Q&A #21: Fermented Foods and Gut Health—Yogurt, Natto, Kimchi, & Kombucha

Hi everyone, welcome back to another episode of the Premium Q&A. This is round 21 of our Crowdcast series. Super excited. I see a lot of people coming back month after month, giving, submitting great questions. For those of you that have not been here before, Typically, the way it works is you submit a question. Those questions are voted by other supporters, and my team and I look through the questions, and I choose questions based on how many times I've been asked that question, or also basically how new that question is. Is something that I haven't really discussed or addressed previously, and so what I do is. Usually, I'll do a deep dive into a couple of those questions. So go in more depth and more details. Usually 2 to 3 questions will be like that.

And then there's a variety of other questions that are shorter answered, and then also some rapid-fire questions, which are, which are really quickly answered. So that's kind of the format. I also don't always go with the top voted questions and addressing them first, but you know, sometimes they, they come later, later in the, the Q&A session. Also, as a reminder, nothing in these Q&A sessions are medical advice. This is often just me and my team diving into the scientific literature and summarizing findings. It's also me telling you guys what I do in my, you know, in my, in my, with my diet or with my lifestyle or what I'm taking in terms of supplements and things like that. And so you should always run any supplemental changes or lifestyle changes by your physician.

With that said, I also will answer questions in the chat live, and I see quite a few questions have already sort of been submitted in the chat. I'll try to, to scroll up and get some of those that were submitted earlier. So I'm going to jump into the first deep dive question. This question was submitted by Donna Jean. They ask, is there any evidence for the role of fermented foods in generating, maintaining, restoring a healthy gut microbiome? So fermented foods are packed with lots and lots, I mean billions of live bacteria, sometimes even fungi that provide various health benefits. So, for example, they can adhere to the mucosal membrane and outcompete other harmful bacteria in the gut.

They also secrete metabolic byproducts such as short-chain fatty acids that can be beneficial to the host, um, which is us, humans. So let's, let's dive into some of the actual types of fermented foods and what those fermented foods, you know, what their effects are in terms of biomarkers or health health status. So the first would be fermented milk, which is known as yogurt. So yogurt's been able to decrease the abundance of pathogenic bacteria while also increasing the abundance of beneficial commensal bacteria like Lactobacillus. It's also been shown to increase the production of short-chain fatty acids within the gut. In patients with Crohn's disease, yogurt decreased inflammatory biomarkers such as C-reactive protein, and it also improved gastrointestinal symptoms like bloating.

In people with type 2 diabetes, yogurt with the bacterial strains Lactobacillus acidophilus and Bifidobacterium animalis, it lowered HbA1c, which is a long-term biomarker for blood glucose levels. It lowered TNF-alpha, which is a biomarker of inflammation. Lowered total cholesterol, it lowered LDL cholesterol, and this was compared to unfermented milk. So the fermented milk being yogurt compared to the unfermented milk, which was the quote-unquote placebo control. There were additional benefits. So in addition to beneficial effects on the gut, the yogurt also— there was yogurt with the bacterial strain L. rhamnosus, which was able to decrease the amount of Streptococcus mutans bacteria in the mouth.

So it's very interesting that there was this crosstalk between the gut microbiome and the oral microbiome. And interestingly, this specific type of bacteria found in the mouth, the Streptococci mutans, which also, by the way, xylitol chewing gum has been shown to decrease. And we're going to talk a little bit about xylitol later on in this Q&A. But that type of bacteria is associated with both blood and heart infections. So I think that was— I thought that was a very interesting piece of information. Back to the fermented milk. So the yogurt with live cultures has also been shown to reduce the abundance of pathogenic bacteria, a variety of types— E. coli, Biophilia, Wadsworthia, also H. pylori.

It's also increased beneficial strains, you know, many different types of beneficial strains in the gut. Just study after study showing this. Yogurt with live cultures also has been shown to increase IgA antibodies, which is the type of antibody that is able to provide immunity along the mucosal membranes in the gut and also in the lungs. So that's really having having more IgA is really associated with better gut health. Interestingly, just as a side bit, in in females, particularly premenopausal females that are experiencing their their cycles, estrogen is known to increase IgA secretion in the gut and. It's, I think, one of the reasons why, you know, many women, I think, have observed there are changes in their gut health that is very, very correlative with their cycles.

And oftentimes when women are in their estrus cycle, the, the so-called follicular phase, they are producing more estrogen and they're producing more, secreting more IgA, and they're having, you know, Basically, their their gut is probably functioning better. Whereas when progesterone is predominant, the luteal phase, that phase is not only associated with a decrease in the secretion of IgA, which also helps stave off pathogenic bacteria in the gut; it's also associated with slowing gut motility. And so you you may often notice if you're a woman that you have more bloating. Maybe you're a little more constipated. Your stools are a little. Harder or different.

So that also is very something to keep in mind when you're tracking your cycles, to basically maybe increase your fiber intake, particularly, you know, even more than you would during that, that phase of your cycle. That all— that has helped me tremendously, and I know a lot of other women that I've spoken with, it also seems to have helped them as well. But that was a complete tangent. So back to the fermented foods. Talking about the secretion of the IgA antibodies, this partially explains why epidemiological studies have shown the consumption of at least one serving of yogurt per week was associated with a 16% reduction in colon cancer risk. There's also been some associative studies that animal-based diets that lack fermentable foods and fiber.

Can increase the pathogenic bacteria, biophilia, and a variety of others. I don't want to go into all the names because I can't pronounce all of them. But you know, ruminococcus and others—they're these types of pathogenic bacteria in the gut. However, people that ate animal-based diets but then also added fermented foods and had an increased fiber intake in their diet had mitigated you know these effects. So basically, they were they were not increasing the pathogenic bacteria; they were increasing commensal. And good bacteria by adding in the fermented foods and yogurt. And also, this was also the case for the vaginal microbiome as well. So let's talk for a moment about fermented cheese.

So there is a type of soft cheese with live culture— cultures, and clinical trials have shown that this type of bacteria that's in this soft cheese Mm-hmm. Camembert cheese. I'm not sure exactly how to pronounce that, but it's been shown that those bacteria colonize into the gut mucosa and it's detectable weeks after consumption, which is interesting because a lot of times there's a— there's like the probiotic strains that you're eating and certainly supplementing, there's like a flow-through where you have to constantly get— keep taking it in. Whereas in this, this case, the fermented cheese, it seems like there was a long-term effect. In addition, the fermented cheese has been shown to decrease carcinogenic nitrosamines in the gut by inhibiting nitrate reductase activity.

So one study showed that cheese fermented with bacterial strains Lactobacillus rhamnosus and Lactobacillus acidophilus was able to decrease Clostridium difficile. So, I mean, that's a pretty pathogenic strain of bacteria that causes, you know, the C. diff in many, particularly elderly folks, but also in people that are taking very strong doses of antibiotics. Fermented soy products such as natto, and we're going to talk a little bit about soy more in depth in a minute, but those products have also been shown to increase beneficial bacteria, Lactobacillus, Bifidobacterium, Uh-huh. And also decreasing other pathogenic bacteria. In addition, the fermented soy products have been shown to decrease the amount of malodorous sulfide gas production in the gut, which most of us know as flatulence.

There's also some other fermented foods like sauerkraut and kimchi that have been shown to increase the gut biodiversity as well as improve symptoms of irritable bowel syndrome. So in addition to improving the symptoms, the irritable bowel symptoms, the kimchi also improved immunity, digestion, and decreased waist size. That's interesting. Kombucha, which is a tea that is fermented with bacteria and yeast, was shown to increase T regulatory cells, which is a very cool study. T regulatory cells are a type of auto— type of immune cell that are very important for preventing autoimmune diseases. So they basically tell your body to recognize your own cells, your own tissues as your own, as yourself and not as something foreign.

One thing to keep in mind with kombucha though, is you really want to look at whatever, if you're not making your own kombucha, you also, if you're buying it, you know, from, from like a store-bought brand, you want to look at the sugar content because there are oftentimes some, some of these kombucha brands can just have an astronomical amount of sugar where it's just like, The benefits do not outweigh the risks of having, you know, a sugar-sweetened beverage. Basically, it does make a difference whether the fermented food still has live cultures in it. So fermented foods that no longer have live cultures, like wine, also many cheeses, can still influence the gut microbiome, but their influence is very transient. So like I was just saying.

A moment ago, the soft fermented cheese with live cultures, which is kind of rare for for cheese, that was able to have a more long-term effect in terms of probiotic commensal probiotic bacteria in the gut versus something that is a fermented food like wine that does not have live culture. Interestingly, studies have shown that one glass of red wine a day increases gut biodiversity and reduces the pathogenic LPS-inducing. Bacteria. And those same studies also showed that red wine decreased systolic and diastolic blood pressure, triglycerides, total cholesterol, HDL cholesterol, C-reactive protein, and liver damage, which is very interesting.

Again, this was, you know, for the— in terms of the gut effects on the biodiversity, this was, you know, they were having a continual, continual, like, one glass of wine a day. It wasn't It wasn't just a, you know, long-term effect. There's also— it is important to point out that the field, you know, this microbiome, gut microbiome field is really— it's really been exploding over the last 5 years or so. And while research suggests that gut, you know, biodiversity is good, Uh-huh. It's not really known, you know, how much biodiversity you want and how optimal, what's normal. You know, there's a lot of questions still that need to be answered. So it's not, you know, necessarily like you always want tons and tons and tons of biodiversity.

We don't really know which strains and how much of those strains you want, and is there an optimal ratio of these. And, you know, there's so many unknowns that are still out there in terms of the microbiome field. Yeah. So that's just something to keep in mind. Someone in the chat is asking about amoxicillin. So Pat says that they had amoxicillin and they've— their blood pressure is being dysregulated. How long will it take the microbiome to recover? You know, each person is different, and I think that it's really good to be eating a lot of fermented foods. The kombucha, natto is really great. That's a really great food to eat, as well as, you know, try to eat sauerkraut. Some people do find a little bit of irritation, gut irritation, with, with the sauerkraut.

But yogurt's another really great one. The Bio-K yogurt is a really good yogurt to get. There, it's very— it's got the live cultures and it comes like in a little container and you shake it up and it's very, very sour, which means it's, you know, got the live probiotic cultures in it, but it's a really good one to get. It's called Bio-K. Okay. So Lance is asking an interesting question that I don't know the answer to. Any information on gut microbiome and heart health? There is certainly— I know, you know, just generally speaking, you know, there, there are, there are definitely associations between certain microbiome species in the gut and heart health, but I don't know all the details of those. studies.

If that's something you want to ask for next time, please, please do put that in the question section. So the next question was submitted by Rachel Swanson, and this question has to do with soy. I told you we would get to that in a minute. Rachel asks, soy intake is a controversial and polarized topic in the field of nutrition, even among physicians. What are your personal thoughts and interpretation of the literature? Do you or your son consume any soy products? Um, so let me answer the second part of that question first. The, the only soy products that I eat and also I give to my son are edamame.

There isn't really any soy products I, I— you— if I could get natto more easily right now, these days I do a lot of Instacarting And the natto I used to get are at like Asian markets, which are not on my Instacart list, unfortunately. But I do think I will be adding natto back to my diet. And if I can get my son to eat it, even better. I'm not sure that's going to happen. But I think natto is one of the best swear products out there. So let's talk a little bit about what our deep dive in the literature on soy found because I was a bit surprised. I have avoided soy for quite some time just because basically the potential estrogen-mimicking effects.

And, those were all sort of minor You know, the studies were really minor and always, you know, high dose in animal or doing some sort of in vitro study. But I just never found because I do eat animal protein. I never found. I never found like the need to use soy as a protein source. But I do want to let's let's just talk about what some of the randomized controlled trials and observational studies. So there's there's meta analyses that have been done. On randomized controlled trials and also observational studies with both soy and isoflavone consumption. First, let's talk about mortality, all-cause mortality. There's been no association found between soy consumption and all-causes cardiovascular or cancer mortality.

When analyzing the data separately with fermented and non-fermented soy products, The consumption of fermented soy products, so miso and natto, was associated with a 16% decrease in cardiovascular mortality. However, natto is high in vitamin K2 and it's also high in spermidine. So there's some confounding factors there. Let's talk about cancer. So high intake of soy was associated with a 48% reduced risk of ovarian cancer, 29% reduced risk of prostate cancer, 22% reduced risk of gastric cancer, 21% reduced risk of colorectal cancer, 17% reduced risk of lung cancer, and 13% reduced risk of breast cancer.

The only one case where soy was associated with an increased cancer risk was in one case and it was with males drinking hot miso and they had an increased risk for— a 14% increased risk for gastric cancer and this was when they— this was only if they had 5 cups of miso soup per day. Sorry, no, 1 cup per day was a 14% increased risk, 5 cups per day was associated with a 31% increased risk of gastric cancer. But it's really interesting and important to keep in mind that in Japan, miso is consumed hot, and there is a a link between consumption of hot beverages and gastric cancer. So that could be the confounding factor here, where it's not necessarily the miso itself, but it's the the fact that miso is a hot beverage that is consumed. Cardiovascular disease.

So soy proteins have been shown to have have a beneficial effect on LDL cholesterol, HDL cholesterol, triglycerides, and total cholesterol in randomized controlled trials. This could explain why soy consumption was associated with a 17% reduced risk of cardiovascular disease, an 18% reduced risk of stroke, and a 17% reduced risk. Coronary heart disease in observational studies. There are some effects on metabolic functions. So soy consumption is associated with a 23% decreased risk of getting type 2 diabetes. So all these associations I'm talking about are observational studies, which it's important to keep in mind. So the biomarkers looking at cholesterol, that's a randomized controlled trial where it's a lot easier to establish causation.

With these with these observational studies, the the thing to keep in mind is while many of these studies try to correct for confounding factors, so they they try to correct for you know people that are physically active, other healthy lifestyle factors or unhealthy lifestyle factors. There's still always the possibility that something's not considered, and you know people that are generally eating soy protein could be more health conscious. They could be extra you know they all those things like I said exercising more, but again. Most oftentimes the data is corrected for physical activity, but just in general, these people are more aware of health, which is which is kind of why they're gravitating to eat soy soy products.

I think the one thing that is clear, and this was sort of surprising to me, is that consuming soy is not associated with more adverse adverse health outcomes. So it's not. You know, it's not causing people to have more increased risks risks of all these diseases, and that is that is something that's that's important. So you know, at the end of the day, I I still probably won't be consuming a lot of soy products just because, and certainly I think that during development when there's a lot you know the the effects of hormones and things like that are a lot more. powerful. I certainly won't be giving my son soy products, uh, for the most part, unless maybe some fermented, you know, like the natto. And, you know, I think the, the edamame is okay.

So I see people in the chat also kind of skeptical about the estrogen mimicking effects, and again, I also that's that was sort of in my mind as well. I would say those those studies are. More often in vitro, they're more often super super high dose or in an animal. It's it's hard to find clinical data showing that relevance. But the fact that it can happen is is is in my mind cause for alarm. And so I you know to me it's just I'm still I'm still kind of not gravitating towards using soy as a as a staple protein source. So there's some other chat questions about— off topic, but about water filters and if reverse osmosis is a good option compared to the Berkey, which someone's pointing out me— there's some— there was some skepticism there.

I can tell you, so I have both a Berkey filter and I have reverse osmosis filter, and I use both. With respect to the Berkey, I've done my own sort of tests, you know, where you like do the food coloring and you see if it's, you know, coming through. And, you know, I mean, I guess there's no way to know for sure if the filters are doing what they are allegedly supposed to be doing, particularly if they're not third-party, you know, being third-party tested by something, someone like NSF or something. So I do think I do think there's some good skepticism to bring up there, and I also do like the reverse osmosis. So I do, like I said, I do have one of those on my sink as well, and I do use both.

There was also another study— sorry, question in the chat about choline supplementation while pregnant. And again, I certainly can't give any advice to someone who's pregnant. I can tell you that there is a published study showing that choline supplementation during pregnancy was associated with improved cognition in the offspring and children. I myself was eating— I was eating like 4 eggs a day. Egg yolks are really high in choline. And so that's how I was getting my choline supplementation. I did supplement with choline while I was, while I was nursing. But the only choline that I had in during pregnancy was from— I had some in my prenatal vitamin, and I also was, like I said, I was— I literally was eating 4 eggs every day. This is like a staple of my diet, so I was getting a lot of it.

I was getting a lot of choline. So let's move on to the next question, which has been a recurrent question. James has submitted this question probably 3, maybe 4 times. So I'm, I'm going to address it this time. And James asks if there's any compelling research on substances that dissolve plaque from arteries so a person who has accumulated plaque can become not so prone to a stroke or a heart attack as they used to be, or, you know, and he links a couple of studies. So I'm gonna just briefly mention the— what the studies he linked actually show. The first study uses something called interference RNA to decrease TGF-beta. Which is an inflammatory cytokine. This was done in mice.

In the study, the TGF-beta was able to— sorry, the TGF-beta is the anti-inflammatory cytokine, and it was able to halt the inflammation in arteries and regress an existing plaque. But medical applications of interference RNA are really very early stage, and I wouldn't expect to see anything even making its way into the clinical arena for 10 years. So, I mean, that's, that's, that's a long ways away. The, the second study was about something called cyclodextrin, which was a study that was also done in mice. Cyclodextrin was able to dissolve cholesterol crystals, and it also reduced the inflammatory response in artery walls. Okay. So cyclodextrin is a complex sugar. It's already used in foods and also in pharmaceuticals, and it's pretty safe for human consumption.

But there are currently no clinical trials evaluating its ability to dissolve plaque from arteries. So whether or not that's going to be something that's in the pipeline, I don't know, but it seems like a logical next step, you know, to investigate. Many of you guys know statins, you know, they've been shown to modestly decrease plaque size in arteries. They also have been shown to stabilize plaques so that they don't rupture. However, there can be a plethora of terrible side effects with statins in the brain and also, you know, the muscle atrophy as well. And so Uh, there possibly could be other— if there, if there are other interventions that could be done, such as aerobic exercise, which also does help.

So like statins, aerobic exercise lowers LDL cholesterol, and therefore, therefore it can reduce plaque size. And also it can increase— um, exercise also increases the plaque stability like statins do. So, and the side effects of exercise are all good because you're getting benefits to the brain, you're getting benefits to other tissues and inflammation and all sorts of things. So I think exercise is a really ideal first way to try to improve, you know, both your reducing plaques and stabilizing, you know, stabilizing them as well. So, oh, aerobic exercise also helps in another way. It increases blood flow to tissues downstream of the plaque by developing collateral arteries. So this has 2 benefits. First, it reduces discomfort associated with peripheral artery disease and stable angina.

These diseases are caused by a lack of blood flow to the narrowing arteries. And second, it also— if a plaque ruptures and forms a clot, the collateral blood vessels can sort of preserve more tissue. So this— if this happens in the heart, it could mean the difference between basically life or death. Yeah. From, from a heart attack, which— so I mean, just there's, there's, there's so many reasons why exercise is just the best for health, you know. It's just overall like just amazing. So let's move on to the next question. And sometimes, by the way, I will choose questions to do a deep dive on that I personally want to learn more about because I don't feel like I know enough about. And so it's sort of a good time for me to, to dive in and learn more about something.

That would be the case with this next question, which was submitted from Tyson. Hi, Tyson. And Tyson asks, could you give your thoughts on advanced glycation end products, which are referred— which I refer to as AGEs? AGE, you know, they're called AGEs. Do you consider AGEs when thinking about your diet or how to prepare your food? Do you recommend any supplements to combat AGEs? So AGEs are compounds that are formed when fat or protein reacts with sugar, and they're formed endogenously in the body. But they're also formed or they're found in food, and typically when the the reaction that happens happens under heat, high heat.

So consuming a diet high in these advanced glycation end products causes an increase in in these ages in our in our blood and also in tissues, and increases inflammatory biomarkers as well. So our bodies do have enzymes that can break down and excrete the advanced glycation end products. Almost all tissues have them, but They're especially prevalent in the brain and kidneys. People with diabetes are most vulnerable to them because their high blood glucose levels cause more advanced glycation end product formation, and they're— because they have kidney damage, that can lead to a decreased clearance of them. So they get not only increased production, but they have also decreased clearance. And so the end result is net increased Advanced glycation end products.

And these AGEs have been shown to play really insidious role in many complications, particularly with diabetes, such as cardiovascular disease, retinal damage, nerve damage, and also worsening of kidney function. They also contribute to age-related macular degeneration, heart disease, and dementia, as well as skin aging, which was something that caught my attention many years ago. One study found that those people with highest blood levels of advanced glycation end products were almost twice as likely to die from heart disease than those with the lowest levels.

And one mechanism for that is the observation that these advanced glycation end products can react—they're highly reactive—and they can react with LDL particles, making them unrecognizable to LDL receptors, and therefore the LDL particles basically don't get cleared, and they sort of. Start this inflammatory cascade in, in the blood vessels. There's also some implications that advanced glycation end products have a role in Parkinson's disease as well, where it can promote the formation of alpha-synuclein inclusion bodies in the brain or neurons. So these, these can aggregate and form these inclusion bodies There's also been studies showing that they increase reactive oxygen species. They cause vasoconstriction. They help secrete pro-inflammatory cytokines.

They basically can, you know, change the function of cell membranes, platelets, coagulation factors. They change the structure of collagen, and so they kind of contribute to skin aging and all sorts of things. So clinical trials have shown that people with diabetes as well as obese individuals. With kidney disease, people that with these with with diabetes that are obese and have kidney disease, if they eat a high advanced glycation end product diet, this leads to increased levels of the advanced glycation end products in their blood as well as increased levels of inflammatory biomarkers. And the reverse is true. So if they eat a diet low in them, they have lower levels in their blood. Makes sense.

The the advanced glycation end product in food is dependent on the cooking modality and also the type of food. So cooking in dry, high temperatures such as grilling, frying, or toasting increases the amount of advanced glycation end products in food up to a hundredfold. For example, one fried egg has one thousand twelve hundred and forty kilo units of advanced glycation end products. Whereas a scrambled egg has 50 kilounits. Bacon that has been fried has 12,000 kilounits, while bacon that has been microwaved has 1,200 kilounits. But who wants to eat bacon that's microwaved, right? Broiled salmon has 3,000 kilounits, while microwaved salmon has 800 kilounits, and raw salmon has 500 kilounits.

In addition, foods that are high in fat and protein are more likely to form advanced glycation end products than foods that are predominantly carbohydrate. For example, roast— a roasted piece of turkey has 4,200 kilounits per serving, while a toasted bagel has 50 units. Now, there's other pros and cons there, of course, like glycemic index and things like that, but I'm just— we're focused on the advanced glycation end products here. There are both pharmaceuticals as well as supplements, micronutrients, vitamins, minerals that have been shown to lower the amount of advanced glycation end products.

So there's a variety of pharmaceuticals that have been— that are being studied that are not really they're usually used for treatments for people with diabetes that have, you know, these all sorts of problems with, with like retinal— retinopathy and stuff like that. So let's talk a little bit about some of the, the natural sources. So pyridoxamine, so vitamin B6, has been shown to preserve kidney function and decrease advanced glycation end products in people with type 2 diabetes. Carnosine, has been shown to improve sight by reducing blurriness from cataracts. And benfotiamine, which is a fat-soluble form of thiamine, has been shown in 2 studies to improve neuropathy in diabetics, which is caused by the advanced glycation end products.

There's also some evidence that antioxidants like vitamin C and vitamin E can mitigate advanced glycation end product damage, so they're not necessarily lowering the advanced glycation end products, but they are mitigating the damage, the oxidative damage that's formed. Aerobic exercise has also been shown to reduce advanced glycation end products. In fact, one randomized controlled trial showed that healthy women that increase their number of steps per day also reduce their number, uh, reduce the levels of advanced glycation end products in their blood. So that's also another thing. And also, again, cooking Cooking affects the the amount of advanced glycation end products that are formed. So cooking with a lower heat, using shorter cooking times.

Also interestingly, using cooking with acidic ingredients like lemon or vinegar also significantly reduces the amount of advanced glycation end products formed during cooking. So that's sort of a little trick as well. So that was all very informative. For me in terms of the advanced glycation end products. So, there was a question submitted by Lisa on about melatonin. And, Lisa asks, does melatonin work for fragmented sleep? Matthew Walker seemed to not be such a big fan, but if you're doing the whole sleep hygiene thing and you're still having a problem, is it worth trying? Again, this is, you know, not medical advice. And I also noticed some people in the, in the chat asking questions about melatonin.

People were asking about whether or not taking supplemental melatonin inhibits your body from naturally producing it. And I think that was the major question. So the American Academy of Sleep Medicine recommends melatonin for a couple, a couple of sleep issues. Particularly delayed sleep-wake phase disorder, people that are having problems with sleep onset, so falling asleep. And that's really what Matthew Walker, in our conversation a couple years ago, had said that basically melatonin isn't necessarily going to keep you sleeping longer so much as it may help you fall asleep earlier. I'm honestly— there has been one study that did find that 3 grams of melatonin a night did decrease sleep interruptions from 4.5 wakes to 3.1 wakes per night. Personally, I think it's worth trying.

I take melatonin. I've found that it helped reduce my night terrors to— they're almost nonexistent. They only now happen when I'm really, really, really stressed. So, and I actually take 10 milligrams a night. I take a pretty high dose. So I'm, you know, for me, it really, I really like taking the melatonin and it helps me out. I mean, I don't see much harm for taking it for myself, but that's something you can discuss with your physician. I think the evidence is sort of mixed in terms of helping people with their sleep. A lot of evidence suggests it does. Others, I think it may also just come down to the individual. So 2 people in the chat are asking what brand of melatonin I take. I take right now, I'm doing 10 milligrams of Pure Encapsulations melatonin. Yeah.

And, some people are mentioning they find when they take melatonin, they get more deep sleep, more REM sleep. I— you hear a lot of anecdotes like that. I think melatonin can affect people's sleep differently in different ways. And, you know, I don't see any harm and I certainly have found it to be beneficial whenever I have traveled. Which hasn't been much in the past. And someone's saying Andrew Huberman is against it, says it's a hormone and we shouldn't just be supplementing hormones so freely. Well, I guess that's one opinion. I haven't found any evidence that it's harmful. Someone's saying melatonin decreases testosterone.

I can tell you anecdotally, my father-in-law has been taking 10 milligrams of melatonin a day for probably a decade, and his testosterone is extremely high, like very high. So I'm not sure it's a— it's, it's always the case. Maybe it did it in one person. I don't know. I certainly haven't seen evidence to, to convince otherwise. Also, as, as a person ages, and by the time they reach the age of 40, melatonin production precipitously like drops down. And so I do think that once, once you reach a older age, then you might, you might consider melatonin as well. So the next question was submitted by Redoon, and they ask, Does xylitol spike insulin or alter the gut microbiome? Is there a safe sweetener like monk fruit, or what about erythritol?

So I mentioned last— back in Crowdcast number 16, I said that we had already covered xylitol and that xylitol did not affect the gut microbiome. However, it was actually erythritol that we covered in Crowdcast number 14. More in detail. So for anyone that wants to go back and check that Crowdcast, we go into more detail on that. So xylitol, the body does not metabolize xylitol to produce energy. So it's, it's, it's zero calories, but it is the— so because the body has to metabolize it to produce energy, it's still, you know, it's still zero calories, but it has It's basically 40% fewer calories than sucrose.

It belongs to a family of sugar alcohols called polyols, which are where the carbonyl group is replaced by an alcohol group, and this change delays digestion and metabolism so that it only mildly elevates blood glucose levels and it does not cause an insulin spike. This is reflected in the glycemic index. So xylitol has a glycemic index of 7. While table sugar has an index of 70. In addition, they both have the same sweetness, and in high doses, xylitol can actually act as a laxative. A handful of both animal and human studies have found that xylitol modestly affects the gut microbiome. However, it is unclear what implications it has for overall health.

I would say the main use that I— the main reason I use xylitol is in my chewing gum because it has been shown to decrease the streptococci mutants in the mouth and the oral microbiome. And that's associated with beneficial effects on cavity formation. It's associated with beneficial effects on both blood and heart health, as I mentioned, because those bacteria are associated with adverse effects on the both blood and the heart. So, so that's, that's— so I do like to chew the, chew the xylitol gum. Interestingly, there's been— there was some preliminary evidence that both aspartame and sucralose could alter the gut microbiome in some preliminary human studies and some animal studies as well.

But there have been some follow-up studies, randomized controlled trials, that seems to suggest that Neither aspartame or sucralose significantly alters the gut microbiome. Most of aspartame is absorbed before it reaches the large intestine, and the the ester compounds of the amino acids of aspartame are aspartic acid and phenylalanine. I am a little concerned concerned about the the phenylalanine. There's been some You know, evidence of neurotoxic effects of phenylalanine. But anyways, the aspartame is metabolized into the the amino acids aspartate and phenylalanine, as well as methanol, which are absorbed in the gut. So aspartame is actually 200 times sweeter than sucrose, and the FDA has an acceptable daily intake of aspartame of 50 milligrams per kilogram body weight per day.

In my opinion, I don't think aspartame is good, honestly. So I choose not to consume it at all. And the same for sucralose, which is Splenda. But again, there have been some studies, randomized controlled trials, that showing that sucralose does not appear to significantly affect the gut microbiome. I do— it's so the sucralose is basically a sucrose molecule where 3 hydroxy groups have been replaced with chlorine atoms, and this results in a sweetness of 600 times sweeter than sucrose. And so Splenda is actually— Splenda is actually 95% bulking agents like dextrose or maltodextrin, and 5% of it being sucralose. And isotope studies have shown that 85% of sucralose is eliminated unchanged in feces. And the remaining 15% of oral intake is absorbed and excreted through the urine.

Again, it's my opinion that I don't— I'm not convinced that sucralose is good, or I'm not convinced that it's not harmful. So I personally don't take sucralose. I don't have it in my diet at all. Stevia, or stevia some people call it, is 300 times sweeter than table sugar. It has a glycemic index of 0 and is really— it's unknown, it's unknown whether it affects the microbiome in humans, although animal studies show negligible effects. Monk fruit is 150 to 200 times sweeter than table sugar. It also has a glycemic index of 0, and it's Uh-huh. It's unknown if there's any effect on the gut microbiome.

And erythritol, which is unique in that 90% of it is absorbed in the small intestines before it's ever exposed to the microbiome in the large intestine, so that 90% is then excreted unchanged in the urine before the body has time to metabolize it. So it has no effect on glucose or insulin levels. The 10% that is absorbed in the small intestine goes unmodified to the stool. So, that means that even though the microbiome is exposed to it in the large intestine, there's likely no significant interaction there. So, all of the sweeteners with a glycemic index of 0 can still actually cause secretion of insulin, but it's not as much of a sucrose— it's not as much as sucrose and it's not enough to drop blood sugar levels. So, it can lead to increases in hunger.

And it and people can compensate by eating more. So this is why studies where people are replacing the sugar-sweetened beverages like soft drinks with diet drinks don't lose weight because they end up actually becoming more hungry and eating more more food. But anyways, I think the bottom line is it's it's it it doesn't seem that many of these non It seems that many of these non-caloric sweeteners don't have a significant effect on the gut microbiome. So, there was another question submitted by Kimber G., and this question was about the recent animal study. That showed heart damage from long-term ketogenic diet. And the diet also, it induced cardiac fibrosis.

I was interested in this study because it was so counterintuitive with respect to everything I had known about beta-hydroxybutyrate increasing mitochondrial biogenesis and being good for mitochondria because The heart predominantly oxidizes, you know, fatty acids, and mitochondria are used, you know, for fatty acid oxidation. So I was very— it was very perplexing to me. And so I decided to kind of look at this question. The one thing to keep in mind in the background of this question is because the study was done in animals.

There have been studies done showing that ketogenic diets in rodents, in mice, in rats are different from humans in some respects because for whatever reason, a ketogenic diet, when you're feeding a rodent a ketogenic diet, there's something that happens to their satiety where they just keep eating and eating and eating and eating and they get obese. And that's not the case for humans. Many humans actually lose weight on a ketogenic diet and become more satiated. So there, there, there have been some studies by Dr. Eric Verdin as well as others, some of his collaborators up at UC Davis, can't remember the name, but where they've figured this out.

And so when they're doing their animal ketogenic diet, they have a They limit the amount of food, so it's not like an ad libitum where they can just eat any amount of food they want. There's like a defined amount of food. That was not done in this study. So let's that is something to keep in mind. However, I am going to reach out to Eric, Dr. Eric Verdin, because I'm very interested in his take on this. Because what the study found was basically using ultrasound of the heart, they found that the ketogenic diet, but not the caloric-restricted diet or normal diet, it led to impaired cardiac function. And heart tissue in the ketogenic diet rats had more fibrosis than the normal diet or caloric-restricted diet.

It also— there was, you know, there's all sorts of markers they measured for the fibrosis. Another set of experiments, they injected beta-hydroxybutyrate into rats and found that it impaired cardiac function on ultrasound. And cardiac fibrosis was formed by, you know, measuring by different stains. That was very surprising to me. There's been some in vitro studies that showed high doses of beta-hydroxybutyrate causes apoptosis in heart muscle cells but not in heart fibroblast cells. In vitro experiments also showed that beta-hydroxybutyrate can decrease mitochondrial mass in heart muscle cells And this is mediated by an upregulation of SIRT7 through histone deacetylase 2. This is something that Dr. Eric Verdin is a— he— that's like his specialty, SIRT7. He knows all about this stuff.

So I'm definitely gonna— I'm gonna send him— I'm gonna shoot him an email about this study and ask him what he thinks. In humans, beta-hydroxybutyrate levels in cardiac tissues are 3.3-fold higher in patients with atrial fib— with atrial fibrillation compared to those with regular heart rates or heartbeats. That's also interesting. So the mitochondria was also significantly lower in cardiac tissues from the patients with AFib, which is also weird because— well, that's not weird, but I mean, the fact that beta-hydroxybutyrate has been shown to increase mitochondrial biogenesis. This is sort of counter to that. So I'm not exactly sure what's going on, and it's a little concerning, to be honest. So I'm, I'm, I'm gonna follow up on that to, to see exactly.

There's got to be something going on here. I mean, there's obviously something going on, but there's, there's got to be something that can explain it that I'm just not getting. So, along sort of along similar lines, people— someone was asking about the exogenous ketones. So, Xavier asks, do we need to manage electrolytes when doing a 5-day fast? If so, shall we target RDAs? Can we supplement with beta-hydroxybutyrate salts like sodium beta-hydroxybutyrate, calcium beta-hydroxybutyrate, magnesium beta-hydroxybutyrate without losing the full benefits of the fast? You previously mentioned that you took a beta-hydroxybutyrate ester and raised your plasma levels. Which brand and what dose did you take? Thank you.

So with respect to the brand I previously have used, I have used the HVMN beta-hydroxybutyrate ketone ester. It is currently unavailable. It's backordered. It's been that way for quite some time. And I took the whole 30 mL. I didn't never— I never tried aliquoting out just like a mL or 2 or 10 or something and trying. So I took the whole bottle and significantly raised my ketone levels, you know, I've heard that ketone aid is good from other people. I have not personally tried it, but I've heard it's good. So let's talk a little bit about the electrolytes and fasting. Again, this is not medical advice at all. Please, you know, do not do anything. Doing a 5-day fast without a physician's, you know, guidance is dangerous.

So I'm just, I'm just going to talk to you about some of the information that I have found in the scientific literature. Honestly, I don't even know, like if I was doing a 3 to 5 day water fast, if I had to take a supplement or not. I think it has a lot to do with the amount of exercise a person does during a fast or how much they sweat and lose more electrolytes as well. I do hear from a lot of people that salt, taking table salt helps. Helps with their, with their longer fasts as well. If you look at studies, particularly older studies in the literature, sodium and potassium excretion does happen pretty rapid, and it's, it's, it's high during the first 5 days of a fast, and then it tapers off when someone's doing a really, really, really long fast.

So the body does lose the sodium and potassium in the first 5 days, and this does occur without significantly changing serum electrolytes or osmolarity or plasma volume. Other electrolytes like magnesium, calcium, phosphorus tend to follow the same trend, again with the greatest losses losses in the first week. There was some data that showed supplementing with electrolytes including sodium chloride during a fast. The sodium excretion increased significantly with sodium chloride supplementation during a fast. But there still was an overall positive sodium balance compared to not supplementing with the sodium. So it does see you know a lot of people do supplement with the sodium.

The one thing is that the supplementing with the sodium during a fast may prevent the weight rebound that occurs because most of the a lot of water body water is lost during a fast, and that doesn't happen as much if people are supplementing with sodium. Some other interesting things is that during the refeeding phase, there's an effect on on electrolyte balance. So carbohydrate refeeding causes a very rapid sodium and potassium retention, which could add more quote unquote weight due to the water retention that occurs because you're retaining more sodium. Um, as well. This only happens after a fast. This isn't like a general phenomenon, by the way. Protein intake upon the refeeding leads to a delayed retention, water retention. So, or the— sorry, sodium and potassium retention.

So day 2 of refeeding, basically. And fat refeeding can aggravate the negative sodium balance after a fast. So I thought that was really interesting as well. So let's talk about some rapid-fire questions. Roshini asks, what biomarkers would you say are the most important and which ones do you check regularly? So there are a lot of the really important ones have to do with lipids, lipoproteins, inflammation, oxidation, glucose regulation. And then, you know, of course, a lot of the, you know, routinely measuring a lot of the hormones, thyroid hormones and stuff are important as well.

But the lipids and lipoproteins, so total, some of my favorites, total cholesterol, of course, LDL cholesterol, direct LDL, HDL cholesterol, triglycerides, non-HDL cholesterol, ApoB, lip— LDL particle number, small LDL particle, small dense LDL cholesterol. APOA1, HDL particle number, HDL2 cholesterol, ApoB, ApoB/ApoA1 ratio, Lp particle or Lp, and LDL triglycerides. I think those are some of, of my favorite lipoproteins and lipids. With respect to the inflammation and oxidation High sensitivity, high sensitivity C-reactive protein, fibrinogen, LPA, PLA2, F2-isoprostanes, and oxidized LDL. The you know the glucose measuring your your your metabolic and and your your blood sugar. I think you know glucose.

HbA1c, which is the long-term marker of your your glucose levels, your insulin, free fatty acids are I think are important as well. And then I do think that getting some of the micronutrients, obviously 25 hydroxy vitamin D. I think you you might you know I think it's good to look at the total iron binding capacity. As well as ferritin, looking at some of your electrolytes, folate, vitamin B12, RBC magnesium, calcium, and then the thyroid hormones. I think the advanced, you know, looking looking more advanced is is more informative. But that doesn't have to always that has doesn't have to be done like quarterly or something. I mean, even just like. You know, looking doing an advanced thyroid once every couple of years.

So you get your total T4, T3 uptake, free T4 index, TSH, total T3, free T3, reverse T3, and free T4. And then also measuring the omega-3 fatty acid levels. And someone else asked about omega quant in another question rapid fire question. And I do think that that's a that's a I haven't used their service yet, but I do plan on doing it. And I think that it's, it's, it's a pretty good one to measure as well. Those are some of my favorites. And then you can also, I mean, measuring, doing the, the, the, the lipids and lipoproteins and the metabolic health and the inflammation, you know, doing that either biannually or quarterly for those of you that are really, really super into it.

Otherwise, you know, doing just an annual, like Doing doing all those things annually, along with looking at hormones. So you know female hormones if you're if you're a woman, you can look at your reproductive panel like progesterone, follicle stimulating hormone, luteinizing hormone, as well as the the other sex hormones and estradiol and DHEA, free testosterone, testosterone, and SHBG. And then liver health, of course, that I think should come along with any of those standard standard tests as well. So, the typical AST, ALT, the total bilirubin and albumin, total protein, and the BUN, creatinine as well. I think those are some pretty good ones in my opinion. So, another rapid-fire question was from Rachel Swanson. Thoughts on minimizing exposure to wheat gluten for babies, toddlers?

Assuming six months or greater, and the ideal saturated fat for babies and toddlers. So interestingly, there have been studies that have shown that gluten exposure along you know along with complementary. So when you're doing complementary foods along with breastfeeding, that it's it's actually beneficial to to expose breastfeeding babies to. To wheat and gluten because they are much, much less likely to have developed any sort of wheat or gluten intolerance or also celiac when they're exposed while breastfeeding because the components in the breast milk, all the, you know, the various components in breast milk is basically having such a beneficial effect on the gut that it's Yeah. It's basically the best, one of the best times to do that, which is what I did for my son.

I also do give my son, who is now a toddler, I give him— he does get sprouted whole grains. So, he gets sprouted whole grains and he gets oats, he gets quinoa as well. And, I also think that— I do think that fat sources are very important for toddlers, all fat sources. Saturated fat, so butter, cheese, you know, avocado. So, you know, the poly and the monounsaturated fat, avocado and nut butter, nuts when age-appropriate. And then also, most importantly, fish, which has got the polyunsaturated fatty acid, the omega-3s. So I think, I think high— I, at least what I have done with my son is trying to, you know, give him a lot of fat, you know, early in development as well. as protein. So another rapid-fire question was from Ron. Ron asks about the cooking oil.

So it seems like the coconut oil and grass-fed butters and the grass-fed ghee are the quote-unquote paleo kind of way of cooking. In your previous— one of your previous Q&As, you mentioned that cutting— you cut out cooking with coconut oil, it dramatically lowered your LDL. What is your recommendation for cooking oil? Um, so, and also, can you revisit the issue with fraudulent olive oils? So I cook with either butter or avocado oil depending on the food. So avocado oil is high in monounsaturated fat. It's got a high smoke point, very, very, very low in PUFA. And so it's a really good cooking oil. And with respect to olive oils, most of the California-grown all olives and oil, olive oils from California are legitimate.

A lot of the fraudulent ones were coming from other countries like Italy. So I always go for California olive oils when I, when I buy my olive oil. And I think even Costco sells a very standard California brand that you can open the bottle and you can smell the polyphenols. Like if you, if you go to a restaurant and you order, you know, their salad dressing, or you order olive oil, and the oil and vinegar that they give you, they usually give you like a little cup of the oil and you smell it. It usually has no smell because it's usually canola oil. It's cheaper. Olive oil has a very like pungent smell to it. It's— you can smell the polyphenols. It's very obvious.

If you open your olive oil and doesn't smell like, you know, that polyphenols, it's probably you know, probably toss it and get another brand. Just back on another rapid-fire question back on the omega-3 question from— there was one submitted from both Colleen and Eric Jung had a follow-up question about the testing omega-3, omega-6 ratio and if I think these tests are accurate and companies like OmegaQuant. So I do think that they're mostly good. I do think that most— that looking at these things mostly identify people that have really big imbalances.

So like if you're— if you supplement with fish oil and you don't— and you don't use vegetable oil for cooking oil, if you don't use vegetable oil and you don't eat out a lot because like fast food and restaurants and things like that mostly do use vegetable oil when they cook their food. And so if you eat out a lot, you're likely getting a source of vegetable oil, then which is high in omega-6. You're not— you're not gonna have a really high omega-6 content. Like, omega-6 is good. You want it from your nuts. You want it, you know, you want it from whole food sources. It's important. But you don't— you don't want to get it from these vegetable oils.

In fact, probably one of the most toxic part of the vegetable oils is the fact that they're cooked with high heat and they're so prone to oxidation. So you're actually consuming oxidized fat, which causes inflammatory response. So, it's just terrible. Another rapid-fire question was from Emily. And Emily asks if I have any insight or research on the sleep training cry-it-out method and on infant brain development. So I can tell you personally, I never use that method. I know a lot of people do use it and their children end up being fine. Babies are, are pretty resilient.

I was worried that there could be, you know, there's all these animal studies that, that show, and also non-human primate studies that show separating Young, you know, the young nurse nursing and just separating the offspring from the mother causes negative effects in the brain and anxiety later in life and all this stuff. And, you know, keeping that in mind, I kind of, in addition to the fact that I just, it didn't feel natural for me to, when my son was crying, to not comfort him. It didn't feel like something natural to do. I just couldn't do it, so I didn't. And, you know, like I said, a lot of people do it and their children are fine, so I'm not saying that, you know, it's a terrible thing to do. I'm just telling you that this was my rationale.

I just, first of all, I just couldn't do it, didn't feel good. And also, I just was thinking about these animal studies and, you know, oh, what if potentially something was happening? So, I probably suffered longer sleep-wise than many other parents that do this sleep training cry it out method. Although my son did eventually just learn to self-soothe on his own. And so, I got there. Maybe it took a little bit longer and maybe it was a little more work on my end for me. But that was fine for me. That's my experience basically. Another baby-related question was submitted by Emily, and Emily asks about introducing solid foods at 6 months, how to ensure the baby receives enough of their daily iron— doesn't seem sufficient— and did I give my son iron-fortified cereal or an iron supplement.

So definitely discuss anything like supplements or anything like that for babies with, with your pediatrician. I didn't find it necessary. Um, the iron actually does add up when you, when you give all the foods, believe it or not, all the little sources, they, they, they add up. I was, you know, like I said, I was doing, uh, I did a variety of foods. You know, early on I was mashing up spinach, which is high in iron. I was doing a lot of spinach with the salmon or the chicken or the You know, or or with some kind of meat and like you know beans and all sorts of things. You know, I felt like he was getting enough iron. Supplemental iron is kind of tricky because I and this is why it's good to talk with a pediatrician because it feeds iron feeds pathogenic bacteria in the gut.

And so there could be where you this this sort of the situation. That giving an infant supplemental iron when they don't necessarily need it can cause problems because it allows this overabundance of pathogenic bacteria to grow. And so they could end up having stomach and gut issues. So I was really trying to stay away from that if possible. I didn't do any fortified cereal, but I did oats and oatmeal. And I, again, I just— the foods do add up, believe it or not, they do. Another question, rapid-fire question, was submitted by Roshini again, and they asked about continuous glucose monitoring and if it helps to measure it as a biomarker for metabolic health. I would say absolutely, absolutely. People can be metabolically unhealthy and they could be lean.

So you could be someone who is, is even physically active and still be metabolically unhealthy. There are— it's really good. The continuous glucose monitor really helps you learn what kind of foods spikes your blood glucose levels. Really high. It helps you learn what kind of life choices can ameliorate that, or lack of lifestyle choices can help you or help— can lead to, you know, unregulated blood glucose levels. And, you know, things like— even things like viruses can spike blood glucose levels and have been— can cause actually type 2 diabetes. I think the continuous glucose monitor is a very informative for monitoring blood metabolic health.

And on a related question from Brett, Brett says that he's noticed when he exercises in a fasted state, so he's wearing a continuous glucose monitor from Abbott, and that when he exercises in a fasted state, he still has rises in his blood glucose levels. And so he's sort of wondering what the deal is and if there's some Some explanation for that, and I would say that you should notice with a with your continuous glucose monitor that you have a dip before a spike. And so usually what's what happens when you're exercising in a fasted state is that you don't have you're you're using up your your circulating glucose and and and and you use it up quite quite quickly, particularly when you start to go into.

Your, your high-intensity workout, when you're really pushing it hard, you go down, you dip, and your body shuts, you know, basically signals to your body, oh, I need to make more glucose. And so glucose gluconeogenesis occurs. So you start to make glucose from amino acids, you start to make it from potentially even glycerol backbone. And, and so you're making, you make glucose, and so it'll spike up because your body's making it. Because it knows it needs it because you dip down really low. And that's, that's typically what happens during exercise is that you'll see a dip and then it goes and then it spikes back up. And so you may wonder, well, why is it doing that? Well, it's doing that because you need it. You need the glucose for energy.

Another related question on continuous glucose monitors was from Kenny. And Kenny asks, do you have any recommendations on how to really use the Dexcom G6 to determine what foods to avoid. For example, how much food do you have to eat to know if your blood sugar is really going out of control? And by the way, there— I think that, you know, Dexcom G6 is not readily available to people, but the— there are some that are really consumer available, like the Libre, I think, is one that people can just, you know, buy. So one thing to keep in mind is you have to calibrate these things. Like I have found, like if I have a sensor, or even even even not having a sensor that's like older, but particularly when the sensor is older, the blood glucose levels are totally off. And so I calibrate them.

It's good to calibrate them on this, particularly on the first couple of days, using another. So like the finger finger prick type of blood glucose monitor. So I have a Precision Xtra. That's what I. That's what I use to calibrate. But it's really important to calibrate them for one. In terms of like setting, you know, how to know how you're reacting. I mean, people are people react differently. I set my my alarm to 120 because I don't want to go above 120 postprandial for my postprandial spike, and that means I really have to eat foods that are low in glycemic index. And so, you know, leafy greens for the carbohydrate sources and meats.

Most, most, most of the vegetables have to be lower in the, you know, for the most part, vegetables, vegetables don't, well, don't, won't spike it above that. But if I do something like eat chips and guacamole, for example, then I can, then I'll spike above 120. I think, you know, it's really good to just experiment and see how your body reacts to these 2 different food types and also give yourself like a really high signal. So see how it reacts when you eat something that is more refined. Like I was eating tortilla chips and that spikes me or, you know, crackers, like you'll see, you'll spike up pretty high. So that's what— that should give you sort of a reference point where it's like, geez, I shouldn't be eating that stuff.

You know, it's spiking versus like if you eat a meal like a meal that's like a protein source, like 4 ounces of cooked salmon, and you eat it with sautéed kale or some steamed broccoli, I mean, you, you won't even like probably go above 100, you know. So it's like, wow, you can eat a whole meal, be satiated, and not go a little like above 100, and versus like eating a few crackers and going up to like 140 or something. So that's something. The other thing is also it's really good to just see how exercise affects it, how not exercising, if you're eating, you know, something a little bit more cheaty, you know, how it helps to exercise or how sleep or lack of sleep affects your blood glucose levels. That's something that I found very useful.

And even just being sick, like sometimes when you're sick and you're, you have more inflammation, like your blood glucose regulation is out of control. It usually is not— it's poorly controlled, like with illness as well. So I think all those things are really useful in general and just trying to like document them as best that you can. And it's very informative. So another question, rapid fire, submitted by Gal related to child development. Gal is asking about taking her prenatal while breastfeeding. Her son is 18 months and she's still breastfeeding and plans to for another year. But the prenatal that she's taking, which is the one I took, Thorne, has iron in it. And so she's wondering if she should switch.

So basically, I personally actually took my prenatal, Thorne prenatal, for like the— for the first 2 years of breastfeeding. I did a very extended breastfeeding duration. So I did my Thorne prenatal for the first 2 years and then I switched to my regular multi after that while I continued breastfeeding a little bit longer. That's what I did personally, but you could ask your physician if it's— I didn't notice any problems with my iron when measuring, you know, my iron ferritin and free iron and stuff. So I didn't find it to be harmful for me to take my prenatal and that's something that you could talk about with your physician. Lisa's asking in the chat, is a few weeks enough with the CGM to figure out your individual responses? I do.

I do think that a few weeks you can really get a lot of information with, with the CGM if it's not something that you can If you know, they're expensive. So if you, if you can't afford to constantly do it, then, um, yeah, I think you can get a lot out of it from, from, from a month. And particularly if you test things out and, you know, try to do it methodically as well. And, and also make sure you're calibrating it though, because you don't want to get like bad data. And people are asking about in the chat again, they're asking about finding a continuous glucose monitor when you don't have insulin resistance or you're not— you don't have diabetes. And so Kevin's mentioning in the chat about Nutrisense. I think I also did look into that as well.

And they do— I thought you could get a Libre Glucose— continuous glucose monitors as well without a prescription. But I could be wrong. I thought last time I checked that was the case. Someone in the chat is talking about the COVID-19 vaccine and miscarriages. The COVID-19 vaccine has not been tested in pregnant women yet, so that's something that isn't— I mean, a pregnant woman is, you know, if I were pregnant, I would not get the COVID-19 vaccine until it was tested and safe and shown to be safe in pregnant women. Okay, I'm just scrolling through to see, see any more chat questions. I think I've pretty much addressed, addressed many of them. So thank you guys so much for a really great Q&A. You guys really make this very informative for me and for everyone. You submit great questions.

I really enjoy them, and I hope you guys enjoy them as well. Make sure that you, you check out your dashboard, foundmyfitness.com/dashboard, to be able to see the replay of this, this this Q&A as well as make sure you have downloaded the private podcast feed so that you can listen to it as well as listen to our AlaQuats. our aliquots we're releasing pretty much on a weekly basis now and I've gotten a lot of really positive feedback from them. So make sure you're, you're getting your, your AlaQuat episodes and also for those of you that are interested in going a little bit deeper in the Q&As, I have my monthly hangout the first Sunday of every month.

My next one's happening tomorrow, and that is a pretty private and exclusive hangout, but it's very— it's a really good one where, you know, you guys, we talk. There's a small group of us that talk about all sorts of, you know, personal questions related to health and, you know, even just science questions or the latest, you know, or pretty much anything. So if you want to check that out, you can, you can go to the premium page and you can upgrade your, your subscription if you want. If not, please, please keep, uh, continue submitting really good questions because I really, really enjoy, enjoy learning from these Crowdcasts as well. And I think that's it. Next time I will see you will be April. And also be on the lookout for an email with the summary and the show notes to this episode that we just recorded today. Thanks a lot so much, you guys. I'll talk to you guys next time. Bye. Bye.