Monthly Archives: September 2018

September 24, 2018

Smart fat with Dr Jonny Bowden

Dr. Jonny Bowden is the author of Smart Fat: Eat More Fat. Lose More Weight. Get Healthy Now. He is a board certified nutritionist. He’s known as the nutrition myth buster. He’s a bestselling author of 13 different books.

I get a book a week doing this podcast. Every time I do an interview, I’m reading their book. But this is one of the few books – Smart Fat, we’re going to talk about today – that I actually purchased on my own just to read. I don’t do that very often because I do get a lot of guests on and I do a lot of reading. So for me to actually go out and purchase a book, you know it’s got to be good. So, This is going to be a great conversation.

Allan (1:21): Dr. Bowden, welcome to 40+ Fitness.

Dr. Bowden (1:25): Thanks. It’s great to be here. Thank you.

Allan (1:27): Today we’re going to talk about your book, Smart Fat, and I’ll tell you, I don’t do this very often because I have a lot of reading to do, reading the books for the podcast. But your book was one of the few books that I actually went out and bought myself, well before I had you on the show. So I was really excited when Krista reached out to me and said, “Let’s get on the show.” And I’m like, “Yes, I definitely want this man on my show.”

Smart Fat was kind of my precursor to really understanding what was going on in my body. I had started eating Paleo as a way of managing my weight, and what ended up happening was I ended up in ketosis. And I was trying to figure out, “I’m in Ketosis, but my doctor is yelling at me about saturated fat and cholesterol in my food. I’m doing this for the right reasons, I think.” And then reading your book set me on a really good, smart course for making sure that I was getting smart fats in my diet. It really made me happy that I had that knowledge coming away from your book.

Dr. Bowden (2:28): Thank you. I’m glad that book accomplished something for some people. It wasn’t one of our bestsellers, but it really warms my heart when someone says, “I got something out of your book that made a difference in my life”, because that really is the reason we write.

Allan (2:41): I think that’s the point – initially you start out and you’re saying, “They are telling you to eat healthy fats, and exactly what does that mean?” And it’s all over the place. We’re going to talk about fats in a minute, the way you break them down, but one of the reasons that a lot of people will come to a personal trainer or they’ll see a book like yours and say, “I need to understand that” is all the conflicting information about metabolic syndrome.

They know that they’re insulin resistant, they know that they’re prediabetic, their doctor is telling them to eat a certain way and they’re reading all this stuff and it just gets confusing. Can you talk about metabolic syndrome? I was really shocked at some of the numbers. I think you said 50% of individuals over the age of 65 suffer from metabolic syndrome.

Dr. Bowden (3:26): Yeah, and it’s even worse than that. One third of everybody suffers from that, and most of them don’t know it. And that’s across adult age groups. Metabolic syndrome used to be called in the ‘80s and ‘90s… It was discovered by a guy at Stanford named Gerald Reaven, and he called it “Syndrome X”. They didn’t even have a name for it. They knew that there were a cluster of symptoms that tended to hang out together, and when you had three or four or five of these symptoms, you were known to have metabolic syndrome.

Your listeners will probably recognize this more than they do metabolic syndrome – it’s also known as prediabetes. So when your doctor says you have prediabetes, they’re talking about metabolic syndrome. And what that is is a cluster of five conditions – low HDL cholesterol, high triglycerides, abdominal obesity, high blood pressure, and some degree of insulin resistance; and we can talk about what that is as well. So your blood sugar is a little elevated, your insulin is elevated, you’ve got a little bit of high blood pressure, you’ve got some fat going on in the abdominal region, and your HDL cholesterol is low. That’s metabolic syndrome. Even if you had four of those five, it’s considered metabolic syndrome.

Why it is dangerous and important and serious – multitude of reasons. The first is, you’re not even going to feel symptoms. High blood pressure doesn’t have a symptom. Diabetes doesn’t have a physical symptom that you feel. In many cases this damage is being done and going on under the hood and you’re not aware of it. So, that’s one reason it’s dangerous, that you live blindly thinking, “I feel fine, nothing wrong.” The second reason it’s dangerous is it almost always progresses to diabetes, and then can progress to heart disease. Diabetics have – I don’t remember the exact number, but it’s a double digit increase in likelihood of getting heart disease. They’re very, very related. In fact, as we talk about all these things – obesity, diabetes, heart disease – we’re going to find time and time again that they all share certain characteristics in common, certain basic causal characteristics. One of them being a disorder of carbohydrate metabolism, which is almost always called insulin resistance, and we’ll certainly get into that.

So, metabolic syndrome needs to be taken seriously. I have said for a decade, I don’t give a you-know-what about somebody’s cholesterol reading, but I do care about their high blood pressure. High blood pressure is a real risk; high triglycerides are a risk in different and interesting ways; low HDL can be a risk; and abdominal fat is a big indicator of insulin resistance. We can talk more about what the definition of insulin resistance is, but for now I’ll just tell you this: If you want to do an insulin resistance test at home for free, it’s real easy. This is how you do it. This is the Jonny Bowden low tech version of an insulin resistance test. Stand in front of a wall, walk towards the wall. If your belly hits the wall before your nose, very likely you’ve got insulin resistance.

Allan (6:42): One of the funny things is when I’m working with a client, they’ll tell me, “I want to lose weight.” And I’m like, “I’d rather not measure weight on the scale. I’d rather we wrap a tape measure around your belly.” In my mind that is a better measurement of health and wellness than what the scale is going to tell you, particularly if we’re trying to also gain some muscle mass and do some other things.

Dr. Bowden (7:07): You’re absolutely right.

Allan (7:10): I know they hate that. They say it’s easier to step on the scale. And I’m like, “Easy doesn’t always win the game. Sometimes we’ve got to go a little bit further.”

Dr. Bowden (7:18): I totally agree with that. I use the scale as well, because it’s an added motivator, it’s very easy, and it’s still a piece of data that you want to know. I know what you’re thinking and what maybe some of the listeners are thinking. It doesn’t reflect body fat and you could be gaining body fat and losing muscle and your weight would be the same. All of that’s true. Nonetheless, someone like me who’s been monitoring my own body functions and weight and whatever else for 30 years – I’m pretty good at figuring out the correlation between weight and if I’m losing muscle or gaining body fat. So I use both. I check the waist measurements of course, but I also do a daily checking on the weight just to see if it’s moving in the right direction or if it’s staying still or what it’s doing.

Allan (8:01): You talked a little bit about insulin resistance, and now most doctors will track that and that point where they’re going to call you “prediabetic” is typically through looking at your A1C, which is a measure of blood sugar over a period of time. That number I believe is still 5.5 as the guideline?

Dr. Bowden (8:19): No, it’s a little higher. I think it’s 6.0 or 5.9, but we’re in the ballpark.

Allan (8:23): Okay. So, for someone that’s actually trying to look after their wellness, what are the health markers? You’ve mentioned a few of them, but what would you say if I was going into the doctor and I was going to get a blood test and talk to my doctor about things? What are the things that I should look for and say, “This is a clear signal that I have to change?”

Dr. Bowden (8:40): I’ll tell you what I would want to be tested, but I’ll also tell you that you may have an argument with your doctor about this, because if the doctor doesn’t know to do these tests and you’re telling them, the likelihood is they’re going to say, “You don’t need that. That’s just Internet stuff.” So if they’re not already giving you these tests, if they don’t already see the value of these tests, they are probably going to take that position that it doesn’t matter and it’s nothing and it’s all just nonsense. I have seen that happen with CRP tests – high sensitive, C-reactive protein, which is a general measure of inflammation that I think everybody should know what their CRP level is. And you’ll get doctors who say you don’t need that, and they’re just plain wrong. They just don’t stay up with the literature, they’re very stuck in their belief system and views. “Cholesterol causes heart disease, fat is bad, stop the saturated fat.” And it’s not going to change. So, it’s not as simple as going into my doctor and saying, “I think I’d like a Fasting Insulin test.” They’re going to say, “What do you need that for? Where did you read that?”

It’s not as simple as that, but let’s take the doctor out of the equation. Let’s assume you have someone who’s trained in functional medicine, which is a certification that MDs, NDs, PhDs and other people in the field will go and get after their graduate work, because it is an orientation to medicine that is not taught in medical school, and that is to look at the whole body as a whole.

  • How do things talk to each other?
  • How do the adrenals talk to the thyroid?
  • How do the neurotransmitters affect the immune system?

So they look at all of it integrated. Most doctors do not do that. They’re all specialists. A thumb specialist looks at the thumb, a heart specialist looks at the heart, and nobody talks to each other. So, if you have one of those doctors, you’re going to have trouble. If you have a functional medicine certified doctor, they’re not going to argue with you about these tests; they probably will have given them to you anyway.

So I would look at the CRP test, I’d look at homocysteine. I would forget and burn forever and ever the stupid HDL, LDL cholesterol test, and I’d get the much more modern and much more informative Particle Test. Another one that your doctor will probably argue with you on, but the Particle Test – and we can get into that later – is the only one that really gives you valuable information about cholesterol that you can use.

I would also look at a marker called Lp(a), which is notoriously difficult to modify with lifestyle. It can be done, but it’s very hard, and that’s one of the reasons that’s not something we bother with, because they think you’re kind of stuck with your Lp(a) levels. But the fact is, Lp(a) is a better predictor of heart disease than anything else; certainly better than cholesterol. It’s a particular kind of lipoprotein; it’s not good to have that elevated.

Other than that, I would do some low tech tests that you can do yourself. And this is for everybody. This is really one of the best secrets in health. If you have a basic blood test, I don’t care how rudimentary it is, it’s going to have triglycerides on it and it’s going to have HDL and LDL. If you take your triglyceride reading and you make a ratio to your HDL reading – that number will predict your heart disease probably better than 90% of the markers out there.

Let me explain how to do it. So let’s say your triglycerides are 160. That’s elevated, that’s high. And let’s say your HDL cholesterol is 40. So the ratio is 160:40, or 4:1. It’s a very high ratio. If, on the other hand, your triglycerides were 100 and your HDL was 50, you’d have 100:50, which is 2:1, which is very good. That’s a little math test that’s very easy. You just divide the smaller number into the bigger number, you get a number, and that’s the ratio. You want that to be as low as possible. When it reaches up into the 4 and 5, it’s high risk. When it’s down into the 2 and 1, you’re in the smooth sailing. And that’s a test everybody can do at home.

Allan (12:56): I’m due for another test here soon, but the last time I had it tested, my triglycerides were 94 and my HDL was 89.

Dr. Bowden (13:06): One out of 300 times somebody will actually have a negative ratio. Not a negative ratio, but under one, like you do.

Allan (13:16): Really close to 1.

Dr. Bowden (13:17): Your triglycerides are so low. It’s a wonderful number – under 100. Fantastic. And your HDL is off the charts high. 89, holy moly, I’ve never…

Allan (13:27): Now, my LDL is really high; it’s typically running around 250.

Dr. Bowden (13:33): So your total is in the 3s.

Allan (13:35): Yes. So my doctor loses his mind and he’s like, “You’ve got to quit eating egg yolks and…”

Dr. Bowden (13:42): This is the point where I would change doctors, and let me tell you why. It’s a legitimate point of view. I have integrative doctors who I love and respect, who do still worry about very high LDL. That’s a legitimate point of view. Here’s where your doctor hasn’t read a research article in 10 years. Dietary cholesterol, such as the cholesterol in eggs, has zero effect on blood cholesterol. Everybody knows this. The USDA and their advisory committee actually put out the comment, “Cholesterol is no longer a nutrient of concern”, meaning dietary cholesterol does not matter. Let’s get that really clear to the audience, in case you’re confused. The cholesterol you eat in your diet – eggs, shrimp, all of it, means zero to your blood cholesterol. So, the fact that he said that… I don’t hate him based on the fact that he’s concerned about LDL – I think it’s a wrong position, but it’s a legitimate position.

Allan (14:44): I’m going to step in and defend him just a little bit. We really diverge and we have that conversation on a regular basis. I get your point, but he’s really, really good at understanding the homocysteine and CRP.

Dr. Bowden (15:04): I understand and I don’t mean to knock on your doctor, but let me explain something. This is not a controversial area, this is not something where there are multiple opinions. Dietary cholesterol doesn’t affect… Let me make this a very clear statement so that the people who said, “But what about this? What about this?” I can handle it. There is a condition that’s called “familial hypercholesterolemia” and it runs in families. It’s a genetic anomaly and it causes you to have extremely high cholesterol no matter what you do. You look at an egg, you get cholesterol. For people who have that – that’s maybe less than 1% of the population – let’s put them in a separate category. They need special medical attention; I don’t want to give them advice. But for the other 99% of people, cholesterol in the diet doesn’t matter, and the fact that your doctor thinks it does puzzles me and makes me think that he has not read an article in the last 10 years.

Allan (15:58): And like I said, we have some really good discussions, and I actually did an experiment.

Dr. Bowden (16:02): How about pointing that out to him?

Allan (16:03): I have. I did pescatarian for an entire four months with no eggs whatsoever. My HDL plummeted, my triglycerides went up, and my LDL moved a smidge, like from 250 to 230. I would have to drop this number down nearly 100 points to get anywhere close to what the numbers would be. Actually when you look at my ratios, like you said, my triglycerides to HDL, I was worse health-wise than I was before. So I went back to a different way of eating. That’s where I think a big part of what’s lost in this research – I’m hopeful that books like yours are going to get more people talking about this – is that people will sit there and tell you they know there are different types of carbs, they know there’s the trash carbs that come in a box. They’re going to tell you they know those are processed carbs. And then of course if you’re getting plant materials they’re going to say obviously that’s a better quality of carb. People will do that with me and they’ll be like, “This is not a grass-fed cow.” So people are starting to have those conversations. They’re having the same conversations about the different fats and which ones are good, particularly when they found out that one that was manufactured for us is actually killing us. I want more conversations about the quality of our food. When you start talking about fat with the smart fat, the neutral fat and the dumb fat, to me it’s like, we need that conversation all the way across the food spectrum. Could you take a little bit of time to talk about smart fat, neutral fat and dumb fat?

Dr. Bowden (17:37): I’d love to, and thank you for bringing that up because it is a very central notion. And it’s a notion that I actually came to after probably 20 years, and I’ve noticed that some of the people I most admire have come to the same conclusion, which is, we have spent decades worrying about the percentage of protein versus the percentage of carbs in the diet, versus the percentage of fat in the diet. We worry about all these things and in fact, the position I’ve come to and many other people are coming to is that the quality of your food probably matters more than whether it’s the right percentage of protein and fat and carbs, or whether it’s Paleo or whether it’s South Beach. The quality of food matters probably the most. I always say that if people would just eat from what I call the “Jonny Bowden four food groups”, which is food you could hunt, fish, gather or pluck, then many of our health problems would disappear. I don’t care if you’re on Paleo or vegan or raw foods or high carb. If it was all these foods that you could hunt, fish, gather or pluck, you’re probably going to be alright. That’s the general way that I look at it in terms of quality of the food. It is probably the most important variable in the diet, the quality of the food that you eat.

Allan (18:53): I agree. I even said that in my book that I’m currently working on. I said it’s sad that we have to use the term “whole food” at all. It’s sad that term actually exists.

Dr. Bowden (19:04): Let me give a shoutout for a friend of mine’s new book, which I have no financial interest in, but she sent it to me and it’s excellent. It’s called Formerly Known As Food. If you want to really read what’s happening to the food supply and the stuff you’re eating that you think is healthy, check that book out, Formally Known As Food. It’s pretty scary. But you’re 100% right, Allan, it is the quality. I know you want to talk at some point about the quality of meat, which is a subject near and dear to my heart, but let’s talk about the quality of fats, since that’s what Smart Fat, the book is about, and that’s what you brought up.

So, the problem with the notion of eating healthy fats is that not everybody agrees on what’s a healthy fat. I guarantee you your doctor has probably been dragged into the 21st century enough to know that there is such a thing as “healthy fat”, but he has no idea what it is. And I’m willing to make a bet on that one. When you talk to these conservatives about healthy fat, they grudgingly admit the fat in salmon is good. They have no concept that there could be a saturated fat that’s good for you – that’s completely off their radar. So, it’s not enough to just say, “Let’s eat healthy fats.” We’ve got to get into the weeds and define what that is, and that’s what we try to do in the book.

There are plenty of saturated fats that are fantastically healthy for you. Whether a fat is healthy or not has zero to do with whether it’s animal or vegetable. I want to make that very, very clear. That is not the marker for good and bad fat. In my opinion, the marker for good and bad fat has one and only one characteristic. Is it a toxic fat or is it not a toxic fat? Here’s what I mean by “toxic fats” – fats that have been heated and damaged, like the foods that have been fried in restaurant fat that is used over and over again for seven days. Cooled and heated, cooled and needed. It’s a carcinogen factory, so that’s bad fat. Trans fats – really bad fat. They contribute to heart disease, they contribute to stroke, they have no particular value. Very bad fat.

Vegetable oils, one of the things we have been hammered to eat more of, are highly pro-inflammatory and probably one of the main reasons that everyone is experiencing inflammation in unprecedented amounts. We eat 16 times more of that stuff than we do Omega-3s, which are anti-inflammatory. So, all of the soybean oils, canola oils, safflower oils, cottonseed oil – all of these things that we’ve been told are healthy and good for us are literally creating tons of inflammation. As you know, and probably your listeners know, inflammation promotes or causes or contributes to just about every degenerative disease we know of. So, the notion of bad fats and good fats being classified parallel to whether they come from animals or vegetables is just antiquated and it’s wrong.

Here are some examples of very, very healthy saturated fats. Coconut oil – loaded with antimicrobials, loaded with lauric acid, which is great for the immune system, loaded with medium chain triglycerides, which help produce ketones in the brain that are used for energy. Coconut oil is a fabulous fat. One that people don’t know about as much, which is equally, if not better, is Malaysian palm oil. And let me tell you why. First of all, it’s red. Why is it red? Because it’s got tons of carotenoids, which is the same thing as Beta-carotene. It’s carotenoid, there are 600 of them, they’re red so they come in red foods like peppers and watermelon. Well, it’s got tons of that. It has something called tocotrienols, which are a fraction of vitamin E. There are four of the vitamin E components, and those tocotrienols in Malaysian palm oil have been found to protect the brain after a stroke. And why do I say Malaysian?

I’ve just got to give a shoutout to the environment, because I do care about animal rights. A lot of places that make palm oil actually deforest, and the orangutan’s habitat is harmed. In Malaysia it doesn’t happen. Fifty percent of the country’s rainforest is protected forever, compared to, say, 3% of ours. It takes 10 times more land to produce canola oil or soybean oil than it does to produce Malaysian palm oil, and the trees grow for 30 years. So this is a country that really protects its rainforest, cares about the environment, cares about the health and wellbeing of the animals that live there. And that’s why I really give a shoutout to Malaysia. Palm oil in general is a healthy oil, but let’s get it from companies that are being responsible and sustainable. So that’s another wonderful path.

The other thing about saturated fats in general is they stand up to heat. What people don’t understand is you can’t buy your extra virgin olive oil and then come home and fry stuff in it. It’s insane. The reason we spend so much extra money for extra virgin olive oil is it’s never been touched by chemicals or high heat. That’s what extra virgin means. If you can imagine the old wineries, where they would have these big barrels of grapes and the old big men would stamp. They would use the pressure of their feet to stamp them and turn them into liquid. But it’s like that – there’s no chemical processing, there’s no high heat. So you come home, you put that oil in the frying pan – you’re now destroying the very polyphenols that you just paid all that money for. You have to understand standing up to heat is a very important characteristic for food, especially if you cook. Saturated fat stands up to heat; you can cook it at higher temperatures without harming it. So there are a lot of wonderful fats in the saturated fat community and there are a lot of really harming fats in the vegetable fat community, such as, for example, canola oil. We’ve got to get past this notion that good and bad fat divides along the lines of animal versus vegetable, because that just isn’t true.

Allan (25:16): That’s one of the things I really appreciate you had in the book, was a table that talks about the smoke point of these various oils, which tells you when you’re going to sit down to cook, which oil would be the most appropriate. So sometimes it can be avocado oil, or the palm oil, or coconut oil, and then you can use olive oil to drizzle, as a dressing, those types of things. I think that’s a really good guideline to help someone understand how to use oils properly. And if the oil can sit on your shelf for years and not change, probably not the best thing to put in your food.

Dr. Bowden (25:49): I couldn’t agree more. My co-author on Smart Fat, Dr. Steven Masley, took a year off of medical school to study at the Four Seasons. So he’s actually quite an accomplished chef and it was his contribution in there to put in these smoke points, because the oil changes quality, literally becomes a bad fat if you cook it at the wrong temperature. It literally creates damaging compounds. So, this is a very important consideration also when it comes to saturated fats – they stand up to heat, they don’t damage.

Allan (26:19): His recipes are excellent, by the way. I did the lemon butter sauce for the salmon, but my wife doesn’t like salmon, so we put it over asparagus last night. Awesome.

Dr. Bowden (26:29): Nice. I’ve done a lot of books that have recipes in them. We usually hire a cook or a chef or a recipe developer, and then we comment on it and all that. But we’re not cooks, we’re not chefs. Steve did his own recipes for that book.

Allan (26:43): Very, very good. You have to tell him that. Now, another area where I think people can get a little confused – it confused me a little bit in the early days – was, if we’re trying to cut back on our sugars, because sugar is a problem, then we’re going to look for foods with a lower glycemic index. Then there’s this term, “glycemic load”.

Dr. Bowden (27:05): I can clear that up for you in a second.

Allan (27:06): Okay, cool. Please do.

Dr. Bowden (27:09): Glycemic index is a measure that tells you how high your blood sugar goes for a given amount of carbohydrate, which is 50 grams. Here’s the problem. If I go to the supermarket and I see a spice, like imported saffron, and it’s $300 a pound – it tells me what it is for a pound, but if I’m making a recipe that needs a pinch of saffron, I’m not going to pay $300; I’m going to pay whatever that pinch is. Very different pieces of information. So with the glycemic index, it’s great that we know how much your blood sugar goes up and how long it stays up based on 50 grams of carbohydrate, but we don’t always eat 50 grams of carbohydrate. For example, we have pasta, even a relatively small portion of pasta, a reasonable portion – what they put on the Ronzoni box, which nobody eats; everybody eats the whole thing. But even if you ate a small portion, you’re at 200 grams of carbohydrate. On the other hand, if you eat a big bunch of carrots, only about 3 grams of that big bunch of carrots are actually usable carbs; the rest is fiber.

What the glycemic load does is it tells you what you’re going to pay at the register. Not how much it is per pound, but what you’re going to pay for the amount that you use. So glycemic load is glycemic index plus taking into account the portion size. That’s critical because again, if I’m going to eat pasta, I’m going to eat four times what the glycemic index shows me, but if I look at the glycemic load, that’s going to take into account that portion and it’s going to give me an idea of how high my blood sugar is going to go up with that amount of food. That’s why I think the glycemic load is far more accurate and far more predictive than the glycemic index, which is kind of a theoretical number. If you ate 50 grams, that’s what it would do. But what you’re actually going to eat – this is what it’s going to do, and that’s glycemic load.

Allan (29:16): I think that’s valuable, because we started the conversation talking about metabolic syndrome. If you are constantly spiking up your blood sugar, maybe you don’t think you are because this has a relatively moderate glycemic index, but the volume that you’re eating is much more than the 50 grams. I shudder to think, when I was training as a bodybuilder in my 20s, I would sit there and get a can of tuna and I would put it on this big, big heaping thing of pasta – pretty much the whole bag.

Dr. Bowden (29:49): That was the bodybuilder lunch. The guys, the trainers with tuna and white rice, or brown rice, at the time. That’s what everybody thought was the perfect bodybuilder diet.

Allan (30:03): And now looking back at it, if I’d known that information and what it was going to do to my future health, I would not have gone that route. I would’ve found a cleaner protein, cleaner way to do that. It would not have been exactly that way. I like having a better understanding of what food is going to do to our body, and glycemic load is going to do a much better presentation of how our body would respond.

Dr. Bowden (30:25): The only problem, Allan, is It’s a little harder to find. You can find glycemic index numbers all over the place, but not everybody knows about glycemic load, so sometimes glycemic index is all we have. But remember, glycemic index is a measure of how much 50 grams of carbohydrate will raise your blood sugar, eaten by itself. The minute you put olive oil in your cornflakes, the cornflakes no longer have the glycemic index that they had when they’re eaten by themselves. So, foods in combination have very different effects on blood sugar than foods eaten separately. For example, the brown rice might have a very high impact on your blood sugar if you ate it alone, but if you put some oil on it and eat it with tuna, the impact is considerably less.

Allan (31:08): Yes. You’re looking at in the book a much different way of eating, and you call it the 5-5-10. I like this because I’m a victim of this as well. We all like something simple. Simple helps us stay on track – calories in, calories out, step on the scale every morning, keep your fat low and this many grams, or however they want to go about this. But your plan basically says we need smart fats, we need clean proteins, and we need fiber, and here’s how you do it. Can you talk us through the 5-5-10 plan? I think we know now what smart fats look like. Talk about the clean proteins versus the mean proteins, and then fiber and why fiber is so important.

Dr. Bowden (31:57): Can I just point out that when you listed those three things that are essential in the diet, carbohydrate was not among them?

Allan (32:03): It’s not essential, yeah.

Dr. Bowden (32:04): Not essential. I always like to point that out to people.

Allan (32:07): Although I would say fiber technically classifies as a carb. It’s coming from carbs, but in a general sense, you’re right. Our bodies need the fiber to feel full and satiated, so that way where we’re not overeating and our body’s functioning the way it needs to, we’re giving her gut flora everything it needs. I agree – we don’t have an essential, but I think you still need to eat some plant matter. That’s why it’s 10 versus 5.

Dr. Bowden (32:36): I couldn’t agree more, but I think it’s important to remember because we’re constantly assaulted by that God awful American Dietetic Association, which changed its name to try to get away from its ridiculous roots. But they are still the American Dietetic Association as far as I’m concerned. They’re still apologists to the mainstream, they’ve never had an original thought, and they’re the ones that will keep going on and saying, “You’re going to lose essential nutrients if you don’t eat your cabs.” That is completely untrue. There is no physiological need for carbohydrates in the diet, in the human body, and that’s been shown time and time again. Now, that does not mean you shouldn’t eat them. As you said, we need the fiber, the polyphenols, the nutrients, the flavonoids, the vitamins, the minerals, all the things that are found in an apple. We need them; we want them. But what it does point out is that we’ve been given crazy dietary advice. We’ve been told to eat 60% of our calories from the one macronutrient we don’t even need. No wonder we’ve got an epidemic of diabesity. I wanted to point that out about the carbs.

Let’s go to the three essential things in the human diet – fat, protein and fiber. So the notion of five smart fats, I think we’re pretty clear on. We want to get things like Malaysian palm oil and coconut oil. By the way, the fat from grass-fed beef is wonderful. Nothing wrong with it. We’re going to get into the difference between grass-fed and not grass-fed in a minute, but there are lots of really healthy fats. I think we have some idea for sure, we talked about them. Five of those a day; 10 servings of fiber a day. That’s the 5-5-10. Ten is the fiber, which, as you point out, is essential for a number of things. One is to feel full, sure, but two is to moderate your blood sugar because when you add fiber to sugar, it has a very different effect on your blood sugar than when you just drink the sugar. Apple juice by itself has one particular effect on blood sugar, but if you were to add some kind of butter to it… I’m not suggesting this; doesn’t sound like it tastes good, but just theoretically if you were to add a thing of butter to your apple juice, it would have a different impact because the fat would slow it down, just like the fiber would. So, we need 5 things of fat, we need 10 of fiber, and we need 5 of what we call “clean protein”. And I would love to explain the difference between clean and mean protein, or what we call “clean and mean”.

Allan (35:03): Please do.

Dr. Bowden (35:05): So, when you buy meat, 95% of it – I don’t know what the figure is; it’s high 90s – comes from places that are known as CAFOs – confined animal feedlot operations, also known as factory farms. When I was a kid, we used to go to farms, different places for vacation as a child, and I know what real farms look like. Cows are grazing on their natural diet of grass. They walk around contentedly chewing their cuds or whatever it is that they chew there. And they’re getting a diet full of some insects and some worms, which contain Omega-3s, and they’re not given hormones or steroids or antibiotics. That’s what a cow’s life is supposed to be like. If you’re going to eat it, that would be the happy cow to eat. In a factory farm, the animals are caged in tiny containers, stressed out of their minds. They’re fed wheat, grain and corn, which does two things. One, it fattens them up and two, it makes him sick as hell, because they’re ruminants, they have four stomachs, they do not do well with grains. They need grass – that’s their natural diet. The grains and the corns and the wheats and all of that just makes them sick and requires more antibiotics. These cows are then shot full of steroids to make them bigger, hormones to make them grow and to make them have more fat, and antibiotics to just generally keep them from getting even sicker under these horrible conditions that they live under, and also because antibiotics fatten them. So the cows that you eat that come from factory farm operations are absolutely toxic waste dose. The fat contains all of the pesticides, fungicides and all the other stuff on the wheat that they shouldn’t be eating in the first place. You’re getting a nice helping of antibiotics, steroids and hormones, and you get none of the good Omega-3 fats, and lots of the inflammatory Omega-6 fats. That’s factory farmed meat. If that were the only protein available to me, I’d become a vegan, and I’m very far from the temperament of the vegan.

Let’s look at the other kind of meat – grass-fed, 100% grass-fed, pastured meat. These are cows or pigs that live in their natural habitat. They run around, they’re not confined, they eat the grass, the insects or whatever it is they run around and eat there in their natural ways. They’re not fed antibiotics or steroids or hormones. They’re not treated cruelly. Those animals are health foods. And yes, I understand the conflict people have about animals. We are huge animal rights people here. We love animals. Our animals sleep in our bed. We love them. We feel about them the way we do about our children. I understand the horrible conflict a lot of people have about eating these things that we love so much. The problem is that human physiology does better with some animal products in our diet. We just do. When I argue with vegans about this, I want to tear my hair out of my head because they just make up their own facts. The fact is you cannot get DHA and EPA, or you can get a tiny bit of it from some algae, but you can’t get significant amounts of DHA and EPA in the human diet unless you’re eating fish. Unlike the vegan propaganda, if you eat plant-based Omega-3s, they do not convert to the kind that your body needs. They convert at such a tiny rate than it doesn’t really even matter. I don’t believe we can have a healthy diet that contains all of the nutrients that we need from a vegan diet, so we’ve got this kind of conflict, especially if we’re animal lovers. Everyone I guess has to find their own level that they can live with themselves on. Ours is, we don’t eat anything that wasn’t 100% grass-fed and raised. There’s enough there for us to be able to eat meat from time to time. It’s not like we can never eat it. That’s our particular line, and everybody has to find their own. The fact is – I’ve never seen any evidence to the contrary of this – the human body does better with some animal food products in it. Sorry, vegans.

Allan (39:13): But at the same time you even acknowledged in the book a little bit, I think Dr. Masley is on the other side. Not on the other side entirely, but at least there’s a conversation there to say all of your protein doesn’t have to come from animals either. You can get those from beans, there’s some really good pea and rice protein powders, whey protein. Again, if the animals are ethically raised, I think that’s also a good opportunity.

Dr. Bowden (39:40): Yeah, I agree with all of that, except for the fact that when you really look at the ratings on protein… And there are five different kinds; they keep improving them. So it’s gone from biological availability to PDA. There are all kinds of different ways of evaluating protein, but if you look at the evaluations, particularly the current ones – pea protein, rice – they suck. You’re way down in the 60s and 70s, as opposed to beef, which is like 92. So it’s important to know that yes, there are other sources of protein, but sorry, vegans, pea protein is not the same as beef protein. It just isn’t. It doesn’t have the same amino acid profile. Soy protein has a whole bunch of different things. And I’m not saying you can’t get protein other than meat. There’s fish, there’s a million different sources – whey protein, powder. Sure, some of the vegan protein powders or the vegetarian protein powders could be used from time to time, but let’s keep in mind, let’s not kid ourselves that pea protein is in any way as valuable, as rich in amino acids, with the same profile, or as usable as, for example, whey protein which does come from cows and which can come from grass-fed cows, by the way.

Allan (40:53): Yes. And one of the other things you mention in the book that I thought was really valuable, and it plays into some of the recipes that are in there, is that some foods actually do double duty, so it might not mean that you’re having as much food as this might sound like – 5, 5 and 10 servings.

Dr. Bowden (41:12): Sure, exactly.

Allan (41:15): So we might have eggs. If they’re well cared for animals, we’re going to get a good, healthy, saturated fat from the egg and we’re going to get the protein from the egg, along with a good dose of choline, which is hard to get from many other sources. I think you also mention in the book avocados are good source of fat and fiber.

Dr. Bowden (41:35): Avocado – we put that on the cover of the book. The avocado is such a star. I eat them as many meals… You can’t get enough avocado. They are great.

Allan (41:47): It also helps with the recipes and the meal plans that are in there for the first 10 days and the final 20 days. And then of course day 31 and beyond, now that they’ve learned this pattern. It becomes very, very simple for you to just blend through and say, “Here are my meals during the day.” You break it into typically three meals and a snack in the afternoon. Just makes it really easy for someone to go through and say, “Here’s my standard days of eating, and I know I’m getting good nutrition because I’m focused more on quality.” But we’re still keeping it pretty simple with the 5-5-10.

Dr. Bowden (42:17): Yeah, and let me just put a foot note to the 5-5-10. At this point in my career, 28 years into it, I’m not really that much of a fan these days of formulas, including the ones I’ve written, like 5-5-10. Here’s why. I think eventually people have to be their own GPS when it comes to food. These are guidelines. I don’t want people sitting there obsessively with a notebook. No, that’s not the point. It’s kind of like the Fitbits with the steppers. We have that kind of general goal that 10,000 steps a day would be great. I don’t know too many people who go crazy like, “It’s only 8,000. Let me go walk a couple of thousand.” We don’t want obsessiveness to replace good sense when it comes to nutrition. So, 5-5-10 is like an aspirational goal. Let’s strive for that. That’s ideal, like 10,000 steps. But please, people, don’t go nuts trying to fit into a formula. These are guidelines meant to help you find your particular pathway that works.

Allan (43:15): I have to raise my hand and admit walking around my hotel room when I was just 300 steps short.

Dr. Bowden (43:21): I would do the same.

Allan (43:24): The number was there and I was 300 steps away. I just started walking around.

Dr. Bowden (43:28): Of course. But you get my point, right?

Allan (43:31): Yes. I do, absolutely. Dr. Bowden, thank you so much for being a part of 40+ Fitness. If someone wanted to get in touch with you to learn more about your books, including Smart Fat, where would you like for me to send them?

Dr. Bowden (43:43): JonnyBowden.com. And starting in September there will be a brand new website with free stuff and all kinds of stuff. You’re welcome to visit me there and sign up for my newsletter, and when the new site comes out in September, you’ll be very happy.

Allan (43:58): Cool. This is episode 338, so you can go to 40PlusFitnessPodcast.com/338 and I’ll make sure to have a link to Dr. Bowden’s site there. I can’t thank you enough, Dr. Bowden, for being a part of this podcast.

Dr. Bowden (44:13): It’s a pleasure, Allan. I loved it. Thank you so much. I hope you have me on again, it was a lot of fun. Went very fast.

Allan (44:23): I hope you enjoyed that conversation with Dr. Bowden as much as I did. I’m actually going to have him on again in a couple of more weeks. I’m really interested in getting into another book that he’s written. Very interesting topics, really interesting guy. If you enjoyed this episode though, please do leave us a rating and review. You can do that through the app that you’re listening to this podcast on, or you can go to 40PlusFitnessPodcast.com/Review and leave a rating and review, subscribe to the podcast there. It really is important for these reviews to be out there. It helps people find the podcast and it does show people what you think of the podcast, which is just social proof that gets them listening. So, go to 40PlusFitnessPodcast.com/Review, or leave a review on the app you’re listening to right now.

I do have a couple of extra bonuses to talk to you about in October. I am going to release some extra episodes in October and probably November. I want to give two a week. I’m not sure if I can keep up with that pace, but it is a goal of mine to start adding a few extra episodes in as we get into October, November, because that’s an important time of the year for us to start focusing on our health. A lot of us will tend to overeat as we get into this last quarter of the year, so I want to have a little bit more out there for you to keep you a little bit more engaged, a little bit more accountable. So I’m going to be trying to release some extra episodes during the month of October. You’ll need to subscribe to make sure that you’re getting all of the episodes. If you just log in on Monday to look for this stuff, you might find that there’s extra episodes out there that you’ve got to catch up on. So, I encourage you to go ahead and subscribe so those things come straight to your app. You can go to 40PlusFitnessPodcast.com/Review, and that will lead you to the iTunes page. Again, you can leave a review and you can subscribe there. Or just subscribe on the app that you’re listening to right now.

Also, I want to announce October 1st, we’re going launch the Sugar Challenge again. I know some of you have already done this challenge. If you have, you know that it’s a really cool thing. It’s a 28-day challenge, it’s going to launch on October 1st. I’m going to be cutting off signups for that on the 30th of September, so you’re going to want to go out to sign up for it. It’s at 40PlusFitnessPodcast.com/Sugar. So go to 40PlusFitnessPodcast.com/Sugar, and that will help you sign up for the Sugar Challenge that we’re going to have in October.

And then finally, again, I do need you on the launch team, so if you would please go to WellnessRoadmapBook.com. I’m updating the website pretty much every week, so there’s new stuff out there, new changes as I build that out to support the launch of the book. And then of course when you’re there, please do join the launch team. Those are the folks that are in the know, those are the folks that are going to get some bonus material, bonus content that nobody else is going to get. It’s related to the book, but it really is a cool process and I want to have you on this team. So, go to WellnessRoadmapBook.com and join The Wellness Roadmap book launch team. Thank you.



Another episode you may enjoy

The worst part of a western diet | Gary Taubes

Managing ketogenic diet mistakes with Eric Stein

Our guest today has authored many books, including the one we’re going to talk about today, Ketogenic Catastrophe. He found a passion helping others after he cured his own IBS, gum disease and insomnia using the Paleo Diet and ketogenic eating. Really cool guy; I know you’re going to enjoy this interview.

Allan (1:08): Eric, welcome to 40+ Fitness.

Eric (1:12): Thanks for having me on. Great to be here.

Allan (1:14): The title, Ketogenic Catastrophe, I really could take that one of two different ways. One is disaster pants kind of style. What you were going after was, what are some of the mistakes that we make when we’re trying to get into ketosis and why do most people fail doing this? Then the other would be, are people having bad experiences with keto? The truth of the matter is keto is not for everybody, but it is a tremendous tool for weight loss, and what I’ve found, for dietary freedom.

I got into ketosis on accident. For those that aren’t fully familiar with what ketosis is, it’s basically where your body starts learning how to burn fat rather than sugar for energy. And because you’re eating predominantly a higher fat diet and not many carbs, your body just gets more comfortable with that and using ketones as a fueling system. I stumbled on it because I was doing Paleo. My version of Paleo was eating more of the healthy fats, so I was eating a lot of avocado, fish and beef. As a result of filling up on the fat, wasn’t eating a lot of anything else. Most of the vegetables I was eating were wholefood, fibrous vegetables like asparagus, broccoli and spinach. So I wasn’t getting a lot of carbs. And then I noticed that my breath was a little sour, more so than not. And I noticed that my body was burning a lot of body fat all of a sudden. I had plateaued – in Paleo dropped about 15 pounds, and then keto took off about, I’d say 45 pounds in just a few weeks. So I fell into it. I figured out what it was. I’m like, “What’s going on with my body? Why am I suddenly losing all of this fat and why am I smelling this way?” Then I got into it and I was like, “Okay, that’s what that is and that’s why that’s happening.”

It’s become more of a seasonal lifestyle for me now, because I’ve lost most of the weight that I wanted to ever lose. I got my body where I wanted to for what I wanted, and then I’m good. But in the book you’re actually talking about the mistakes that keep people from doing this, and I think that’s really important. I was reading a study, and it was a Harvard doctor that had done this study, and they found that the high fat, low carb diet helped people lose more weight than the people who ate the low fat, high carb diet. But in the end his conclusion was, it’s so hard to eat this high fat diet that we’re just going to keep prescribing the low fat diet. My hands hit my head and I’m like, “Oh my gosh.” But it’s not simple; there are some mistakes people make. And that’s what your book is getting into is, what are those mistakes that most people make that would keep them from being successful with this? And what are the tips and tricks and things that we can do to get past them?

Eric (4:12): Yeah, that’s basically what I’ve covered. I had a lot of stumbling when I first started with this whole keto diet thing. This was basically my attempt to share with whoever wants to read it, all of the mistakes that I went through. I think it was Warren Buffett who said, “You can learn from your own mistakes, but you don’t have to. You can learn from other people’s mistakes.” So, my goal with this whole thing was to just share everything that I personally went through in hopes that it will help others become more enlightened about the whole keto thing and just get through it, because it can be difficult. Like you said, it’s not the easiest thing to start. But what people should definitely take from this whole thing is that after you do it for a while, after you get comfortable with it, it becomes much easier too. You can do it seasonally, like you do as well, where you don’t have to do it all the time. So this was my attempt to really help people feel better in the long run.

Allan (5:14): I think that’s the thing. I don’t have any kind of resistance, insulin resistance, any metabolic problems. So for me, keto is just a way to have clarity, to feel better, to have freedom from food, because I can go a day without eating and I don’t panic because my blood sugar’s going to crash or something. So, keto is very comfortable for me, but I don’t do it all year round because there are periods of time when I want to drink beer and go tailgating and enjoy my life and the things that I’m going to do. I’m going to go to Thanksgiving with my mother, I’m going to go do New Year’s Eve with my wife. So, since I know I’m going to have that period of time, I just plan around it and say, “That’s my time to go off keto. I’m not going to feel as good. I’m going to have as much fun as I can and I’m going to make good selections.” So, I do drink the higher quality beers. But beyond all that, when it’s time to go back into my season of famine, so to speak, I get into it. I think a lot folks think it’s a lifestyle, yes. Once you get into it, then you have to stay in it, and that’s not entirely true for everybody. That’s why I think this book is particularly poignant because if you go in and out of ketosis on a regular basis, you’re going to deal with these things. The first one is what you call the “biggest mistake”, and I agree with you. Do you mind talking about what you think the biggest mistake is that most people will make when they’re trying to get into ketosis?

Eric (6:38): Sure. The biggest mistake by far – it’s very simple – it’s just giving up. If you can imagine training for a marathon, let’s say. You do all this prep work, and you get up to the race day, you’re feeling great. You start the marathon, you get through the first mile, 7th mile, 12th mile. You’re getting through it and all of a sudden you get to mile 25, right before the finish line, and you just give up. That’s what a lot of people do, is they get so close to the finish line, building this metabolic flexibility, this ability to burn fat instead of sugar, and right before they get there they just say, “You know what? I’m done.” To put it back to the marathon runner – it’s not like the marathon runner couldn’t finish. No, he just decided, “Well, I’m just not going to finish the race today.” So many people run into that because it’s difficult to get going in the beginning. It’s difficult because your body needs to produce the enzymes and all the wiring that’s required to burn fat for fuel. There’s an adjustment period, but once you get good at it, it becomes much, much easier, and over the long run obviously works out a lot better.

The biggest mistake that people make is they just can’t sack up and get through the first little part. And to give most people more credit here – a lot of keto diet books and a lot of keto diet advice is not the greatest advice out there. They tell people, “Cut your carbs down to 20 grams of carbs, even if you’re eating buckets of sugar each day, and then just do keto.” And you’re going to run into huge problems if you just make an abrupt switch like that. So, to give credit to everybody that’s tried and failed before – maybe you got some bad advice too. But absolutely the biggest mistake is just not pushing through and getting to the other side, because once you get to the other side, then it becomes much easier, even if you have those cheat days, like you say, go have a couple of beers. Once you get back on the train, it’s not nearly as hard to get going again, if that makes sense.

Allan (8:53): It does. I think the difference and the way I look at it is, when you’re talking about the marathon – the runner knows that there’s only 1.2 miles left to go in this race. They’re at mile 25 and there’s only a 1.2 to complete the race. Unfortunately with ketosis you don’t have that mile marker to tell you that it’s that close. I think that’s where that “quit” comes in. I remember I was in the army and I was going through air assault school. And at the end of air assault school you do this 25-mile run. And you’re carrying your M16 and you’re in boots and you do this 25-mile run. Each of the units has people in there, so my unit was there and they were cheering us all on. I was a front runner. I knew there was one guy in front of me, I just didn’t know how far he was in front of me. So I asked one of the guys, “How far is he ahead of me? Just tell me.” And they said, “Oh, he’s too far. You’re never going to catch him.” And I come around the corner and realize that I’ve got maybe half a mile to go and he’s only a hundred yards ahead of me. But by that time I had shut my mind down to the possibility that I could do this, and therefore I ended up coming in second.

I only say that because it’s probably closer than you think it is. Once you get into this and you’re starting to really have that struggle, look for the things that are going to motivate you to keep going. You talk in the book about measurement, and I do think that’s important. The urine strips are really good when you first get started, because they’re going to allow you to see the ketones are starting to build up in there. And they’re color coded so you can see it happening. Since your body doesn’t know how to use the ketones effectively, you’re peeing them out. Eventually the urine sticks won’t be any good for you because your body’s using those ketones and now you’re going to have to be looking to your blood and your breath to understand if you’re in ketosis. But for the most part you are, and you can feel it and you know it. I agree with you – as people are going, just push to the next step. Just take that next step. Keep at it just a little bit longer and you’ll get there. It’s a dip, and once you get past that dip, you’re going to enjoy what you’ve done.

Eric (11:04): Sure. And you can always test and tweak things all along the way too. You don’t have to stick yourself into a rigid structure. Now, if something’s not working for you, you can always pivot and try something new – maybe increase your exercise a little or decrease your exercise a little if you’re working too hard. You can always play with the different approaches and find out what works for you. But keep pushing forward, absolutely.

Allan (11:31): I think that’s another important thing. You’ve got this as mistake number 8 in the book, and it’s bio individuality. You talked about how the basic advice is 20 grams of carbs, and then they kind of stop there. I know from experience working with clients that if you get down to 20 and you stay at 20, you will get into ketosis, but there are some people that can go as high as maybe even 100 grams of carbs, because they’re athletic and they’re doing things. And there are other people that can get to 50. You’re going to have a carb threshold in there and it’s going to be individual to you. You’re going to have nutritional needs that are based on your environment and everything else. Can you talk a little bit about bio individuality and how you’ve seen it work for or against people who are trying to get into ketosis?

Eric (12:23): Sure. That phrase actually was originally coined by the Institute for Integrative Nutrition. They’re the folks that came up with that. Basically at a high level, it just means we’re all different. Some people can eat a vegan diet, and they feel great and it seems to work really well for them. Some people, like myself, feel awful. I’ve tried to do the vegan thing and it doesn’t work for me at all. I had no energy. It just was not something that really worked for me. And we’ve always got to think about where we came from. What has our family’s bloodline been eating for the past 10 generations? That’s going to play a role in how we metabolize things, what we’re used to eating, what our genetics are used to. So, everybody is so different, and this is especially true for the carbohydrate threshold. I’ve talked to people who could not get into ketosis until they got down to that 20 grams of carbohydrate. Now me personally, I was more along the lines of, I could get back into ketosis after eating 80 to 100 grams of carbs for dinner one night, and then the next day around lunchtime be back into a ketogenic state. All the books that I was reading about this, they said, “That’s impossible. It’s going to take you days. You have to do this, you have to do that.” And really, it’s just about finding where you fit, where you feel best and what works for you. And the mistake that people make is having this mindset that everybody’s the same. It’s like this cookie cutter thing, and it’s definitely not true.

Actually there’s a great story. One of my roommates from many years ago, he and I lived together, and this is right around the time when I was trying to clean up my diet and try to lose the weight that I had been gaining. And living with him, I watched him every day just eat fast food. And it was constant drinking sodas, drinking beers all the time and doing whatever he wanted, and he stayed lean. I had no idea. Here I was, even trying to eat healthier at the time, but I was still gaining and gaining and gaining, and I just watched him not gaining a pound. It was very frustrating and really killed a lot of my motivation because it’s like, “Why me? Why can’t I be like him?” At the end of the day, bio individuality means that none of us are going to be the same. Individual results may vary. That phrase is so perfect for many different things in life, but especially people who are trying the ketogenetic diet. You’ve got to really look at yourself and what you’re going through, because everybody’s going to be different. Somebody might lose 30 pounds in a month doing the keto diet and you may sit there and lose a pound and a half. But it could be just because your body is working on fixing other things first, or whatever reason genetically that you’re going to be slower to lose the weight. We have a lot of similarities, but at the base level we have a lot of differences as well.

Allan (15:48): Part of it is genetics, part of it is your hormone mix. I know a lot of people are coming at this metabolically damaged. I was reading another book that actually said the Baby Boomers, which I’m just short of – I’m an X Gen – but 50% of Baby Boomers have some form of metabolic syndrome. I’m just trying to wrap my mind around that.

Eric (16:12): That’s a big number.

Allan (16:13): It’s a huge number. So, we’re approaching this because we want to get healthy. Like you said, your roommate may have had no problem whatsoever. You might run into him today and it may have caught up with him.

Eric (16:29): It did.

Allan (16:32): Okay. It’s not a happy story, but it’s a story. I think the core of this is, there’s that individual that smoked cigarettes from the time they were 14 years old and they’re 104 and they still smoke. And then there’s the individual who got lung cancer in their 40s after smoking only 20 years. So we’re all going to have our own individual path. I think the good thing about knowing that is if you can stop comparing yourself to others and just recognize that what you’re doing is positive for yourself, you’re going to have a lot better mindset going into this whole thing.

Eric (17:08): Yeah, you nailed it right there. The comparison to others is a very difficult thing. It’s something I struggled with tremendously when I first started out on this journey. You definitely want to be sure to remember that what you’re doing is for yourself, and you’re going to be different than everybody else. There are probably people that are going to react the same, but just keep in mind what you’re doing it for.

Allan (17:36): Another big area where mindset comes to play is what you call mistake number 5, “The Social Trap”. I know when I first started this and realized I was eating this way and wanted to keep eating this way, my wife thought I was out of my mind. She was like, “There’s no way.” She’d seen me try other things, and when she saw me try this she said, “I understood the Paleo thing. I do not understand this. I can’t do that.” But she has since turned around. I took her to Ketofest and she met some people and she listened to a few talks. She now knows about keto and for the most part will eat keto most of the time. But that’s not always the case; some people are going to look at you like you’re insane. How do I deal with that going into this? Like you said in the book, I go to order my burger and I say, “Just wrap mine in lettuce. I don’t want the bread.” And you see that look in their eyes.

Eric (18:37): The looks come to you. It can depend on the group of people you’re with as well. Me personally, I had some ruthless friends. We would kind of joke with each other and make fun of each other, but then it can be difficult when you continue to do this thing, you pass up on the beer. I remember sitting at a table at a restaurant and doing the lettuce-wrapped burger and just getting that, “What are you doing? Why are you doing that?” What that elicits in a lot of people, and I know this because it happened to me, is almost a fear to do it. The next time you hang out with everybody, you want to just be like everybody else. You don’t want to be out of the crowd. As humans, we want to be a part of the group. It feels safe. We want to be like everybody else.

So, to have that situation where you’re walking into a wedding or something or you’re going out with your friends and maybe you go to an Italian restaurant and the bread bowl comes around somewhere, and you’re put in that precarious situation where you have to make your decision now. The bread’s coming to you, and you have to make the choice and the people are looking at you. The mistake that people make is falling victim to that social pressure, because it’s, again, going back to being worried about what other people are thinking of you. It’s a very real mistake that most books that are written about the keto diet just kind of glaze over. But it’s such an important piece of this, because we are social creatures, we thrive on being social. I personally love being social. But it was a difficult transition to get over that fear of what other people are thinking of you. It can be one of the most difficult things. It can be actually the one thing that will stop you.

Maybe you have a group of friends, there’s like six of you and everybody’s overweight, let’s just say. All of a sudden you guys are going out to dinner and you start passing on the bread bowl. People are going to look at you funny and they might not even want you to do that, because it’s like, “Hey, where do you think you’re going? We’re all in this together”, that kind of thing. The social aspect of it is such a huge piece. I recommend that people, before they go somewhere like dinner or a party, and you know the temptation is going to be there but you’re not ready to start doing the cheat days yet – visualize it. Walk yourself through the scenario. Imagine yourself passing as the bread bowl comes to you. And then you’re going to have a lot higher chance of success, because you’ve already got the mental rep. You’ve already done it once in your head: “No, thank you”, so it’s going to be easier when game time comes around. The social aspect of it is such a huge piece, especially if you’re an extrovert, you like to go out, you have a lot of friends. People can be judgy. It’s very powerful to know going into this why you’re doing it, the reasons you’re doing it for yourself, and to understand that it’s okay for other people to have opinions. It’s okay for other people to think what you’re doing is crazy. Some people even say it’s dangerous, if you can believe that. So just remember why you’re doing it, and when the time comes and you have that social pressure, to be prepared for it is going to make you more successful.

Allan (22:18): You just hit on something I want to emphasize here – this is your “why”, this is why you’re doing this, and you need to keep that top of mind as you go into this. Yes, the bread bowl comes around and you just pass the bread without taking a piece and someone comments on it. Fairly simple – you can say, “I just got my A1C in and it’s high. I’m prediabetic, and I need to change how I eat.” And when they recognize this is not about you being thinner and more attractive than them, this is actually something you’re doing for your health, it does change the conversation. You can tell them, “I can’t have the simple carbs anymore. I can’t have the beer anymore, because my A1C is too high and I need to get it down. I don’t want to use medication to do that.”

Eric (23:07): Just to touch on one thing that came to my mind – a lot of people, once they’ve done keto and lost weight, want to continue to do it. You can still run into situations where you’re not prediabetic, you don’t need to lose any weight. It becomes easier to say, “I just feel better. I feel better not doing this. I feel better passing on the bread bowl.” Down the road when you don’t have those things to lean on, like, “I need to weight” or “I’m not feeling well. I’m sick for some reason”… There are other aspects of the social trap that can come up, but like you said, keep in the front of your mind why you’re doing it.

Allan (23:56): I call that the “crabs in the bucket”. If you’ve ever seen crabs, none of the crabs can get out of the bucket because the other crabs are pulling the crab down to get on top of it. So the crabs can’t get out of the bucket. Just realize that’s what’s going on. If people keep harassing you about what your choices are, you know what’s working for you. You know why you’re doing this. At that point just stop participating in the food conversation with them, because they’re not looking out for your best interests. I know that’s easier to say than to do, but you have to have this mindset, as I said, going into this to say, “This is what I’m doing and why I’m doing it.”

Now, the other thing that I wanted to get into – you mentioned this earlier and this was one you called mistake number 17. So much advice out there tells people, particularly during the adaptation period, to not exercise. And I don’t entirely agree with this. We talk about bio individuality. I think some people can continue to do their workouts. I know I did and didn’t have a problem in the world. Maybe I’m unique, and that’s great. But I believe people can still get the benefits of exercise during that period of time. They don’t have to forgo it. Your thoughts?

Eric (25:08): I think it probably goes back to that bio individuality thing. I was reading Mark Sisson’s book, The Keto Reset Diet, and I was listening to one of his podcasts. He was talking about how he recommends people not exercise during the adaptation period, because for some it can be difficult. If you’ve been consuming a lot of sugar and you’re metabolically damaged, the process of adaptation can be difficult. He recommends that you just rest through it, which there’s validity there. I think everybody needs to take a look and see how they’re feeling. I personally think it’s a huge mistake to not exercise while you’re doing the keto thing, because having personally gone through it, exercise is so much more enjoyable when you’re doing keto. I have more strength and more energy than I know what to do with when I’m in that keto state. That being said, if you’re just looking at this for, “I just need to lose some weight”, you don’t have to exercise. But I think it’s a huge mistake to not add on this component of it to get your blood flowing. Even if it’s the most basic exercise, like power walking or going up and down some stairs, doing some body weight stuff, push-ups, sit-ups, cleaning your house vigorously. We think of exercise as it has to be in a gym, but there are so many different ways to get your heart pumping, get your body moving. It’s just going to only compound the results that you get.

So, you can do the keto thing and not exercise, but again, I think it’s a big mistake to not do that. And when you realize it too, when you actually get into that keto state – you’re burning ketones for energy – you’ll have this incredible outpouring of motivation too. You will want to go exercise, and you’ll have more energy. I know it sounds funny. People think that if they exercise, they’re going to be tired and have less energy, and it’s actually the opposite. You exercise and you will have more energy – kind of that, “You don’t use it, you lose it” thing. Along with that I’ve noticed that the more you exercise, the greater the mental clarity that you’ll get as well. I’m not sure exactly the mechanics behind why, but I’ve noticed that I’ve become much more mentally clear. It’s almost like you’ve been wearing a pair of prescription glasses your whole life that weren’t even supposed to be yours, like they were the wrong prescription. You suddenly take them off and the world just looks clear. Or you get in your car in the morning and the window’s fogged up, and you turn the defroster on. That’s what happens as you keep going through this. And exercise I think is just a tool to accelerate these benefits and really compound them for everybody.

Allan (28:20): I agree with you. I don’t think there’s a reason to forgo exercise, unless you’re metabolically damaged and you know that this could be a problem for you. Then take it easy and don’t stress yourself. But the reality of life is our muscles and our liver hold roughly about 90 minutes to two hours of moderate intensity work. So when folks are running marathons, they bonk it at mile 18 because that’s about the time that the glycogen that’s in their muscles and their liver starts to run out. You have that in your muscles and your liver all the time. That glycogen’s there all the time to fire off for energy. So, doing moderate intensity work, lifting weights, doing bodyweight work, walking, maybe even some jogging – that’s going to use that glycogen. Now, you are still taking in some carbs. We’re not complete carnivores, zero carb here. You are taking in some carbs and your body has the capacity to take some of the protein you eat and some of the fat and actually turn it into glycogen that you can then use to restore what you need for your muscles and your liver. Your body’s going to still do that. I just think what you force your body to do if you do keep your activity at a good steady pace is you actually force the adaptation a little bit faster. That’s my opinion. Again, I don’t have any scientific proof that that’s the case, but I do know when I have clients cut their sugar back and I have them walk in a fasted state, they lose weight faster. That’s happening in their bodies because it’s forcing them to use more of the glucose that they are eating. It’s forcing them to use the glycogen in their muscles, they’ve got to restore that, so that process just starts working for them.

On the mental clarity note, I don’t know if you’ve read the book Spark, but this was an excellent book that talked about exercise and cognitive health. They found that just having the kids do a PE class in the morning before school helps their grades immensely. Their test scores went up, they had more clarity in class, they were more focused in class. So, there is an exercise–neurological connection that you’re going to get clarity from exercising and yes, you’re going to get mental clarity from powering your brain on ketones. So I think there can be a multiplicative effect there if you’re doing both.

Eric (30:47): Yeah, absolutely. That makes perfect sense. That’s very interesting to hear about the kids. I’m just seeing my path and how my mental state has changed over the years now. I think that would be brilliant to make sure that kids did PE before school and didn’t get rice crispy cereal before school.

Allan (31:14): That’d be a lot better.

Eric (31:17): I look back on my upbringing. That’s what I had.

Allan (31:21): It was the standard American diet, what our government was telling us to eat. That goes to this whole thing, that ketogenic diet is not new. It’s been around for a long time, but it’s just starting to get to a point where people are recognizing they can get great health benefits from it, they can get weight loss from it. And the people that are on it become evangelists for it. It’s a growing trend as a way of eating. It’s not that it’s better than being a vegan or a vegetarian or anything else; it’s just a way of eating. It can benefit you, but it’s not for everybody, as I said earlier. I think if you’re wanting to lose some weight or you’re concerned about your metabolic numbers – your A1C is high, you’re prediabetic – there have been some great results using this. And again, most people that get onto it just feel great.

Eric (32:14): Absolutely.

Allan (32:16): The book is called Ketogenic Catastrophe. Eric, if someone wanted to get in touch with you, learn more about the book, learn what you’re doing, because you and your wife are doing a lot of great stuff over there – where would you like for me to send them?

Eric (32:29): My wife and I run a blog called AncestralJunkie.com, and that’s where we’ll be posting some articles. We’ve been a bit inactive lately. We have our son now and things have been a bit hectic, but we’re back on AncestralJunkie.com. And then you can find my other books – I’ve written a few others – on Amazon. If you search for Ketogenic Catastrophe, my name will pop up and there’s a couple of other things. If you go to the blog, you can get a free meal plan, a free grocery guide and some other goodies for just visiting. And we have a nice little newsletter that goes out. Today’s Friday, so Friday we send out a weekly newsletter where we’ll give you our top five articles and neat products that helped us or quotes that were motivating us, that kind of stuff. So you can get us at AncestralJunkie.com or on Amazon, is where my other books are located.

Allan (33:27): Okay. This is going to be episode 337, so you can go to 40PlusFitnessPodcast.com/337 and I’ll be sure to have links to all of those available there. So again, Eric, thank you so much for being a part of 40+ Fitness.

Eric (33:43): Thank you, Allan. I really appreciate you having me on, and thank you so much for what you’re doing for the health community and just the world at large here. You’re really making a difference, so thank you for that.

Allan (33:52) Thank you.

Thank you for being a part of the 40+ Fitness podcast. I’m really glad you’re here. I hope you enjoyed the conversation we had with Eric. Anyone that’s trying to use the ketogenic lifestyle as a way of eating often finds that they make mistakes, and Eric’s put together a really good book to talk you through how to manage those mistakes. So do check that out – Ketogenic Catastrophe. I have a link to that in the show notes, if you’re interested. And if you enjoyed today’s show, I really would appreciate if you would go to the “Review” section on your app, or go to 40PlusFitnessPodcast.com/Review, which will take you to the iTunes page. Leave a review for the podcast. I really read each and every one of these reviews. The ratings and reviews help us get noticed out there. So really, really important – please do take the time to give us a review; takes you a few minutes, and it can mean the world to someone finding the podcast and finding health. So, 40PlusFitnessPodcast.com/Review. Thank you for that.

A little bit on a personal note, I’ve kind of indicated over the course of the last few episodes that my wife and I are traveling around looking for potential retirement / downscaled life. It looks like we’re going to settle on Panama. That’s not set in stone at this point and it might not be a permanent move, but we are looking to potentially within the next six months sell our house and move out of the country, which will be a very different lifestyle. It’s a change that I’m doing because it will reduce risk from stress and will keep me kind of a in a lower keel, slow things down. I’m really looking forward to something like that. In looking at my health and fitness, that’s the one area where I can get the most bang for the buck. That’s my big rock. If you get into The Wellness Roadmap book once I get that issued, you’re going to learn a lot about how to identify those big rocks. For me, stress is the next big rock that I need to deal with.

I wanted to mention that I am setting up a mini Ketofest. I know I talked about going to Ketofest in July and doing a talk there. I’m going to do that talk again here at my home in Pensacola Beach, and that’s going to be on October 5th. Right now we’re looking at probably having it between 4:00 and 8:00 PM on October 5th. There will be food provided, there’s a small charge to cover off some of the costs of that food. Carl Franklin from 2 Keto Dudes is coming down here and he’ll also be giving a talk, and you’ll be able to meet him here at the mini Ketofest in Pensacola Beach. So do check that out – you can go to 40PlusFitnessPodcast.com/Ketofest. There you’ll find a link to the Eventbrite page. We can only handle a certain number of people. I do have a nice size house, but we still are going to have to limit the number of people that come so everybody can enjoy the food and the talks. So, you do want to go ahead and make sure you get yourself on that list. Go to 40PlusFitnessPodcast.com/Ketofest.

Now on the book, I’m not going to spend a lot of time on it, but it’s gone very, very well so far. I’m getting some blurbs back from folks which basically are just reviews. They’ve seen the book and they felt compelled to help me market the book by writing some really cool, really nice things. And I’m humbled by that. It’s really coming together. The next week I should get the proofs back from the editor and at that point I’ll be able to sit down and batten down and spend some quality time on the book to get that final finish in there. But we’re getting really close to having everything locked down and ready to go, so I’m pretty excited about that. If you want to be a little bit more in the know, get a little bit more detail on how the book is going, you can go to WellnessRoadmapBook.com. You can join the list and become a part of our launch team. That launch team is my go-to group, they’re the folks that I’m going to share the most information about the book. I’ll tell you a little bit about it on the podcast, occasionally I’ll mention it in the groups, but really if you want to be in the know about the book, when it’s coming live, discounts, bonuses, all kinds of stuff that I’m going to be putting out there – you need to join the launch team. So go to WellnessRoadmapBook.com and join the launch team today. Thank you.

Another episode you may enjoy

Keto Cure with Dr. Adam Nally


September 10, 2018

Your brain knows more than you think with Dr. Neils Birbaumer

Allan (0:49): Our guest today is the author of Your Brain Knows More Than You Think. He works with some of the most amazing people in the world from the perspective of understanding the brain and how it’s all wired together. Very interesting conversation. He has done a lot to help a lot of people, albeit some of his methods have been a little bit controversial and maybe a little bit extreme. But a very, very interesting conversation. I know you’re going to enjoy learning a lot about how your brain works today. With no further ado, here’s Niels Birbaumer.

Allan (1:20): Dr. Birbaumer, thank you so much for being a part of 40+ Fitness. How are you?

Dr. Birbaumer (1:27): Perfect.

Allan (1:29): Your book, Your Brain Knows More Than You Think, was not the book I thought I was going to read when I started reading it. Neuroplasticity is a topic that I’m very fascinated by, because as we get older we kind of feel like maybe we should decline a little bit, maybe we should let our brains go a little bit. But we also know if we work our brains, it’s like a muscle and it should get stronger.

Dr. Birbaumer (2:01): True. But even if it gets weaker with age, it gets strong in other areas.

Allan (2:07): Yes, and that’s what I really took from your book, that our brain is actually a very, very interesting organ in what it can do to change us. What I took from the book was, we’re not fixed. I think we all like to think we’re fixed, but we’re not fixed.

Dr. Birbaumer (2:28): Exactly.

Allan (2:29): We can change.

Dr. Birbaumer (2:30): Right, at any time in any direction.

Allan (2:35): And that’s what was fascinating about the book, was the stories and the things that you put together to say that. I think it came down to this concept of what you call “desired effect”. It’s the first time I’ve really ever heard someone put it that way, to say we all want something. Our brain, our bodies, our minds, our being wants something, and as long as we’re getting that, we will keep doing the things that help us get that. And if we’re not getting that, then we have to change. So, could you get into the concept of what “desired effect” means to our brain and why that drives our behavior so strongly?

Dr. Birbaumer (3:24): There is a circuit in the brain which is extremely sensitive to reward – any type of reward. Could be internal, thought reward, image reward, but mostly it’s external reward. That circuit drives us forward, and it reactivates all the time. It constantly asks, “Is this wish fulfilled? Where should I go? Is there a chance that I get this?” It’s what we call the wanting, the will system. That system usually is extremely active during the whole life, but I described in the book several conditions, like complete paralysis, diverse illnesses, meditation, diet, experiences, where that circuit is stopped or degenerates, or is eliminated, or the muscles are completely paralyzed so the brain learns that it cannot will anything because nothing of its wishes would be fulfilled. And even then, if all your possibilities which you imagined during your life are completely blocked forever, the brain adapts, and at the end of that adaptation process, these people – I’m talking about completely paralyzed people as an example, but there are many others – these people have a high quality of life, meaning that even if the central brain circuit of wishful thinking, which drives us forward, is degenerating or blocked, or the external world does not allow the fulfillment of our desires – even then the brain adapts and you can have a high quality of life in such a situation. That’s one of the topics.

Allan (5:20): The locked-in syndrome was something I had never heard of before, so it was really fascinating to think about a situation where this individual has zero control over anything around them, and now their brain is adapting to try to find a way, any way, to affect change in their lives. And most of us, we have so much capacity for change in our lives; we just choose not to.

Dr. Birbaumer (5:54): Right, because we are driven by the environment, usually.

Allan (5:58): We’re driven by the environment, and again, that’s this whole concept of neuroplasticity and saying, “What are the things we want?” Because when we say “desired effect”, I think everyone would want to eat healthy, to exercise, to do the things we know we should be doing for our health. But our brain has different answers for us than what we might want. So it’s desired effect, but the brain has its own kind of desire.

Dr. Birbaumer (6:30): The desires and most of the plastic changes the brain does are not conscious. That’s why you say, “It’s the brain that does different things than I want.” But the brain is you; you are your brain. So the brain is you, but the brain has the body which is hanging on to this brain, and most of these processes of wishful thinking and fulfillment and everything you do in your life – 90% of these processes are not conscious. That’s why you think it’s not you, because the brain then decides… Assuming you get paralyzed for some reason or another. You’re paralyzed, and then the brain doesn’t need your conscious. You think, “This is a catastrophe in my life. It’s terrible. It’s the end of my life.” But meanwhile, the brain adapts to the loss of this full circuit and develops a new strategy to quiet down different areas of the brain. And at the end you will experience the end result of that plastic process. But don’t think that you are different from your brain. You are your brain, but your brain often does things which you don’t know of, and it does it very often on a long-term basis, and you will not know of that adaptation process until the end, when it becomes conscious. That could last a few days, and few seconds, but it could also last several years. My patients at the beginning say, “Oh well, I will kill myself. I cannot live in such a condition.” And after a year of this adaptation process, they say, “Now I’m really happy. I’m completely paralyzed, I’m on artificial respiration and feeding. I can do nothing, but I feel very good.” And that is an end result of such an adaptation process.

Allan (8:34): I think it’s really hard for us to accept that we can change that much.

Dr. Birbaumer (8:38): Yes, it is difficult. But on the other hand, it’s the only thing that should give us hope to get out of misery.

Allan (8:47): Yes. Now, you took that conversation in the book and you went into changing personality. This was an area where I thought you were going to lose me, because like everybody else, and as you mentioned in the book, I think my personality was pretty much set. I was not raised by my father, so when I met my father I was actually very, very surprised by how much I was like him. You get into the book about twins that had been separated at birth, and I’m looking at it from a different father / son and some of the aspects of my personality that are very similar to his. Can you talk about how our brains create personality and what that actually means with regards to neuroplasticity?

Dr. Birbaumer (9:41): First of all, all the circuits in the brain that create what we call “personality” are circuits which in principle are plastic; of course they’re created by the genetic upbringing. So when you are similar to your father, that’s not surprising. There was an excellent study in the U.S. in the ‘60s or ‘70s, where monozygotic and dizygotic twins who were raised apart for more than 20 years were brought together in Saint Paul, Minnesota, and they all stuck together. It was the last time that this happened in history, because now this type of twins cannot be separated anymore. In that study the main result was of course if the environment in which people live, and these separated twins, like you from your father – if the environment was roughly similar, they developed similar. If the environment was completely different, they developed differently. The main genetic factor, which was similar in both, even if they were separated, was a thing which is a personality factor, but we usually don’t ascribe to personality. It was political opinion. So, the genetic root of what we call “political opinion” is much, much higher than all the other similarities you have. That means the similarities with your father are mainly similarities of course in appearance, but what you call your personality, you are probably completely different from your father, except that your political opinion probably is the same.

But you know that political opinions and political ideas can be easily learned and re-learned, and the brain under different environmental circumstances can completely change these opinions. So, here we have the most plastic attitude which we think in life, which is political opinion, has the strongest genetic basis. At the same time it’s a personality characteristic, which can be very easily changed. And from that knowledge, I argue that the brain circuits that run these genetically determined personality traits can be easily changed by certainly strongly environmental change. If your father lived in the U.S. and you were raised in the U.S., even separated from your father, the chance that you become different is very low.

Allan (12:21): That’s the whole point – actually my brothers and sisters on the other side were raised different but still in the same country, so still with some of the same aspects, so very much politically aligned with the way we think. Like I said, it was very interesting to understand how my personality can be shaped by my environment, but that’s actually a good thing, because that means that I can by changing my environment, change my personality.

Dr. Birbaumer (12:55): Of course, completely.

Allan (12:57): So if I happen to be an overeater or someone who’s dealing with a problem, make some changes to my environment. You’ve done some interesting experiments, I’ll just put that out there. You’ve been out there on an edge with the studies that you’ve been doing, so you’ve made some friends and you’ve made some enemies, I think, is what I’ve come to understand from the book. You’ve used this thing called “shock compliance experiments”, and they don’t sound pleasant, but they get really good results. Could you talk about the change of environment or the change of desired effect to effectively almost change personality?

Dr. Birbaumer (13:40): I have some examples from my clinical work here in the book, which show how plastic the brain is. But the methods to change these circuits in the brain, if they are fixed over a long learning process, are extreme, and some of them are not allowed anymore. I’ll give the example which I also gave in the book, I think, but I don’t remember. You have a person who is washing themselves all day long because they’re afraid of getting an infectious disease. So these people clean themselves all the time, so they have an attitude and fear of getting contaminated by bacteria or viruses, and they had this fear all their life. What are we doing with these people? For example, we put them in Hyde Park – at that time I lived in London – we put them in Hyde Park, we picked up the sh*t of dogs, they had to put the sh*t of the dogs in their face and on their body, and they were not allowed to wash themselves for a week. And in order to avoid that they wash themselves in between, we changed them to the therapist, so even at night, they could not leave the therapist. We just blocked them from washing themselves. After a week of that treatment, they never, ever had a tendency to wash themselves immediately, and they never, ever developed a fear of contamination of bacteria.

This type of treatment, which was at that time called the “Trojan treatment” is so extreme that it changed the personality of these people for a lifetime, which is now not allowed anymore. If I would do that these days in the U.S. or in Europe, I will end up in prison as an academic for quite some time. But this is the only way to treat these things. Now what are they doing? They implant electrodes in the brain and they can train a brain area which is responsible for this type of personality. Because there are multiple brain areas, you would have to insert many, many, many electrodes in many brain areas to stimulate those brain areas and to treat the disease, which is life threatening. Of course I’m in favor of changing the brain by these types of stimulation, but this is much more dangerous than putting sh*t on the face of these people for a week and end up with the same result. You see the absurdity of the argument.

Allan (16:26): I do. But again, it was interesting to understand what you were doing was effectively putting them into the worst of their fears. You were putting them in the worst of their place and saying, “If things were the worst, what’s the outcome?” And the brain actually adapts and realizes and says, “I survived, so it’s not as bad as I thought.”

Dr. Birbaumer (16:55): It is important that this is not torture. Torture is if somebody has such an experience under forced circumstances, but in these situations there are no forced circumstances. In this case, the brain knows, “There’s no force here. I agreed to do this, I do it. But if I’m in there, then I’m forced and they’ll continue forever to treat me.” And they may not get well, because if I would’ve let these people wash themselves in between, they would have a tremendous relapse and would be a terrible result. Yes, they got the point.

Allan (17:42): Now, the cool part of this though is, from that we now move on to these therapies that are actually some of the things we’re dealing with today. My grandmother had a stroke, and it slightly bothered I think it was the left side of her body, which made it difficult for her to do certain things. Now, she wasn’t as bad off as other people, because some people will go through stroke and lose complete access to half of their body. Now, you’ve used some of your learnings, predominantly through the electric capacity of our brain, to re-teach us how to move our body when otherwise there is no way for us to make that connection. Can you talk about BMI as a strategy for dealing with stroke?

Dr. Birbaumer (18:36): I’m not claiming that I have a miracle cure for chronic stroke. I just follow the data, and the data of our studies and the replicated show that the best way in people who have a very severe chronic… Go back to your grandmother – if your grandmother’s hand is completely paralyzed on the left side, so far there was no way to get this hand functional, in the sense that she could grab a glass, that she could drink, she could walk on a stair without getting a lot of help, and so forth. Now, with BMI this can be done. That doesn’t mean that these people at the end are completely healthy. They still have some problems, but they’re much less. So, the only thing we do here which is different from all the previous treatments, is that we ask the brain to get immediate feedback off the success of the paralyzed finger, arm or whatever is paralyzed. So, the patient normally, in real life, wants to move the hand. So the brain says, “Move the hand.” And the hand is not moving, because the connection between the command, which is in the brain, and the hand is interrupted by the bleeding of the stroke. So the only thing we do, we just reconnect the brain with the hand.

So we build a prosthetic device. We put a prosthetic device on the hand and we put an electrode on the brain or in the brain – it doesn’t matter where you put it – where the command is created. So the patient thinks, “I want to move my hand”, and in that moment the patient thinks, there’s electric activity in the brain. That electric activity will then transfer to the prosthetic device or directly to the hand, and the hand is moving. So the interruption is between the command in the brain and the hand. We then have transferred the command across the lesion, across the interruption, and that gives the brain the experience, “A-ha!” The brain learns that way, “If I have a command, it’s followed by a consequence.” And by that the circuit between the command in the brain and the periphery which executes the command, is reactivated and restores itself. We have to do this thousands and thousands and thousands of times with the electrodes on your head or in your head, and after a while, other brain areas take over. They take the command from the top of the head and they bring the command back to the periphery. So it’s a very simple trick, which in that case of course technology does that. You have to have the electric brain signal of the command and the technology then, which is wireless, brings the electric activity of the brain back to the hand. That’s the whole trick.

Allan (21:52): I think that’s just fascinating, and it really speaks to the capacity of our brains to deal with problems. If we give them the opportunity, you see the solution.

Dr. Birbaumer (22:06): For some of these things you need technology. This was clear to many doctors for many years that it has to be that way, but they didn’t have the technology to grab the command in the brain and then transfer the command to an external device. The new brain amplifiers and brain technology, we can easily do this fairly cheap with wireless devices. So, it’s a technological advancements. The principles are known since people lived; it’s nothing new.

Allan (22:37): Yeah. Now, stroke is a big one because it is a killer and it is something that really puts a lot of people down. But more and more we’re facing Alzheimer’s. We’re living a little longer, which is one reason that people are saying we’re dealing with Alzheimer’s more, but I think there’s also some dietary issues and some other things that are going on that are causing it. If not an epidemic, it’s still much more prevalent today than it ever was. You’ve actually used similar technology to help Alzheimer’s patients deal with some of the memory loss and some of the issues they’re dealing with.

Dr. Birbaumer (23:14): I’m not saying that we can treat Alzheimer’s. There is no treatment available for the causes of the disease. The only thing we claim, and we showed it in some experiments, that even in the advanced cases, when patients don’t know their own name, they don’t know the name of their family members, and they seem to be completely distant from everything – even then, if we get the activity of the emotional areas deep down in the brain, we see that they recognize in an unconscious manner, but emotionally – they recognize, for example, the difference between a positive emotion to a family member and a foreigner. Then we take out this information, we put an electrode in those brain areas or we calculate mathematically the activity of the brain areas, and then we know when the patient recognizes something and remembers emotionally something. You cannot remember it consciously because the conscious memory is destroyed by the disease. But he knows that this is something familiar, and then we can discriminate between a positive emotion and a negative emotion. And for the personnel who treats those patients this is very important, because right now they don’t know when the patient is in a positive mood, what does he want, what is necessary, does he have a negative emotion? What should I do in that situation? Is he aggressive? And by detecting the activity in these emotional areas, we can tell the family members and the caretakes what to do in that situation. So that helps. It’s not changing the treatment, but helps in having everybody – patient, and the family, and the environment, and the caretaker – a better quality of life. It’s not helping the disease, but it’s helping the situation.

Allan (25:18): I think that’s really the positive message of this whole thing. You’re touching on some very important aspects of when you get down to those emotional centers, those are going to drive more of who you are than you ever wrapped your mind around before, because when you get to emotion, that supports your desired effect, that supports what you need to go forward.

Dr. Birbaumer (25:45): And what you want.

Allan (25:47): So, the more emotional you can make the things that you want in your life, the more they matter to you, the more likely you are to accomplish those things.

Dr. Birbaumer (25:58): Yes. The circuits that we’re talking about, these circuits of will, the circuits that drive us forward – all these circuits anatomically are identical with the emotional circuits, and they’re not connected very strongly with the cognitive conscious circuits. Of course they are connected with them, because all these wishes and desires at least come to that circuit. That’s not new; we know this since mankind exists. If you go down in antiquity and you go back for thousands of years, this was always known. The only difference between those times and now is that now we have the chance to make these processes, which are of course deep down in the brain, to make them visible, and we can modify them directly, and we can change them directly. And we see in the development of mankind these very old circuits, which everybody saw unchangeable, like the one you were talking – personality circuits – now we know that these circuits are extremely plastic also, like the rest of the brain. That’s the surprise I want to transfer to the reader of that book.

Allan (27:18): Yes. So the book is called Your Brain Knows More Than You Think: The New Frontiers of Neuroplasticity.

Dr. Birbaumer (27:23): Exactly. That’s what it meant.

Allan (27:27): It’s a wonderful, interesting read. Some of the experiments you have done are very, very interesting. So, it was a very good book, a very interesting read, and it taught me that I have capacity within my brain that I never actually understood. But it comes back to the reality of what I’ve always kind of known – that if I really, really need something, my brain is going to help me get there. So, very, very positive.

Dr. Birbaumer (27:54): Yes, you don’t need it now. If you don’t need it now, it’s okay.

Allan (28:00): But when I need it, it’s going to be there. Thank you.

Dr. Birbaumer (28:07): I appreciate it.

Allan (28:08): If someone wanted to learn more about you, learn more about the book, where would you like for me to send them?

Dr. Birbaumer (28:12): You could put my email in the book, or whatever, in your…

Allan (28:20): I can send them to Amazon to buy the book, I can send them to your website, I can send them to an email. Just let me know.

Dr. Birbaumer (28:27): Sure. You can.

Allan (28:30): Doctor, thank you so much for being a part of the 40+ Fitness podcast.

Dr. Birbaumer (28:34): Thank you very much.

Allan (28:36): I really appreciate having this conversation.

Dr. Birbaumer (28:37): Take care, Allan.

Allan (28:38): You too.

I hope you enjoyed that conversation as much as I did. Very fascinating man, very fascinating career, and I learned a lot from him. I hope you did too. And if you did, if you enjoyed this episode, would you please leave us a rating and review? It means the world to me. You can do that through the app that you’re listening on right now, or you can go to 40PlusFitnessPodcast.com/Review, and that’ll take you directly to iTunes, where you can leave a rating and review for the podcast there. And I’d really appreciate it if you’d subscribe as well, so you don’t miss any episodes. I am looking to launch a couple extra bonus episodes in October, so be on the lookout for those. I don’t want you to miss any of those, so please do subscribe. You can go to 40PlusFitnessPodcast.com/Review to leave a rating review for the podcast, or just through the app that you’re listening on right now. There’s probably a review button pretty close to the top, somewhere around there. Just click that button, leave us a rating and review. It helps other people find the podcast and helps us get this information out to more people. So, I really do appreciate you and I really would appreciate a rating and review.

I spent last week in Belize with my wife. We are actually trying to look for a place where we might do our active retirement. I’ll continue to do the podcast, I’ll continue to do the training and whatnot, but we are looking to downscale our lives, reduce our stress and effectively go into an active retirement, and we’re looking at Latin America as a location for that. So, took a trip down there, really enjoyed it. Got eaten up by mosquitoes, so hoping I’m not going to get malaria or Zika or something like that. But it was a fun trip otherwise, and really enjoyed the time down there and liked the place. So, hopefully we’ll have settled on something soon, but right now we’re just in that looking and searching mode. But that was kind of fun.

And then the book is currently off with the editor. I’m working through some of the marketing side of things with the book and I’ll be working with the layout team fairly soon here. That’s where I am right now, but I would really love to have you as a part of my launch team. With the launch team, there are some bonuses, some things you’ll get as we get closer to the launch. You also get a weekly update from me that will have a lot more information about the book, about what’s going on than what you might be getting on the podcast here, and a lot more timely. So, if you want to be a part of the launch team, and I really would appreciate having you there, go to WellnessRoadmapBook.com. Again, that’s WellnessRoadmapBook.com. On that page you’ll find a sign-up form to join the launch team. You’re not going to get inundated with stuff; this is just a way for me to keep you in touch with what’s going on, have you a part of the launch team so as we start looking at booking events and doing different things related to the book, you’ll be a big part of it. I really do want to have you on the team, so please go to WellnessRoadmapBook.com and be a part of The Wellness Roadmap launch team. Thank you.


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How’s it hanging with Dr Neil Baum

On episode 335 of the 40+ Fitness podcast, we meet Dr. Neil Baum and discuss his book, How’s It Hanging?: Expert Answers to the Questions Men Don’t Always Ask.

Allan (0:49): Our guest today is a professor of Clinical Urology at Tulane Medical School. He has written several books and many long-running columns for American Medical News and Urology Times, and more than 250 peer-reviewed articles on various urologic topics. He is Dr. Neil Baum. Dr. Baum, welcome to 40+ Fitness.

Dr. Baum (1:11): Good morning, Allan. Thank you for the invitation. I look forward to our discussion.

Allan (1:17): Absolutely. Now the book that you have here – I have a copy of it; I really enjoyed it – is called How’s It Hanging?, which is an apropos title. We’re going to talk a lot about men’s health, but I want to be clear because I do this when I talk about women in menopause and I’ve had a few experts on that. We’re talking about men’s health, but for anyone who has a man in their life, this is an episode worth listening to, because you’re going to learn a little bit and it’ll help you have the right conversations with him so he knows what’s going on. I just want to put that out there first because I think a lot of people will hear this is a men’s topic and think they can tune out. And the reality is, our health and the health of the people around us is really, really important, and this book can be a great resource for the men in your lives, if you don’t happen to be a man. Before we get into it, as I got into the book, one of the things that was really good about it was how you very carefully went through. Some of this is really complex medical information, but you’ve taken it down to, “Let’s just have a conversation, guys. Here are what the basics are.” Pretty scientific, pretty difficult, and really kind of dumb it down for the rest of us, for a lack of a better word.

Dr. Baum (2:25): That was very much intended, that I didn’t want to talk in medical language and be high-brow about it, but I wanted to make it something that everyone could understand, and then take that information, digest it and become more knowledgeable when they go and speak to their physician, so the patient, or the man, and the doctor are on the same page. That was what was intended.

Allan (2:55): I think that’s so important because it used to be a situation where the doctor said, “This is what you should do.” I think the medical practice is that people now are being given decisions, opportunities to choose different paths of how we deal with different medical things. Having a basis of understanding where you can go in and have that conversation with your doctor is really, really important because the doctor won’t necessarily tell you, “This is the treatment you’re going to do.” In many cases, they’re going to give you these different treatments with all the pros and cons, and then you personally have to make the decision that’s right for you.

Dr. Baum (3:38): This has been the shift in thinking in the last four decades of health care. In the past, the doctor had all the knowledge and the patient was at the mercy of the doctor to tell him or her what advice or what they needed to do. In 2018 any patient has as much information as the doctor has. Consequently, the patient can be in the driver’s seat and it can be shared decision making. I think that’s a much better way to have a doctor-patient relationship, when they’re a team working together to help the man or the woman achieve optimal health.

Allan (4:27): That’s why this book is so valuable, because this is going to give you the information so that you can be a valuable team member in your own decisions, so you’re not just going at this saying, “Okay, the doctor says this.” This book will actually give you an understanding of why the doctor’s saying what they’re saying, and as things continue to advance, this is a good primer for you to basically be in the driver’s seat as you’re going through making those decisions. I wanted to shift the conversation, because as you go through the book, you talk about various things that men may or can deal with, particularly as we’re getting older. One of those that I think strikes home for a lot of people is the prostate cancer. Can you tell us a little bit about what’s going on with prostate cancer, why it could be a big problem for us, and what we can do to know whether we have a problem or not?

Dr. Baum (5:14): Can I begin by telling the audience what is the prostate gland? Is that okay to start?

Allan (5:19): Sure, absolutely.

Dr. Baum (5:21): The prostate gland is unique to men; we’re the only ones that have it. It’s a small, walnut-size organ. It’s located at the base of the bladder and it surrounds the tube called the urethra that goes through the man’s penis. It is that gland that secretes fluid that nourishes sperm when a man is in his reproductive years. So, when a man is younger, it’s a gland of enjoyment and pleasure. However, as men age, for reasons not entirely known, the prostate gland grows. And when it grows, it compresses that tube, the urethra, making urination difficult. Most of the time when that prostate gland grows and compresses that tube, it’s benign and it can be treated usually with medication. However, for reasons not entirely known, sometimes the gland grows and develops a malignancy in the prostate gland that can spread locally to other organs in the pelvis, and it can spread to distant sites like bones and liver. These are examples of what we call “spreading” or “metastasis”. 250,000 men every year develop prostate cancer. That’s new cases every year. It usually begins around age 50 to 55, and then it gets more common as men age. By the time a man is 80, most men will have prostate cancer. However, in an older man it is usually not a major problem, and most men die with prostate cancer, not from it. However, if it develops in a younger man, 50-55, in his middle age, then it can be very problematic, and then it requires aggressive treatment. We’re not going to talk about treatment today, but I want to point out that about 35,000 men every year die from prostate cancer. Most of those deaths don’t need to occur, because if a man gets a diagnosis early, when the disease is confined to the prostate gland and it’s slow-growing, it can be cured. Have I explained everything so far?

Allan (8:25): Yeah. One of the interesting things that I got out of the book was, this is not something where you’re going to have really any outward symptoms that you have a cancer. Some cancers, you can kind of sense that there’s a problem early on, but this is one that it can get all the way to the point where it’s spreading and you may not even know that you have a problem.

Dr. Baum (8:47): If there’s one thing I want to leave this program with, it’s that comment – that early prostate cancer has NO symptoms. It does not affect the urethra, it does not affect urination. It may have no symptoms, and that’s why men over the age of 50 need to talk to their doctor about getting screened for prostate cancer. That requires an annual blood test called PSA – Prostate-Specific Antigen. That’s a very simple blood test; the result is available in 24-48 hours. And they have to have a digital rectal exam, and that’s where the doctor inserts his finger into the rectum and feels the prostate gland because it sits right on top of the rectum. Now, what’s the doctor looking for? If I can ask you, Allan, and the audience – if you make a fist and you feel the soft part at the base of your thumb, that’s what the prostate gland normally feels like – kind of rubbery, movable, and soft. Move your finger to the top of the knuckle. Have you done that, Allan? I’m kind of watching you.

Allan (10:20): Yes. I’m here, I’m doing it.

Dr. Baum (10:23): Alright. If it feels like the top of the knuckle – that’s a nodule, and that’s suspicious and it needs to be evaluated. Now, there are certain men who are at a higher risk of prostate cancer. Those are African-American men, and any man who has a brother, uncle, cousin, father – a blood relative who has prostate cancer. Those men are at risk for prostate cancer, and they need to start being tested with that blood test and the digital rectal examination around age 40 to 45. If it is a man with no family history, not African-American, he can begin testing at age 50. And then I recommend at age 70 they stop getting tested. If you have prostate cancer at age 70-75, it’s a very slow-growing cancer, it’s not going to cause a significant problem, and it does not require treatment. But every man should have a discussion, have this communication with his doctor and decide should he agree to a screening or testing program, because if you wait until there are symptoms, like you said a few minutes ago – those cases where it produces symptoms, it’s going to be too late. Then it has spread to other organs in the pelvis, to the bladder, blocked the kidney and spread to bones and to the liver. Don’t wait for prostate cancer to develop symptoms before starting to proceed on a screening or treatment program.

Allan (12:34): I think “cancer” is one of those words for a lot of people, I know for myself, it’s just a scary word, because it seems like your body is going haywire and there are things that you can or can’t do about it, but there’s not a good cancer out there. But sometimes we go out and get these screens, and I understand we can get a positive PSA. That doesn’t mean we have cancer. It’s a marker that we then need to do additional diagnosis on, so I don’t want a person to go out and get their PSA tested, have an elevated PSA and freak out, because two things: One, you said it’s very slow-growing, and there are treatment options.

Dr. Baum (13:09): And also the majority of mild elevation of PSA in men is usually, most frequently not due to prostate cancer. It’s due to inflammation of the prostate, infection called “prostatitis” – easily treated with antibiotics, or it is due to that growth of the prostate gland that most men have after the age of 50. So it is really the trend of the PSA. The normal range is 0 to 4. If you have a PSA that is 3, that’s not alarming. The next year the prostate gland grows a little bit; it’s a little larger and the PSA is 3.5 – really not that alarming. Then if all of a sudden, four or five years later, the PSA is 6 or 7 – that becomes an issue. It’s the trend in the PSA. That’s why it’s good to get a baseline PSA. There are men I see who have a PSA less than 1.0. I don’t want to bog us down in numbers in this program, but they have a normal examination of a PSA less than 1. They can come back every two to three years for a test, if the PSA is that low. But if the PSA is in the 3 to 4 range, they probably ought to come back annually.

Allan (14:43): Okay. Now, another cancer that I think scares a lot of men, because now we’re getting close to home, is testicular cancer. Can you go through the same exercise we just did with prostate cancer, talk about what this is, how we would potentially know that we have it?

Dr. Baum (15:00): The testicle is the organ that is located in the scrotum; there’s one on each side. Most men have two testicles, and the testicles have two functions. One – production of sperm, which is necessary to fertilize an egg and start the reproductive cycle. And the second is, the testicle is responsible for the male hormone, the testosterone, that is responsible for muscle mass, it’s responsible for libido or sex drive, it is helpful for erections, bone mass, wellbeing, controlling the red blood cell production from bones. It is a very important hormone that begins when a boy is in adolescence. Around the age of 12 to 14 a young boy develops pubic hair, hair underneath his arms, and by 16 he starts to grow a beard. That’s all due to testosterone; that’s the male hormone. The counterpart in a woman is called estrogen, and in a man it is testosterone. The testosterone unfortunately peaks around age 22 to 25. Around age 25, the testosterone slightly decreases about one percent a year. So a 25-year-old man, very sexually active and functional, and has good muscle mass – he’s not going to notice that one percent change at age 26. He won’t notice it at age 30. But by the time he reaches age 50 to 55 and his testosterone has gone down 10 to 15 percent, he may become symptomatic.

The symptoms of low testosterone are decrease in libido, a lethargy or a lack of energy, the erections are not as good or as strong as they were when the testosterone was normal. They may notice a decrease in muscle mass and strength. One of the common symptoms that’s often overlooked as a cause of low testosterone is falling asleep after meals. A man usually will report that he just runs out of gas at 4:00 or 5:00 in the afternoon. He has his dinner meal, and then he’s sitting in a chair watching TV and falls asleep. Often times that symptom is due to low testosterone. Also, I want to point out that testosterone increases the risk of obesity, it increases the risk of diabetes, and it also increases the risk of depression. This is a condition that is very common after the age of 50 to 55 in almost all men, because the normal aging process results in a decrease in testosterone one percent a year. It becomes symptomatic at age 50 to 55. That’s a beginning introduction, and let me turn it back to you and see what questions you have, and then I’ll go on and talk about the treatment, Allan.

Allan (18:50): Okay. Obviously we need our testis to make sure that we’re keeping the tee that our body can produce. And then here we are faced with the potential that we could get cancer. How are we going to recognize that we have a cancer, that we may have a problem there, so that we can know that we need to have a conversation? I’ll go to my doctor and they’ll ask me basic health questions about how I feel, but they’ve never specifically tested me to say, “You might have this problem.” So, I want to take it upon myself to understand what I need to do to, not self-diagnose, but to recognize there’s a problem.

Dr. Baum (19:28): I want to answer that question, and I want to backtrack, because I do want to talk about testicular cancer, but those are two entirely different conditions, because one part of the testicle makes sperm; another part of the testicle – different cells – make testosterone. So let’s talk about the two different conditions. What you have to do regarding testosterone – you say, “I’m in my early 50s and just not feeling quite as peppy as I used to. I’m having difficulty holding my erection. My interest in sexual intimacy has diminished.” You say to your doctor, “Would you please order a testosterone level on me?” I would request it for a middle age man who has symptoms. Now, if you don’t have any symptoms, you don’t screen for testosterone deficiency. If a man is sexually active, strong, energetic, no problem with the muscle mass or energy, not irritable or depressed – you don’t need to get a testosterone. It’s fine; that’s not a problem. But if you’re starting to feel the symptoms of decreased energy and decreased sex drive, falling asleep after meals – you need to ask the doctor for a testosterone level.

Shift gears now for a second. Let’s talk about testicle cancer. Testicle cancer is the most common cancer in men between the ages of 20 and 40. Again, like prostate cancer, early testicle cancer has no symptoms. Now, here’s the suggestion that I hope men get from this webinar. I want to mention again, there are no symptoms for early prostate cancer. There are no symptoms for early testicle cancer. Women are instructed every month, after their period, to do a breast self-examination. The health care profession is deficient in not instructing men between the ages of 20 and 40 to do a testicle self-exam every month. When they’re in the shower and the scrotum is relaxed, they need to feel their testicle and examine it. It feels very smooth and there are no lumps and bumps in the testicle. If they feel that nodule, like I showed you when you make a fist on the top of your knuckle – if you feel that in the testicle, you need to make an appointment with your doctor to get this examined. Often you will get a blood test and a testicle ultrasound examination, and that will make the diagnosis of testicle cancer.

When I began my career as a urologist in the 1970s, testicle cancer took the lives of a lot of young men. Today, the treatment is so effective that very few men will succumb or die to testicle cancer. But they must make the diagnosis, and it is the responsibility of the health care profession to explain to young men. Men in high school and young boys should get health classes and learn how to do a testicle self-exam. There is nothing wrong with men doing it. It is good. Women do it for breast self-exams; there’s a lot of publicity around this. It’s kind of amazing to me, Allan, that every October, the National Football League goes pink. You know what I’m talking about? The breast cancer awareness month. Are you aware of that?

Allan (23:55): Yeah, absolutely.

Dr. Baum (23:57): What happened to the National Football League telling men to check for prostate and testicle cancer? It just boggles my mind that the women, who are much more aggressive about the marketing and promoting of breast cancer awareness, got a boys’ game to put the pink on and get the word out. I think the month of September or November ought to be men’s health awareness month and talk about prostate and testicle cancer.

Allan (24:35): Before we get off that, there actually is a movement to do something exactly like that. It’s called Movember, and it’s an organization I participated in last year that basically you try to grow a mustache for the month of November. You donate money and you’re trying to raise money, so all of us are doing fundraising. We did it at our company; there was a big group of us that got together and we all grew a mustache. The basic thing is, someone is going to comment if you start growing a mustache out of nowhere. If you’ve never had one and you start to grow one, you actually start getting comments on it, and that’s the opportunity to have that initial conversation about men’s health issues that include these two cancers. So, it is happening.

Dr. Baum (25:19): That was a genius idea. I believe it started in Australia. I’m not sure. Does that sound familiar?

Allan (25:25): I’m not sure of the exact origins of it. I just know it was interesting around the office, because people were talking about men’s health issues like they never had before. It was a very interesting opportunity and I’m glad I went through it. I think it’s a growing movement and I hope it does continue to grow, because this is one of those big things. It kind of goes down to that whole point – women seem to be the caregivers in the home, and men want to be these macho tough guys. It’s how we were brought up – we’re here to take care of other people. The women tend to look on the health side. You wanted me to ask you the question why do men live shorter lives, why do women live longer than men? And I do think that’s a big part of it, that there’s much more awareness by women of their health issues.

Dr. Baum (26:08): Women start into the health care arena right after they graduate from high school and college, when they are in their reproductive years. They frequently see their obstetrician and gynecologist, and they are programmed into annual health by getting a pap smear and a mammogram at a very early age. Men, on the other hand, have a void. After they graduate high school, they will seldom see a physician until they’re in their mid-50s, and consequently they’re not programmed to take care of themselves. In the South we have a saying here, “If it ain’t broke, don’t fix it”, but men apply that not only to their cars and their fishing boats, but they apply it to their bodies. Unless they’re having a symptom, they don’t have to go in to see the doctor, so consequently they can go years with hypertension, diabetes, high cholesterol, because early on they don’t have any symptoms. So if it ain’t broke, they don’t fix it, and by the time they go in, when it becomes symptomatic and they have full-blown diabetes and they’re overweight and hypertensive and they have high cholesterol, they end up being on four to six medicines a day. The average man, after the age of 50 – middle age – is taking four to six pills a day. He wouldn’t have to do that if he went to see his physician early on, got his blood pressure checked, got his weight down, got an annual examination, and practiced good health habits. Men take on risky lifestyles – they smoke more than women, they consume more alcohol than women, most of the drug abusers are men more than women; and as a result, it’s impacting their longevity, and they die five to seven years earlier than women. I think the playing field is equal when we’re born. We all have two kidneys, one heart, one brain. And what happens, I think, women take much better care of themselves than men do. Men often take better care of their cars and their fishing boats and spend more time planning a vacation than they do taking care of their health. So programs like Movember are absolutely phenomenal in increasing awareness towards men’s health.

Allan (28:59): I agree. I don’t take that same mindset of, “Wait until it’s broke to fix it”, because I’ve seen how bad broke we can get before we actually recognize we have a problem. We hear a screech in our car and it’s in the shop the next day. We get a little sore here or there and we think, “I’ll just work this out and I’ll figure it out”, and then it becomes a bigger and bigger problem as it gets worse. You’re right, Movember is a very good movement, but I really believe that men and women should make a point of what I call “wellness visits”. The doctor is so used to seeing people that are already sick or already in bad shape and need a lot of help. If you make a practice of wellness visits – which I do anywhere between three to four a year, where I’ll go get a blood test and talk to my doctor about it, just to see if there’s anything out there that alarms him or that should alarm me – then we can have those conversations as a part of a wellness visit, not as a part of a care visit.

Dr. Baum (29:56): I would like to see the time come when the doctor would be paid to keep you well, and if you got sick, he didn’t get paid. I think we need to shift gears.

Allan (30:09): I don’t think you’re going to get a single doctor to sign on for that.

Dr. Baum (30:12): I know that’s unlikely to happen. That’s the pie in the sky.

Allan (30:18): That’s where the man, we have to step up and realize our importance in this health team. We have to be the instigator; we have to be the one that manages the situation and drives the car, so to speak, to say, “I am going to have these wellness visits because I want to know that I’m in good health. If my health habits are working, I should see my numbers trending better. And if it’s not working, then I need to maybe readjust and do something because I don’t want to be the guy on four to six medications per day. I’d rather not go through the expense of a surgery or having a foot cut off or whatnot because I have diabetes.” So, I make a point of the wellness visit and I think that’s what we should all do, as men and women, is step forward and say, “How do we become more empowered?” And that’s just by doing, by saying, “I’m going to get the blood tests, and then I’m going to make an appointment with my doctor and we’re going to talk about this.”

Dr. Baum (31:10): You made a good point when we started, right from the get go, when you said women should be listening to this program. And the reason is, even in my own household – I’m a physician – my wife takes responsibility upon herself for my health care. On my birthday every year, an appointment is made for me to go in and get screened and treated on a regular basic. In the Western world, but particularly in America, culturally, women are in charge of men’s health. Consequently it behooves women to be as responsible and as forthright, and maybe even read the book How’s It Hanging?, so they can be on the same language and the same page as the men, and get the men to the health care provider at a much earlier age. I think that’s really important. Our society seems to work that way, and I think women should take part of the responsibility. Ultimately it’s the man; we are in charge of ourselves. We have no excuse. But I think in our society, women control the health care of the children, and it is often that they become responsible for the health care of their spouses or their significant other.

Allan (32:41): And to make your job easier, let’s go in for those wellness visits and we’ll find these things like prostate cancer, testicular cancer early. And he’ll have the discussion with his doctor about fatigue levels, his energy levels, his libido. All those conversations that he would be having with his doctor are going to help him get the treatment so he stays well and he stays energetic and he stays the guy that you may have married 20 some odd years ago, because he’s taking care of his health and he’s keeping his body from aging faster than it needs to.

Dr. Baum (33:15): These men who take testosterone replacement therapy – their lives are like a light switch has been turned on. They just have been living in the dark, and are suffering in silence and not having the quality of life that they should have when it can be treated. I also want to point out about the abuse of testosterone. Let’s talk a little bit about that. Can we do that, Allan?

Allan (33:41): Yeah, absolutely.

Dr. Baum (33:43): For men who have everything, they’re firing on all cylinders – they don’t need a testosterone level, that’s not necessary for screening, and they should not take extra testosterone to make them extra strong or build more muscle mass. This is a dangerous thing to do, and to increase the testosterone beyond physiologic normal can have repercussions. The repercussions are that it tells the testicles you’ve got extra testosterone on board; the testicles will stop producing testosterone for people who are taking testosterone when they don’t need it, and the testicles shrink and they don’t come back. Consequently they’re stuck being on testosterone forever. That is something that should be avoided in normal men. The way to build up muscle mass is get into the gym, work out, lift weights, and not take creatinine and supplements and testosterone when you don’t need it.

Allan (34:58): Actually testosterone is one of those interesting hormones that if you’re in the gym lifting heavy weights, your body is naturally going to want to produce more. So there are things you can do in a natural sense. If you’re eating well and you’re exercising, and particularly lifting heavy things, you’re signaling to your body that you need more muscle mass, and your body will often respond by producing more testosterone.

Dr. Baum (35:20): Exactly. You can’t short circuit it or speed it up. It does happen when you do that, but at a risk. And the risk is that your testicles will stop making testosterone and you’ll be deficient forever. The second thing I want to point out is, testosterone is what fuels prostate cancer. So, if a man has a prostate cancer and he takes testosterone, he is going to fuel the prostate cancer and it’s absolutely contraindicated in men who are getting treatment for prostate cancer. So, before a man who is symptomatic, he has all the symptoms we’ve just discussed, he should have a testosterone level to show it’s low and a PSA to show it’s normal – then he can proceed with testosterone replacement therapy. No man should receive testosterone if they haven’t had a PSA and a digital rectal exam to make sure he doesn’t have prostate cancer. The extra testosterone or replacement therapy can accelerate the growth of prostate cancer.

Allan (36:39): I think the core of this, and the cool thing about this book is that you talk about a lot more than just what we went over today. You really go from one side to the other of men’s general health issues that we’re going to deal with, particularly as we age, and that awareness of what you should be looking for, what it means. And of course you get a little bit into what are some of the current things we can actually do about it. The book is How’s It Hanging? Dr. Baum, if someone wanted to get in touch with you, learn more about the book, where would you like for me to send them?

Dr. Baum (37:08): They can go to my website, www.neilbaum.com. They can write to me at doctorwhiz@gmail.com. And they can get a copy of the book How’s It Hanging? on Amazon.com.

Allan (37:39): This is a book that I think every man should read, and most women should probably read as well, particularly if you are the head of health at your house. You should know about some of these issues, and this is a really good book to have available so you can help understand them and be a driver in your own health and fitness. Dr. Baum, thank you so much for being a part of 40+ Fitness podcast. I really appreciate you.

Dr. Baum (38:02): Thank you, Allan. I enjoyed chatting with you, and hope we’ve brought some light onto the topic of men’s health.

Allan (38:11): Absolutely.

I hope you enjoyed that conversation with Dr. Baum. Men, we do need to be more proactive in looking out for our own health. I know a lot of us like to let the women in our lives be the ones that nag at us to do those things, but really, we need to be doing that for ourselves. So I hope you got something valuable from today’s session, and if you did, would you please go out and give us a rating and review? You can do that through the app that you’re listening to this podcast on, or you can go to 40PlusFitnessPodcast.com/Review and leave a review today. I read each and every one of those and I really do appreciate hearing what you’re getting from the podcast, what you’re learning and how it’s changing and working for you. So please, go to 40PlusFitnessPodcast.com/Review, or leave a rating and review on your app of choice.

As you’re listening to this podcast, if you’re listening to it the first couple of days it’s come out, I’m either in Belize or I’m on my way back. You’ve probably wondered, I’ve talked about taking a couple of trips here and there. I guess I’ll go ahead and somewhat spill the beans. My wife and I are looking to further downsize, further down-stress our lives. It’s no secret that stress has been something top of mind for me for over the past year as I’ve looked at what it’s doing to my health and wellness and seeing it as my next big rock, the next big thing that I need to take care of to get my health and wellness exactly where I need it to be, because my stress level tends to be the one thing that really foils and stumbles up everything else. When I’ve got my stress under control, everything else seems to just fall in place, and that’s what I’m working on doing. So my wife and I may actually move outside the country to find a lower stress, lower cost, lower maintenance level; minimalize some things and get ourselves into a better place. And so, we are checking these places out. If you are living abroad, if you are an expat and you’ve tried different places, I’d love to hear from you, really. You can contact me – allan@40plusfitnesspodcast.com, and I’d love to hear your stories, love to hear what kind of guidance you can give me on that, because we are looking to do this type of thing in the near future. I’ll still do the podcast, I’ll still work with clients. That is a big part of what makes me happy and where I find joy, so I’m not letting that leave my life just for the sake of living in a smaller, quieter, less stressful location. But I do want to do something like this and I will keep doing this podcast and I will keep doing the training, and God willing, I will get this book out.

As I talk about the book, I wanted to remind you, you can go to WellnessRoadmapBook.com to learn more about The Wellness Roadmap book. It’s due to come out at the end of November, but there are still a lot of things that need to happen between now and then to include getting a launch team together. And I’d really appreciate if you would join me on the launch team. You can go to WellnessRoadmapBook.com, and there on the bottom of that page you’ll find an opportunity where you can go ahead and give me your email address and your name. I am not going to use this email address for anything else other than to give you updates on the book and to ask for your help as a part of The Wellness Roadmap book launch team. So I hope you will go out there today – WellnessRoadmapBook.com. Thank you.


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