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Transform Your Health by Improving Metabolism, Hormone & Blood Sugar Regulation | Dr. Casey Means

Episode 175 May 6, 2024 2h 52m 29 insights
In this episode, my guest is Dr. Casey Means, M.D., a physician trained at Stanford University School of Medicine, an expert on metabolic health and the author of the book, "Good Energy." We discuss how to leverage nutrition, exercise and environmental factors to enhance your metabolic health by improving mitochondrial function, hormone and blood sugar regulation.  We also explore how fasting, deliberate cold exposure and spending time in nature can impact metabolic health, how to control food cravings and how to assess your metabolic health using blood testing, continuous glucose monitors and other tools.  Metabolic dysfunction is a leading cause of chronic disease, obesity and reduced lifespan around the world. Conversely, improving your mitochondrial and metabolic health can positively affect your health span and longevity. Listeners of this episode will learn low- and zero-cost tools to improve their metabolic health, physical and mental well-being, body composition and target the root cause of various common diseases. For show notes, including referenced articles and additional resources, please visit hubermanlab.com.
Actionable Insights

1. Prioritize Real, Unprocessed Food

Consume as much real, unprocessed food from good soil as possible, regardless of specific dietary philosophy, to provide cells with necessary molecular information for proper function and satiety, thereby addressing the root cause of chronic overeating and disease.

2. Walk 7,000+ Steps Daily

Aim for at least 7,000 steps per day, incorporating short movement breaks (like walking or air squats) every 30 minutes, to stimulate glucose channels and improve glucose disposal, significantly lowering the risk of all-cause mortality.

3. Follow Exercise Guidelines

Engage in resistance training for major muscle groups 2-3 times per week, and accumulate 75 minutes of strenuous or 150 minutes of moderate cardiovascular activity weekly, to stimulate mitochondrial biogenesis, mitophagy, fusion, and increase antioxidant enzymes.

4. Prioritize Sufficient, Quality Sleep

Ensure you get sufficient and quality sleep, including the later REM-dominant phases, as sleep deprivation and poor sleep quality can negatively alter resting blood glucose levels and overall metabolic function.

5. Spend More Time Outdoors

Radically increase time spent outdoors (aiming to reduce indoor time from 93.7% to 50% or less) to connect with nature, reduce anxiety, improve metabolic health, and foster a sense of abundance, which is an antidote to fear and stress.

6. Obtain Key Metabolic Blood Tests

Request annual blood tests for fasting glucose (<100 mg/dL), fasting triglycerides (<150 mg/dL), HDL cholesterol (>40 men, >50 women), hemoglobin A1c (<5.7%), total cholesterol to HDL ratio (<3.5:1), waist circumference (<35 in women, <40 in men), and blood pressure (<120/80 mmHg) to assess metabolic health.

7. Walk After Every Meal

Take a 10-minute walk or engage in light movement after each meal to drastically reduce post-meal glucose response by bringing glucose channels to the cell membrane for uptake, offering a high-impact, high-leverage intervention.

8. Compress Eating Window (TRE)

Practice time-restricted eating by compressing your daily food intake into a shorter window (e.g., 6-10 hours) to lower 24-hour glucose and insulin levels and promote metabolic flexibility, even with the same caloric intake.

9. Cultivate Inner Sense of Safety

Address personal fear triggers and unresolved psychological stress to create a sense of safety in your body, as chronic threat perception diverts mitochondrial resources away from repair and thriving, impacting metabolic health.

10. Build Diet Around 5 Key Nutrients

Focus your diet on five key components: fiber, omega-3s, adequate healthy protein, probiotics, and high antioxidant sources, to support mitochondrial health, reduce inflammation, and decrease oxidative stress.

11. Use CGM for Metabolic Awareness

Wear a continuous glucose monitor (CGM) periodically to gain real-time insight into how diet and lifestyle choices affect blood sugar, identify personal glycemic responses, and proactively manage metabolic health.

12. Minimize Glucose Spikes to Curb Cravings

Actively work to lower the magnitude of post-meal glucose spikes, as large spikes lead to reactive hypoglycemia (crashes) which are predictive of increased energy intake and carbohydrate cravings.

13. Add Fat & Fiber to Meals

Include healthy fats (e.g., olive oil) and fiber (e.g., basil, chia, hemp, flax seeds) with meals to slow gastric emptying, blunt glucose spikes, and reduce glucose absorption, thereby improving glucose response.

14. Utilize Under-Desk Treadmills

Incorporate an under-desk treadmill at a slow speed (e.g., 1 mph) for a couple of hours daily during work to increase daily steps, improve body composition, and build constitutive movement into modern life.

15. Increase Non-Exercise Movement

Actively seek opportunities to contract muscles and move the body throughout the day, such as fidgeting or performing soleus push-ups while seated, to burn more calories and keep metabolic pathways active.

16. Naturally Boost GLP-1 Production

Increase L-cells in the gut by consuming more fiber and polyphenols (colorful fruits, vegetables, spices, teas, cocoa), ingesting 1-3 servings of low-sugar fermented foods daily (e.g., sauerkraut, kimchi), and potentially using ginseng, to naturally enhance GLP-1 production and satiety.

17. Stimulate GLP-1 Secretion with Food

Potently stimulate GLP-1 secretion by consuming high-protein foods rich in valine and glutamine (meat, turkey, eggs), eating about 100 grams of raw spinach daily for thylakoids, and incorporating green tea (ECGC) and curcumin into your diet.

18. Inhibit GLP-1 Breakdown with Foods

Inhibit the enzyme DPP-4, which breaks down GLP-1, by consuming foods like black beans, oregano, rosemary, guava, and muricitin-rich sources such as berries, cranberries, peppers, and Swiss chard.

19. Utilize Deliberate Cold Exposure

Expose yourself to deliberate cold (e.g., cold showers, plunges) to stimulate mitochondria to produce more heat, increase brown fat, and enhance metabolic function, serving as a valuable tool to speak to mitochondria.

20. Utilize Deliberate Heat Exposure

Engage in deliberate heat exposure (e.g., sauna) to activate heat shock proteins, which can upregulate antioxidant defense systems and protect mitochondria from oxidative stress, helping to quell cellular ‘wildfires’.

21. Eat Earlier in the Day

Consume meals earlier in the day, aligning with your chronobiology, as eating the same meal later at night can lead to significantly higher glucose and insulin responses due to transiently impaired insulin sensitivity.

22. Ensure Morning & Exercise Hydration

Dissolve one packet of electrolytes (sodium, magnesium, potassium) in 16-32 ounces of water and drink it first thing in the morning, and also during any physical exercise, to ensure adequate hydration and electrolytes for optimal brain and body function.

23. Practice Meditation & NSDR

Engage in meditation, yoga nidra, or non-sleep deep rest (NSDR) sessions, even short 10-minute ones, to restore cognitive and physical energy and explore different brain and body states.

24. Aim for Fast Glucose Clearance

Monitor your CGM to ensure glucose levels return to baseline quickly (within 90 minutes to 2 hours) after a meal, as a slow return (high Area Under the Curve) indicates potential insulin resistance.

25. Reduce Glycemic Variability

Strive for stable blood glucose levels throughout the day, as high glycemic variability (spiky curves) in non-diabetic individuals is associated with worse metabolic biomarkers and underlying dysfunction.

26. Monitor Dawn Effect Magnitude

Observe your morning glucose rise (dawn effect) on a CGM; a rise of less than 10 points is desirable, as a larger rise can signal increased insulin resistance or stress due to cortisol.

Understand that elevated fasting glucose and triglycerides, or values at the upper end of normal, can signal underlying insulin resistance and mitochondrial dysfunction, even if within ’normal’ lab ranges, requiring a focus on improving mitochondrial capacity.

28. Optimize Biomarkers Beyond ‘Normal’

Strive to achieve biomarker levels better than the standard ’normal’ ranges for true metabolic optimality, using these metrics to validate the effectiveness of personal diet and lifestyle strategies.

29. Consider Direct-to-Consumer Lab Tests

Explore direct-to-consumer lab testing companies to access comprehensive metabolic biomarkers regularly (e.g., 3-4 times a year) without needing a doctor’s order, empowering self-monitoring and reducing confusion.