed to heat
    • These have been shown to prevent proteins from forming aggregates/plaques in your arteries and brain – which can lead to things like Dementia
    • Sitting in a 163 °F sauna for 30 minutes increases HSP production 50% – this effect lasts for 2 days
  • Sauna use results in a robust increase of growth hormone, which helps prevent your muscles from atrophying
  • Even with just one sauna session, blood pressure improves, C-reactive protein (an inflammatory biomarker) drops, and vascular compliance increases
  • Frequent sauna use increases mitochondrial biogenesis and allows for improvements in mitochondrial function
  • Using the sauna before a workout has been shown to reduce DOMS (delayed onset muscle soreness)
    • Note from Podcast Notes – it was never specified for how long to use the sauna pre-workout 
  • Using the sauna mimics moderate aerobic exercise (it raises heart rate)
    • Many of the benefits of aerobic exercise are a result of an elevated core body temperature
  • Sauna use has been shown to aid sleep
    • The more negative the derivative of temperature – so d(Temp.)/d(time) – when you sleep, the faster you’ll go to sleep, and the longer you’ll stay asleep
      • So… sauna before bed, then take a cold shower, and then go right to bed, you’ll sleep like a rock- Rhonda swears by it
    • Heat stress has been shown to elongate the REM stages of sleep in piglets
  • Sweating allows you to excrete BPAs, mercury, phalates, and heavy metals 
  • One animal study showed that heat stress increased levels of glucose transporters – it improved insulin sensitivity, and lowered blood glucose (the glucose was being taken into muscle better)

How long should you stay in the sauna, and how often should you use it?

  • Rhonda advises using the sauna 3 times a week, for 20-30 minutes, at a temperature of 175-190 °F
    • If you were to use an infrared sauna (which don’t get as hot as a typical dry sauna) you’d have to stay in longer
  • The real benefits come when you get to 180 degrees
    • 180 degrees for 20 minutes is the sweet spot

Is there much of a difference between an infrared and a standard dry sauna?

  • Much of the scientific studies detailing the benefits involve using the dry sauna
  • Rhonda thinks the standard/dry saunas are better, because they get hotter (and hotter quicker), which allow you to produce more heat shock proteins (HSPs) and get more of the benefits

Using the Sauna to Treat Depression

  • Even a single sauna session has been found to improve depressive symptoms
  • So what’s really going on in your brain/body when you’re sweating your ass off in the sauna?
    • Heat stress causes the release of beta-endorphins in the brain (exercise also does this)
    • Dynorphin is upregulated during heat stress to cool you down
      • Dynorphin is responsible for what one might call, a dizziness feeling, at the tail end of a sauna session – that feeling of “oh god, I have to get out”
      • Dynorphin binds to kapa opioid receptors in the brain
        • This causes a feedback response in other opioid receptors in the brain (mu opioid receptors) which bind to beta endorphins
      • Once your are past the dizziness/dysphoric feeling from dynorphin release, you feel really good
        • Why? – More mu opioid receptors are binding to beta endorphins
        • This explains the lasting “feel good” effects from sauna use throughout the day, and allows you to feel the effects of beta endorphins even more
  • As mentioned above (see section “The Ties Between Exercise and Depression”), exercise, and heat stress, activates interleukin 6 (IL-6) like crazy
    • Studies show that the higher the rise in IL-6 after an experience of heat stress, the happier people felt a week later
      • The acute mood elevating effect, was also correlated with IL-6 levels – if you had a higher IL-6 response, you’d be happier at the end of a sauna session
    • Studies have found that the higher your baseline core body temperature (and therefore, the more depressed/inflamed you are – inflammatory markers are elevated in depressed people), the better antidepressant effect of a sauna session

Cold Stress

  • Rhonda will sometimes take a cold shower before a big talk
  • If Rhonda stacks a sauna session with a cold shower afterwards, she sleeps amazing
  • Benefits of Cold Stress:
    • A large release of norepinepherine from the brain
      • This is important for focus and attention
      • It also improves mood
      • Just 20 seconds of exposure to 40 °F water, can increase norepinepherine levels 2-3 fold over baseline
    • An increase in mitochondrial biogenesis (a growth of new mitochondria)
      • But exercise does this more efficiently
  • The UCP1 Gene
    • People with certain variations of this gene are able to tolerate cold better
    • These people can ramp up their metabolism more, and generate more heat to stay warm
    • People with this variation also burn more fat in the cold
  • Cold exposure within an hour after strength training seems to blunt some of the hypertrophy (growth) effects
    • This is the same reason people shouldn’t take any form of anti inflammatory agents after working out – it impairs the rebuild
    • The anti-inflammatory response starts to peak about an hour after exercise

Sleep

Peak Performance is Tied To Circadian Rhythm

  • Early Risers (7-8am)
    • Studies show their peak performance occurs between 5-6 hours after their waking time (this is only an increase in performance of 1-2%, but if you’re an Olympic athlete, this might make all the difference)
  • Later Risers: 10am onward
    • Their peak performance has been shown to occur 11 hours after waking (also an increase in performance of 1-2%)

Artificial Light

  • Until fairly recently on the scale of human life, mornings were light, and nights were very dark
    • Artificial light has changed this
  • Artificial light can change cortisol levels
    • Cortisol is a hormone that can change the expression of 25% of the human genome, many of those genes involved in inflammation
  • Rhonda has Philips Hue light bulbs in every room of her house
    • They can change color – Rhonda recommends blue light in the morning, and red light at night 
      • Even a little bit of blue light at night screws up melatonin release
    • Rhonda also use f.lux to lower the amount of blue light emitted from her computer screen
  • Bright light exposure has been known to treat people with both seasonal and non-seasonal depressive disorder
    • Go outside in the morning to get bright light, even on a cloudy day

Genetics

Nutrigenomics

  • 23andMe works great for genetic testing
  • Nutrigenomics – This is the term for the interaction between genetics and nutrition
    • Rhonda’s website has a service where you can upload your genetic data to be analzyed
    • Example – how your body responds to saturated fat (found in dairy products, butter, and fatty cuts of meat) and in turn how that effects cholesterol
      • APOE – a gene important for recycling cholesterol
      • About 25% of the population has a version of this gene, APOE4, that can predispose them to very high LDL cholesterol levels
        • People with this gene have a high risk of developing heart and Alzheimer’s disease (discussed more below)
    • There are a variety of different genes that regulate how the body metabolizes saturated fat
      • FTOPPAR-alpha and PPAR-gamma
      • If you have variations of these genes, and have a high saturated fat + low polyunsaturated fat/monounsaturated fat intake – you will be at an increased risk of obesity, and more likely to have higher triglyceride levels
      • So – it IS possible, if you have certain genes, to eat fat and have your blood glucose levels rise
        • If you decide to go on a ketogenic diet – monitor blood glucose and cholesterol levels before and after switching

The Palcebo Effect is Genetic

  • Genetics determine if you are likely to experience a placebo effect
  • The gene that is important in determining whether you will experience placebo vs. nocebo, also controls the degradation of dopamine 
    • So people who are more likely to experience a placebo response, have more dopamine in the brain
    • People with less dopamine, are more likely to experience the nocebo response
  • The gene SNP is called COMT
    • Gene SNPs are single nucleotide polymorhisms – it’s a slight change in the sequence of DNA in a certain gene makes it function a little differently

Carcinogens, Disease, and Cancer

Carcinogens

HCAs

  • Heterocyclic amines (HCAs), formed when meat is charred, are a carcinogen
    • Our bodies have genes that can inactivate/detoxify these HCAs (through detoxification enzymes) – people can do this to varying degrees
    • Cruciferous vegetables can also inactivate these HCAs – Things like broccoli sprouts, cauliflower, broccoli, cabbage, and brussel sprouts
      • So, if you’re going to eat charred meat, it’s best to consume with a vegetable

BPA

  • Boiling water, and putting it in plastic, increases the amount of BPA that leeches into the water 55-fold
  • Animal studies have shown that BPA exposure has negative consequences on the endocrine system, and these negative consequences can be passed on to multiple generations
  • A single exposure to BPA can disrupt insulin sensitivity
  • Typically we excrete BPA through urine and sweat
  • While pregnant, Rhonda made sure not to consume any water from plastic bottles due to the concern of exposing her son to BPA
  • If you keep using a bottle with BPA in it, as the bottle ages, more BPA will leech out into the liquid
    • This includes baby bottles, as well as plastic water bottles’

Pollution

  • Living in a major metropolitan area, like NYC, can shorten your life by allowing you to constantly breath in the air pollution
    • There are compounds in air pollution, like benzyne, which are carcinogens
  • Exposure to air pollution can increase the risk of stroke, heart attack, and Alzheimer’s disease

Alzheimer’s Disease

What is Alezheimer’s Disease?

  • The literal definition is when you have amyloid plaques in the brain, and phosphorylated tau tangles
    • Tau tangles form inside of neurons and disrupt microtubule transport (the neuron’s system for transporting fatty acids to the synapse)
  • These ultimately lead to cognitive decline and dementia

ApoE4

  • The biggest risk factor for developing Alzheimer’s Disease? – Whether or not you have any copies of the ApoE4 gene
    • Everybody has 2 copies of the ApoE gene (1 from mom, 1 from dad) – it’s either ApoE2, ApoE3, or ApoE4
      • 75 million Americans have a single copy of ApoE4 – Their lifetime risk for developing Alzheimer’s Disease is about 30%
      • About 7 million Americans have 2 copies of ApoE4 – If you have 2 copies, your lifetime risk of developing Alzheimer’s Disease is over 50%
    • The gene also increases the chances of a poor outcome if you have any kind of traumatic brain injury (TBI)
    • One of the ways we clear out amyloid plaques is through an ApoE mediated mechanism
      • ApoE4 does it 20 fold less efficiently
    • You can test your ApoE phenotype with 23andMe

What are some of the best ways to help prevent Alzheimer’s Disease?

  • Eat a low inflammatory diet
  • Exercise
  • Limit your exposure to mold and other mycotoxins
  • Keep an eye on your copper and zinc levels
    • You don’t want your copper/zinc ratio to be too high
    • About a billion people on earth are deficient in zinc – you might want to supplement
  • Limit your exposure to mercury
    • If you eat fish, make sure it’s wild caught, not farm raised
  • Eat organic to avoid toxins
  • Get enough sleep
    • Sleep is one of the ways you clear away amyloid plaques (which develop and cause dementia) in the brain
    • During sleep, your brain swells, and you squirt cerebral spinal fluid into the brain which clears out amyloid plaques and other junk
    • “If you have ApoE4. but you’re getting good quality sleep, you have the same risk as someone who doesn’t have APOE4”
  • Use the sauna
    • Sauna use has been shown to be very protective against developing Alzheimer’s Disease
    • One of the biggest benefits – detoxing
      • There are certain toxins that you sweat out – like mercury, BPA, and cadmium
      • After using the sauna, and getting all sweaty, use a non-emollient soap castile soap, like Dr. Bronner’s, to prevent toxin repenetration

Alzheimer’s Disease and DHA

  • There’s evidence that suggests that when people who have a copy of the ApoE4 gene eat more fish, they’re better protected against Alzheimer’s Disease
  • DHA (found in fish and fish oil – Rhonda recommends this brand of fish oil), is important for some glucose transporters on the blood-brain barrier
    • If you’re DHA deficient, those glucose transporters aren’t working well, and you’re not getting enough glucose into the brain – this is a hallmark of Alzheimer’s Disease

The Protocol for Helping to Reverse Cognitive Decline

  • Follow a ketogenic diet 
    • This involves being in a mild state of nutritional ketosis
      • Being in ketosis, seems to improve cognition, and many people do better with their cognitive decline
      • Use things like MCT Oil (Podcast Notes recommends this brand)exogenous ketones (we recommend this brand), and coconut oil to raise your blood ketone levels
      • To be in a state of ketosis, you want your blood ketone levels to be greater than 0.5 mmol/L
      • For more on the ketogenic diet, check out these Podcast Notes
    • To help facilitate a state of ketosis, you’d eat a very low carbohydrate, high fat diet
      • Eat fats that are of the healthy variety like nuts, seeds, olive oil
      • 70% of calories should come from fat
    • Some other important nutritional notes:
      • If you eat beef, make sure it’s grass fed
      • With fish, make sure it’s wild caught, not farm raised
        • Don’t have fish with high mercury contents – these are typically things like tuna (stay away from tuna sushi!!) and swordfish
      • If you’re going to eat chicken, make sure it’s pasture raised
    • You can lose weight on the ketogenic diet, so once a week have a cheat meal or cheat day
      • Eat some higher carb foods, like sweet potatoes etc.
  • Fast for a minimum of 12 hours each day, and don’t eat for 3 hours before bed
    • 12 hours allows time for autophagy (death of weak cells)
    • If you are ApoE4 positive, fast for a little longer, like 14-16 houts
  • Eat organic to avoid toxins
  • Use the sauna

Other

What are some good markers to have blood tested, when just getting started on your health journey?

  • Small dense LDL
  • Total LDL
  • Triglycerides
  • High sensitivity C reactive protein
  • HBA1C (marker of long term fasting blood glucose)

Check out Peter Attia’s AMA for his recommendations on the most useful blood tests

Pregnancy and Kids

  • Your lifestyle while pregnant affects your child’s neurocognitive development – if you’re pregnant, stop using it as an excuse to eat like shit. You’re only hurting your baby.
  • The health of the father matters as well
    • Rhonda recalls a study – Sperm DNA was collected from both males that were obese and males that were lean. About 300 genes were different, in regards to how they were/were not activated in the sperm DNA of the obese men. A lot of these genes had to do with learning memory, cognition, and metabolism.
  • Children that are not breast fed lack 4 different species of gut bacteria, and have a 3 fold increased risk of developing allergies and autoimmune related diseases
  • There are links to pregnant woman consuming acetaminophen (an active ingredient in Tylenol) and negative consequences for children – one Norwegian study links it to ADHD
  • Eating a pro-inflammatory diet will have an adverse effect on your offspring
    • Two possible side effects – higher rates of Type I diabetes, and lower cognition scores
    • It’s hard to do causal studies showing this (in which you would feed someone high inflammatory foods during pregnancy, as it’s unethical), so all the scientific data is from animal studies, or looking specifically at obese mothers who are thought to have eaten badly during pregnancy
  • In male mice fed a high fat and high sugar diet, in which they became obese, their offspring (who were fed a normal diet) have a higher rate of Type I Diabetes
    • The obesity in the father changes genes that regulate pancreatic beta cell insulin production in their sperm DNA, which is passed on to the offspring
  • Pregnancy Supplements and Foods
    • While pregnant, Rhonda ate Wild Alasakan Salmon Roe from Vital Choice on top of an avocado, with lemon juice and hot sauce
      • In the roe of a fish (aka fish eggs) – 40-70% of the DHA is found in the phospholipid form
      • DHA in the phospholipid form gets into the developing fetal brain 10x better than DHA in non-phospholipid form – for comparison, only about 1% of a fish’s DHA is in the phospholipid form
    • Rhonda took Thorne’s Prenatal Vitamin while pregnant

And To Wrap Up – Put in the Work

  • What advice would Rhonda give to her 15 year old self?
    • “You’re capable of achieving whatever you want. Don’t let your insecurities hold you back.”
  • What advice would Rhonda give someone looking to grow their following?
    • “If you’re doing something of quality, and are passionate about it, and you put in the work, people will notice it”
    • “Put in the work, and things will start to work out”
      • She’s been working on Found My Fitness for a decade now
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