Episode 126: Dr Casey Means
Episode introduction
There’s no question that nutrition, diet, and metabolism are key to overall health. Genetics do play a role, but so our habits and the food we choose to eat. The amount of information published about diet is astounding. It can be difficult to know what to trust. The answer is to not place too much trust any diet information you read. It’s best to gather the data yourself, from your own body, using a biowearable fitness tracker like Levels. In this episode of Systema for Life, Levels co-founder Dr. Casey Means explains how the Levels technology measures blood glucose levels in real-time in order to provide trustworthy insights into your unique metabolic picture.
Show Notes
Key Takeaways
02:49 – The new age of bio-wearables
We have bio-wearables for sleep, stress, walking, but we don’t yet have one that gives us real time feedback between what we’re eating and what’s happening in our body. That’s the gap Levels is serving with CGM.
“I think we have just entered the reality of bio wearables, being something for consumer use. And what I mean by bio wearables is a wearable that’s actually tracking an internal biomarker. We’ve had trackers that sit on top of the skin for things like heart rate, heart rate variability, sleep tracking, and activity tracking, all these wonderful products like Whoop, et cetera. But we’ve actually never had something that’s measuring an internal biomarker that we wear all the time that’s for mainstream consumer use to understand how nutrition is affecting our bodies in real-time. We’ve had that feedback on sleep activity, stress, but we’ve actually never had a closed-loop feedback system between what we’re eating and then what’s happening in our body. You can’t do that with heart rate, unfortunately. But fortunately, there are these tools now that have been developed and they were primarily developed first for medical use in the diabetic community. And these are continuous glucose monitors that literally just stick on the back of your arm. They’re completely painless. It’s like a lab on your arm. It’s telling you about something floating around in your body 24 hours a day, seven days a week.”
05:33 – Why you can’t trust nutritional value in packaged food
Sugar is in every packaged food being sold now, including those marketed as healthy. That’s why nutrition labels are incomplete information and are leading to an epidemic of metabolic dysregulation in America.
“Wouldn’t it just be so easy to look at the back of a nutrition label and say, Oh, it’s got sugar. So I’m not going to eat this. But if that were the case, we wouldn’t have the metabolic epidemic that we’re dealing with today. When I say epidemic, I’m in no way hyperbolizing there. In America, 72% of Americans are overweight or obese and 128 million Americans have prediabetes or diabetes. So that’s over a third of the population. This is largely preventable. The majority of this is type two diabetes, which makes up 95% of diabetes of which most of that is preventable. It would be great if we were able to take in that information and make better decisions, but that’s very challenging. Sugar is addictive. Sugar is everything, it’s added to 60% of processed foods. It’s literally everywhere. Having information that says, Hey, you ate this and it actually caused a real issue. They did do something in your body. That extra closed-loop biofeedback can be very powerful for motivating behavior change.”
07:26 – When healthy is not always healthy
Everyone has their own individual reaction to glucose. How the body responds to food depends on a variety of factors including sleep, stress, microbiome, etc. What is healthy for one person is not always healthy for another.
“Recent research out of this real landmark paper from the Weizmann Institute in Israel, about five years ago in the journal Cell that was called prediction of personalized nutrition by prediction of glycaemic responses. What they showed is they put glucose monitors on about 800 healthy people, gave them all standardized meals, and found that they were all across the board in terms of how they responded in terms of glucose elevation. Then they looked at what the reasons for that were. And one of the really big reasons was microbiome composition. They also had everyone do stool samples, they sequence their microbiome and they found that different microbial composition in the gut actually changes the way you process carbohydrate and sugar metabolism. They’re taking the first pass at all this stuff. It’s so fascinating that we really don’t know what we’re putting in our mouth and how it’s actually going to affect our bodies unless we test it. We can certainly do a good job of trying to guess, but this is less even about micro-optimization and more about just having some feedback to know how these foods are affecting us and especially in our food culture, where so much is just marketed as healthy. You walk into a store and it’s healthy this, organic that, gluten-free that, it’s really hard to know what’s actually right. That’s why I think tracking can give us a real leg up.”
09:18 – The open-loop problem in nutrition
Even when people get information about their bodies, the data is not always understandable and more importantly does not clearly help in making day to day decisions about improving health and wellness.
“I think so much in health and nutrition is what I would consider open-loop systems, meaning that there is a very little one-to-one relationship between an action and a reaction. That unfortunately really pulls out the rug from effective behavior change because there are so many variables in our lives day-to-day, and to not be able to link them to an outcome, makes it hard to go back and choose which variables to change. That can make it really frustrating. So for instance, with diet, some of the only pieces of feedback we get, or maybe the scale the next day is a little bit different than the day before, maybe six months from now, we go to the doctor and our fasting glucose is two points higher than it was last year. Maybe our Cholesterol, our LDL is 15 points different than it was the year before. And the doctor says, Oh, you should probably clean up your diet a little bit. What in the world does that mean? That’s an open system, it’s really difficult. And so when you can actually close that action-reaction as tight as possible, that drives behavior change.”
15:34 – How to not get hangry
Our body can burn both glucose and fat for energy. Training the body to switch between burning glucose to fat, helps the body become metabolically flexible and have sustained energy instead of becoming “hangry”.
“Glucose and fat are our two main forms of energy in the body. And when we have a lot of glucose, our body shuts down using fat for energy. And so what people who do time-restricted feeding benefit from is they’re having a lot of time in their body where their insulin is in a low state, which means the body has the ability to burn fat for energy. Fat is a great thing to burn for energy because it’s a much more stable form of energy. We have only about two hours of glucose stored in our body at any given time. But we have like days with the fat stored. So your body becomes trained through time-restricted feeding, intermittent fasting, low carb diets. You end up spending a lot of your day in this low insulin state tapping into fat burning. You build those metabolic pathways. You become more efficient at that cellular signaling and you become a fat burner. Let’s say you’ve gone three hours since your last meal, instead of getting jittery and hangry and needing food, your body can flip on the fat burning and you have this sustained energy.”
21:55 – How to run a marathon without eating anything
An average person can burn stored glucose for an average of 3 hours, but can burn fat for energy for a lot longer. This is how endurance athletes are running marathons without carboloading.
“The thing that I really think about is cleaning out the liver. The liver is where the majority of our stored glucose is. It’s stored in chains called glycogen. Only when you really deplete that glycogen, that stored glucose, do you switch over into using fat, this secondary form of energy. When I’m fasting or when I’m working out in a fasted state, so using energy, but I haven’t eaten anything. I’m very much in my mind visualizing a cleaning out of my liver glycogen. I want that to be depleted so I know then that I’m moving my body more towards that fat burning. This kind of coincides with a lot that’s going on in the athletic world, looking out there’s many in the elite athletic world that are doing glucose monitoring as a way to improve performance. It’s becoming popular in the endurance athlete world, especially because you can imagine for endurance athletes who are going to need sustained energy, if they are not metabolically flexible, they are dependent on the exogenous oral intake of glucose throughout their event to basically maintain their energy levels. But if they’re highly metabolically flexible, then you could potentially run a marathon having not eaten anything because you’re so good at burning fat.”
25:06 – How athletes are fueling on sugar bombs
A lot of health drinks marketed to athletes like Gatorade and protein shakes can cause massive blood sugar spikes. These athletes would be much better off tracking their blood sugar and getting a slow elevation.
“So for people who are doing more explosive type events in the competition, that is where having readily accessible carbohydrate glucose is important because, at those very high, quick intensity type events, you’re going to be just preferentially burning glucose over fat. I still think it’s valuable to have an awareness about glucose, even for those types of athletes, because a lot of the products that are marketed towards athletes right now are these total sugar bombs like Gatorade and goos and protein shakes and bars that have like 30, 40 grams of sugar. And to deplete all the glycogen in your body that you would need to fuel your muscles, you don’t need to have a crazy spike and a crazy crash, which you can imagine who wants that before, during, or after their workouts? With this big glucose spike and insulin surge crash, halfway through your workout, you’re feeling tired and jittery. You don’t want that. So I would recommend for those types of athletes still track how your energy type, foods that you’re using for recovery or for performance, how much they’re changing your glucose. Because you don’t want to overshoot it. You don’t want to go crazy. You need much more of a gentle, slow elevation to still get all the benefits of loading your muscle with glycogen.”
32:24 – Cut out the noise and listen to your body
The conflicting advice is creating frustration and confusion, especially in those who are trying to live healthy. CGM can cut through the noise with objective data which is personalized to each individual.
“I think there’s so much noise and there’s so much confusion in the nutrition space. That’s one of the reasons I, as a nutrition-obsessed physician, am like, how do we cut through this noise? Because it not only creates frustration and confusion in people who are trying so hard to be healthy, so hard to lose weight, having difficulty, and then you hear all these different voices, it makes you doubt your choices. That can make a hard lifestyle change even more difficult when there’s mistrust in even what you’re doing because there are so many people yelling. And so to me, cutting through any of that with objective data is a step in the right direction. You don’t have to listen to anyone. You just have to listen to what’s happening inside your body. You just have to listen to your objective data. In a way, it’s very liberating.”
49:17 – Why we can’t just listen to our body
There is so much marketing that is pushing us to eat comfort foods and lead a sedentary lifestyle. It’s not always possible for everyone cut through this and be able to listen to their body.
“I’m very much about everything you’re talking about, self-awareness, hearing our body cues, that somatic awareness, and tapping into what’s going on inside. So it seemed really counterintuitive to be someone who’s also like, Oh, I think we should use tech to better understand our bodies. There could be an argument to be made of like, well, why don’t you just listen to your body? But I think we’re in a very difficult place right now because it’s actually hard to listen to a lot of our internal cues in our modern world. We are inundated with just sensationalist media. We live in a digital world that’s highly addictive. We have foods that are literally engineered to take us to our bliss point and activate our reward circuitry in our brain. It is a confusing time to be alive in terms of understanding your body signals because essentially every industry is trying to get us to be completely in love with what they’re doing on a neurologic level…It really comes down to this balance between these dopaminergic rewards, which is like that instant hit of happiness, but not actually reading long-term contentment versus our serotonin system, which is more associated with long-term happiness.”
Episode Transcript
Dr. Casey Means:
We know that ups and downs in our glucose, like we were talking about, that variability, those peaks and valleys, they translate to our lived experience. Those end up translating to often how we’re feeling, up, down, up, down, whether it’s mood, energy, alertness, et cetera.
Glenn Murphy:
This is Glen Murphy with NC Systema, and this is Systema For Life. Dr. Casey Means, thanks so much for joining us on the podcast.
Dr. Casey Means:
Thank you so much for having me. Thrilled to be here.
Glenn Murphy:
Yeah. Thanks so much, and especially in the midst of lots of ice storms sweeping across the country, and the East Coast, West Coast time difference. We’ve had to battle a few things in order to get together today. So I appreciate you making the [crosstalk 00:00:45]-
Dr. Casey Means:
But we’re here. Yeah.
Glenn Murphy:
Great. First up, can you tell folks a little bit about who you are and what you do? I was primarily introduced to you through Howard Jacobson, his Plant Yourself Podcast. He has a vested interest in metabolism via veganism and the plant-based lifestyle, and all of those things as well. But we’re coming from a slightly different angle. Can you tell folks a bit about what it is that you do?
Dr. Casey Means:
Absolutely. I’m Casey Means. I am a medical doctor. I live in Portland, Oregon, and I am really focused on health and wellness and longevity. I am very interested in how our health behaviors determine our health outcomes and how to motivate personalized, sustainable lifestyle change and health behaviors to essentially optimize our cellular biology for good living. Where I really focus on in my career is metabolic health. So really optimizing metabolism in a personalized way.
Dr. Casey Means:
And so, that’s my clinical work focus on this. I’ve also started a company called Levels, which empowers people to understand their metabolisms with a wearable device and to learn how to optimize that.
Glenn Murphy:
Yeah. I’m really looking forward to talking more about that and folks have heard me talking a little bit about wearables as well. I’m a big fan. I like heart rate variability monitors for stress perception and modeling what kinds of things affect your stress levels throughout the day. But I’m really intrigued by this idea of getting more acquainted with your internal metabolic state. With the tool, can actually get you there without being super invasive. It seems like if you’re diabetic or something, you can do blood tests multiple times a day and stab yourself with it, like a blood [inaudible 00:02:26] type thing.
Glenn Murphy:
But it seems like this is bridging the gap between the glut of mini wearables with very limited functionality in devices that have hit the market over the last couple of years, and something that’s truly deeply informative in figuring out how our eating patterns and how our behavior patterns and sleep patterns might be all forming a bigger metabolic picture. Is that fair to say?
Dr. Casey Means:
I think it is. I think we have just entered the reality of bio wearables being something for consumer use. What I mean by bio wearables is a wearable that’s actually tracking an internal biomarker. We’ve had trackers that sit on top of the skin for things like heart rate, and heart rate variability, and sleep tracking, and activity tracking, all these wonderful products, Whoop, et cetera, but we’ve actually never had something that’s measuring an internal biomarker that we wear all the time, that’s for mainstream consumer use, to understand how nutrition is affecting our bodies in real time.
Dr. Casey Means:
We’ve had, like I said, that feedback on sleep activity, stress, but we’ve actually never had a closed loop feedback system between what we’re eating and then what’s happening in our body. You can’t do that with heart rate, unfortunately. But fortunately there are these tools now that have been developed and they were primarily developed first for a medical use in the diabetic community. These are continuous glucose monitors that literally just stick on the back of your arm. They’re completely painless.
Dr. Casey Means:
It’s like a lab on your arm. It’s telling you about something floating around in your body 24 hours a day, seven days a week. The beautiful thing about tracking glucose with a continuous glucose monitor is that glucose changes very rapidly in response to our behaviors. It actually not only responds to what we’re eating, which it can do within literally minutes. Something goes in your mouth, you get this immediate feedback in your glucose levels. But it also changes in response to other factors like stress.
Dr. Casey Means:
Excess stress, your glucose is going to go up. Too little sleep, your glucose is going to go up. Haven’t exercised much, your glucose is going to go up. If you exercise, your glucose is going to go down. So it’s this beautiful centralizing biomarker that really serves as this hub for so many of the dietary and lifestyle things that we’re all trying to improve. So it’s got multivariate input, but this beautiful readout that can help us really optimize so many aspects of our lifestyle, but for the first time diet, which is pretty incredible.
Glenn Murphy:
Yeah. To play devil’s advocate here, this is not really my voice, but the voice of an imagined skeptic coming into this.
Dr. Casey Means:
Yes. Bring it.
Glenn Murphy:
Why do we need to go quite so deep on glucose levels specifically? Don’t we know that sugary foods are bad for us and we shouldn’t eat too many of them at once, and maybe let’s limit the carbohydrate intake and all of those things? Do we need to fine grain it so much in order to really understand [inaudible 00:05:18]?
Dr. Casey Means:
Such a great question. I think there’s two points there. One is the personalization piece, and two, is a piece about, does information really change behavior? I’ll actually start with the second one. I agree. It’s like, wouldn’t it just be so easy to like look at the back of a nutrition label and say, “Oh, it’s got sugar, so I’m not going to eat this.” But if that were the case, we wouldn’t have the metabolic epidemic that we’re dealing with today.
Dr. Casey Means:
When I say epidemic, I’m in no way hyperbolizing there. We have, in America, 72% of Americans are overweight or obese and 128 million Americans have prediabetes or diabetes. That’s over a third-
Glenn Murphy:
Across the population.
Dr. Casey Means:
It’s getting close to that. This is largely preventable. The majority of this is type II diabetes, the vast majority, which makes up 95% of diabetes of which most of that is preventable. And so, yes, it would be great if we just were able to take in that information and make better decisions, but that’s very, very challenging. Sugar is addictive. Sugar is in everything. It’s added to 60% of processed foods. It’s literally everywhere.
Dr. Casey Means:
And so, having information that says, “Hey, you ate this and it actually caused a real issue.” They did do something in your body. That extra closed loop biofeedback can be very powerful for motivating behavior change. And then, the second point was that it’s interesting, actually, different foods are going to affect different people differently in terms of how much it affects your glucose. You and I could both eat a seemingly healthy food, like a sweet potato, or a banana, or brown rice, and you and I could actually have vastly different responses in terms of how much that elevates our blood glucose.
Dr. Casey Means:
That actually goes a little bit counter to the prevailing glycemic index philosophy that we’ve seen, which is like, oh, if we both eat a piece of white bread, our blood sugar is both going to rise a certain amount. That’s the glycemic index of the food. That’s actually been shown to be not quite accurate. There’s a really landmark paper out of the Weizmann Institute in Israel, about five years ago in the journal Cell that was called Personalized Nutrition By Prediction Of Glycemic Responses.
Dr. Casey Means:
What they showed is they put glucose monitors on about 800 healthy people, gave them all standardized meals, and found that they were all across the board in terms of how they responded in terms of glucose elevation. Then they looked at what the reasons for that were, and one of the really big reasons was microbiome composition. They also had everyone do stool samples. They sequenced their microbiome and they found that different microbial composition in the gut actually changes the way you process carbohydrate and sugar metabolism. So pretty-
Glenn Murphy:
Makes sense. It should. Yeah.
Dr. Casey Means:
It does. They’re taking the first pass at all this stuff. And so, it’s so fascinating that we really don’t know what we’re putting in our mouth and how it’s actually going to affect our bodies, unless we test it. We can certainly do a good job of trying to guess, but this is less even about micro optimization and more about just having some feedback to know how these foods are affecting us, and especially in our food culture where so much is just marketed as healthy.
Dr. Casey Means:
You walk into the store and it’s like healthy this, organic that, gluten-free that. It’s really hard to know what’s actually right. So that’s why I think tracking can give us a real leg up.
Glenn Murphy:
Is it the real time element that makes this so powerful? Because it seems to me that you could keep a food diary, and eat foods and then examine your poop and then see how you feel, and log your moods and all these different things. But there’s differential times for digestion for people as well, aren’t there? Like some people take longer to digest things than others.
Glenn Murphy:
So sometimes it’s hard to put together the cause and effect of the thing that you ate, and the mood that you had, and the interplay between all those things, and sleep patterns and mood. Is it the fact that you actually see the glucose arc, the processing arc in real time, that makes it such a powerful tool?
Dr. Casey Means:
I think that really is the crux of it. I think so much in health and nutrition is what I would consider open-loop systems, meaning that there is very little one-to-one relationship between an action and a reaction. That unfortunately really pulls out the rug from effective behavior change because there’s so many variables in our lives day to day, and to not be able to link them to an outcome, makes it hard to go back and choose which variables to change. And that can make it really frustrating.
Dr. Casey Means:
For instance, with diet, some of the only pieces of feedback we get, or maybe the scale the next day is a little bit different than the day before, maybe six months from now we go to the doctor and our fasting glucose is two points higher than it was last year, maybe our cholesterol or LDL is 15 points different than it was the year before and the doctor says, “Oh, you should probably clean up your diet a little bit,” what in the world does that mean? That’s an open loop system. It’s really difficult.
Dr. Casey Means:
And so, when you can actually close that action-reaction as tight as possible, that drives behavior change. And so, you can imagine like you eat a sweet potato and 20 minutes later, you see a sharp acceleration of your glucose. The next day you eat a green smoothie and nothing happens to your glucose. That’s like, “Okay, the sweet potato is probably causing a significant insulin release as well.” That insulin is going to be counterproductive in terms of any weight loss efforts. It’s going to cause potentially other issues.
Dr. Casey Means:
If I do that over and over every single day, seven days a week for the next year, that’s a lot of glucose and insulin elevation that you had no idea you were doing. So I do think tightening that one-to-one relationship is really important. You talked also about the subjective part of things too. I really think of behavior change as a trifecta. It’s an action, an objective response, but you also have to link the subjective component.
Dr. Casey Means:
How did you feel? Were you tired? Were you energized? Did you have a crash after it? Did you feel jittery an hour after you had that thing? When you can link all those three things, I think it’s really helpful. An example for myself is oatmeal. This is something that a lot of people consider to be a healthy breakfast food. I was eating it frequently for breakfast. But normally, mid morning, early afternoon, I have this mid morning slump, need a cup of coffee, need a snack or whatever.
Dr. Casey Means:
So going along thinking that’s just normal. That’s what everyone has and does. Then you throw on a glucose monitor and you see, “Oh, my glucose raised 90 points in response to oatmeal,” which is an amount that a healthy person would never want to see on their glucose. You don’t want to go up even close to that. And then, because of that huge glucose surge, my body’s releasing a lot of insulin to take up all that glucose, which causes this crash. I’m actually going below my baseline, and then it has to recover.
Dr. Casey Means:
Right around that time is always when I’m feeling a little tired and a little jittery in the morning and need that extra hit of maybe a treat or a coffee. Then all of a sudden, it’s this link of subjective, objective, and action. Well, I’ve never eaten oatmeal since then and totally have switched up what I eat, more a higher fat, higher protein type breakfast, and it changes quite a bit. That’s really the fun. That implies that you have to eliminate anything that spikes your glucose, which actually is not true, in my opinion.
Dr. Casey Means:
There’s other ways to modulate our response. You can include more fat protein or fiber with your carbohydrate choices. You can make sure to eat higher carbohydrate foods on days that you have had good sleep, on days that you are exercising, on days that you are lower stress, that you’re just not getting this compounded metabolic response. So definitely not all about deprivation, but just being thoughtful about all the different ways that we can keep our glucose low and stable throughout the day, which is what we want and what translates to essentially a more stable day overall, mood, energy performance, et cetera.
Glenn Murphy:
Yeah. So not just stable weight, but stable mood, stable you, stable health over time.
Dr. Casey Means:
Yeah.
Glenn Murphy:
Yeah. That’s fascinating. Resonated on two levels. One is that I stopped eating brown rice and oatmeal a long time ago. My wife is a big proponent of oatmeal in the morning. She likes to eat it. But I just found that I was getting up in the morning, eating oatmeal and just feeling terrible, having a crash as if I’d eaten a big sugary donut or something like an hour later, and then mainlining tea. I drink tea because I’m English, instead of coffee. I’m just feeling really bad on it and not really knowing why.
Glenn Murphy:
And then, again, trying to switch to brown rice thinking, “Oh, it has more fiber, more nutritive content than white rice, and just feeling awful every time I’d eaten brown rice, oddly, and not really being able to explain it, but moving on. So you feel it is explainable by differences in glucose metabolism and the way that it hits different people at different times? Because I know plenty of people who can eat oatmeal in the morning and feel great on it. I’m not one of them.
Glenn Murphy:
I either have a largely protein-based breakfast, or actually, I typically do time-restricted eating. So I’ll just eat between the hours of 12:00 and 8:00, and I feel a lot better for that. I seem to do better in terms of digestion if I don’t eat in the mornings right away. Is that within the bounds of what you’re talking about?
Dr. Casey Means:
Definitely. I think, for sure. I think that point about time-restricted eating is really fascinating as well because we know that ups and downs in our glucose, like we were talking about, that variability, those peaks and valleys, they translate to our lived experience. Those end up translating to often, how we’re feeling, up, down, up, down, whether it’s mood, energy, alertness, et cetera.
Dr. Casey Means:
And so, what you’re doing when you’re time-restricted feeding is you may be eating the exact same number of calories as someone would be if they spaced the eating out, but doing it in a shorter window. What you’re doing then outside of that window is you’re essentially eliminating glucose elevations related to food. And so, you’re also eliminating insulin elevations in response to food. Insulin is the really key piece here because insulin is this amazing hormone in the body that has two main functions.
Dr. Casey Means:
It has many, many functions, but two of the big ones in relation to metabolism is, one, it helps your cells take glucose out of the bloodstream and into the cells for use, for energy. But the other thing it does is it blocks our body from burning fat for energy, because glucose and fat are two main forms of energy in the body. When we have a lot of glucose, our body shuts down using fat for energy.
Dr. Casey Means:
And so, what people who do time-restricted feeding benefit from is they’re having a lot of time in their body where their insulin is in a low state, which means the body has the ability to burn fat for energy. Fat is a great thing to burn for energy because it’s a much more stable form of energy. We have only about two hours of glucose stored in our body at any given time, but we have days worth of fat stored.
Dr. Casey Means:
So if your body becomes trained through time-restricted feeding, intermittent fasting, low carb diets, you end up spending a lot of your day in this low insulin state, tapping into fat burning. You build those metabolic pathways. You become more efficient at that cellular signaling, and you become a fat burner. And so, then, let’s say you’ve gone three hours since your last meal, instead of getting jittery, and hungry, and needing food, your body can flip on the fat burning and you have this sustained energy.
Dr. Casey Means:
Also, when we burn fats, we produce ketone bodies. There’s good evidence that ketones are actually beneficial for the brain. They’re anti-inflammatory. Some people feel like they get a ketone high when their ketones are very high in the body. So it’s all a good thing to give your bodies conditions where it can actually tap into a cellular pathway of fat burning, that the average American’s virtually never doing, because we’re always hitting ourselves with carbohydrates, and sugar, and keeping the insulin high. And we’re just blocking the ability to actually burn this alternative fuel source, which is a really stable, healthy, fuel source to burn.
Dr. Casey Means:
That whole process that I’m talking about is essentially called metabolic flexibility. We want to move into a state where we are not rigidly dependent on glucose, we are metabolically flexible between glucose and fat burning. That state is associated with longevity and good health, and that’s where we really want to be.
Glenn Murphy:
Hi, folks. Glenn here. Our Systema For Life approaches its 100th episode. I’d like to take a minute to thank everyone who has contributed to the show, all our listeners, and to everyone who’s offered requests, encouragement, and feedback along the way. I also need to ask a quick favor. We have already enjoyed two years of high-quality interviews, insights, and ideas on Systema For life. We’d like to keep the show going and we want to keep it open to all, but we need your help to do it.
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Glenn Murphy:
Yeah. It’s the first time I’ve ever heard that phrase, that metabolic flexibility phrase that way. I’ve been aware of this concept that it’s possible to move between different burning preferential fuels within the body with practice, essentially. That if you’ve never practiced burning fat, essentially, or your body doesn’t get good at those pathways, then you just keep subsisting on these peaks and troughs of glucose all the time and you’re not good at it.
Glenn Murphy:
And then, when you have to fast, you get really angry and other things happen. But you practice fasting, your body seems to adapt to that and be a bit better at it over time. In our style of martial art that we practice, this Russian-derived old style that comes from the old Orthodox… Very much, “Let’s withdraw from everything and be very stoic and see whether or not we could still survive it,” type thing. “This is the best you can do,” Russian.
Glenn Murphy:
So there’s a tradition there of fasting, in which maybe once a week, you’ll just fast for 24 hours. It will be usually a wet fast. Usually, you just sip water, but there’s nothing else, literally nothing else going on. Some people even do it completely dry. The idea of that, it seems to be two-fold. The analogy I was first told with it is that it’s like cleaning the oven.
Glenn Murphy:
If you just keep shoving things in the oven, it just gets this caked surface around the inside of it, mold, and stuff like that. It’s not very efficient. It doesn’t burn very well. Won’t heat things up. And so, the analogy was just like, “This is what it’s like in your gut. You just build up all these gut bacteria and stuff like that. And if you never give your gut a rest, then it gets crazy.
Glenn Murphy:
I thought that was broad brushing it, but in light of what we know about the microbiome, I think that’s quite an interesting point to make. Maybe it’s not the matter of the microbiome itself, but maybe it’s the glucose matrix that they exude and all of those things as well, that there is something akin to cleaning oven when you just give your gut a rest for a while.
Glenn Murphy:
But the other idea being that it’s the withdrawal of that comfort of eating when you feel that urge to eat, and you mistake the discomfort of vague hunger for real hunger, the hunger that comes with the famine, like you need to eat something or you’re going to be in trouble kind of thing. But most of us just mistake that discomfort and then we just start to put things in our faces the minute we become not full, which is very different.
Glenn Murphy:
Not satiated and hungry are two different things, but they seem to be conflated in modern developed societies a lot. And then, if you can train yourself to notice that difference, then you’re okay with it psychologically and you’re better at doing without, and you’re better at being uncomfortable. It’s like a dual approach to this. You need to practice being uncomfortable, and you also need to train your body to be okay with it.
Glenn Murphy:
And so, I love hearing this scientific rationale for exactly where both those things are coming from. I’ve heard the rationale from the stress and resilience point of view, that you’re inoculating yourself against stress when you’re fasting or you’re tipping buckets of cold water over your head, or all the other crazy things that we do. But I love this idea that that there’s a documentable researched pathway towards actually that your body does adapt and does get better at adapting through this kind of withdrawal.
Dr. Casey Means:
Yeah. It’s so true. You mentioned the gut microbiome and the oven cleaning. The thing that I really think about is cleaning out the liver. The liver is where the majority of our stored glucose is. It’s stored in change called glycogen. Only when you really deplete that glycogen, that stored glucose, do you switch over into using fat, this secondary form of energy. So when I’m fasting or when I’m working out in a fasted state, so using energy but I haven’t eat anything, I’m very much in my mind visualizing a cleaning out of my liver glycogen.
Dr. Casey Means:
I want that to be depleted so I know then that I’m moving my body more towards that fat burning. This coincides with a lot that’s going on in the athletic world, looking out… There’s many in the elite athletic world that are doing glucose monitoring as a way to improve performance. It’s becoming popular in the endurance athlete world, especially because you can imagine, for endurance athletes who are going to need sustained energy, if they are not metabolically flexible, they are dependent on exogenous oral intake of glucose throughout their event to basically maintain their energy levels.
Dr. Casey Means:
But if they’re highly metabolically flexible, then you could potentially run a marathon having not eaten anything, because you’re so good at burning fat. There’s a lot of terms for this, fat-adapted athletes, carb-cycling athletes, keto-adapted athletes. But it’s definitely gaining a lot of momentum because it is very different than the concept of glycogen loading or carb loading, eat the huge pasta before your event, load the body with stores of quickly accessible energy.
Dr. Casey Means:
This is a slightly different paradigm, which is actually, if you don’t load the body with that, you build alternative pathways that actually keep you stable, potentially more anti-inflammatory state, which can help with recovery. Not something you want to jump into immediately, like tomorrow, everyone who’s listening goes out and does a fasted five-mile run. That would probably feel very uncomfortable because your body is not adapted to burning fat.
Dr. Casey Means:
Everything in the body takes time. It takes consistency. And over time, you change gene expression, you change cellular pathways. It takes time, but it is something interesting to ease into. Most of the people at my company, I would say, at this point, because we are able to track our glucose, we know that in the morning, actually our glucose is generally fine levels, that you can maybe jump on the Peloton and do a workout without having had breakfast and you do fine.
Dr. Casey Means:
And then, over time, that’s just going to create a more metabolically flexible body. I’m at the point now where almost all my workouts are fasted because, to me, it feels like getting double bang for my buck, from the workout. I’m improving my insulin sensitivity. I’m improving my metabolic status. And I’m also just getting the fitness benefits in general. I will say, a caveat to that is, for people doing more sprint-like or-
Glenn Murphy:
That was going to be my next question.
Dr. Casey Means:
… power-
Glenn Murphy:
Is there a difference between endurance sports and power-based sports, where you might need a quicker growth curve, essentially?
Dr. Casey Means:
Yeah. For people who are doing more explosive type events in competition, that is where having readily accessible carbohydrate glucose is important, because at those very high quick-intensity type events, you’re going to be just preferentially burning glucose over fat. Now, I still think it’s valuable to have an awareness about glucose, even for those types of athletes, because a lot of the products that are marketed towards athletes right now are these total sugar bombs, like Gatorade, and Gus, and protein shakes and bars that have like 30, 40 grams of sugar.
Dr. Casey Means:
To replete all the glycogen in your body that you would need to fuel your muscles, you don’t need to have a crazy spike and a crazy crash, which you can imagine, who wants that before, during, or after their workout? This big glucose spike, an insulin surge crash, halfway through your workout, you’re feeling tired and jittery. You don’t want that. I recommend for those types of athletes, still track how your energy type foods that you’re using for recovery or for performance, how much they’re changing your glucose, because you don’t want to overshoot it. You don’t want to go crazy.
Dr. Casey Means:
You need much more of a gentle, slow elevation to still get all the benefits of loading your muscle with glycogen. Anyways, it just allows us to be thoughtful regardless of the type of event. But I’d say more for the endurance athletes, that’s where getting into that fat oxidation can actually be a real, I think, competitive advantage. So yeah.
Glenn Murphy:
Sure. Just seems like there’s so many good reasons to have the information and then you can act on it, regardless of whether or not you’re going to make massive tweaks to your eating patterns and daily behaviors. It’s like at least you’ve got the data to act on. It’s not guesswork anymore when you have that feedback. So yeah.
Glenn Murphy:
One reason, again, I love this is that it just pushes forward the paradigm that we are somewhat individual in our metabolism, and we have to take account of that. It’s not a one-size-fits-all plan. You can’t just push one specific diet onto everybody and then hope it is going to pan out in exactly the same way. Like you said, like, “Here’s the glycemic index of this banana, and when you eat this, it will go up by X.” It’s like that’s not quite how it works, and we know that it’s not, intuitively.
Glenn Murphy:
We work out really hard and then you get a craving sometimes for lots of carbohydrate-rich stuff. Sometimes you can get away with eating that and you still feel fine. And then other days, when you haven’t done anything, and you eat even less than that, you’ll put on weight and you’ll feel lethargic and you’ll feel terrible. We know there’s an interplay between energy expenditure and putting it in.
Glenn Murphy:
But I think all too often, we’ve just fallen into that simplistic paradigm of just straight calories in calories out. Right. There’s a friend of mine who’s a personal trainer, who once a year, with monotonous regularity, he posts on social media this meme. It just says, “Here’s all the diets that are trending right now.” It has carnivore, keto, vegan, plant-based or vitarian, all these different diets, all the way down to the bottom.
Glenn Murphy:
And then, on the other column, it says, “Here’s how this diet works.” And it just says, “Calorie restriction, calorie restriction, calorie restriction,” all the way down. And it’s just like, “Any questions?” It says at the bottom. That really annoys me because on one hand, it’s partly true. Of course, there’s truth in that, that if you use fewer calories than your body actually needs, then of course you will start to lose weight as a net effect.
Glenn Murphy:
And if you consume more calories in terms of net expenditure, than your body is putting out, then you’ll start to gain. It could go both ways, and that sort of stuff. But it’s simplistic both in the sense of behavior, because counting calories is super monotonous and we’re not going to do it in a sustainable way for our entire lives, so that way. It’s also simplistic in the sense that not all of those calories are quite created equal, that there are curves to the way that our bodies respond to those things. And so, we’ll process them in different ways.
Glenn Murphy:
Knowing that and having a backup for that, and not having it be some woo-woo thing that’s connected to some Ayurvedic diet or something like that, but having it be a science-based researched, demonstrable effect, I think it’s really, really powerful. I think people need to be shocked out of that simple energy paradigm. We’re not machines. We don’t fill up with battery power and then run out. That’s not how we work, right?
Dr. Casey Means:
Right. It’s so true. I think it’s just so simple example about the calories in, calories out. It’s like you take a hundred calories of broccoli or an egg, let’s say, and you’ve got a hundred calories of candy with a bunch of high-fructose corn syrup, glucose, whatever, in it, and sugar. Those are both a hundred calories, but are going to definitely have a different impact on metabolism and weight, because the thing that the calories in, calories out model is missing is the hormonal element, the downstream pathways that it happened that those calories go into your body.
Dr. Casey Means:
The sugar is going to cause a glucose release in the bloodstream, and insulin response. The broccoli and the eggs are not. What that insulin is then going to do is tell your body very differently how to process and store those calories. For the sugar and the candy, it’s going to say, “Okay, load this glucose into your cells, and then all the excess stored as fat, converted to triglycerides or stored as glycogen…
Dr. Casey Means:
With the others, it’s not going to have that insulin surge. And so, your body’s going to say, “Okay.” It’s going to use what it can. But then it’s going to burn through it because insulin break, that is not in the picture. You can burn that fat in the egg. It’s just a totally different downstream response. So it’s really interesting how we’ve gotten so deep in that model when it’s a very limited view of what’s happening inside the body.
Glenn Murphy:
Do you feel like it’s been difficult to exit because there have been so many abortive attempts? It seems to me the calories in, calories out, well, nozzle has been around for, what, about century now? I think, or something like that. It’s based on the idea of how much a food stuff will raise a volume of water or something ridiculous like that. It’s literally like the chemical, like heat-raising content of a piece of-
Dr. Casey Means:
Exactly.
Glenn Murphy:
… food, which is a daft model when we’re not really burning it that way, metabolism. We’re processing it through enzymes and processes that shift things around. So it’s kind of daft, but it seems to me there’s been all these different claims that you need to forget entirely about calories because the Atkins plan is what you really need to think about. Just your gross carbohydrate intake is the only thing you need to worry about.
Glenn Murphy:
And then people start to discredit a severe carbohydrate limited diet or something, and then somebody else comes along with something else, says, “No, what you need is the carnivore diet,” or, “No, what you need is the keto diet.” And then, there’s so many deviations from it, that all seem to have their own little downstream side effects that are undesirable. Like a carnivore diet, it’s possible that you could survive okay on that.
Glenn Murphy:
But there’s some evidence to show that it feeds tumor cells, and tumor cells grow faster under a meat-heavy diet, whether or not you’re getting good triglyceride levels, and whether or not your glucose metabolism is fairly stable. It might be doing other things in terms of cancer growth, and repair, and things like that. So there always seems to be some side effect to it. And so, is it just that people keep coming back to the orthodoxy, because they’re like, “Oh, all of these fads don’t work, so I’m going to come back to the calories thing”?
Dr. Casey Means:
Yeah. Yeah. I think there’s so much noise and there’s so much confusion in your attrition space. That’s one of the reasons me as a nutrition-obsessed physician, I’m like, “How do we cut through this noise?” Because it not only creates frustration and confusion in people who are trying so hard to be healthy, so hard to lose weight, having difficulty. And then you hear all these different voices. It makes you doubt your choices and that can make hard lifestyle change even more difficult, when there’s mistrust in even what you’re doing, because there are so many people yelling.
Dr. Casey Means:
And so, to me, cutting through any of that with objective data is a step in the right direction. You don’t have to listen to anyone. You just have to listen to what’s happening inside your body. You just have to listen to your objective data. In a way, it’s very liberating, I think. For me personally, I’m a plant-based person, which is… We got connected through Howie, who’s plant-based.
Dr. Casey Means:
And so, for me a lot, I would say, like, “Oh my gosh, plant-based, it’s so high carb, how do you possibly keep your glucose low?” What I say to that is food is molecular information. That’s all food is. It is information you’re putting in your mouth, which tells your cells in your body how to function. You can get that molecular information from all sorts of different types of diet.
Dr. Casey Means:
For me, plants have a lot of molecular information in them, that are very positive for cellular biology. I want to maximize that. But I also know that I want to minimize my glycemic fluctuation. How do you do that? I test it. There’s a whole bunch of very healthy foods I can eat from a whole foods plant-based diet, and then I can choose the ones within that that don’t have the collateral damage of a high glucose or metabolic response.
Dr. Casey Means:
For me, what that looks like is I’m focusing mostly on green, leafy, colorful vegetables, which tend to have virtually no glucose response. I eat a select amount of fruits, but definitely still eat a lot of fruit. I just choose the ones that don’t spike me. Bananas take me to 180, apples don’t they. They maybe raise my glucose 10 points. So I stick with apples, unripe pears, cherries, and berries, blueberries. Oranges are generally pretty good for me. It depends on the variety though. Some oranges will spike me, others won’t, so that’s interesting.
Dr. Casey Means:
And then, I really figured out swaps that work for me in terms of the grains. Rice spikes me, most grains will. So now I’m eating a lot of cauliflower rice, broccoli rice. Beans and legumes don’t spike me at all. And so, I eat tons of beans and legumes, even though they are high-carb foods. I’m pretty convinced my microbiome just processes them in a way that doesn’t raise my glucose, because I actually have other members of my team who are not plant-based, who spike a lot more with beans. I think because I’ve been doing this for years-
Glenn Murphy:
In all kinds of ways probably as well.
Dr. Casey Means:
Gosh. But for me, in my body, for some reason, doesn’t create a glucose elevation. I think, over time, probably in the course of years of eating tons and tons of fiber, my body just maybe has a like microbiome composition that just doesn’t lead to that. And so, yeah, so it looks like a lot of legumes, beans, grain alternatives like broccoli rice, cauliflower rice, tons of nuts and seeds, olives, avocados, greens, spices, some fruit. That essentially keeps me glucose flat almost all the time, in a really low and healthy range.
Dr. Casey Means:
If you looked at my glucose curve, I think the average person would definitely think I was carnivore. I’ve seen some of them posting their glucose responses, “Oh, this is what carnivore can do for you.” But I think it’s what any diet can do for you as long as it’s thoughtfully chosen and you’re being smart about it. That’s what I’m trying to optimize for. I do think it means that you can optimize for both things, the highest nutrient value of your food without the collateral damage of spikes.
Glenn Murphy:
That’s excellent. Yeah. That’s fascinating. Another thing that I love about that is what you said there about having a subjective comparison in addition to these objective voices that are coming in from all over the place. I think one of the problems about that noisy space is that even if you’re trying to look in the right places, even if you’re not just going to Facebook for your dietary advice, or just the next fad that comes through the news, even if you’re reading all the journals and you’re trying to read things, there’s so much disagreement, just even among nutritionists.
Glenn Murphy:
The field, it’s so complex, in a very real way. When you talk to people who are deeply versed, professors, nutrition, they’ll say there’s so much that we don’t know about nutrition and how it works. Some of them are even like, it seems to be, even half miraculous, so I can’t even explain the other half. Part of it just gets that crazy complicated. There’s this admission that there’s big black holes in our knowledge and our understanding of how things put together.
Glenn Murphy:
We have certain pathways, but there are obviously just millions of other pathways that we haven’t mapped yet biochemically. And so, we can’t see the whole picture. I think, arrogantly, sometimes individual diets or ways of eating assume the whole picture. They say, “Well, we have this pathway. We know this happens. Therefore, this is the only important pathway.” For people on keto diets, ketosis is the only thing you need to know about.
Glenn Murphy:
People on low-carb plans, all you need to know about is this and [inaudible 00:37:49], things like that. But what I like about this is that it reconciles the data you might be getting from other people, including respected scientists from every way you can get them, with your own subjective experiences of what it’s like after you eat a banana or a pear. It’s hard to lie to yourself if you eat something that puts you on the toilet for an hour and a half afterwards. You’re like, “Yeah, I’m pretty sure that had an effect,” regardless of what somebody else said.
Glenn Murphy:
Or if you consistently get the rage or get jittery after eating or drinking something very specific, you know deep down that that’s having an effect and you can’t lie to yourself. So it allows you to reconcile it. It seems to me having a… what, you termed it a closed loop?
Dr. Casey Means:
Closed loop biofeedback. Yeah.
Glenn Murphy:
Closed loop biofeedback system like this, it’s almost like having a Rosetta Stone, where you could translate all of those different inputs, plus your own subjective experience into something that’s genuinely actionable. Yeah.
Dr. Casey Means:
I think that’s true. I will say, I mean, glucose is one biomarker and it’s the only biomarker we can measure continuously right now at home. There are others that are very, very important. And so I’m very excited to see how this space evolves because I think that if we’re only optimizing around glucose, there are problems that can arise. You could drink only vodka all day long and your glucose would be low. But you’re obviously not going to be healthy.
Glenn Murphy:
Now you’re preaching to the Russians listening to this podcast.
Dr. Casey Means:
Yeah.
Glenn Murphy:
They’re very happy about that. There’s Russians everywhere saying, “This is exactly my day.”
Dr. Casey Means:
No doubt. I could eat all broccoli all day or all meat, and your glucose would also probably look entirely flat. And so, I think what we need is, in the future… I mean, it’s honestly a great place to start. I think we’ve already talked on this podcast a lot about the benefits, why orienting around glucose is important. But I think it is also very important to remember that that’s not everything. There’s still going to be things that don’t spike your glucose that have other effects that we’re just not seeing.
Dr. Casey Means:
That’s where I think the carnivore thing is going to become interesting. Sure, the glucose is flat. That’s good. Insulin is probably pretty low. But what’s happening with… If we had a continuous inflammatory marker, if we had a continuous uric acid marker, if we had a continuous CRP, whatever, or free fatty acids, triglycerides, what else would that build into the algorithm?
Dr. Casey Means:
So in terms of the future of this nutrition wearable, continuous feedback space, what I want to see is a more holistic picture of the continuous variables, so that we can make even more nuanced decisions. But with that said, I think it’s a great start. We’re moving in the right direction. But the model is not complete.
Glenn Murphy:
[inaudible 00:40:27]. Yeah. So that’s where you’d like to see it. That’s the vision that you’d have in the future, is to have a wearable like then you have with Levels, but that measures more different biomarkers and gives you a more complete picture of what’s going on.
Dr. Casey Means:
I would like to see that for sure. I think that would be really, really helpful. And then, we do integrate sleep data, exercise data, heart rate data, because those things can help you parse out what non-food factors are affecting your metabolism. But I think that those metrics, plus other biomarkers, that I think we’re going to see stuff like that coming down the line.
Glenn Murphy:
Yeah. Let’s pivot to that for a second, because we talked a lot about the benefits of flattening out the glucose curve for maintaining peak metabolism in terms of making sure that you’re healthy in terms of weight and maybe health in terms of nutrients and things. But I’m really interested in the interplay between metabolism and stress, how it can work. Because obviously when we are stressed out, when our sympathetic nervous systems are firing up, it changes our metabolism. That can affect the way that we process even the same foods under the same conditions.
Glenn Murphy:
The inverse can also be true. Some foods can change our metabolism, and our sympathetic nervous systems, or rather the limbic system can perceive that as stress going on, and then drive up a system and then you become hypervigilant because you’ve been eating a lot of sugar, and things like that. So there’s this two-way feedback loop going on. One drives the other.
Glenn Murphy:
Then in the stress proof courses that I run, I ask them to do this exercise for like a week or two weeks called stress bootcamp, where I take five areas of comforting behaviors, there’s sleep, there’s diet, there’s movement, there’s focus, and there’s connection, connecting with other people. And focus is multi-tasking and picking up social media in between meetings and things like that.
Glenn Murphy:
I essentially asked them to go Spartan one of them for like a week. So if they really drink a lot of coffee and they tend to comfort eat, unlike for a whole week, no caffeine of any kind, no processed sugar. You don’t eat anything at all for a window of like 18 hours, like from 6:00 until 12:00 the next day, or something like that, and then see what happens. It’s not a name and shame thing. It’s just to see what other behaviors come out of that, when they’re hungry, to then they stay up all night binge watching Netflix because they’re bored or something.
Glenn Murphy:
What other behaviors does that translate into? For the sleep one, it’s like, okay, you have to go to bed, you have to try and get eight hours of sleep, which means going to bed early. What happens then when you get up in the morning, or what happens to your diet patterns? What other things come out of that omission? And just seeing those. That’s my attempt, in a way, of without having specific biomarkers for everything, just saying, “Let’s do a null hypothesis on all of these little comforting behaviors, and then see what the effect is on all the others.” Like, where does it go? And that kind of stuff.
Glenn Murphy:
What kinds of things have you been interested in looking at you? You mentioned that the device features… The wearable features heart rate variability, and maybe correlating that with metabolism markers and things like that. What kinds of things are you looking for or recommending when you’re giving the reports to people who are monitoring both glucose, and sleep levels, and all those things?
Dr. Casey Means:
Yeah. Currently we don’t have HRV incorporated in it, but that is a next step that we want to do. But we are really helping people more subjectively draw an association between what’s happening with their metabolism and what’s happening with stress, because like you mentioned, there’s a really, really strong link. Physiologically, what we know is that when we experience stress, whether it’s physical or psychological, physical being a very hard workout, is a stressor on the body.
Dr. Casey Means:
And then, psychologically, anything from a fight, to a ping on our phone, to honking in traffic, to stored stress in our body from like childhood events and trauma and things like that, all of those things can have an impact on our catecholamine hormones, our cortisol, our epinephrin, et cetera, our stress hormones. What’s interesting is that the body has evolved to basically think, “Okay, if there’s a stressful situation, we probably are going to need to mobilize.” The body is going to need to pick up and do something. We’re going to have to respond to whatever this threat that’s causing stresses.
Dr. Casey Means:
Our body’s response to those hormones is actually to release glucose into the bloodstream. The way it does that is that cortisol and epinephrin, they tell the liver to dump this stored glucose into the blood because the body needs to have energy to mobilize. It needs to be in circulation for the muscles. While that may have been a really effective strategy when most of our stressors were physical, like we’re being chased by a lion or whatever, they’re just not as evolutionarily advantageous now when the vast…
Dr. Casey Means:
We have really virtually no physical threats in our modern world compared to historically. It’s a safe time to be alive, by and large. However, psychologically, we’ve never had more access to stressors.
Glenn Murphy:
Sure.
Dr. Casey Means:
We’re getting little glucose spikes all the time, literally that we’re thinking ourselves into, which is incredible. Examples of this is we see people giving a talk, or even being on a podcast, or having an argument, or even a stressful conversation with a loved one, and people will send us screenshots or post on social media, 20, 30 point glucose rise, totally fasted, no food. That is just their liver dumping their glucose.
Dr. Casey Means:
And so, we want to do everything we can to avoid that. I think similar to HRV, which is this wonderful objective marker of our stress so that… Glucose does a similar thing. A lot of us walk around saying, “Oh, I’m not stressed. I feel fine. Everything’s fine.”
Glenn Murphy:
Yeah. Dying on the inside. It’s like-
Dr. Casey Means:
To [crosstalk 00:46:05], it’s like you’re being called on it by a good friend, being like, “Oh, I know you think you’re fine. I know you’re telling everyone that you’re killing it and you’re hustling. But you’re actually hurting your body by doing this. So you need to rethink this.” I use the Lief Therapeutic HRV monitor. Of course, I use Levels for the glucose monitoring.
Dr. Casey Means:
What I find is that if you take 10 deep diaphragmatic breaths and really focus on the moment, it can totally short circuit my HRV plummeting, and it can also help with the glucose response. That’s where I think it’s really nice, just giving you objective… You cannot outsmart this, unless you focus on really getting your cortisol down, which fortunately, I’m sure you teach your clients this.
Dr. Casey Means:
We have evidence-based ways to get our stress response down. You’ve got to actually tap into those. To have that extra layer of accountability I think is so valuable. The stress piece, I care a lot about, in addition to the food.
Glenn Murphy:
Yeah. It has to be a physical intervention. That’s the whole thing. I think the way that people go when they become stressed, it’s like, “I’m going to think my way out of this. I’m just going to positive self-talk,” go to your happy place, and everything will go away. But that’s not how it works because that higher cognitive part of your brain essentially goes offline when you’re stressed out. The limbic system is taking over. The limbic system’s calling the shots, and it’s been doing it for a very long time quite successfully. It’s just not very good at doing it during internet arguments.
Glenn Murphy:
Great running from lions, not particularly great when you’re trying to flame somebody online. The examples that I typically is about how the stress response shifts blood pressure. It obviously shunts blood into the limbs and into the head towards the sense organs preparing you for a fight that you’re not actually having. So when you’re having a stressful experience and it turns into a physical fight where you have to run from something, there’s a genuine emergency, you at least have something to do with that shifted blood pressure, when you feel like you’re mobilizing with your fear.
Glenn Murphy:
But if you’re sitting immobile with your fear, and you have this raised blood pressure for hours on end, it’s really difficult to reconcile that that dissonance creates even more stress. It’s like, “Well, why am I just sitting here with my heart rate so high and my blood pressure so high?” And we’ve got nothing to do with it. Some people deal with that by going to exercise. They’re like, “Oh, I’m going to go and do some high intensity interval training or something.”
Glenn Murphy:
But even that you’ve got to be careful with, because if the heart rate’s really high and then you do something high intensity, it’s not necessarily good for you right away.
Dr. Casey Means:
Right.
Glenn Murphy:
So there’s this recognition of what’s going on inside your body. There’s methodologies that you can teach, technologies that have been around for a very, very long time, and some spiritual practices in which you’ll just get more awareness of what’s going on inside your body and become your own biofeedback monitor. But to augment that with a physical biofeedback monitor, that gives you, again, data in real time about what’s going on.
Glenn Murphy:
To me, that’s the confluence that’s going to get us to a really, really interesting place, where we have a deep awareness of ourselves, which is supported by real data so that we can’t lie to ourselves as well. No, I think that’s really interesting.
Dr. Casey Means:
Definitely. Yeah. I think about this a lot because. fundamentally, I’m very much about everything you’re talking about, self-awareness, hearing our body cues, that somatic awareness and tapping into what’s going on inside. It seemed really counterintuitive to be someone who’s also like, “Oh, I think we should use tech to better understand our bodies.” There could be an argument to be made of like, “Well, why don’t you just listen to your body?”
Dr. Casey Means:
But I think we’re in a very difficult place right now because it’s actually hard to listen to a lot of our internal cues in our modern world. We are inundated with just sensationalist media. We live in a digital world that’s highly addictive. We have foods that are literally engineered to take us to our bliss point and activate our reward circuitry in our brain. It is a confusing time to be alive in terms of understanding your body signals because essentially every industry is trying to get us to be completely in love with what they’re doing on a neurologic level.
Dr. Casey Means:
And so, I think that’s why we see a lot of breakdown in consistent positive choices, because it’s just very hard to listen to what’s going on. You feel sad and then you eat cookies and you play a video game and watch TV, and then you feel not sad for a second. But are you really… It really comes down to this balance between these dopaminergic rewards and more long twitches, like that instant hit of happiness, but not actually reading long-term contentment versus our serotonin system, which is more associated with the long-term happiness, but actually it takes a bit more of an investment and lack of quick hits.
Dr. Casey Means:
It’s written about in his fabulous book by Robert Lustig, The Hacking of the American Mind. But I think a way to bring it together is to use personal data to bring awareness, and to, like you said, augment our personal inward experience of listening to our body. It’s like extra support for hunches that you have about what’s going on inside your body.
Glenn Murphy:
True.
Dr. Casey Means:
I see it as a boomerang effect, like we’re going to use tech to build awareness, but with the intent of actually just being much more grounded and much more connected to mindfulness, and whole foods, and living close to the earth so we can support our microbiomes, and getting away from things that cause us stress like tech, and media, and all that stuff, in this cycle of using these tools to actually bring us back to what really matters in the long run.
Glenn Murphy:
That’s wonderful. Yeah. Seems like the tables are rigged and we need some help getting back to the baseline, right?
Dr. Casey Means:
Right.
Glenn Murphy:
It’s easy to listen to the cues of your body when you’re at a meditation retreat in Bali, right?
Dr. Casey Means:
Right.
Glenn Murphy:
A little bit harder when you’re in New York City. People are screaming at you and your iPhone is beeping and you’ve got five meetings to get to. A little bit more tricky.
Dr. Casey Means:
And you’re eating a croissant.
Glenn Murphy:
Yeah, exactly. I’m reminded. I used to live in Japan. I was teaching there for a while, and I had a colleague. She’s wonderful, [inaudible 00:52:11], her name was. Her mother-in-law lived with her and she couldn’t stand her mother-in-law, and would tell me about this because she could tell me. I was the foreigner. She could never have vented to our Japanese colleagues.
Glenn Murphy:
I’d just been on this weekend in Kyoto, and I’ve been to these temples all over the place. Loved them. Saw these Zen rock gardens. Very peaceful, and ended up talking to an abbot. He gave me this scroll thing and he was just like, “You should take this home.” It says that you should practice being happy today because if you don’t practice being happy today, when do you plan on starting? When you’ve got your new car, your new job? Every day is practice of being happy. So you need to start today.
Glenn Murphy:
I’m like, “Whoa, it’s deep. It’s deep.” I went back and told [inaudible 00:52:51] up about this, and I thought had this great, enlightened moment and I was fully Japanese, like getting there and stuff. I told her and she said, “Easy for him to say.” I thought that was wonderful. I was like, “What?” “He’s a monk [inaudible 00:53:05]. He sits around all day, breathing. Maybe he begs for some rice.” Yeah. So basically her thing was like, “He hasn’t got kids. He hasn’t got a mother-in-law.” It’s easy for him to be like, “Practice being happy every day.”
Glenn Murphy:
I was like, “Okay.” So yeah, kind of reminds me of that. Yeah. Wonderful. So maybe, yeah, that Levels can help to bring us back to the baseline in a way that we might not need the training wheels one day. But we definitely need something in the fight against big tech and attention, and all the things that are driving us in the other direction right now.
Dr. Casey Means:
Oh yeah. Oh, your story is bringing me back to Japan. Favorite place in the world.
Glenn Murphy:
Oh really?
Dr. Casey Means:
Yeah. Oh, it is. It is. Yeah. I got to spend some time in Kyoto, and Tokyo, and Nikko. And so, it was-
Glenn Murphy:
Oh, Nikko’s lovely. Yeah.
Dr. Casey Means:
Yeah. Yeah.
Glenn Murphy:
Well, before we leave, I’m mindful of your time here. We’ve been on for an hour. How do people find out more about this? Is this something that’s actually commercially available to everybody? Or is it only prescription only? Or how can they get involved and sign up for one? I mean, I’m really excited now about the whole [inaudible 00:54:03].
Dr. Casey Means:
Yeah. Continuous glucose monitors are prescription-only devices because their indication is for the treatment of type I and type II diabetes. Our company, what we offer to people is a telemedicine consultation, to be evaluated for a prescription-only CGM. You fill out an online form, a physician in your state reviews your materials. And then, if you’re approved for one of these prescriptions, they are sent to your home.
Dr. Casey Means:
And so, we send you a month’s worth of sensors. They stay on your arm for two weeks. Two sensors will get you through a month. And then, our competency is the app. It’s the software that helps you interpret that data stream so you know what to do with it. Telemedicine consultation, actual hardware, and then, app access, which together is our one-month metabolic awareness journey.
Dr. Casey Means:
And so, we are currently in a beta stage where we’re just working with beta customers. But we anticipate a full launch later this year. So more information-
Glenn Murphy:
Okay. To more commercial folks across the way. When you say for people who might be able to get it prescription wise, is that people who are already diagnosed diabetic or pre-diabetic, or just [crosstalk 00:55:16]-
Dr. Casey Means:
No. Actually, so our company we’re firmly in the health and wellness space. We’re actually only able to give our products to people who do not have type I or type II diabetes. It’s an off-label use of the actual device, and which is why the physician consultation is so important because they’re being evaluated. Is it safe for this person for personalized nutrition indication and health optimization, to have this?
Dr. Casey Means:
This is the first time it’s really being used for a different market, because we see huge potential in how this data can actually keep us healthy and keep us eating and living in a way that hopefully keeps us out of those long-term issues that result from a lifetime of dietary and lifestyle issues.
Glenn Murphy:
Yeah. How did the early adopters jump in? Is there like a wait list? Is it like ordering a Tesla and you’re going to have to get on the big list and then wait for it to come around?
Dr. Casey Means:
Yeah. Yeah. There’s a wait list. You can go to levelshealth.com and sign up for the wait list. There’s actually a really big plug for levelshealth.com/blog, which is our blog, and just amazing guest experts, MDs, PhDs, writing about metabolic health, fitness, athletics, nutrition. It’s really high quality information, so definitely check that out.
Dr. Casey Means:
And then we’re @levels on Instagram and Twitter, just @levels. That’s fun to follow because we’re constantly reposting our beta customers’ experiences using CGM for athletics and whatnot. We have a number of pro athletes using the program. So you can see how people use it, and start getting the wheels turning for when it becomes more widely accessible.
Glenn Murphy:
Sounds wonderful. Brilliant. But I, for one, I’m excited, I’m sure as a lot of people listening to this, who want to jump into the space as well. I’ll put the links to the blog there and all that kind of stuff on the show notes so people can click through as well. Any closing thoughts, if you had any advice for people in general, whether or not they’re going to get a Levels monitor?
Dr. Casey Means:
I would just say I am very optimistic about health and the future of healthcare. I think one of the things I love most about the body is that it is not a one-way direction with health. It’s always a two-way street. We can always improve, and especially with metabolism. And so, I think it’s just a great time to be alive because we used to think that we get old and we get sick and then we die.
Dr. Casey Means:
But that’s really not the way it has to be. We can always move in the right direction on the spectrum. I love what you’re promoting in your work, and certainly support that. So yeah. Just want to leave with a message of optimism.
Glenn Murphy:
Marvelous. That’s great. Maybe we can do this again at some point down the line when things are off and running, from the commercial space, and things like that.
Dr. Casey Means:
Yes. That’s great.
Glenn Murphy:
Introduce it to more people. Marvelous. Thank you so much. Dr. Casey Means, and hope we can stay in touch. Thanks for listening. If you’d like to find out more about classes, workshops, and seminars at NC Systema, please visit us online at www.nc systema.com.