In this episode, we unpack every single question you have about glucose.
Dr. Casey’s mission is to use scientific knowledge as a tool to maximize the human experience for herself and her patients. Life is precious, and Dr. Casey believes that science can help us all experience better, happier, and healthier lives if we choose to effectively implement scientific knowledge.
Originally from Washington, DC, Dr. Casey headed west for college and graduated with Honors from Stanford University with a degree in Human Biology, with a concentration in the Cellular and Genetic Basis of Disease. She completed her medical degree at Stanford School of Medicine and subsequently trained to be a Head & Neck Surgeon at OHSU before the transition to Functional Medicine.
In this podcast, Is Glucose the Cause of Chronic Disease, we cover:
Why we need to look at glucose more frequently
All about the reasons our healthcare system needs to focus on root causes
How wearables are revolutionizing behavior change
About the correlation between metabolic health and Covid mortality
The importance of minimizing inflammatory triggers
Why We Need To Check Our Glucose Levels
Our medical system doesn’t address things until they have fully manifested. Unfortunately, we don’t focus as much on prevention as we should. In our current healthcare model, we don’t think about critical biomarkers. Plus, when someone hears glucose, they think about diabetes. However, we aren’t thinking about acne, depression, fertility, and chronic pain. These conditions all have to do with glucose. From now on, people need to reflect on glucose more holistically. Fortunately, a fascinating movement is that doctors are thinking more about the root causes of issues and symptoms. When we look at root causes, then we can solve most of our health problems.
The Healthcare System Should Focus On Root Causes
We tend to think of diseases and symptoms as isolated issues. However, this way of thinking is an issue with the system. The way we code and label things as doctors feed into this system. Plus, doctors will label things as individual conditions. In reality, it would make more sense to code the underlying physiology. That way, we think more about what the root cause is. For instance, instead of treating acne, let’s treat metabolic dysfunction. With advanced technology, we can understand diseases at a core functional level. Understanding glucose levels is just one low-hanging fruit in the healthcare industry. Luckily, the most beautiful part of glucose is that it’s super easy to modify.
Wearables Are Revolutionizing Behavior Change
If Americans got healthy, a lot would change with big pharma and our food industry. Growing up, we hear loads of different things about how we should be eating and which diet is right for us. Sadly, that leads to a lot of trial and error when it comes to our health. However, what people don’t understand is that there is an open-loop system to nutrition. Someone can change their diet and not notice results quickly. When we make a nutritional choice, there is very little feedback that we can get at the time. Therefore, it’s hard to generate behavior change with nutrition. That’s why wearables are so exciting! Luckily, Levels will track your blood glucose in real-time so that you can maximize your diet and exercise.
The Correlation Between Metabolic Health And Covid Mortality
This year, we have seen how metabolic dysfunction leads to increased Covid mortality should be on every billboard in America. There’s a place for preventing the spread – inside our bodies! However, the virus is only half of the equation. The virus needs a host. Unfortunately, we don’t talk about the host ever in mainstream media. Luckily, we have a lot of control over our metabolic health, and metabolic dysfunction is the key predictor of mortality from Covid. In the news, we should be listing examples of how we can improve our metabolic health.
Glucose is not just a problem with Covid in diabetic individuals. Also, glucose is a problem with Covid for individuals who don’t have diabetes. Even in non-diabetic people, if your blood sugar is higher, it will put you at higher risk for Covid mortality. The best thing we can do to empower ourselves is to keep our glucose flat and stable. Factors like vitamin D have a significant relationship with Covid mortality. Plus, vitamin D is a substance that we get from our food and will have a crucial role in our overall functioning. So, the first step to improving your metabolic health is by knowing your glucose numbers.
The Importance Of Minimizing Inflammatory Triggers
Covid isn’t killing anyone. In reality, the immune response is killing people. Our immune response will cause a massive cytokine storm. Diabetes and obesity are leading to increased mortality with the virus because of reduced immune function and higher inflammation levels. Anything we can do to decrease our inflammation will help with the virus. A massive thing that increases inflammation is glucose. Plus, we need to avoid seed oils and stress – it will increase our inflammation. Overall, now is the time to think about minimizing inflammatory triggers in your body.
Dr. Casey Means: [00:00:00] We all have this deep intuition that actually our bodies are very unique and individual. And what works for one person may not work for another.
[00:00:10] Mindy Pelz: [00:00:10] I am a woman on a mission that is dedicated to teaching you just how powerful your body was built to be. I like to do that by bringing you the latest science, the greatest thought leaders and applicable steps that help you tap into your own internal healing power.
[00:00:26] The purpose of this podcast is to give you the power back and help you believe in yourself. Again, my name is Dr. Mindy Pelz, and I want to thank you for spending part of your day with me, Dr. Mindy here, and on this episode of the reset podcast, I am bringing you Dr. Casey meat. Now Dr. Casey is a, or was, I should say a head and neck surgeon who turned to functional medicine to start to answer some of the questions she was seeing in her surgery practice.
[00:00:58] And I will tell you that we have never untacked blood sugar to the level that we do in this episode of the reset or podcasts. Dr means now works with level. It is a company that has a continuous glucose monitor. So it’s an app and they’re making it available to the everyday person. So I’m excited to share that with you guys, but all of your questions that you’ve ever had about blood trigger.
[00:01:27] What breaks? What raises your blood sugar? What breaks a fast, all of these things. Dr. Means, and I unpack in this episode. So again, as always bringing you guys information, that’s going to make your fasting lifestyle so much easier. And especially those of you who have engaged in, in asking us questions on all of our platforms, we want to make sure that you’re getting your questions answered.
[00:01:51] And in this episode, we are going to unpack every single question you ever had about blood sugar. Dr. Casey means enjoy this one. You’re going to want to take notes. It has so much incredible information to change your life. I feel like blood sugar is so helpful for people to understand, but why are we not getting a tool?
[00:02:16] Like what you’ve got in the hands of the everyday person? Why hasn’t it made it mainstream? And I, and we’ll go into, like, I want to talk a little bit about how you got to this place in your career. Um, but I really just want to answer this one question right off the bat, because we are ignorant as a, as a society when it comes to blood sugar.
[00:02:39] And it just seems like it would be the most helpful tool, like throw away the scale. Let’s start looking at the blood sugar. Why are we not doing this?
[00:02:46] Dr. Casey Means: [00:02:46] This is the key question I think. And I actually think it comes down to really how our medical system fundamentally works. We tend to be a very reactive medical system.
[00:02:58] We sort of don’t address things until they are full minutely manifested and. Because of the way our healthcare system is structured. We don’t focus as much on prevention as we maybe should. And you know, a lot of this comes into the nuances of how we finance healthcare. We’ve traditionally had a fee for service model where, you know, we kind of wait until things manifest and then we treat them and then we get paid for that.
[00:03:23] But in that model, unfortunately, something that falls through the cracks is thinking about these critical biomarkers before disease emerges. So the average person, when they hear the word. Blood glucose, immediate thing they think about is diabetes. We’re not thinking about things like depression or fertility or acne or liver disease, you know, or chronic pain, all conditions that have to do with dysregulated blood glucose, but we’ve just so much linked glucose to diabetes that we haven’t really zoomed out and thought about.
[00:03:59] Metabolism more holistically. And I think a really exciting movement that we’re seeing in healthcare now is there’s a lot of doctors who are thinking more about the root causes of issues. And when we actually look at root causes, we start to think about. Okay. There’s all these diseases. There’s all these symptoms out there.
[00:04:18] And sometimes we call conditions and symptoms comorbid, you know, meaning that they arise together in the same patient. What does that really mean? What it means likely is that there’s a core underlying biologic pathway. That’s linking a lot of these conditions and what we’re learning more and more is that dysregulated blood glucose links.
[00:04:37] So, so, so many. Conditions. And I think this really comes down to the fact that metabolism. I mean, it’s just how we convert food to energy in the body that we can actually use to help fuel ourselves. Metabolism is this core pathway required for every single cell in the entire body. We have trillions of cells and every single one needs to convert food, energy to cellular energy for that cell to function.
[00:05:04] And that largely means. Efficiently processing glucose or fat into energy. When that pathway, that core pathway is perturbed is awry. We can see dysfunction manifesting in so many different ways. If that dysfunction is happening in the ovaries, it could look like polycystic ovarian syndrome. If that is happening in the brain, it could look like depression, all timers, chronic pain.
[00:05:27] Chronic fatigue, all things related, metabolic dysfunction. If it’s happening in the vessels, it could look like heart disease or peripheral vascular disease. So, you know, this is one of these core fundamental pathways and the way we are living these days, what we’re eating the massive amounts of refined carbohydrates, refined sugar, eating all the time and not having fasting or regularly spacing out meals, getting poor sleep, lots of stress, lack of physical activity.
[00:05:51] All these things perturb this key process. So as a society, because of the way we’re living these days, metabolism as a core fundamental pathway is sort of going off the rails. And so really helping people, I think orient, orient around glucose. Much earlier on in their lives, thinking about their diet and their lifestyle through the lens of glucose could keep us out of so much trouble that we’re, we’re seeing these days, but it’s exciting to see people start to talk about it, start to think about it.
[00:06:21] I think the keto movement has helped people start to think about it, intermittent, fasting, things like this, but, um, I think there’s huge room for us to expand the conversation on it.
[00:06:30] Mindy Pelz: [00:06:30] Yeah. I have a friend, who’s got a daughter who has type one diabetes and she was upgrading her monitor and asked me, Oh, do you want it, you know, try her old one out.
[00:06:41] And with of course, new, new, the new adapter to it and everything. And I was like, sure, let’s let me try it. So I tried it for two weeks and. I, when I got done, I was like, why does not everybody have this? I learned so much about myself. There were, and I did it. I purposely did it when I did a five day water fast so I could understand what was going on there.
[00:07:05] I was shocked. That I could be in a fasted state and I could have an argument. My daughter was a teenager at the time, and I’ll never forget, like sitting at the, at my kitchen table. I hadn’t eaten anything. She came in, we had a disagreement, I looked down at the monitor and my blood sugar was up. And I was like, what?
[00:07:25] I started to learn what foods brought it down, what I mean, and I was. Educated at that point. So why do you think that the medical world, I know you came from that world, like, how are we not, I know we’re waking up to it, but why hasn’t this tool been accessible or been used much earlier? Is it just because the healthcare system has been.
[00:07:49] Focused on symptoms that they do. They not think that the, the individual would want it. Like I would, I fell in love with it after that. And I, and I, and I, my scale through my scale away, like it totally changed my relationship to food.
[00:08:04] Dr. Casey Means: [00:08:04] Yeah. You know, I think it’s so great that you had such a great experience with it and, um, You know, I think that, that part of the issue with sort of the, why we haven’t made this mainstream yet so far is because we tend to think of, you know, these diseases and these symptoms as very isolated silos, you know, it’s, it’s like we, we diagnose it and then we either give a pill or we do a surgery and.
[00:08:30] We think of these things as very much, all these symptoms we have is like totally separate entities. And so it, we have it. And a lot of this, again, it comes back to systems issues, even the way we code in healthcare and bill and healthcare feeds back into this. We label things as these individual.
[00:08:47] Conditions when in fact it might make more sense to actually code the underlying physiology like metabolic dysfunction, as opposed to coding the downstream symptom that arises from that. Because then we’d think more about, well, instead of just treating acne, you know, with. Hormones or antibiotics or topicals or knowing what if we actually treat the physiology, which is in many cases, metabolic dysfunction and dysregulated blood sugar, which drives oil production in the skin.
[00:09:17] So I think there’s, there’s these systems level issues, but I think we are moving in this different direction where we’re seeing, I think a big movement in healthcare is what’s called network and systems biology with like proteomics and whole genome sequencing and, and sort of advanced technology. We can actually now.
[00:09:35] Really understand diseases on these core fundamental levels of like how they’re connected from a cell biology and a genetic pathway. And, and what’s emerging out of all of this, this research. And this study is that, Oh wait, there’s a couple really, there are a couple of really big things that are linking a lot that are like low hanging fruit and healthcare.
[00:09:56] And one of those is do glucose dysregulation. The most beautiful part of it is. It’s really easy to modify. This is not like a hopeless path. We can rapidly improve our glucose levels in literally days. And there’s been companies who are even like Virta health, for instance, which is a diabetes reversal program, which is showing that.
[00:10:16] In 10 weeks, they can take people from a diabetic state to a non-diabetic state through, through coaching and nutritional intervention. So the beauty of, I think it’s a really hopeful time, cause we know a lot is related to metabolic dysfunction and glucose dysregulation, and we know that it’s highly, highly actionable, but the disconnect there is.
[00:10:36] Well, how do we get the tools to people so they can measure where they’re at and then learn to optimize. And I think that really speaks to what your experience it was using a continuous glucose monitor. You know, we have this wearable sensor, it’s the size of a quarter. It’s painless. You stick it on the back of your arm and it’s testing your glucose 24 hours a day, seven days a week, and sending that information to your smartphone so that you can actually get instant feedback on exactly how your stress, like you mentioned your diet.
[00:11:06] Sleep exercise is all impacting glucose. And what we want is the flattest most stable, you know, in the low unhealthy range glucose possible. What the average American is seeing is just up and down swings all day from how we’re eating and stressing and living, et cetera. Um, and so with that tool immediately, you can say, this is where I’m at.
[00:11:27] This is where I need to go. And this is how I can tweak little things in my life. Like the food I’m eating and the exercise and the sleep and the stress and all of this to, to move there. So, so now, you know, all the pieces are kind of falling into place. We have the technology, we have increased understanding and the healthcare system, we definitely have a movement, I think, towards people being more interested in prevention.
[00:11:46] And I think that’s going to all come together. With seeing more of an expansion of this technology to, um, to, to more people, because previously, like you mentioned that you got the CGM from, uh, from someone who was, or you had heard about it from someone with type one diabetes, this technology has only been accessible throughout.
[00:12:06] It’s been around for about 10, 15 years for people with type one or type two diabetes. And we’re now realizing, wait, What if you took this technology, this continuous glucose monitor and give it people to people before they developed the disease. So they could actually improve and not get to that, to that end stage.
[00:12:23] Um, when you don’t, you never, you never really need to get there. I mean, I think some of the most recent research I’ve looked at showed that, um, Up to 87% of cases of type two diabetes are completely preventable. So this is, this is where we need technology to be, you know, be used earlier and not just sort of sequestering it to when the disease has fully emerged.
[00:12:44] Mindy Pelz: [00:12:44] Yeah. Wait, we’re kind of in a really cool time of healthcare because people are using Fitbits. And they’re like, we’re getting used to this more personalized approach we’ve got, our whole team has whooped bands. Now you got to whoop. I want to talk about blood sugar and HRV too, but it’s been really fun.
[00:13:02] Like just with the woop alone, we’ve been going to bed earlier. We’ve been making some changes. And just to have that in our hands. And then if you combine that with a continuous monitor, like, wow, we could really start to make some smart choices. My question, and this is I think a difficult one to answer.
[00:13:23] And, um, is if, if we got a continuous monitor in everybody’s hand and people started managing blood sugar, and if they manage blood sugar better and their health got better. What would that do for big pharma?
[00:13:43] Dr. Casey Means: [00:13:43] Great question. I think, you know, I think we would see some really big changes in the way we utilize healthcare.
[00:13:52] And I think we’d also see big changes in consumer decisions related to food, because those are, I think two industries that would be impacted from, from this type of technology, because it’s pretty incredible. I don’t know if you’ve had the success. But I I’ve been wearing a continuous glucose monitor now for about 18 months and my diet is radically different than it was 18 months ago.
[00:14:13] And it’s not because of, I had to give things up or I had to, you know, eliminate whole, whole things. It’s just that I learned over time. It’s exactly how to, you know, which foods were total culprits and did have to go, but also how to like, modify. Meals and pair foods differently and sequence foods differently and do fast appropriately.
[00:14:37] And what times of day were better for me to eat and how to pair exercise with food for the lowest, you know, for good glucose response, it just changed really everything. And what’s nice about it is that. It was not emotional. I think a lot of people associate diets with deprivation and it’s like, someone just tells you from a pie, whether it’s Instagram or the government or your doctor, this is what you have to do.
[00:15:01] And we’ve been kind of hearing really loud. Voices can a lot of conflicting nutrition information for our whole lives, which leads us to, um, basically do a ton of trial and error with our diets and our lifestyle plans. And this can be extremely frustrating. And part of that is because. There’s a really, basically open loop system.
[00:15:20] With, with nutrition and with exercise and other lifestyle factors as well, you might, you know, change your diet, but not really notice any results quickly. You might, you know, eat something and, and what, you know, the feedback you have is like maybe the next day, you step on the scale and it’s a few ounces, different, maybe six months later, you get a cholesterol test and it’s a little bit different.
[00:15:41] Maybe you get a fasting glucose in a year and it’s a little bit different, but those are open loop systems. They’re very little one-to-one feedback between a choice you’re making, which can sometimes be difficult and be associated with deprivation and then an outcome. So it’s very hard to generate behavior change with nutrition and other lifestyle activities that are heavy lifts that don’t have an immediate response.
[00:16:02] And so one of the things that’s so exciting about wearables and now with continuous glucose monitoring, which is really poised to be the first nutrition bio wearable, where you’re actually getting close loop on nutrition. What’s great about that is you can start to close that loop between what choice you’re making and what the health effect is immediately.
[00:16:20] So instead of like having to wait six months for a cholesterol test or a blood sugar test, you see within 10 minutes, how your glucose is responding to a specific. Neil. So that’s revolutionary. I totally revolutionary behavior change. Yeah. Yeah. And also, Oh, go, please stop.
[00:16:37] Mindy Pelz: [00:16:37] Well, I just on that topic, one thing that, again, this one I just worked for two weeks, but one thing that really shocked me was when I get on the scale, what I realized.
[00:16:50] Is that I have a whole story about what the numbers on the scale say, if, if I’m a certain way I go, Oh, that’s the weight I was when I was in college. I have a wait, I don’t want to get above like every number on that scale has a story. And it’s a story that isn’t really beneficial to me. It’s based off my past.
[00:17:11] And I just, it, I, I found it to be so. Um, uh, hard to get on the scale and ridicule myself, or applaud myself based off of that number now with a blood glucose monitor, I could just sit back and almost be an observer to my own health. Yeah, it was free and it was so
[00:17:35] Dr. Casey Means: [00:17:35] frayed is so funny. You mentioned that because both in my personal experience and many customers who are using my company’s products levels, we are finding that people are saying that they are no longer basically getting on the scale.
[00:17:49] They’re totally reorienting around this new metric. And I think part of why it’s such an empowering metric is because you have this opportunity. Every single day, multiple times a day, and the choices that you make to improve that metric, you can see it in real time. If you exercise, your glucose comes down.
[00:18:06] If you get a poor night of sleep, your glucose is going to be higher in the morning. If you eat a bunch of refined, carbs or sugar, it’s probably going to have a higher response. If you. Eat whole food cards and pair them with that in protein. It’s probably going to be a lower response. So each day you have all these opportunities for these micro wins and overall, and when, and they’re very, there’s no real mystery to it.
[00:18:26] You learn about how your body reacts and then you make those choices. And so you really get to orient around this really positive, actionable, um, Actual a metric, whereas weight can really be sometimes very, very difficult one because we’re playing trial and error, um, and kind of going on blind faith.
[00:18:44] That’s what someone recommended to us. Whether it’s a book or, you know, doctor government recommendation recommendations that that’s going to work for you. When I think we all have this deep intuition that actually our bodies are very unique and individual and what works for one person may not work for another.
[00:19:01] And so to see a personalized response also makes it very, very empowering. Um, and the beauty about metabolic health and improving our metabolic processes in the body is that. If you have a S you know, a good metabolic day, cause you’ve seen your data, you’ve made these choices that is going to lay the bricks for basically improving the health over time.
[00:19:23] I like to think about. Metabolic health. I like to call it metabolic fitness. Cause it’s just like going to the gym to build muscles. You don’t immediately build big muscles overnight. You go, and you do the reps every single day. And over the course of weeks or months, you generate adaptations that are ultimately, you know, bigger muscles.
[00:19:42] The exact same is true with cell biology. As we do something day in and day out consistently over and over, you generate the cellular adaptations to improve the way we process energy in the body and the reps. For metabolism are keeping our glucose low and stable day after day. The more you do that, the more you improve your insulin sensitivity, the way our cells respond to insulin and glucose, and you end up building a body that can process carbohydrates more efficiently for us.
[00:20:10] Energy and fat more efficiently for energy. So the reps are keeping the glucose, you know, lower and stable, and you can do that by measuring and tracking it and sort of be empowered with all those like wins throughout the day. Um, as you make choices that you know, are generating better health. So, um, yeah, so certainly what you’re saying really speaks to me about the scale and, um, you know, and ultimately one of my goals with, with.
[00:20:35] Continuous glucose monitoring and being more mainstream is that it also generates an internal sense of body awareness that I think we’ve lost in a lot of ways. Like it’s it’s, um, You know, I think in our modern world with just all the stimulation, we have hyper palatable foods that help us reach our bliss point.
[00:20:52] You know, we’ve got these crazy digital environments with so much stimulation and buzzing and beeping, and it can be hard to sort of hear the internal cues of our body. And I think something with bio wearables, that’s quite interesting is that when you can see your data and you can link it to a subjective feeling like, okay, I had a huge glucose spike.
[00:21:12] And then it came crashing down and now I feel tired and I feel anxious when you link that choice with a subjective experience with data. I think that trifecta actually helps us tune more into what we’re doing. And so whoop, I think does a phenomenal job of actually helping you subjectively and qualitatively.
[00:21:31] Think about how you’re feeling in regards to your data and for, for levels, our product. We’re really trying to help people link. Their data to how they’re feeling, because that’s kind of like this extra step too, to make it not just about, I want to hack my data, but I want to feel better. I want to hear the signals of my body and, and go off of that, you know?
[00:21:52] So it’s almost like using, it’s like a boomerang of using tech to get back to the basics. Yeah, I got,
[00:21:57] Mindy Pelz: [00:21:57] I got chills as you were talking. Cause I just, you know, this year above all years, I have been blown away at how little faith people have in their own bodies and probably a better, an extension of that thought is how little people understand their bodies.
[00:22:17] And a lot of that has. It’s been because of the metrics we’ve been using, the scale, the traditional blood tests you get at your doctor. Most people don’t even know how to read that. Nobody knows what their A1C is or what their insulin or their glucose should be when their doctor says it’s okay. They don’t even throw out numbers.
[00:22:34] They’re like, okay, it’s okay. Or it’s bad. But when you, when this year hit and we had this pandemic and I dove into the science, and I know you already know this, it’s like, Okay. The root issue of the, of this pandemic spreading across the world is metabolic syndrome. So what if we slapped one of these monitors on everybody instead of slapping a mask on them.
[00:22:57] And we got everybody to understand their own body, how quickly we would change this experience,
[00:23:07] Dr. Casey Means: [00:23:07] man, I think you said that so beautifully. I could not agree more. I think what we have seen. This year with how metabolic dysfunction contributes to increased COVID morbidity. Mortality is, should be on every billboard in America.
[00:23:24] And unfortunately it’s not. Um, I, you know, certainly I’m not going to slam like, you know, I think there’s. A place for hand sanitizer. We want to prevent, you know, the spread of the virus, but the virus is only one half of the equation. The virus interacts with a host and we are the host and we are virtually not talking about the host at all.
[00:23:46] I think, I truly think on the New York times front page, it should be a reminder every single day that we have. A lot of control over our metabolic health and metabolic dysfunction is the key predictor of mortality and morbidity from COVID. And then you list examples for people of how they can improve it and simple steps they can take.
[00:24:05] Um, you know, it is, it is strange to me not to go too far on this standard, but like that we’ve got, you know, magazines and news outlets that are constantly talking about increasing. Testing death rates and, um, cases growing up. And then the next page is a recipe for, you know, a pie with two cups of granulated sugar.
[00:24:26] When what’s, what’s really interesting is that, um, more recent research has come out that blood sugar is not just a problem for COVID in diabetic individuals. It’s actually also a problem for nondiabetic individuals. So, so research has shown that even in non-diabetic people, if your blood sugar is higher, Um, in a higher range that will put you at increased risk of in-hospital mortality, if you have COVID.
[00:24:52] So every single one of us, the, one of the best things we can do to empower ourselves, improve our bodies, improve our resilience is to do everything we can to keep that glucose flat and stable, improve our metabolic fitness, improve our biologic resilience, and the same goes for so many other papers that have been shown.
[00:25:08] That have shown that, um, factors like micronutrients, like vitamin D and selenium and zinc actually have a significant predictive relationship with COVID mortality. These are substances that we get from our food that have key roles in our, some of our immune functioning, like. Selenium for instance, um, you know, I don’t like if you look at an immune cell, one of the key proteins they use are called Celeno proteins, they’re proteins that actually have selenium in them.
[00:25:37] So to think that food doesn’t have a relationship with our biologic resilience, it’s absolutely insane. These are key building blocks of proteins that let our immune cells function. So, you know, we’re, we’re speaking the same language. I think we, you know, But, and I think it’s premature to say that, Oh, if we put CGMs on every single person in the U S we have better COVID outcomes because that research has not been done, but I would.
[00:26:07] Darn sure. Like to see that happening very soon, because the first step to improving it is understanding where you’re at and tracking it. Um, and so, um, yeah.
[00:26:18] Mindy Pelz: [00:26:18] Yeah. And I, you know, not, I’m not. Picking on the mask either. I’m just frustrated that we’re over here, debating the mask when we’re w all that energy could be over here, educating people on what they can do so that they aren’t a good host.
[00:26:32] For example, I just found a study and did a video on it, on my YouTube that showed. That viruses are like, uh, parasites. When they come, they don’t have a metabolism of their own. So when they come into a host, they are going to live off the host metabolism. So if they come into a sugar burning metabolism, just for the simplicity sake, they can move into that cell.
[00:26:57] They can replicate and they can gain energy and they can. And, and wreak havoc in that body. If they go into a cell that is living off the ketogenic metabolic pathway, they can’t replicate because they don’t have, they will, there’s no energy for them to gain, to live off of and to be able to gain momentum on.
[00:27:19] And this was a study on pub med. I was like, why aren’t we talking about
[00:27:24] Dr. Casey Means: [00:27:24] this? Right. I or front, I mean, it is, it is literally front page news. Like it is very simple to get into a ketogenic state with mild dietary tweaks that don’t even require deprivation. They just require thinking differently. Um, another thing that really blows me away is, you know, and then I talk about a bit with the patients, is that.
[00:27:45] You know, it’s not actually the virus that is necessarily killing people. It is the immune response to the virus that causes the terrible lung symptoms and, and the, the massive cytokine storm inflammatory response is what ends up killing us. And so one thought about why diabetes and obesity and. Other metabolic conditions are leading to increased mortality with the virus is not just because these conditions and hyperglycemia reduced immune function, but also because these are pro-inflammatory States in the body, people with diabetes and obesity tend to have higher levels of circulating immune cytokines and mediators like TNF alpha and interleukin six and, and these other, uh, CRP, et cetera.
[00:28:30] And so. What the way I like to think about it is, you know, anything we can do to decrease the baseline inflammatory state in our body means that when the inflammation occurs, if you were infected with COVID starts that we went well, we’re starting from a better place. And so one of the big things that can generate inflammation is hyperglycemia blood sugar spikes, high blood sugar.
[00:28:53] This can cause immune activation. But, um, so, so two are so many other parts of our diet and lifestyle, you know, refined seed oils, lack of sleep, lack of physical activity, chronic stress, all these things also create a higher pro-inflammatory state of the body. So now is the time to be thinking, how do I just minimize.
[00:29:12] All the possible inflammatory triggers in my body, um, to just create if I’m, you know, going to be infected with the virus, I want to be starting from that place of just really low cytokine level. And again, these are things that are very, very, very simple. Um, but we just, it’s not a part of Western culture, I think to really, to think that way about diet and environmental exposure.
[00:29:38] So, um, You know, but, but you know, I see it in the podcast community for sure that there are people talking about this, like you and others. And I think there’s, there is, there is hope
[00:29:47] Mindy Pelz: [00:29:47] so. Yeah. Yeah. I mean, I, even on my YouTube, I have to be careful like it’s censored and I, this study was so profound. I’m like, I don’t care if I get centered censored.
[00:29:57] This has to get out there because like you said, to tap into these ketogetic pathways are not that difficult. This doesn’t mean. Okay, starve yourself. This means manipulate your food in a way so that you’re not a sugar burner. And that is so incredibly important. Hey guys, Dr. Mindy hair. And I want to tell you about my book.
[00:30:17] That’s coming out very, very soon. It’s called the menopause reset. One of the things that we realized from our community that was so desperately needed was a book on how women over 40 should do fasting, how they should do keto, what principles they need to apply to their lifestyle, to be able to balance their hormones.
[00:30:40] So you all asked. And so I put it in a book and it’s called the menopause reset and poured my heart and soul into this book. I walk you through the five steps that I took when I went into my early forties and found myself down a bad, bad menopause path. And like many of you guys, I found no answers. I didn’t want to take medication.
[00:31:06] I didn’t want to wake up at night. I would didn’t want any more hot flashes. So many parts of my menopausal menopausal journey that I did not like. So I took matters into my own hands and I researched the heck out of what happens to our body as we move from 40 and beyond. And I found that there are actually five things that you need to implement.
[00:31:30] Five lifestyle changes that you need to look at in order to weather these menopausal years with grace. And so I put it in a book and it’s available for pre-order now. Um, I made it a simple, easy read. You’ll hear about my journey in each step. I give you steps as much as I love inspiring you. I also love moving you into, into action.
[00:31:54] So the book is filled with ideas. Followed by action steps you can take. And it’s now available for, pre-order really excited to share it with you. The menopause reset. You can find all the information that you need on it in the show notes. I hope you enjoy it as much as I loved writing it. Let’s move into a little bit of the weight loss world with, with, uh, and I’m sure a lot of people would come to a product like, like yours, because they want to lose weight.
[00:32:24] Where do you think we’ve gone wrong with weight loss? As far as looking at it from the wrong angle, do you think something like a continuous glucose monitor could totally change the weight loss world?
[00:32:39] Dr. Casey Means: [00:32:39] Yeah, I think that continuous glucose monitoring is going to be. One of the biggest game changers for weight loss that we’re going to see in the next decade.
[00:32:46] I think it’s going to become part and parcel with any weight loss plan within a couple of years. And I think there’s been, there’s been some amazing thinkers and authors who have been writing about this. I think a lot of the, the ketogenic, you know, authors have been thinking about this for awhile, but, um, some of the key books that I love are.
[00:33:05] Jason Fung, uh, the obesity code, he talks about, um, a different way of thinking about weight loss, why we get sick by Dr. Ben Beckman, which just came out this summer is all about this. And then Mark Hyman, the blood sugar solution, which is about weight loss. And the key thing that these people are talking about is that this calorie in calorie out model of diet has not worked almost all weight loss studies.
[00:33:29] In published literature fail or within two years, people regained back the weight. And this is because it’s often looking at reducing caloric content, reducing fat content. When in reality, we need to be thinking through a hormonal lens about weight loss, just very basic. You know, hormonal biochemistry. We know that insulin, the hormone, and I know I’m totally appreciate it.
[00:33:53] No, that’s good. I love it. Insulin. The hormone released when we, when we elevate our blood sugar through, through food choices. Is the hormone that allows glucose to get taken up into ourselves to be processed. But it’s also the hormone that tells our body to stop burning fat. It’s basically a full block on fat oxidation or fat burning.
[00:34:14] So you can imagine if you’re eating the standard American diet where you are. Probably eating five or six times a day between meals and snacks. The vast majority of our calories are coming from refined carbohydrates and sugars, which generate glucose spikes and therefore insulin spikes. You are virtually never giving your body a time when insulin is low.
[00:34:31] Therefore you are not giving your body a time when you can burn fat. So really a new lens that I think we’re looking at weight loss through is how do we keep insulin down so we can take the break off fat burning? Well, we have to do that by keeping glucose low. And this is a, a lot of people to be interested in ketogenic diets, which keeps carbohydrate content per day, very, very low.
[00:34:52] But I actually think there’s another way to do this, which is by tracking with a continuous glucose monitor. And that’s because each person actually responds to carbohydrates in the diet very differently in terms of how it elevates their glucose. You and I could both eat a banana and I might have my glucose go up 50 points and you might go up five points.
[00:35:13] So for you, there may not actually be a large insulin response for you. And for me, there might be a huge one. So it’s really CGM, continuous glucose monitoring can be somewhat empowering and liberalize a really strict keto diet and allow you to kind of find the foods that may have a little bit higher carb content, but actually don’t spike your glucose.
[00:35:32] And in the main study that looked at this phenomenon, which is that different people respond differently in different carbohydrates in terms of how their glucose. Changes, which was a study out of Israel called, um, personalized nutrition by prediction of glycaemic responses. They found that things like microbiome composition, just
[00:35:51] Mindy Pelz: [00:35:51] that I’m like, okay, keep going.
[00:35:53] Dr. Casey Means: [00:35:53] It’s all comes back to microbiome. You know, it’s like Tyria process this stuff differently. And so it’s going to be a different reaction. Um, other things that were involved were, um, recent physical activity, uh, body type, um, body type can kind of be a predictor of insulin sensitivity. And so, um, those are some of the key factors, but microbiome was a big one.
[00:36:13] And so, um, we’ve actually had a number of people on ketogenic diets, use continuous glucose monitoring and find that they were actually able to eat more carbs than they thought, and still stay very much in a fat burning ketogenic space because. State, because for whatever reason, those carbs weren’t actually affecting them quite as much.
[00:36:33] So I think we’re going to see, and I would also say we’ve had lots of early customers come to us seeking continuous glucose monitoring for weight loss, and we’ve seen some really exciting. Early results. And people saying that like, this is the easiest it’s ever been, because as opposed to just guessing and debt depriving, I’m just figuring out how to eat and live to keep my glucose low.
[00:36:54] And then you basically know that you’re keeping your insulin low and then you know, that you’re going to be, have more likelihood of getting into, to fat burning. So we actually.
[00:37:04] Mindy Pelz: [00:37:04] Yeah, I love this. I know. I just, like, I hope all my recenters are listening to this. This is just beautiful. This is the kind of level of healthcare we need, but continue on.
[00:37:16] Dr. Casey Means: [00:37:16] We’re just going to say we did, we, we did, uh, a small pilot, um, with called it was called our weight loss challenge. And basically the only thing we asked you will do is to try and keep their glucose under. 120, so 120 milligrams per deciliter, which is pretty liberal. Like it’s not that hard to stay under one 20, but for the average American they’re getting higher than that quite frequently.
[00:37:38] And we found that in 30 days, for people who were able to keep their glucose under one 20, um, they lost an average of eight pounds in, in that 30 days. And it actually, if you actually stratified them by BMI, the higher, the BMI. The more they, um, the weight they lost and that makes we didn’t study this in, in explicit detail in this particular pilot.
[00:38:00] But I would expect that the people with the higher BMI’s had slightly more insulin resistance. And so by keeping the glucose low, they really were able to kind of get that break of the insulin off and start to really see some of those quick results. So I think there’s a lot of promise there, but it’s just more, more research needs to be done.
[00:38:19] Mindy Pelz: [00:38:19] You know, we do a lot of Dutch tests on women that are over 40 going through hormonal changes. And the one thing that we can see when we start to monitor repetitive Dutch tests is that when they get their insulin under control, all of a sudden their sex hormones get under control. So I’m thinking, as you’re talking, I’m like, what about for the menopausal woman who is looking to HRT or bio identicals is out of answers and you put a continuous glucose monitor on her, you get her to stabilize her sugar and then, and her whore enter insulin.
[00:38:51] And now you’re in the ballpark of being able to manage her sex hormones. Like to me, insulin is the door in blood. Sugar is in the door into all these other hormones. Yeah. Because it’s the one that changes so fast and that you can manipulate so easily with, with lifestyle.
[00:39:13] Dr. Casey Means: [00:39:13] Yeah. I think there’s so many interesting implications for women’s health with this.
[00:39:17] And I think this is going to emerge as the technology that can really uniquely impact women, um, men too. But I think there’s a lot of amazing use cases for women in particularly into hormones. And so one interesting thing about insulin is that there are insulin receptors on. I believe every single cell type in the entire body, which is pretty incredible that, that every, we have so many different cell types and almost every single one has insulin receptors.
[00:39:41] So it has. Incredible amount of activity all over the body. So when it’s dysregulated, it can cause problems. And one of the places that there are quite a few insulin receptors are the FECA cells of the ovary. And so they are going to respond to high insulin levels, which are going to have, if you are, you know, eating that.
[00:40:01] Refined carbohydrate, refined sugar diets, spiking your glucose a lot and going down that trajectory of insulin resistance. So what happens when the insulin stimulates the FECA cells is they actually have the ovaries as they increase in number, but they also produce more androgens, more male hormones. So you’re basically insulin is stimulating your ovaries to make more male hormones.
[00:40:21] And this is really foundationally. One of the, one of the. Pathways that leads to polycystic ovarian. I was just going
[00:40:27] Mindy Pelz: [00:40:27] to say, is the number one hormone issue of for women? This makes perfect
[00:40:33] Dr. Casey Means: [00:40:33] sense. Yeah. So there have been amazing studies that have been done one a few months ago that was powerful looking at a ketogenic diet for PCLs and that the data was phenomenal in terms of resolution of, you know, FSH and LH and estrogen, progesterone, testosterone, weight.
[00:40:50] Um, cholesterol, everything improved by keeping glucose down on the diet. And it makes a ton of sense and their insulin sensitivity of course went up. And so insulin sensitivity goes up by keeping the glucose down over time. That means less insulin circulating in the body, less stimulating Thika cells, less androgens.
[00:41:07] And then it’s just like a waterfall effect of. All the goodness that, that comes from that. Um, and then the second thing with the menopausal women is that, you know, something really interesting about menopause is that, you know, as estrogen declines, estrogen tends to be sort of like a pro metabolic hormone.
[00:41:24] It helps us. And when estrogen declines, we see women start to have really increasing rates, the slope of the line of. Incidents of obesity and diabetes goes up right after menopause. And that’s actually when women start to exceed men in terms of rates of diabetes and obesity. So when that estrogen declines, you know, you, you’re in worse shape, basically worse risk metabolically.
[00:41:47] So I think there’s a huge opportunity to help women become more metabolically aware during that time. So that they can modify their activity, their food, and be aware of whether they’re starting to kind of go off this metabolic cliff, um, at that time. Cause it’s, it’s an at risk. Time. So I think that would be great for women in their sort of perimenopausal time to be thinking through the lens of metabolism, glucose.
[00:42:12] And then you also think about how Alzheimer’s rates are double in women compared to men Alzheimer’s, which is becoming called, which is now being called type three diabetes, because we’re realizing that, um, One of the physiologic pathways that leads to it is insulin resistance in the brain. The brain cells can’t get enough energy because they’re resistant to this hormone.
[00:42:33] And what happens when you can’t get an energy in a cell type, they start not functioning well, and that can lead to dementia. And so I think this, this metabolic cliff that happens at menopause plus, you know, what we’re seeing with Alzheimer’s, I think that’s very related. So first step. Helping people understand where they’re at and how the, the choices they’re making are impacting that.
[00:42:54] So, um, so that’s how I’m very passionate about.
[00:42:58] Mindy Pelz: [00:42:58] Yeah. So I have a book coming out in the spring called the menopause reset, and it’s all about. My journey. I’m 51. And it’s really about my journey with my health as I have moved through menopause. And one of the things I wish somebody had told me and I I’ve had a really, I mean, my lifestyle at 40 and in my forties was healthy.
[00:43:18] I wasn’t eating, you know, going to fast food or anything like that. But what I found is that at 40, as your ovaries stop producing sex hormones. And you become more and your estrogen is going up and down and you become more insulin resistant. There is a lifestyle that has to match that. And once I figured out that lifestyle, I found I could manage my hormone ups and downs a lot better, but how many women are aren’t finding that lifestyle there and then they’re being shamed or they’re not talking about it.
[00:43:53] Or they’re being given medication. And that the damaging part of that is if the lifestyle doesn’t change, like you said, they now move into their fifties, sixties, and they’re unprotected. They, as far as their hormone, imbalance is so low, they’re getting cancer. They’re getting all timers. Like there’s, there’s so much that needs to happen for a woman as she shifts into that.
[00:44:17] And again, this is why I’m like. You got to get this out to the
[00:44:21] Dr. Casey Means: [00:44:21] world. I think that book is going to be so valuable for people and I, I can’t wait to read it. And, um, we actually, I just published an article on our blog, uh, uh, or level’s health, uh, blog about menopause and glucose. Because aside from all the stuff we were just talking about, like risk profiles, there’s actually some evidence that the symptoms of menopause could be quite a bit better if.
[00:44:44] People’s glucose were under control and a key one is hot flashes. Um, insulin sensitivity seems to really impact the autonomic nervous system and create basically more of a Zometa motor activity. So like blood vessels, constricting and whatnot. And so people who are insulin resistant. Um, or have overt diabetes tend to have significantly higher, hot flash frequency than people who don’t.
[00:45:09] And so I think there’s going to be maybe some interesting opportunity there to help people actually almost like a biofeedback tool for hot flashes. How could keeping glucose more stable, be actually an adjunct, very natural tool, you know, no hormones or anything like that to help people, uh, to help you with that symptom that is so troubling to so many people and, um, I was very hard to, there’s a company, um, a digital health company called the cuss, but that’s, that’s really interesting.
[00:45:38] That’s basically holistic telemedicine, menopause care. And, um, they’re all over this, you know, they’re thinking about like, we’ve gotta be thinking about metabolic health and glucose when we’re talking about symptoms. And, um, you know, I, I don’t think it’s something we’re thinking about in the mainstream OB GYN community, but I, I.
[00:45:56] Certainly talking to my OB GYN colleagues about it, and everyone’s very receptive to learning about it. So, um, yeah, I think,
[00:46:03] Mindy Pelz: [00:46:03] yeah. I actually tell a story in the book about how, when my symptoms started to appear, I went to a friend of mine. Who’s an OB GYN. That’s very well-respected. And I was hoping she was going to have the cure for my menopausal symptoms.
[00:46:17] And she, she stopped everything she was doing. And she looked at me and said, Mindy, I have a practice full of women like this and my medical textbooks have failed me. That’s literally what she said. And I was like, Whoa, you mean there’s no solution. And that was almost 10 years ago. And I’ve since uncovered so many solutions, but blood sugar being a major, major one, and it’s just not talked about and women are suffering in menopause.
[00:46:47] And this is a time when wisdom is at its highest and the kids have left the nest. And this is a time we should be thriving, not a time. Right. That we should be now struggling with our health.
[00:46:57] Dr. Casey Means: [00:46:57] Yeah, absolutely. And you know, the same goes for men. There, there are so many sexual health, uh, areas where I think glucose monitoring could help men.
[00:47:10] So, so much, you know, I think one of the key ones, you know, Erectile dysfunction. We know that erectile dysfunction is significantly worse in people with higher glucose levels. And this, you know, I don’t think the average neurologist is talking to their patients about this, but it just, for anyone out there listening who may have a friend or a partner who has this issue, If you’re not thinking about glucose, like you’re doing yourself a total disservice because it’s actually such a strong link that there are there’s research published, suggesting that people who present with erectile dysfunction should be considering that are basically a warning sign that they need to get checked for metabolic dysfunction, because it’s so, so, so related.
[00:47:54] So before reaching for a pharmaceutical or other things, Truly the easiest thing you could do is figuring out how to clean up your diet to keep your glucose stable and improve your insulin sensitivity. So, um, I just think it’s fascinating and I’m really hoping we see that, you know, more of this trend over the next five to 10 years, to thinking about these, these root causes, because.
[00:48:15] When you let’s say the motivator for a 40 year old man, who’s having this issue is to improve their, you know, erectile dysfunction. What they’re going to get from that as a side benefit is so much in terms of improved health, they’re going to have better workouts. Their brain is going to function more properly.
[00:48:33] Mood is probably going to improve less risk of heart disease, diabetes, and obesity. So whatever the motivator is, you know, that’s great. But the beauty is that this has such pleiotropic. Impact on health that, you know, it’s going to have wide reaching effects. So yeah,
[00:48:47] Mindy Pelz: [00:48:47] I love that. It’s like you clean up one thing and all these other can, all these conditions that the comorbidities, they all clear up.
[00:48:54] It’s, it’s quite incredible. Talk to me a little bit about what else raises blood sugar. So we know that we. Have food is, is a big thing. So we also, my community knows quite well that w how often you’re eating. So if you’re eating all day, that messes it up, but there are other things that are messing up our blood sugar.
[00:49:14] Can you talk a little bit about that?
[00:49:16] Dr. Casey Means: [00:49:16] Yes, absolutely. So I would say there’s really like five others that are, I think, important to recognize. So sleep. So food that’s a whole category that I think, yeah, like your listeners are probably very familiar with food. Time is a big one food sequencing and then food combinations.
[00:49:32] So. That’s huge. Um, but the others would be exercise, physical activity, stress, sleep, micronutrient status, and microbiome. So those are kind of the key things that I focus on. And I’ll actually add, I’ll add one more, which is organic, which is environmental. I was just going to
[00:49:49] Mindy Pelz: [00:49:49] say where, where obesogens and toxicity.
[00:49:52] Okay. Yeah. That
[00:49:53] Dr. Casey Means: [00:49:53] one. Yeah. You know, it’s becoming more and more recognized, but, but very much early, early on. Uh, with, with that aspect of things. But I think it’s key for us to start thinking about, so exercise just briefly kind of touching on these. So exercise, we pretty much know that every single type of activity you could POS, if you’re moving your body, you’re improving your, your metabolic health and your insulin sensitivity, whether it’s resistance training or like power sports, um, Whether it’s stretching and yoga and more gentle type activities like that.
[00:50:22] High intensity interval training, or just moderate aerobic activity. All of these things in research has been shown to improve our insulin sensitivity and our, our blood glucose control. One, two things that are worth mentioning here. One is that high intensity interval training. People actually often see their glucose rise during high intensity training.
[00:50:42] So if your heart rate or your VO two is above about 80% of your max, um, You’re actually going to see your glucose rise during the workout. And that’s not necessarily a bad thing cause it’s not from the food you’re eating. It’s actually your body releasing. It’s stored glucose to feed the muscles. So actually you’re working through your stored glucose to feed those muscles and clearing out that liver storage, which is a good thing.
[00:51:06] Cause it means that once you have through that, you’re going to start burning fat. And you’re going to flip that switch from glucose burning. To fat burning. So not a bad thing. If you see your glucose rise during high-intensity training, even if you’re fasting, don’t have glucose on board. So that’s one thing to note, the second fun sort of thing to think about with exercises.
[00:51:24] There’s some studies showing that, you know, Dave basically taking three different groups and saying, if people work out. Once a day for like an hour versus take that amount of time and split it up into really small chunks all throughout the day, which is better for glucose. It turns out that the small chunks throughout the day is better for glucose control than one workout.
[00:51:48] So if you just take a one-hour walk in the evening, it’s going to improve your glucose and your insulin. But what would be better is to actually take a two minute walk. Every 30 minutes throughout the entire waking day. So like, like 30, really short. So that’s, that has huge implications for our Workday, like standing up every 20, 30 minutes and just taking a brief two minute walk is actually going to have a lower 24 hours glucose and insulin levels.
[00:52:12] And they’ve done a similar study with like taking 20 minute walks before every meal taking 20 minute walks after every meal or taking two minute walks. Every 30 minutes throughout the whole day. And again, it was the more frequent ones that was better. So moral of the story be more active consistently throughout the day.
[00:52:28] And I think that my, my thought on the mechanism of this is that even when you stand up from a chair or even walk five feet, you’re having to activate basically every single muscle in your. Big muscle groups, your quads, your hamstrings, your calves, your abs, maybe not so much your arms, but that’s a lot of muscle contraction even just to walk across the room.
[00:52:48] And if you’re just doing that throughout the whole day, that’s a lot of activating those pathways, you know, and it’s getting things moving and it’s it’s it’s. Reinforcing those adaptations. So bottom
[00:52:59] Mindy Pelz: [00:52:59] line and it’s doable, it’s doable. So instead of waiting, I got to work out at the end of the day, and then you don’t work out.
[00:53:06] If you think of it in shorter chunks again, now we’re back into making an effortless lifestyle.
[00:53:12] Dr. Casey Means: [00:53:12] Right, right. But it does, it does it. Doesn’t jive with our normal Workday and the way schools and work is set up where it’s just like fits it fits it’s set. So it does. It doesn’t make, um, inspire the need to think a little bit differently about how we structure our time, but it’s very achievable.
[00:53:31] It’s very easy. It doesn’t hurt. So that’s, that’s just a few things about exercise. Stress is the second one. Really a key factor in maintaining stable glucose levels. When you stress, you release cortisol and epinephrin, you know, are the catecholamine hormones and these travel the body and they tell our liver to dump our stored glucose to basically help.
[00:53:51] Fuel our body for another stressful thing we have to respond to. And this made sense way back in the day when maybe our stressful events actually were physical in nature, we were being chased by a lion and we needed to, we got stressed and we had to run and our muscles needed sugar. That’s no longer the case.
[00:54:07] Now almost all of our stressors are actually psychological in nature. It’s a text. It’s an email
[00:54:13] Mindy Pelz: [00:54:13] do is go to go to your phone and cortisol.
[00:54:17] Dr. Casey Means: [00:54:17] So. So we need to recognize this maladaptive physiology and realize that when we do evidence-based mindfulness activities, like taking a deep diaphragmatic breath, which activates our, our parasympathetic restful part of our nervous system lowers our cortisol.
[00:54:35] We are actually. Our cells here that every cell hears that and they, they, it, it, it stops that sort of, that, that pathway of glucose being released to sort of in this maladaptive way, you’re just basically causing little glucose spikes throughout the day. If you’re having an uncontrolled stress response.
[00:54:54] And the, the key point here is we can control that stress response. We can do it. There are so many evidence-based strategies. The simplest is breathing. Every time we feel stressed, we should take a deep breath and realize that we’re actually. Having an impact on one of the key health pathways of our body, which is our metabolism.
[00:55:10] So, yeah.
[00:55:11] Mindy Pelz: [00:55:11] And where we see that just in our community is people are like, I’m doing everything, but I’m struggling to get into ketosis or I’m not losing weight. And what I want to add on to that sentences, you might be doing everything with your food. But where is your stress? Like, we don’t tend to think of stress as being this thing that elevates our, our blood sugar.
[00:55:34] Dr. Casey Means: [00:55:34] so true. I think we focus a lot on food and food is food is key, I think. Um, but I like to say that food is necessary, but not sufficient for optimal metabolic health. And if it’s, you know, it’s, it is ness. You, you, you can’t meditate your way out of a terrible diet in terms of metabolic health, but you also.
[00:55:53] If you are chronically stressed, you are going to see problems with glucose, in my opinion, and from what I’ve seen in my patient population. Um, so the S the one that goes hand in hand with that is also sleep, which is kind of the third pillar that I think is under-recognized. And. You know, I’ll keep this one brief.
[00:56:10] Basically, if you sleep one hour less per night, than you should for your body’s needs, you will see a significantly higher insulin and glucose response. The next day, and sleep deprivation increases cortisol growth, hormone insulin. It also changes our ghrelin and leptin levels, which are satiety and hunger hormones, and just creates a profound hormonal cascade that is not good for metabolic health.
[00:56:35] And. Just two, just briefly to two quick studies, one, they took healthy young non-diabetic men and subjected them to four hours of sleep per night for six nights and took them from non-diabetic to pre-diabetic in that short amount of time, it was reversible, but like a lot of college students out there are probably, you know, burning the candle at both ends, maybe four hours of sleep multiple times per week.
[00:56:59] Um, and the second one is that, um, there was a study that looked at. Basically people who needed 7.5 hours of sleep who got 6.5 hours of sleep the next day, if you do that. So just one hour less, and you do an oral glucose tolerance test, which is test for you, chug, you know, a bunch of glucose. If it’s 75 gram glucose load, and then you see what your glucose and insulin do in the two hours after that, the people who slept an hour or less had.
[00:57:27] The same glucose response, but they needed us to create 50% more insulin to get that same response. So they were insulin resistant the next day. So we do not want that. So
[00:57:39] Mindy Pelz: [00:57:39] hi, missing one hour, one night increased your insulin resistance. Wow.
[00:57:46] Dr. Casey Means: [00:57:46] That’s cool. And I’ll, I’ll, I’ll follow up with some of these links cause it’s yeah, no, it’s great thing.
[00:57:51] Um, yeah. So sleep stress, food, timing, exercise, and then the micronutrients. And one is really one of my favorite, cause I really practiced like food as medicine. And I love, I love nerding out on the biochemistry of food, but I think the key thing here to remember is that for glucose to be processed by the mitochondria or for fat to be processed in the cells that requires proteins, it requires enzymes requires pathways and all of those.
[00:58:15] Machinery require micronutrients like locks and keys to let them work. Some of the key ones for metabolism are vitamin C zinc, magnesium manganese, a lot of the B vitamins lipoic acid. So. These are things that come from food. We are eating the most nutrient poor diet we’ve ever basically eaten throughout history.
[00:58:36] Our soil is deplete, you know, lots of issues with that. So we’re micronutrient depleted for a lot of these key nutrients. So we have to remember that for our machinery to work. It needs these micronutrient substrates. So it’s way more than just macros. It’s also micro. So that means getting back to that whole foods.
[00:58:53] Diet, you know, really getting nutrient rich foods, making sure we’re getting lots of, you know, probiotics sources, um, for, for, to basically optimize our machinery. Same with microbiome. We know that dysbiosis and poor microbiome is associated with worse metabolic health and increased risk for obesity. So we’re doing a lot in our culture that.
[00:59:13] Parts of our microbiome from chronic stress to non-steroidal anti-inflammatory medications, to pesticides, to overuse of antibiotics, to so many other things. And so, you know, the more we can do there to seed our microbiome with healthy foods and probiotics and prebiotics, I think the better for metabolic health.
[00:59:30] Mindy Pelz: [00:59:30] Yeah. Yeah. And where, where we see that is that people are frustrated with their health and they don’t realize how many things are taking them down a bad path. Cause they’re just living life the way they did 20, 30, 40 years ago. But the environment has changed. The food has changed. The amount of information has changed.
[00:59:53] The toxic load has changed. Your microbiome is being destroyed. It’s overwhelming and it’s hard to grasp which, and then you feel lost and you don’t really know what you can control, which again is why something like a monitor would be so great because it is, I can see where it would just be like the way to claw yourself out of this modern world that has our health really mixed up.
[01:00:19] Mm. Yeah. Okay. Talk about HRV. Cause I have to ask you about HRV cause we’re, we’re mildly obsessed on HRV, uh, in and within my office and within my resetter community. I love my whoop has just really been helping me understand all the different things that might, will affect my HRV. What H what is blood sugar and HRV?
[01:00:42] You talked a little bit about it. Is there a connection there?
[01:00:45] Dr. Casey Means: [01:00:45] Yeah. So there is a connection and an HRV, you know, is this objective measure of stress that we can, we can find Z now, which is. Credible. And so to me, I wear an HRV monitor. I actually wear the leaf therapeutic HRV monitor, which I love it’s and I love Oop as well, but it’s the, the leaf therapeutic is actually a little stick on that goes under your heart.
[01:01:09] And it’s like an EKG that’s real time is amazing. Um, it’s giving you as opposed to sort of like averages, it gives you real time every second HRB, cause it’s actually EKG on your, on your chest. And, um, So you can see if you do breathing or whatnot, um, it immediately will bring down, um, increase your HRV.
[01:01:32] Yeah. So, um, so that’s what I’ve been using and trying to make some correlations between my glucose and my HRV. And I certainly think that just from my anecdotal experience, that when I have more. Glycemic variability, meaning ups and downs spikes in my glucose. I tend to see my HRV go down. And so, um, so, and, and you know, and I’m not, I am not, I do not think we have any research in non-diabetics to actually support, uh, a direct link there, but from the cortisol and the stress standpoint, I think it’s, there’s definitely something there that we’ll, we’ll see more research into, but.
[01:02:08] Um, I think it’s, it’s really bi-directional. And so we can think of a glucose monitor and HRV monitor together as a really powerful mindfulness tool. Like it could really become something that motivates us to both, you know, eat in a way that keeps HRV down, but also keep our HRV up. Sorry. I keep saying down to, we want our HRV to be, yeah.
[01:02:29] Mindy Pelz: [01:02:29] is confusing like that. Cause you want it high and everything else we’re trying to get low.
[01:02:34] Dr. Casey Means: [01:02:34] Exactly. So, um, Because I think that the higher, the low HRV telling us that we’re sort of objective stressed, we’re going to see glucose, you know, potentially go up. And if who goes those up and it’s really fluctuating, it might also make HRV go down.
[01:02:47] So it’s this loop and the more we can tap into ways to improve our HRV, the more we might see glucose be controlled and same with glucose in HRV. So I think there’s huge, huge potential there and something that excites me a ton, because I think LA all about, you know, mindfulness and mindfulness based stress reduction is how.
[01:03:05] This tool that’s a glucose monitor could actually end up becoming a mindfulness tool like that just blows my mind, but I think, I think we’ll get there.
[01:03:12] Mindy Pelz: [01:03:12] Yeah, yeah. Yeah. Like I said, when I wore this, uh, monitor that my friend had given me, this was like three years ago and I re I just was shocked, like literally one disagreement with my teenage daughter and she walked out of the room.
[01:03:29] And I looked down at my monitor and I believe it had gone up 20, 30 points. And I thought, Oh my God, like I had, at that point, I had never realized the impact that stress was having on my blood sugar. I was more into looking at it from a food standpoint and a fasting standpoint, but that just was my mind
[01:03:49] Dr. Casey Means: [01:03:49] blowing.
[01:03:49] It is mindblowing. This very similar thing happened to me when all of this COVID remote work stuff happened. I had to give my first talk a presentation on zoom and it was just confusing. I, you know, you had to share your screen and so much was going on and you can’t see all the people watching. And I was, it was very stressful because I didn’t.
[01:04:07] Quite know if it was working. And I looked down afterwards and my glucose had gone up like 35 points right then. And I was like, this is fascinating because I did feel stressed. I didn’t feel profoundly stressed, but he was telling me you are churning out stress hormones. And so from then on out, I’ve been much more intentional about, about doing, you know, dreaming.
[01:04:30] When I’m feeling even a little bit activated because I do not want it to be throwing off my glucose. So,
[01:04:36] Mindy Pelz: [01:04:36] yeah. And if you have the monitor there, I mean, this is how the woop works. You know, the other day my parents were over and they might, they wanted to sit and chat and I was like, you got to go to bed because there’s people watching my sleep.
[01:04:48] Now we were all done and I’m like, and so I need you to leave so I can go to sleep so that I don’t have my friends tomorrow morning, look at my, my, our little whoop team and say, Hey, What happened to, right. Exactly. So it’s awesome like that.
[01:05:05] Dr. Casey Means: [01:05:05] Wait to see how the social community emerges around glucose as well.
[01:05:09] Cause I think it’s inherently very fun to share with people. And I think similar to whoop, we’re going to start seeing people we already see on Twitter and Instagram with people using levels that everyone screenshots their data and wants to share it and like, Oh my God, I can’t believe this is what ice cream did.
[01:05:25] Oh my gosh. I can’t believe how much this walk decreased my glucose. So yeah. You know, I think, you know, so much research has shown that social elements to health programs helps with success. And I think this will be no different with, with glucose as well.
[01:05:40] Mindy Pelz: [01:05:40] Yep. Yeah. One of my major principles is that, especially for women, is that we shouldn’t be doing health alone.
[01:05:47] Because when we thrive off oxytocin and we get a burst of oxytocin when we’re connected to others and oxytocin brings down cortisol and cortisol brings D can affect insulin and insulin can affect sex hormones. So if we do things in community, we really can have a massive impact on all of those hormones.
[01:06:07] So I hope are you guys coming out with like, like whoop has a. Uh, has a like team effect where you can all share data. Does your app do that
[01:06:18] Dr. Casey Means: [01:06:18] right at this moment? We do not, but our, we just raised our round of seed funding. And so we’re really investing in the product and community features are, are a big part of our roadmap because, um, yeah, I’m a big believer in exactly what you just said.
[01:06:32] You know, we do better with community and, um, And I think you inherently love talking about food, so it lends itself to
[01:06:40] Mindy Pelz: [01:06:40] that. I love it. I love it. So how do people find your product? How do we, I know when I first heard about it, this is what I heard. It’s amazing. And there’s like a 40,000 person wait list.
[01:06:54] Dr. Casey Means: [01:06:54] we, you can, people can find us at levels, health.com and I definitely recommend our blog too. It’s level health.com/blog. Lots of awesome really forward thinking guest writers who are writing about metabolic health and how it relates to the average person. Um, no non-diabetic individuals, people looking for performance gains disease, pervert, uh, prevention, all sorts of stuff, um, to get access to the product, which is, uh, continuous glucose monitors, um, and an app that helps you interpret the data really effectively.
[01:07:24] That we are now in a beta program for that. So we do have 54,000 people on the wait list now, but, um, we have a code for your listeners and so they can skip the wait list if they want to sign up. And so, um, we will get that to you and then hopefully in the show notes or something. Yeah. Yeah.
[01:07:40] Mindy Pelz: [01:07:40] We’ll put you guys, we’ll put a code in there and, um, as your words were, and I love it was that we could hop.
[01:07:46] The waiting list. Is that correct? How this works? Yeah. We have a motivated group of people that will definitely jump on board. So we’ll put the link in the show notes and I appreciate you doing that for us. Mostly we will get, and then we also have we’re taking. The, the large amount of people that are fasting and applying variations to diet in our community.
[01:08:08] And we’re having them all look at their whoop. And what I’d love to do is be able to have everybody’s woop and have everybody share what they’re learning with your continuous glucose monitor. And then it’d be fun to give you guys the data back over a hundred thousands of people. And it would be fun to see what you do with it or what we can all pull out of that.
[01:08:29] Dr. Casey Means: [01:08:29] Definitely. Yeah. I think, I think especially with like the recovery score and whatnot, which I believe we’ve had,
[01:08:35] Mindy Pelz: [01:08:35] you know, the scores strain has a strain screen score. Right,
[01:08:38] Dr. Casey Means: [01:08:38] right. It’ll be, so it’d be interesting in your, in your groups to see if people start to see, we have a metabolic fitness score, um, in our app.
[01:08:46] And so. Starting to see how those things can, can connect. So, um, yeah, that’d be great to, to get some feedback on that. Yeah.
[01:08:55] Mindy Pelz: [01:08:55] We’ll go to town on this, so we appreciate it. Let me finish up with this. I have five questions for you. Um, and so let’s start with this idea of medicine is changing. And if you were talking to somebody who was thinking about a career in Western medicine, what, what advice would you give them?
[01:09:17] Dr. Casey Means: [01:09:17] Wow. That’s a big
[01:09:18] Mindy Pelz: [01:09:18] question.
[01:09:23] Dr. Casey Means: [01:09:23] I think I’m biased, but I think there’s no better career to be in than healthcare. I think it is just the intersection of so many things that are important. It’s the intersection of community of, um, you know, Of our personal identity of the environment of all of our behaviors and, and also with the earth, because ultimately health is the intersection between the earth and our body and how those two things interact, you know, food and environment and air and water.
[01:09:56] Um, these are all things that translate, um, you know, in our bodies to our biochemical reality. And so to me, I mean, healthcare. It’s just, it is a constant joy. It’s always evolving and it really brings philosophical, um, and very, um, meaningful, uh, thoughts and, and relationships into everyday life. So I can’t recommend it highly enough.
[01:10:22] I think. Something that I would say is I’ve taken a somewhat unconventional road through, um, through medicine I, you know, was at Stanford for my whole training. I became a head and neck surgeon, and then I completely transitioned out of surgery because I wanted to really focus on doing everything I can to empower people, to understand their own health better and to, to really look at tools that could help people make decisions in their life that.
[01:10:48] Would generate better health and just empower the individual as opposed to be really reactive and telling people, um, things from this much more sort of authoritative place. And so, um, so that’s what my career is focused on now is empowering you with data, um, to understand their bodies and their lives better and feel more agency and empowerment.
[01:11:06] And the, the in terms of my journey, like I think. What it really highlights. And I hope to others as well, is that you can take any path you want through healthcare. I think we often make medical students or students think that there’s like one road in healthcare and you just have to follow it or some sort of like prior outcast.
[01:11:26] But the reality is is that you can do whatever you want in this life that, um, that is the way that you wanna, you know, make a stamp on the world and the sky is the limit. And so I think. Getting the education and the learning, however, whatever path that is, whether it’s MD O nurse practitioner, nurse, you know, physician assistant, whatever it is like having that knowledge gives you a lot of ability to have an impact in the world.
[01:11:50] Mindy Pelz: [01:11:50] I would say so well said, you know, when we were in school, there was a very. Cookie cutter path for every degree you got and now it seems like that you really do create your own career. So pick what you love. If you could add anything into the medical school curriculum, like any courses, what would you add in
[01:12:12] Dr. Casey Means: [01:12:12] nutrition?
[01:12:13] Like about 150, more hours of nutrition? I would say, uh, we, the average medical student gets, I think, less than 15 hours of nutrition in their whole medical school training. And yet. Almost every leading cause of death in the U S is related in some way to diet. And so it’s apps. It’s just, it is. It does one of the most massive disconnects in our country that that doctors are not experts in nutrition.
[01:12:38] So, yeah,
[01:12:40] Mindy Pelz: [01:12:40] and I, I really hope that changes. I, you know, again, when we look at how the world needs to change and look at health differently, gosh, I agree. Nutrition needs to be at the top. What, what do you feel like was the biggest lesson you have learned in 2020? We all got a big dose of life lessons. Do you have one that you feel like was an aha for you this year?
[01:13:04] Dr. Casey Means: [01:13:04] Oh, so many lessons this year. And these are, these are great questions. I think, um, I think this year has been wonderful for sort of like bringing, bringing back, bringing me back to sort of some of the simple pleasures I think, um, You know, never more than I’ve never more than this year. Have I just really cherished like a neighborhood walk or, um, you know, getting to connect with someone socially distance in a park?
[01:13:31] Um, it’s, it’s just, uh, incredible. I think when you’re, when everything changes and you know, a lot of, sort of our flexibility and options are sort of removed to realize that actually like. Pure bliss and fundamental happiness can, can, can come from just the absolute simplest things. And it was really nice to kind of have this forest, you know, stepping out of our normal hustle and bustle and flow, and just realize that so much of that joy, um, is, is not related to any of those externalities.
[01:14:02] And so, um, I didn’t say the spring, especially I was in Portland, Oregon, the flowers are blooming and the fruit trees were blooming all over the city and it was just like, Just those, some of those walks or some of the happiest moments of my, of my year. And I think it’s cause a lot of distractions were removed, so, yeah.
[01:14:17] Mindy Pelz: [01:14:17] Amazing. Okay. Last question. If you had one message for the world that you could get implanted in everybody’s brain that would really move our world forward, what would that be?
[01:14:30] Dr. Casey Means: [01:14:30] It would, for me, that would be that health is in no way, a one way street, you know, we can always improve and we can always, the body is such a resilient, beautiful machine, and it has the ability to self heal and it’s constantly just churning and buzzing and wanting to get back into order.
[01:14:49] And the choices we make every day. Um, related to all the things we talked about today are the way that we can give our cells and our bodies, the instructions to move in the right direction. But there’s, there’s always hope with the body and with health. And that’s just a really beautiful thing about biologic organisms.
[01:15:05] And so, um, you know, never feel hopeless. Um, there’s always a way to improve and there’s a lot of people out there who want to help others improve their health. And, um, you know, I think, uh, Starting with things like listening to podcasts like this and reading some of these wonderful integrative and functional medicine, doctors, books, and books like yours.
[01:15:26] And, um, and you know, instead of searching, you know, looking at maybe web MD or what was just going to say,
[01:15:34] Mindy Pelz: [01:15:34] yeah,
[01:15:35] Dr. Casey Means: [01:15:35] like. Search a symptom or a term, and maybe tack on like integrative health or functional medicine or root cause and start to see what else you see out there, because there’s a lot of, a lot of evidence and research to support, um, sort of more holistic approaches to things.
[01:15:50] And that are very, very science and evidence-based. And unfortunately we don’t see a lot of that in the mainstream, but, um, it’s out there and so lots of great information, um, but just have to sometimes look through a slightly different, uh, portal to find that stuff. Oh,
[01:16:04] Mindy Pelz: [01:16:04] well said. That was amazing. Thank you so much, so much for taking your time.
[01:16:09] And I just, I it’s funny cause I do get all these questions about blood sugar, uh, that people ask me all the time and you just took my understanding of blood sugar to a whole nother level. So, and I love, I love your science. I love what you guys are doing. So thank you so much for taking what over an hour and a half with me and educating our community, you guys are doing.
[01:16:31] Incredible work. So thank
[01:16:32] Dr. Casey Means: [01:16:32] you so much for having me on Dr. Mindy, and I really enjoyed this conversation and very grateful to be here. Thank you. Hey,
[01:16:39] Mindy Pelz: [01:16:39] recenters I just want to start off by saying thank you so much for all your wonderful reviews and those of you that have left me comments on. ITunes. I just greatly appreciate your thoughtfulness and how much you guys are enjoying these episodes.
[01:16:56] And it, and it seems like you’re enjoying them as much as I am enjoying doing them. One of the things that I’ve learned in just interacting with. So many people is that we’ve really lost the art of deep conversations. And for me, the reset or podcasts stands for having meaningful conversations with people who are thinking about health, about life, about mindset in a way that we may not be getting on social media or in mainstream media.
[01:17:26] And so I just want to say, give you guys a shout out and just say thank you for participating in this process with me, because as much as I. Absolutely loved delivering the information to you. I love even more knowing that it’s impacting your life. So please let us know if there’s anything we can do to make this podcast more customized to you to make it better.
[01:17:48] We are now officially in season two, and we are working to bring you the best conversations that health influencers have. That mindset changes can give and to really deliver you something that you’re not able to get anywhere else. So from the bottom of my heart, as I always say my YouTube from the bottom of my heart, I am deeply appreciative of you.
[01:18:10] I am deeply grateful to be on this journey with you and let’s get healthy together.