- in fitness , guest/interview by allan
Reach your peak with Dr Marc Bubbs
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Allan Misner: 01:20 Dr. Bubbs welcome to 40+ Fitness.
Dr. Bubbs: 01:23 Allan, thanks so much for having me on.
Allan Misner: 01:25 You know, occasionally I will run into a book, your book is called peak, the new science of athletic performance that is revolutionizing sports. And like I said, I run into a book and I start reading it and then the author's cites this study. And so now I'm on Google trying to read the study. So then I read this study abstract and I'm like, oh, that's really interesting. So then I pull up the actual study and I read the actual study then to get back into the book and I read a little bit further and I find another one.
Dr. Bubbs: 01:56 There are lots of opportunities.
Allan Misner: 01:56 Yes there is. This is, this was a very well researched book and the research that you went to, I was actually pleasantly surprised that that was really good research. It was not this, uh, you know, put together by some, you know, by Gatorade and they're trying to advertise their sports drink. These were good solid studies that really do back the science of this book. And so I was really impressed with the citations and I have to admit, because I usually read all of every book before I do an episode, but I've still got a ways to go on yours because I'm learning new things pretty much every page I turn.
Dr. Bubbs: 02:38 Well listen, I appreciate that. And yeah, definitely the book is all about connecting people with the experts in their respective field in terms of not only athletic performance but human performance in terms of just upgrading how you look, feel and perform and also providing people with just some general rules to follow as well as what you just mentioned, which is that deep dive that if you do want to go down the rabbit hole, then there's lots of places that you can definitely do that as well.
Allan Misner: 03:02 Yeah. and you know, I guess the other side of this is a lot of times people will sit there and we use the word performance and yes, you're dealing with a lot of athletes and coaches and that type of thing. But in reality, the way I look at it is human performance is just sure ability to do the thing you want to do the best you possibly can. And a lot of the lessons that are here that even though we're, in many cases sometimes we're talking about those elite athletes, there are parallels to how we want to manage our health. You know, in terms of longevity, in terms of, capacity and then just overall wellbeing
Dr. Bubbs: 03:40 100%. I mean, as you get to working with really elite athletes and Professional Olympic level athletes, I mean, the level of training and the volume of training, the intensity of training is a tremendous load on the body. And it compromises health at that elite level. And for folks who are just trying to improve their health or lose weight or if they're struggling with whether it's weight gain, you know, pre diabetes, high blood pressure, those are big stressors on the body and they're there 24/7. So even though it's coming from different areas, you know, when you talk about human performance, the stress load can be just as high, if not higher. And folks that are struggling with their health as they are in and athletes were really pushing themselves.
Allan Misner: 04:17 Yeah, the statistics are baffling to me. You know, half, half the people in the United States, have prediabetes or worse. The obesity rate is just astronomical. So a lot of people right now are really struggling with their health. And I think it's just a common misconception of, I go in and get a blood test and the doctor tells me I'm fine. Uh, cause I had a consult I was doing just a week or so ago. And he told me, he went to the doctor and his blood glucose levels resting, fasting blood glucose levels were hovering right around a hundred. And I said, Ooh, I think you should try and get that down closer to 80 and maybe even below 80 if you can. And he thought I was, you know, a little weird. He's like, what are you talking about? My doctor says I'm fine. And I'm like, well, you know, your doctor is looking at a reference range, that includes a lot of sick people and so he's getting you to what he's calling average and I think you want to get closer to optimal. So you introduce in the book the concept called the blood glucose dysfunction spectrum. And, and I really liked that because it doesn't, it's not this, you're sick or you're healthy. It really kind of goes to that range of you're really, really sick. You're kind of, average. You're doing okay. And then your peak. Can you kind of talk about that spectrum and how it relates to us as humans being healthy and overall performance?
Dr. Bubbs: 05:47 Absolutely. I mean, I think the first thing is, you know, it's nothing inherently new in a sense, just looking at things in terms of a continuum. In science and in medicine, we have to define things. And so when we look at things like blood glucose dysfunction, we say, well, if you're less than a hundred milligrams per deciliter, then you're considered normal. If your levels are between a 100 and let's say 125 milligrams per deciliter and a course, these are, you know, us, measurements, then you be considered prediabetic. Now that's a pretty wide range. And so this idea of continuum is, well, if you're 99, you're normal, but if you're one on one, you're now prediabetic? That's, that's a pretty small shift there. So we have to then consider that as you move up that chain, if you get above 125 and now you're considered diabetic. And so classically in medicine we've said if you are type two diabetic, it is irreversible.
Dr. Bubbs: 06:39 It needs to be managed with medications and therefore people tend to get put on medications for prolonged periods of time. Sometimes those medications, if they do need to take things like insulin can make them gain more weight, which tends to make the process worse. But really if we even zoom out just for a second to kind of look at the general population. This past summer I was in the UK and they had a picture of a beach from the 1970s cause there was a heatwave this past summer in the UK. So they had a picture about 40-50 years ago of a beach in the UK. And you literally hundreds and hundreds of people in this photo. It was difficult to pick out anybody who was really overweight or obese to almost impossible. It didn't look like anybody was, you fast forward, you know, 40 50 years later and we're, you know, two thirds of the population now are overweight or obese and starts saying, okay, well what the heck's going on here and there, of course it's very complex and there are lots of different reasons, but part of the book is we're trying to hammer on some of these bigger points.
And one of the ones that really hits at home as the, the amount of household spending on what they call ultra processed food, things that come in boxes and bags and junk food, so to speak. And if we look at the US and the UK, it's over 50% of what we buy comes in a box or a bag. We think about the European countries. This is where it really stands out because if you go to places like Spain, it drops all the way down to 20% places like France, 14%, Italy, you know, classic Mediterranean diets and those regions, 13%. And when you get into places like Portugal has only 10%. So this is really interesting because now we have this idea of effectively when you're eating processed foods, you're getting stuff that's packaged, even things like cereals or packaged breads, pizzas, all that stuff, um, comes from these types of foods.
And that's an easy way for people to, if you start to limit some of those foods, you're going to reduce your total caloric intake. You're going to reduce typically your sugar intake, but also your intake of added fats and these foods as well. Cause there's a nice, you know, processed food companies are pretty smart. They make sure that combination of salt, sugar and fat is just the right amount to really stimulate the brain, stimulate all the, you know, the, the hunger and the thirst and to make you want to eat more of it. Right. That becomes interesting because obviously in the news now we see is it sugar, is it carbs? Then we have folks focusing on fat and a lot of the newer research now coming out, I mean a lady named Emma Stimpson and her um, group there at the National Institute for Diabetes in their research, they found that effectively it's the combination.
So when you put high fat together with high sugar, which is again what you typically find in ultra processed foods, that was an independent predictor of weight gain and obesity and overeating. So those are some really big points to say, okay, this is one of the, our food environment plays a big role in this whole story. And if we come all the way back to that sort of idea of blood glucose dysfunction, this is where you'll find a lot of folks hovering up towards the top end of that range. So hovering up around 101, 110, 125 so that should definitely be a little bit of a yellow flag to say, or a red flag, if you will, to say, okay, we've got to go back and look at what you're doing from an attrition standpoint. But also things like exercise, things like sleep, things like stress. Those can also increase blood glucose levels as well. So just knowing where you are in that spectrum and then comparing yourself to yourself year after year, after year rather than, as you mentioned, the general population because unfortunately, yeah, you're comparing yourself to a group that aren't in the best of health.
Allan Misner: 10:15 Yeah, I know they'll do these studies sometimes and they'll say, okay, well what did you eat last week? And, you know, someone will go through and kind of list out and I think if they actually truly logged what they ate, that they would find that they're in a box or a bag, a lot more than they think. I mean, I'm here in Panama on an island and I was thinking, okay, you know, we have fresh produce, it's year round because the weather's great, It's moist, wet and rains. And I said, I'm not going to have access to all kinds of fresh, healthy food, but there's all these supermarkets here that are catering to, you know, the, the backpackers and the expats and there they're carrying the same bagged and boxed crap that I think could get in the United States, uh, and charging people a premium to have it for sure. But people are buying it.
And you know I think that's kind of one of the core lessons as you come into this is, you know, if you're finding yourself in that spectrum and you're moving up rather than at least maintaining or moving down, you're not doing what's best for yourself. And I liked that in the book you were talking about. When we started talking about longevity, you know, from an athlete's perspective, it's their ability to continue to perform at that high level but it also involves our ability to live longer and they're kind of following the same track if we can keep ourselves where we're supposed to be. So can you talk about how this concept of Blood Glucose in our blood glucose levels, how that's affecting our longevity?
Dr. Bubbs: 11:51 Definitely. I mean, that's one where, you know, having some metrics and some markers to assess year end year out of how you're doing is a really important thing. And Blood Glucose is fasting. Blood Glucose can be a really nice one of, when we look at mortality rates, what do people die of? What's the number one killer of, when we look at that heart disease by far, you know, almost 50% it's about 41% of fatalities are from heart disease. So we say, okay, well what happens then if you're a person whose blood glucose as you mentioned, like your friend there, maybe you're in the 100 milligrams, 110, 125 or maybe you're even prediabetic. Well what does it tell us about some of your risks? Well, you know, there was a large study done in the late nineties a 22 years study on fasting glucose. A risk factor for your heart disease risk. And this is done in folks that were non diabetic.
And so in this one, if you were actually greater than 85 milligrams per deciliter, so you're in that upper core tile, that top fourth you're actually at much greater risk about a 40% higher risk than the, than the other folks, the lowest folks in the, in the study. So that's an issue around heart disease risks. A follow up there that's called the Whitehall study that was also done in this connection between fasting blood glucose and cardiovascular disease. And what they found takes it a step further because what they found is that as your blood fasting blood glucose increases, so does your risk of cardiovascular disease. So again, another really important point to kind of hammer home how this can be a decent metric for us to track. And interestingly, I found the strongest association was in 40 to 49 year olds, which typically obviously as you get older, your risk increases, you know, but one of the things that we tend to forget about is things like lack of sleep.
You know, if you don't sleep enough at night that following morning, your blood glucose levels will tend to be higher. And if you do that persistently, that can really lead to, you know, causing you to have persistently higher blood sugar levels. You see this even if you do a lot of traveling, if you take a lot of planes, for work, travel, jetlag, all that type of thing, you'll notice even if you do a blood test on the back end of that, your blood sugars will actually be higher than they normally would be. And that all comes down to this idea of, you know, lack of sleep is a stressor as well. And so that's kind of the trickier one to put your finger on with folks is you know, that stress load in their life can be a key point as well in terms of how good their blood glucose control is.
And you know, for the athlete that typically come from intense training and we see that as well, athletes who are really fit great blood glucose control. If we really pushed them hard, their fasting glucose in the morning, will also be elevated. Now in the acute term, that's not a problem. It's okay to have that happen. But if you're at a period where you're resting or you're deloading if you're an athlete training, then it should come back down into this ideal range of, you know, definitely less than a hundred and ideally less than sort of 80, 85. Um, that would be what we'd be looking for in those periods of rest. And I think for a lot of folks, sometimes when you get a few metrics done and get a bit of testing done, that's when you can actually really, you can put a number to things for people and that really hammers home the idea of, okay, let's, we've got to go back to how you're eating, how you're moving all these lifestyle factors and figure out what are the biggest levers that you need to adjust to help, uh, improve your overall health. And as you mentioned, just improve your, your longevity or what we call health span, which is the amount of years that you live in, in very good health, your total control of independence. Um, you know, unfortunately the last 8 to 10 years, the last decade of most people's lives is spent in pretty poor health and you know, needing, requiring care, full-time care even. And so that's really what we want to strive for folks, is to be able to, to age healthfully.
Allan Misner: 15:36 Yeah. And I think that was one of the kind of big wake up calls here because you know, you hear a lot about particularly some elite athletes that really push themselves over the years and how it adversely affects their health in particularly longevity, you would think, okay, they're eating the best quality foods and you know, they're aware of the nutrition and you know, they've got the right people behind them making sure, of course, you know, the glycemic index of their food is there, so they're not necessarily eating, you know, all the crap because of the way they're pushing their bodies because they're not getting the sleep because they're flying, you know, from east coast to west coast to play a game or being in a match or do an event. They're taking a toll on their health and it's showing in their numbers. If we were looking at it, just trying to reverse engineer and say, how did I get here? There's a lot more to it than just what you put in your mouth.
Dr. Bubbs: 16:31 100% and I think you know, one of the big differences as well as this, as you mentioned, if somebody is physically fit than what we're seeing is just an acute picture. And because they have such greater resiliency, when they do take the stress load down, everything falls back into these sort of normal ranges are ideal ranges. Where for, unfortunately for a lot of folks that that stress or that season doesn't end, so to speak, right? You're always going to have the long hours at the office. You're always not sleeping enough because of the kids or projects or family commitments. And so all of a sudden that becomes your chronic picture. And that's definitely when it's time to, to figure out how we can tweak your exercise program or make sure you're getting sufficient sleep and all these things that are real fundamental pillars, but they're often times not quite as sexy as some of the new, you know, whether it's a supplement or medication or or or, or trendy exercise that comes out that people tend to get their attention directed towards. But when you look at what the best in the world are doing, it really is just being excellent in the fundamentals.
Allan Misner: 17:26 Yeah. I liked the story you shared about Federer and how kind of maybe one of his secret weapons of how he came back and really started dominating again was just focusing on something as simple as getting enough sleep.
Dr. Bubbs: 17:39 Yes, it's incredible. I mean this was obviously this, the research on sleep in the last decades really exploded in an interview I did with Dr. Cheri Mah who is a medical doctor and sleep expert that works with professional sport and I had her on my podcast and and she was mentioning how he was definitely an early adopter and for quite a while there was trying not to let the cat out of the bag so to speak because it was having some significant impact on his performance and obviously now more people know about the benefits of sleep for performance in terms of things like reaction time, sprint speed, accuracy, all these, these types of metrics, but also for general population in terms of memory, cognitive function. Absolutely crucial. The tricky part is even despite everyone kind of knowing now that sleep's good for us, when you look at the numbers, we're still not, you know, not getting enough. Even the athletes aren't getting enough. The average person gets 6 1/2 hours of sleep a night, 30% of the population get less than six. And that's when things really started to nose dive. I mean, if you're getting less than six, that's one big flashing lights on the dashboard of your car start to go off. And you know, it's definitely time to check the engine or a reboot a little bit.
Allan Misner: 18:43 Yeah. In the book you introduced, I mean, it's a concept I've known about for awhile because I'm obviously talking to folks about this all the time. It's carbohydrate tolerance. And the gist of it when I'm having a conversation with a client would be, you know, how many carbs should I have? And you know, I'd be like, okay, well it depends, you know, for me, I'm like, depends and they don't like that answer. But can you talk a little bit about carbohydrate tolerance and why what works for one individual may not work for another?
Dr. Bubbs: 19:13 Yeah, this is definitely, I mean, nuance is definitely an area that's, that's tricky for folks because people want to have, especially when you're starting out, you want to have a nice clear roadmap or plan of what I should do. Um, and so if we look at the example of the popularity of the low carb diets, you know, something I use a lot in my clinical practice, again, if we zoom out to 30,000 feet, what are the top six foods that people eat? Well, unfortunately it's things like grain based desserts, breads, soda, pop, alcohol, pizza or five out of the top six. And so that's where the bulk of your calories are coming from that are going to impact ultimately how much weight you're gaining or how much weight you're losing. And so if we put somebody on a low carb diet, all of a sudden we cross off five out of the top six most calorie dense foods.
Dr. Bubbs: 19:59 And so that's a great way to help to support weight loss. You're basically directing people to eating more protein, to eating more vegetables, fruits, etc. And so that can be a great strategy for people to lose weight as this idea of how many carbohydrates that, I mean at the end of the day it comes down to your total caloric intake. Now, the tricky part is, as I mentioned, the carbohydrates make up just so much of what's in our own food environment. So they're much easier to come by. And so this is where for some people in general rule we would say is the more activity you're doing, you know, if you're an endurance athlete, you might get up to eight to 10 grams per kilogram of carbohydrate, which is, you know, you just imagine a guy riding in the tour to France with a whole table full of pastas and breads and all these types of things, right?
Just a ridiculous amount of food. But that could come all the way down to folks are falling more of a low carb Keto approach or maybe more sedentary or have to work at a job or you know, they're not moving very much. You're sitting at a desk and you might only be eating 50 grams instead of 850 and so that's the one that swings the most in terms of the amount that we can take in. What I try to do and whether it's with athletes or with clients, is to first start with protein intake. Protein has a lot of benefits in terms of overall health, in terms of bringing on not only the essential amino acids you need, but also bring on a lot of vitamins, minerals, nutrients, really supportive in terms of weight loss because you get a bigger thermic effect. So it costs more energy for your body to break it down, which has beneficial and it also tends to keep people full.
And so if you can, if you can solidify somebody's approaching intake and say, okay, we're going to consume, you know, typically you don't always have to tell the clients how many grams per kilo, but you might say we're going to have 20 grams three or four times a day. Or if they eat three meals a day, you know, have a bit of their palm size worth as opposed to 30 25 to 30 grams. And then that way you've got the protein dialed in, they get used to that, they don't need to think about that and all of a sudden it becomes easier to sort of turn these dials if you will. The dials being fat intake and carbohydrate intake. And it really is different depending on the person and depending on what the person likes to eat is important because when we look at, you know, the problem isn't taking weight off people, the real problem we look at the research is keeping it off right because nine out of 10 people will regain it at the end of the year.
So ultimately, you can do strategies in the short term that helped you to lose weight, but ultimately you have to find a strategy that you enjoy enough to keep doing. Right? Because compliance is is the best predictor of how well you're going to do on a diet. So I try to tell clients you know that first four, eight or 12 weeks, there might be some strategies that you've got to just grin and bear it and get used to it. And then as, as we move down for down the road, we're trying to match up what you like to eat with your lifestyle so we can kind of see some can support that longer term weight loss.
Allan Misner: 22:48 I've found with a lot of my clients that if I, you know, we go ahead and we introduced maybe some new foods that they haven't tried before. We take away quite a bit of foods that they typically enjoy and they go for a little while. Their pallet kind of resets the way they taste, sweetness resets. And in many cases what they used to not like, they now find themselves enjoying. And when they go back and try some of those things that they used to like they taste the chemicals, they taste the ultra process and they don't like it nearly as much.
Dr. Bubbs: 23:22 Absolutely. And I think that's one where, you know, in North America or in the West, you know, breakfast is that meal that tends to be the one. If people are on the run, you're grabbing a coffee and all of a sudden, you know, all the options in the menu tend to be higher calorie, higher carb and higher fat. Right. So not the greatest combination. So if you can get people to have, you know, basically protein and veggies and some healthy fats and then the amount of carbohydrates or it depends on, you know, the amount of weight you want to lose or how much activity you're doing. That can vary a bit in terms of if it's a, you know, a very small to small, so it's a more moderate portion.
And we typically try to time the carbohydrates around exercise too. If you're going to have, you're trying to get leaner, you still want to have a decent carbohydrate consumption or you do want to enjoy some, you know, sweet potato or whatever it may be. Then having that before you do higher intensity sessions or directly after, it can be a nice strategy to help direct that into either being able to use it for fuel while you're training or on the back end as you've broken down your muscles in that training and used up the glycogen, which is the carb stores on the muscles than the carbohydrates you're eating are going back into the muscles to top that up, which is, you know, a nice way to be able to recover from exercise.
Allan Misner: 24:32 I definitely want to circle back around on this concept a minute. One of the things I did want to get in before we leave this whole blood glucose dysfunction spectrum was the linkage between your blood glucose levels and depression. That kind of actually got me. I spent a lot of time looking at your research in that area because it was something I had not really thought about. You know, obviously you eat something and there's a kind of a mood affect to it cause there's things such as dopamine and everything's going on, but I had not really understood that connection before for the long-term actual diagnosis of depression. Could you kind of get into that?
Dr. Bubbs: 25:12 Yeah, it's one that I started to see more and more of in my practice. I deal a lot in men's health and it was surprising to me the number of clients that were coming in that were taking medications that you know, felt that they were struggling with low mood, and depression is defined as having low mood for greater than 12 months. And more and more patients were coming in. And it's, when we look at markers like blood sugar levels, I mean this is again, this idea of trying to find the minimal amount of markers to follow that influence the most number of sorts of systems or the most areas of the body. And when we start to look at the connection between blood sugars and mood, you know it gets to be pretty compelling. There's a lot of research coming out of Scandinavia around you know HA1C Levels, which is your HBA1C which is your three month average of blood glucose.
And so when that is higher, you're in a much greater risk of depression as well as when you're fasting insulin. So insulin does a lot of things in the body, but it's typically classified as the blood sugar hormone, right? It's helping to get the food you eat into your cells. Now that's persistently high. It's also associated with increased risk for depression. We see studies in military cadets as well. If you're, when you get yourself tested the morning, if your fasting glucose and insulin its higher first thing in the morning, as well as post-meal, those are also predictive of depressive symptoms, more depressive symptoms. And for folks who are struggling with, with diabetes, we know that when if you're insulin resistant, you're actually three times more likely to struggle with depression. So the really interesting thing is when we look at actually all those studies is medications don't alter any of those responses.
When we look at the general population, it's definitely one that we want to make sure we're considering. And to your original point around just knowing where you are in that sort of continuum or knowing what your number is for for your blood glucose level. And we'll probably talk metrics here as we go with HBA1C would be a good one to always have and typically run by your doctor. But that way you know, and this isn't to say that just your blood glucose is the only factor that leads to low mood and depression. But it's definitely one that contributes. There's obviously all the, you know, psycho social emotional factors as well. But for me as a clinician or a nutritionist, it's always, I'm trying to raise the playing field. So if I can get rid of or improve blood sugar dysfunction than it might be, you know, we're raised the playing field so that, you know, the cognitive behavioral therapy or whatever other talk therapy that the person might require, it's going to help them and improve their condition. And again, even if they're taking medications, we're still seeing improvements if we just help to correct the blood sugar, the assumption.
Allan Misner: 27:54 That was so fascinating to me because I'd never really made the connection to food a little bit, but not to that level, which was, like I said, just really, really fascinating. So someone decides, okay, I want to go ahead and get this tested. And we've talked about fasting the blood glucose levels. We've talked about, you said HBA1C I just typically we just say A1C. Those are the common. What are some other tests that you think would be appropriate for someone that just kind of wants to get a good baseline to know that they're managing their carbohydrates appropriately?
Dr. Bubbs: 28:27 Yeah, so those first two tests are typically run by by most doctors there is, you could add fasting insulin to that. You typically have to ask your doctor, you probably have to pay out of pocket but that's used in combination with fasting glucose to give you an assessment of your insulin resistance, a measure called homa-IR which is a calculated measure that gives you a bit of a deeper picture. You know, none of these metrics are sort of infallible or you can't hang your hat on just one. But it does give you another big piece of the puzzle to look at. A few more that I tend to look at with clients, GGT is a liver enzyme and of course everything that we eat primarily gets directed to the liver. And then particular obviously carbohydrates, sugars. And this is where, you know, I'm sure your listeners have probably seen the movie Super Size Me from years ago when the guy decides to eat nothing but Mcdonald's for 30 days, I believe it was every meal of the day.
And this is where there's a moment in the movie where the doctor's eyes are kind of bulging as he's looking at the labs for this individual who's only eating Mcdonald's and the liver enzymes were through the roof. So as GGT levels are enormous and this is due to the high processed foods, high simple sugars, etc. Um, and so it's a very early predictor of things going wrong. And so that's kind of a nice one to throw in there. Again, it's very, and then the last one would be around inflammation. Systemic inflammation again goes part and parcel with weight gain, with prediabetes, with poor cardiovascular health. And so CRP would be a measure of that. And that's, you know, a pretty easy set of metrics to, to be able to track, uh, you know, year on year. And then if you are, if you're struggling with your health, then you want to track more frequently, maybe a couple times a year.
And if you really need to shift things, you know, if you're looking like you're in moving into diabetes or you're really, you know, there's hypertension or what not, then you might want to even go quarterly. And always, the first line of the first port of call is obviously for the doctors is to compare you to the norms because they're trying to cross off serious conditions and diseases. But once you're past that threshold and that's when you want to start comparing you to you every time and making sure that, you know, are you trending towards disease? Are you trending away from disease? Cause obviously we want you to be trending a side that's pulling you away from all those chronic conditions.
Allan Misner: 30:40 Yeah I go in for wellness visits three, four times a year. And I happen to have a really good doctor that kind of understands that just being average is not really what I'm after and that's not why I pay for additional lab tests. But I'm actually looking for, you know, what's that good thing that I can do for myself to kind of get myself more optimal and the actions and the things that I do with my health and wellness that are always kind of directed towards that you got me really intrigued about the continuous, blood glucose monitor and I was looking it up and unfortunately I'll have to ask my doctor if he's willing to give me a prescription for one, cause you can't just buy it over the counter. But, um, I was really interested in trying, try and one of those out just to see what it tells me about some of the foods that I'm eating and how they affect me. So thank you for reminding me that those are available. But like I was doing some research after I read that your book. I was like, Oh, I've got to get a prescription for this. Uh, which is kinda sad.
Dr. Bubbs: 31:38 Well, I mean, nowadays you can actually even order them, you should just be able to order them online. And you get the continuous glucose monitors are a really fascinating way to look into how you personally respond to food. Because you know, for anyone who's not familiar, they effectively, you know, in the back of your arm you, it's a little bit of a pin prick that goes in and this sensor stays on you continuously for a week or two. And it's basically measuring your response to all the food that you're eating. So how high your blood sugars get when you eat a meal. Importantly afterwards, how low they get and for how long they stay low. But also things like, you know, if you get a bad email and you're stressed out, well your blood, your blood glucose will respond to that or, or maybe you don't sleep enough and you'll see some big shifts there.
So it's definitely a really nice way to see individually how you respond. Because in some of the earlier research, you know, someone who ate a banana or let's say, or a piece of fruit that should have a moderate glycaemic index response, they were seeing responses as if they didn't know, eaten a cookie. And on the flip side, people who ate a cookie had a really smooth response to glucose. And so this is where, you know, depending on our individuality, we actually, you know, you could end up on one side of the coin or the other and we dive into this a bit in the chapter around digestion because it looks like the microbiome, all the bacteria in your gut are having a big impact on how you as an individual are responding to the food you're eating. It can sort of amplify your blood glucose response, you know, in sort of the, you know, the bad scenario if you will or, or buffer it. And people who are, you know, maybe genetically or whatnot. Lucky.
Allan Misner: 33:08 Yeah. There was an Israeli study that I had read about one time and they use these continuous monitors, and logged everything they ate. So they logged what they ate, the time of day they ate it. And the differential between how different people experience the food from a blood glucose level and then even a recovery perspective afterwards, uh, was really kind of fascinating because, you know, everybody just thought, okay, this is the GI of this food. So if you eat and your blood sugar's gonna soar, but that's true for some and not necessarily for others. So I do think testing is really a kind of a cool way for you to really know, uh, how things are affecting you and then it'll just allows you to make better decisions. Now, a lot of my clients, and a lot of folks that I interact with a, they're in the Keto environment. I practice seasonal ketosis and I know, okay, as soon as I go into Ketosis for a period of a month or so, ny endurance performance is going to be, uh, well rubbish for lack of a better word. Uh, and then, you know, over time I pick up that performance my body gets more metabolically adapted. Um, and I'm able to go. Now if, if someone wants to use ketosis, what are some things that they can do to optimize their general performance, in one case I guess it would be a weightlifting or, or you know somewhat for body composition and then also for endurance athletes.
Dr. Bubbs: 34:35 This is a really interesting area and in the research, especially as it relates to not only general health but also in terms of athletic performance, cause when we look at even the highest level, so in an endurance sport you know cyclists, tour de France, they're now using in the last half decade or more targeted plan strategic workouts where they will have very low carbohydrate intake and this can be anywhere from 30 to 50% of the workouts were there on purpose trying to have these workouts where the person's intake of carbohydrate is low and or the glycogen, you know, the storage form of carbs and our muscles is low and that can be low due to you know, doing two day sessions. So you maybe do an intense session in the morning, you deplete the Glycogen, you don't consume a lot of carbohydrate and then you have an afternoon or aerobic session.
Or it could be after a fast. If you sleep at night, you're going to use up the liver glycogen overnight and then the morning that liver glycogen is going to be low because your liver also stores a carbohydrate in the form of glycogen. And that again elicits a different response. So what does all this mean to the person listening in at home? It means you don't always have to carve up for your workouts. If you're trying to be fit and stay lean or be fit and lose weight, then you definitely want to start to take advantage of these opportunities to have workouts where you don't have a lot of carbohydrate. And so I think for a lot of people, the easiest one is that morning workout, right? You go to bed, you wake up in the morning, you might have a coffee and then off you go.
So again, because your liver glycogen levels are lower, you're going to have a different response at the cellular level. And that can help in terms of training adaptations as well as some beneficial health effects. And so with that, you don't have to always, you don't have to go into a full ketogenic diet to elicit a lot of these benefits. You know, we see in some of these trainings studies that even a few days of of lower consumption can elicit a lot of these positive effects. If you're somebody who, you know, let's say if you're somebody who's struggling with weight gain or you're prediabetic or you have a lot of weight to lose, then the more quickly you drop your, your carbohydrate intake. If you're really trying to get into Ketosis, you just need to be careful a little bit cause it's gonna feel definitely a quite intense for you.
And so making sure you might pair that up with more lower intensity exercise for that person who just kind of dipping their toe into it. Where as someone who's more seasoned, let's say, um, I recently talked to a guy named Dr. Wes Kephart who did a study on the ketogenic diet and crossfit trainees. And then these were, you know, moderate to advanced trainees and they got very good results in terms of leanness. They maintain muscle mass and they were obviously doing intense exercise with very low carbohydrate intake. And so you can push it up to that scale. If you're more seasoned to it, if you're used to doing it. Yeah. So you definitely got some options on that front. And at the end of the day, as I mentioned before, you know, in looking at all this research, like if we look at bodybuilders, you know, their carbohydrate intake can be up as high as in the elite ones up as high as five grams per kilo, which is, which is a lot of carbs.
So, you know, try not to fall into the trap of thinking that if I just lower my carbs, I'm going to get leaner. You know, it still comes down to these principles, which is what the book's all about as well, which is your total caloric intake. So you know ketogenetic diets can be a great way to reduce calories. That can be a great way to elicit a lot of these positive adaptations to exercise. But then you need to do a little detective work, you know, just see how you respond, see how you feel with various workouts and ultimately always know what your goal is as well. You know, is it to lose weight? Is it to improve your health? Are you really chasing some performance metric that you're, that you're after? Cause that'll dictate the way that you should do it.
Allan Misner: 38:16 Yeah, you got me thinking in the book as I was going through the book and I was like, okay, you know, I like when I'm in ketosis, it's kind of almost a natural thing for me to kind of drift into intermittent fasting. I wake up in the morning, I'm just not really hungry. Like you said, I'll probably have a coffee but I don't do the bulletproof or any of that cause it's just black coffee. And then I'll go, I'll go work out. Uh, and I typically do the workout fasted, which you've got me thinking in terms cause you even put that quote in there, you know, breakfast like a king lunch, like a pauper, mean like a, like a prince and then a dinner like a pauper, which is effectively the kind of the flip scale of the way I would do intermittent fasting. Do we have less, uh, general glycogen when we're in Ketosis or does it not recover at some level where we just maintain it? Or exactly how is all that working? If I want to, you know, actually as if I'm lifting or doing endurance athlete, endurance work is, I mean obviously I could, you're saying I should just try it and see how it works?
Dr. Bubbs: 39:19 There's a few options here. So let's start with even the intermittent fasting. So there's, you know, an easy way to start people off is to do the idea of not eating breakfast. Right? Cause again, as we mentioned before, breakfast is typically the meal a day where people, there's a lot of bad options on the menu if you're, especially if you're eating out. And so I find a lot of my clients, men in and women, you know, you just canceled breakfast out all together. All of a sudden there's more time in the morning to get some emails done to call clients or customers or get the kids out of the house or whatever, or meditate you know, you've got more time on your hands all of a sudden and now you're eating, you know, typically a 16 and eight, um, you know, technically call this time restricted feeding, which means you're just shrinking the window that you're eating.
Dr. Bubbs: 40:02 So you might delay your breakfast till 10 or 11:00 AM and then you're going to eat for about eight hours. So until six or 7:00 PM and then again, you're not going to eat for 16 hours, which sounds like a long time. But you know, you're sleeping hopefully for seven or eight, so it's not so bad. And so that's one way of reducing.
Allan Misner: 40:19 We know from the book they should know from the book eight to 10.
Dr. Bubbs: 40:22 Yeah, yeah, for sure, but the interesting thing as well, so that's the one strategy that you can use and it's an effective strategy. You know, it's no better than than caloric. Um, and effectively counting your total caloric intake in a day. There are some different benefits to it, but it isn't a strategy to get people to lose weight. So you can, you can use that for awhile. The flip side of that is when you look at a lot of the research on fasting, if you just stop eating at 6:00 PM, even if you have breakfast, if you just stop in the evenings to allow that longer period of time, then you'll also get a lot of benefits.
So, you know, the big take home message here is that in today's environment we eat for 14, 16, 18 hours a day. You know, if the average person is only sleeping six hours, we're effectively eating for 18 hours a day, which is just way too much. Um, so finding a strategy that works for the person to be able to say we've got to shrink that window, because you know, grabbing a snack on your couch at night if you're watching game of Thrones or whatever it might be at 9, 10, 11 PM, you know, those are the opportunities where now when we feed in the evening, that really starts to disrupt circadian rhythms.
And you know, as you mentioned Dr. Satchin Panda's work at the Salk institute and you know, he found his original research in animals was where all of a sudden if you fed, you know, animals the same amount of calories, but you allowed one to do it in an eight hour window and you let the other one just eat all day long. The mice who had access to food 24 seven and they effectively got fatter and sicker and follow up studies in humans. This is just in prediabetic men. If you compare it to even a 12 hour window to a six hour window, you'd actually see that oxidative stress, blood pressure cravings are all increased in the folks that are eating in the bigger window. So again, another interesting strategy of using that time, restricted feeding, intermittent fasting to be able to say, hey, if we shrink the amount of hours in the day that you can eat, you're going to tend to eat a lot less calories.
And the other big fundamental is this. Yeah. If you can try to limit how much you eat late at night, you know, if it's Friday or Saturday night, don't worry about it. We want people to live a little, but it's that, you know, five other days of the week where we should just be a bit more vigilant and just get into a good routine and good practice of not eating. Because once we get used to the, um, the habit, I mean it's a bit like Pavlov's dog where as soon as you sit on the couch, uh, 9:00 PM to watch a show or whatever it might be, all of a sudden you just want to eat something even though it's sort of mindless eating and reacting. Right?
Allan Misner: 42:53 Yeah. And, and I've seen that, you know, anecdotally with a lot of people I've talked to and worked with and if, you know, if they will go ahead and do that, that restriction and just start walking their breakfast back and they get into a shorter window. One, they find that they're associated better. They're not snacking as often. They're having bigger, better meals and uh, they, they lose weight. You know, it happens time and time again and they just feel better. I think that's the other side of it is when your body's not constantly working to deal with the food, you're sleeping better, you're feeling better and you get used to that new way of eating that I think is probably a lot more ancestral than we would than we would think because you wake up in the morning, if you don't have refrigeration, um, and you didn't have boxed foods, uh, there's no milk and there's no cereal. When you wake up first thing in the morning, you've got to go catch or you know, forage for what you're going to eat. And by that time it's probably a little bit later in the day.
Dr. Bubbs: 43:54 It's definitely something that, you know, we've only really eaten three meals a day for the sort of the last century or so since the industrial revolution. So that's one that, uh, um, you know, it's definitely an interesting note and one of the things that I found in my practice is guys and gals do great with the intermittent fasting or a time restricted feeding, delaying breakfast for the first while if they do hit a roadblock at some point down the line, you know, their weight loss has plateaued or they haven't achieved the goal, they want it. They just flip it and, and, and kind of do the reverse way of what we just discussed, which is having breakfast, lunch, but making the dinner earlier, you know, cutting things off at 6:00 PM is a great way to again, you know, see some more progress.
The trickiest part is that our society today doesn't tend to lend itself to, to try not to eat after 6:00 PM cause you know, it's normally like meetings, family dinners, social events, everything happens at night. So that's, that's a trickier one to actually get people to do, but they can get some great success with it as well.
Allan Misner: 44:52 Absolutely. Dr Bubbs, I define wellness as being the healthiest and happiest you can be. What are three strategies or tactics to get and stay well?
Dr. Bubbs: 45:02 That's a great question. I mean, this is where, you know, in writing the book, it's a combination of my work with in an elite sport or at work, in clinical practicing, you know, all types of patients. And it does come back to this idea of we want to really focus on the fundamentals. So even complex problems that I see with the general population are athletes who are struggling. When we go back and look at these big pillars, there's still a ways to go, or sometimes it's just the fact that the person is taking their focus off of them and they sort of dipped off a little bit.
So if we're looking at three things, the first one's going to be nutrition. You know, what, what are we doing and what are we consuming? And so again, based on today's talk, avoiding ultra processed food, so eat real food, whether you know animal protein or vegetable, protein, veggies, healthy oils and fats, those are crucial to have it. If you eat most of the mostly that and try to keep that eating window to, you know, a maximum of 12 hours, that's a great first place to start. You're going to improve your health, you're going to lose weight, and the more you need to do that, then then you can refine that as you go.
Number two is going to be sleep. Sleep dovetails in with stress. And when we look at whether it's athletic performance, cognitive function, overall health, you know, sleep correlates to all these things. And so most people now sort of give you the, I know, I know I should get more sleep, but you need to, if it's listening at home or, or a coach or a clinician listening in, you know, we need to find out how much they're actually sleeping and then hold them accountable to say, hey, every week we're going to add 30 minutes. So if you're only getting six, we got to get you to six and a half. And then the next week we got to get you to seven. And as long as you're in that range of seven to nine, which is the national sleep foundation recommendation, typically like see people about eight, but, and giving them some strategies because again, people will tend to work on their laptop before bed. People will tend to watch programs that are really stimulatory at night. People will tend to do things that don't set them up for sleep. Um, so, so layering in whether it's some relaxing work, some stretching, it's a hot bath or shower, meditation and any kind of those practices is really big as well.
So once you've got that nutrition, sleep, the third one for me is going to be movement. And this is one where when we talk about weight loss, we always think about the hour that we're in the gym in the day. We don't tend to think about the other well not quite 23 hours cause hopefully you're sleeping for those eight but the rest of the day, which in that research would call non exercise activity thermogenesis. And that's just the amount of moving you do in the day. You know, the walking around up and down the stairs around the office, that accounts for a massive portion of your ability to lose weight. And when we look at no hunter gatherer populations or before the industrial revolution, we were far, far, far more physical and doing things. When we look at the blue zones today, all of those areas in the world where people live the longest, that's a huge common area amongst all of them as the fact that they all had to move and be physical and go up and down, you know, whether it's mountains or etc. So make sure there's movement in your day, whether that's 10,000 steps, whether that's carrying the groceries home, whatever it might be to start spending less time being sedentary and more time being active. Uh, is definitely a huge part. And if you can tie that in with some aspect of being, you know, community or friends, you know, it's a walk with your friend or meeting somebody for coffee or you know, whatever it might be.
I had one client actually we got him to every morning rather than have his coffee at home. He was a retired guy, uh, you know, he's pretty fit but still had to improve his health and we just got him to go walk 15 minutes to get his coffee and walk back home. Uh, and that was enough to start shifting things a little bit and then improving his health. So anything that you could layer in that just becomes part of your routine that you know in a few month's time you don't even think about anymore because it's just so second nature. That's when you're really going to get some of these big wins to help achieve your goals.
Allan Misner: 49:01 Those are really, really cool. Thank you. Thank you so much for sharing those. So Dr. Bubbs if someone wanted to get in touch with you, learn more about your book Peak, and the things that you're doing, where would you like for me to send them?
Dr. Bubbs: 49:13 Absolutely. Well listen, it's a pleasure to be on Allan and they can definitely check out the books available, Peak at all the major bookstores, Barnes and Noble, Chapters Indigo, Amazon, local book retailers. They can also check out my work at drbubbs.com, my podcast, as well as on their Dr. Bubbs Performance podcast. And if they're on social media at Dr. Bubbs, on Twitter, Instagram, all those good things.
Allan Misner: 49:38 Cool. So Dr. Bubbs, thank you so much for being a part of 40+ Fitness.
Dr. Bubbs: 49:42 Fantastic, Allan, I really appreciate it.
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