Hi everyone, welcome to Crowdcast number 33. Excited to be here this morning. Welcome for those of you who are new and this is your first time. If you're kind of wondering how this goes, typically I go through a variety of questions that I have selected to answer, and the questions range from ones that I'm interested in, ones that I think haven't been covered before, and ones that also have been asked frequently through multiple channels that I get questions through. So I kind of do a mixture between all those. I like to do a few deep dives each month. So I like to go in depth on at least a couple of questions. And then I go and do and try to answer a lot of rapid-fire questions. So these are questions that I can answer with A sentence or 2, sometimes a word.

This round, I have a couple of deep dive questions that I'm answering first, mostly because I wanted to deep dive into them myself. So there was a little bit of a personal interest there. This is also a time for me to learn more material and learn more as well. So it's always fun for me. And then I like to answer some live questions in the chat here that kind of makes it worthwhile coming to the live Q&As. I already see people here asking questions in the chat. So I'm going to go ahead and start with the first question that is a deep dive question. And That question was submitted by SC. And SC asks about zone 2 training. He says, Peter Attia talks about zone 2 training with limited zone 5 training for longevity.

Can you explain in simple terms, as I nor most people can be hooked up to machines for VO2 max, how often should one do zone 2 versus 5? All right. I'm a 65-year-old female and I want to enhance my cardio fitness. So just for quick reference, for people that don't know, zone 2 refers to 70 to 80% of max of your maximum heart rate. And if you don't know what your maximum heart rate is, the equation to figure that out is quite simple. It is the number 220. Minus your age. So that would be your absolute maximum heart rate. So then zone 2 would be about 70 to 80% of that number.

Peter likes to define that as the highest level of exercise while maintaining lactate less than 2 millimolar, which is around the equilibrium where the rate that your body metabolizes lactate is equal to the rate it produces it. I personally don't think you have to do anything with lactate. Heart rate is, in my opinion, actually even a better way to measure zone 2 because heart rate changes linearly, whereas lactate changes exponentially. So I don't think you need to worry about hooking up any devices to measure your lactate, just a simple heart rate monitor. Lots of those available: Apple Watch, Whoop, Fitbit. Things that you can drop to your chest, you know, et cetera. Subjectively, this sort of can feel like moderate exercise that you can maintain over 45 minutes.

Zone 2 is really good for losing weight because it maxes out the amount of energy that comes from burning fat while also being sustainable for a longer workout. Peter likes to recommend 3 hours a week of zone 2. with 1 or 2 sessions of zone 5 in the week. Realistically, most people cannot and will not do that. So in a previous Crowdcast, number 19, we talked about the longevity benefits that can be achieved from exercise. And if we look at some of the meta-analyses in terms of exercise and all-cause mortality, for example, Exercising at a moderate intensity or zone 2 for 2.5 hours a week decreases all-cause mortality by 31% compared to not exercising at all. However, more exercise past that, past the 2.5 hours per week, shows diminishing returns.

So essentially, exercising moderately for 10 hours a week only decreases all-cause mortality by an additional 8%. So, and then there's sub-analysis on this mortality data that showed a mortality benefit that's mainly due to a decreased risk in cardiovascular disease and a decreased risk in cancer, which is good because those are the 2 leading causes of death in the United States in adults. The current US Preventative Task Force recommends that exercise 2.5 hours of moderate level like zone 2 or 1 hour and 15 minutes of vigorous exercise, which would be zone 5 per week. So 2.5 hours per week of that. Honestly, what I do, I mean, there, you know, all of us are busy, we have busy lives, you know, I'm a busy mom, I also am a busy, you know, business owner. And so I work and I'm also parenting.

So what I honestly do often is I will do more zone 5 training Because I can, I can do a high-intensity interval training 10 or 15-minute workout. And I mean, I am pushing, I am sweating. I am like, you know, people, you tell someone, oh yeah, I just did a 10-minute high-intensity interval workout, you know, with a, it's a Tabata 2 to 1 ratio. And they're like, oh, well, you're not really exercising. But until someone actually really is pushing, you know, doing a zone 5 and they're doing it you know, pushing it to like the max level, like it's a good workout. So, you know, I think that if you're short on time, personally, I would do more zone 5 than zone 2. If you're really trying to lose weight, doing more zone 2 would be ideal.

Okay, I'm going to— there was a few questions in the chat that weren't really related to what I just spoke spoke about, but before I lose them because the chat sort of changes quickly, I will answer. There was a question about omega-3 supplements and finding a quality supplement. So I went through and I have a spreadsheet. I think I talked about this in a few Crowdcasts ago, but I went through and talked— I went through and based on the International Fish Oil Standards website, I looked at a variety of fish oils. They rank these fish oils by product number, so, you know, or lot number.

Basically, each— you want to check back and keep checking back, you know, year after year, because things can change with batches and lots, etc. But the way that I separated out my top supplements were based on low oxidation number, ideally less than 6, but definitely less than 10 total oxidation. And then I, you know, low mercury, low contaminants, but that's pretty— those are pretty ubiquitous. It's hard to find omega-3 supplements that are not low in like mercury and PCBs, for example. And then the other thing I separated was concentration of EPA and concentration of DHA. Now, a lot of you will remember that I like to take 2 grams of EPA in the morning and 2 grams of DHA in the evening, which essentially means separate omega-3 supplements.

So my high EPA list is— would be NutraGold, OmegaVia, Norwegian Gold, Barlean's Ideal Omega-3, Viva Naturals, Sports Research, Genuine Health for Canada, and Bear Biology for Europe. My high DHA supplements are Sealicious Yeah. So, those are sort of my— those— so, I'm currently still taking my N-Pure 3, but if I were not, those are the supplements I personally would be going to for the high EPA and high DHA. And again, this is something that I'm not affiliated with any of these companies or anything. I just sort of went through and made a top bulleted list for each EPA and DHA omega-3 supplement based on total oxidation and high concentration of the omega-3 fatty acids. Abby is asking if we have access to this spreadsheet.

I am— I will find out about posting it on the member dashboard to see if that's something that's easy to do. So, um, and then also maybe we can send out an email telling people, telling you guys about that. So your member dashboard, if you guys haven't logged into your member dashboard, that is, uh, you can find that at foundmyfitness.com/dashboard. And that is where you can listen to your podcast. You can listen to them on the dashboard. You can download your private podcast feed player to listen to the Aliquot, to listen to these Crowdcast. Again, And also other things you can access there like member slides and things like that. Tim is asking about omega supplements that combine EPA and DHA.

So, by the way, the supplements that I just mentioned, there is— so the high DHA ones do have EPA, and the high EPA ones do have some DHA. They're just— the ratios, you know, are— it's such that the EPA is, you know, at least 2 times greater than the DHA and vice versa if we're talking about high EPA. So I don't think it's a big deal if you're just taking one supplement that has both. It's just my own personal preference to take the EPA and DHA sort of separately and one in the morning and one in the evening. So I think it's fine. Okay. I'm going to go back to the questions.

Another deep dive question was submitted by Tom, and Tom asks, adverse effects of too much vitamin D. Consumerlab.com shows studies that, that show the adverse effects of too much vitamin D. All-cause mortality is higher for those with high levels, and they really aren't that high, say 40 to 50. I recently stumbled on this article, and, um, he lists the title of the article. having to do with kidney stones. And so, okay, let's talk about this. First, let's talk about short-term adverse effects. So a review on case reports of vitamin D toxicity found that the range of vitamin D levels that were found to be toxic blood levels were 150 nanograms per milliliter to 1,220 nanograms per milliliter. Okay, 150. That is really, really high blood levels.

The most common causes for these crazy high blood levels were manufacturing errors on the vitamin D supplements or prescription errors. In other words, people were taking orders of magnitude higher doses of vitamin D either because their prescription was wrong or because there was a manufacturing defect. And this is really important because doing a blood test will tell you If your vitamin D supplement, you know, is way off, and and that could happen. You could have a supplement that says five thousand IUs, and it's actually fifty thousand. Like like things happen like that.

There are errors that are made, and you'll you'll know that if you get a blood test and all of a sudden your levels are super high, and and and you'll find the opposite as well, where a supplement may say five thousand IUs, and it's actually got five hundred IUs. And so. Unless you do a blood test to know your vitamin D levels, you won't know whether or not that supplement's helping you achieve them or if it's making you go way higher than you should. The range of the dose that people that had toxic vitamin D doses, the levels they were taking to lead to high blood calcium were between 50,000 IUs a day. And 260, 200, about 206,000 IUs a day. So, I mean, these are really high, high, high doses. This is not something that people are taking on a daily basis.

So, you know, I just, I find it reassuring that there have been no reported cases of high calcium blood levels below 50,000 IUs a day. So, 50,000 IUs a day is extremely high, and that is not something that people should be taking. I mean, a doctor may prescribe it for some weird, you know, thing, but that is extremely high. Long-term adverse effects. So, kidney stones, because vitamin D increases calcium absorption in the gut, there has always been a concern that it may increase the risk of calcium-based kidney stones. However, that risk is like it's theoretical because there's no data to support it.

So there was a 2020 meta-analysis of many different observational and randomized controlled trials that showed there was a positive association of higher dose vitamin D with calcium kidney stones in the observational studies. There was no association in randomized controlled trials, which essentially tells you that, you know, observational data has a lot of confounding factors. Like people could be taking higher dose vitamin D because they've already had some kind of kidney stone or they're sicker or something. But when you actually give the same dose of vitamin D in a randomized controlled trial where people are getting either vitamin D or a placebo, it's not causing kidney stones.

So it really tells you that there's some sort of confounding factor likely at play here for the observational data. Lastly, there's also 2 older meta-analyses of randomized controlled trials showing no association between vitamin D and kidney stone risk. So meta-analysis of randomized controlled trials are the highest quality of evidence in science. When they repeatedly show the same results from different scientists publishing them, it's pretty confident that you can say, okay, this is real. And so, at the end of the day, there's no effect of vitamin D supplementation on kidney stone risk.

So I just don't know, you know, you can cherry-pick and find a study that says this, but at the end of the day, unless you have scientific consensus, unless there's multiple studies and randomized controlled trials showing it, it might just be some other association that's being biomarked by what you're looking at. So the study that Tom asked in this question was a paper that was an opinion piece. It was not data. It was an opinion piece. And it expressed— this was the ConsumerLab one. It expressed concern over a theoretical risk. So even the paper itself admitted that there's no quality evidence to support the concern. So, you know, kidney stones and the risk of high calcium in the blood, again, theoretical risk for kidney stones.

When you start to get levels of 50,000 IUs a day, yeah, that's concerning. You shouldn't be taking that high of a dose. With respect to mortality, the increased all-cause mortality for vitamin D, I couldn't find that. All-cause mortality for people with vitamin D below you know, 60 nanograms, it's decreased all-cause mortality. You know, so I don't know exactly what the aim of this ConsumerLab little vitamin D synopsis was, but it seems as though it was not based on good science. It's not based on solid science, and it was a little more on the fearmongering side of things. So I'm not a fan of what was stated there. In fact, I think it's really not grounded in science.

Monica's asking in the chat about ubiquinol, saying it is expensive, and if I could speak about the benefits to someone with high levels of inflammation. So we're actually working on a topic page right now on— so I'm going to save the ubiquinol for a future Crowdcast, and also we're going to be releasing a really in-depth topic page on that. So that's coming out soon. Alan and Caroline are saying in the chat that chest strap heart rate monitors are much more accurate. And I do agree than the wrist ones. They are, they are more accurate for sure. But you know, at the end of the day, there's, there's, there's a bit of, you know, error that's gonna, that's gonna occur with The wrist ones, but I think that whatever you're going to easily do and do more consistently is the way to go.

So my husband likes to use the chest strap, and I used to like—I like to use my Apple Watch. I just—I'm not—you know—I think—I think men are can easy—it's easier for men to kind of put a chest strap on, whereas I think women are a little more prone to using something on their wrist. James asks if there's evidence that sulforaphane breaks up the hormone DHT, which is the main cause of hair loss. So for background, DHT is dihydrotestosterone. It's produced from testosterone through the enzyme 5-alpha reductase. One of the medications for treating baldness inhibits the 5-alpha reductase. DHT is the, the cause of male pattern hair loss, which is the most common cause of baldness. However, there are other forms of hair loss that are not caused by DHT.

There's a 2016 study that was in mice showing that sulforaphane increased hair production by accelerating the breakdown of DHT. However, this has not been tested in humans, and so really it's kind of too soon to know whether or not sulforaphane will work for male pattern baldness. It's certainly an interesting hypothesis. So there's been a variety of questions submitted by people, including Maximum, and some related questions as well, about resveratrol and new potential negative effects with supplementation or trade-offs, and whether it increases cholesterol, reverses the effects of exercise or blunts the effects of exercise or is heart damaging.

And I did want to take time to go through just a couple of these studies because when it comes to something that people are supplementing with, I think it's important to really know, you know, the trade-off, the potential trade-offs. So with resveratrol, One of the studies that was linked was an in vitro study, and it was a study that suggested there was replicative stress caused by resveratrol. So it was an in vitro study, and it caused low levels replication stress, which implies that it inhibits the proliferation of new cells.

As an in vitro study, when you dump something on cells, I mean, the amount of resveratrol that are going you know, getting into those cells, you just, you would never find that in an in vivo model, like, particularly with humans that are, you know, our CYP enzymes are getting rid of most of the resveratrol. I mean, there's not, you know, the bioavailability is much lower. It's not something that's— until that is shown to be, you know, first in animals at a dose that's even relevant to humans, I think it's impossible to say that even has any relevance. So with an in vitro study, it's kind of interesting, but I mean, you dump enough of anything on a cell, like vitamin C, and you can cause damage.

But, you know, it's not like we don't need vitamin C. So really, in vitro studies are taken with a big grain of salt. There was another randomized placebo-controlled trial that was done with resveratrol stating there was no beneficial effects on metabolic syndrome. 66 male participants with metabolic syndrome, and one-third of them got 1 gram of resveratrol a day, and one-third got 150 milligrams a day, and then the last third got a placebo, and this was for 16 weeks. The authors concluded that basically, you know, there was no effect on any of the metabolic parameters, so cholesterol, glucose regulation, things like that.

But on the contrary, The high-dose resveratrol, the 1 gram a day, actually was associated with an increase in circulating fructosamine, total cholesterol, and LDL cholesterol. So we've previously talked about multiple studies in people who have type 2 diabetes that demonstrate that resveratrol treatment of 1 gram per day can decrease systolic blood pressure, fasting blood glucose, hemoglobin A1c, which is a marker of long-term blood glucose, circulating insulin, while also improving insulin sensitivity. And there's like 4 different studies showing that. So when clinical trials have conflicting results, the next step is to look into the details of the study. And it's important to not ignore negative results because they can give you just as much insight as a study with positive results.

So one thing that was noticed between this study and the several other studies was that there were significant differences in the participants between the studies. So for example, the study that had negative results only included men, whereas the other studies included females as well. Also, the body mass index and the severity of diabetes were also very different between the studies. Diabetes severity is a very important confounding factor because that means participants are taking different type of antiglycemic medications that will probably interact with resveratrol. Sometimes negative results can be due to a methodological issue, like a difference in the manufacturer of the resveratrol, or whether or not participants were instructed to take it with food or on an empty stomach.

So, you know, resveratrol is barely absorbed when taken on an empty stomach, so you have to take it with a pretty moderate fat meal. So honestly, what needs to happen now is a meta-analysis that compiles all the metabolic data together together and includes confounding factors and includes sub-analyses to figure out, you know, what effects resveratrol has on cholesterol and blood glucose regulation, blood pressure. Because, you know, when you do have conflicting data, like I just mentioned, there are several things at play, and we just don't know what is at play. The other potential trade-off that's been A concern is, and this is something that is on our topic page on resveratrol, is the potential to blunt the positive effects of exercise. So it is a bit concerning.

There was a randomized controlled trial of 27 men. And after an 8-week workout program, the placebo group showed more cardiovascular improvements than the resveratrol group. The dose of resveratrol was 250 milligrams in this study. Now, there was another study, and again, you can find this on our topic page. So that would be on foundmyfitness.com/topics, and then you can scroll down. They're alphabetized, and you'll find resveratrol there. Another study which was similar, it was 30 men, and they were— it was a 12-week aerobic training program. These men got 500 milligrams, so they got twice the resveratrol dose.

At the end of the training program, participants experienced an increase in mitochondrial density, muscle fibers, maximal oxygen consumption compared to the placebo, basically exercise training alone. And then there was even another study who— there was men who did high-intensity interval training, and there was no effect on aerobic or anaerobic capacity. And this was also a low dose, 150 milligrams. It's possible. We do know that resveratrol at a low dose can act as a mild antioxidant, whereas as a higher dose, it's more of an indirect antioxidant, which means it's more of like activating a hormetic stress response pathway.

So it's possible that the first study I mentioned, because it was a lower dose, maybe is blunting some of the negative effects of aerobic exercise because it was blunting some of the reactive oxygen species produced. It's possible. We don't really know. You know, honestly, it is a little bit of something to be aware of. Personally, now I had mentioned I was taking resveratrol. I like take it maybe once a week and I do it in my yogurt, my yogurt smoothie that I make, which is made of kefir, goat kefir. And so, you know, it's not something that I'm doing daily. And, you know, I'm still sort of looking at the data to make sure it's something that is, you know, safe to take. And a related question was from James, and it had to do with the pros and cons of resveratrol versus pterostilbene.

Pterostilbene is something that is found in, for example, the skin of blueberries. There have been animal studies that have found pterostilbene is about 80%, you know, more bioavailable. Than resveratrol. But, you know, we just don't have enough data on the two with head-to-head comparisons, and we certainly don't have enough data in humans to know. I do think pterostilbene is good, and there have been some positive clinical effects as well. Myrick is asking in the chat about The difference between cardiovascular training and resistance training, perhaps, as well, with respect to resveratrol. And, yeah, that could be also another difference. Again, we just need more data.

And honestly, again, like I said, you know, I think it's safer, you know, if you're concerned about potentially blunting the effects of exercise, to do something where you're taking it, like, once or twice a week on days where you're not exercising. would be something probably to consider as well. Do you have a suggested target range for vitamin D blood levels? 40 to 60 nanograms per mL. Ideally, I like— mine are usually around 50. Okay, I'm going to move on to some rapid-fire questions now. And Chad asks about Xylitol and sorbitol, and most sugar-free chewing gums have them. I have covered the topic of xylitol and sorbitol in several Crowdcasts previously, so I'm not going to go into too much detail.

I do chew xylitol gum, and it increases— there's many studies showing that it increases the cause of— I mean, it decreases the bacteria that cause cavities, so that would be Streptococcus mutans, without having any effect on beneficial oral bacteria, so it's not a affecting beneficial oral bacteria in any way in the mouth. The amount of xylitol, sorbitol, etc., like making its way to the microbiome when you're chewing gum is like so minuscule that I just don't even— I think the stress of worrying about that would probably damage your microbiome more. There have been some like animal studies that have shown, you know, insanely high doses Of some of these things may change microbiome composition, but again, it's like, how relevant is that to a human?

Because we're not taking in 5 grams of xylitol per kilogram body weight a day, you know. So it's kind of those— it's one of those things where it's like, hmm, okay, well, interesting. When you do nothing but eat xylitol, there's an effect. Well, big surprise. So, um, I, you know, until we really have more data With respect to humans, you know, and then again, it's like I wouldn't go out and start like baking with tons and tons and tons of xylitol, but I certainly wouldn't be concerned about chewing gum either. Another rapid-fire question from Chad. Chad asked, do you think sauna would be safe for those with a heart valve replacement or organ transplant? We have a sauna on the way, but there's a study showing both negative and positive effects on allografts. How's this wondering?

Always, I would ask your physician. Always run it by your physician. But is my looking at the literature? It seems safe for both of those things. But again, definitely want to ask your physician first. So so Boldy has a question about berberine exercise. She says thank you for covering, or they say thank you for covering berberine last month. But the one missing piece is whether it inhibits benef. beneficial effects of exercise the way metformin does, like muscle adaptations, for example. Please see our topic page on berberine. Again, we cover this, but, you know, there was an intervention study showing that the effects of berberine on circuit training in sedentary overweight men enhanced the effects of exercise.

Similarly, berberine potentiated the effects of aerobic exercise, and this was in a rodent study. These were diabetic rats. More clinical evidence needs to be done. We need larger groups, more participants, more types of exercise to really know whether or not or what effect, if any, berberine has on exercise-induced benefits. So that's something to, again, keep in mind. A related question was from SC asking about the dose and type of berberine. Obviously, I can't give medical advice. Most of the doses in the studies that I referenced last time were at about 500 milligrams. And I do know that Pure Encapsulations makes a pretty reliable berberine supplement.

Joy asks about studies regarding collagen peptide supplementation, particularly type 1 and type 3, and if consuming collagen can actually build collagen levels. In the skin and other tissues. So again, we have a topic page on this, on hydrolyzed collagen. So go to foundmyfitness.com/topics, click on the hydrolyzed collagen page, goes very in depth. We have a whole section on skin collagen. Hydrolyzed collagen has been shown in several, uh, both placebo-controlled intervention studies to improve both wrinkle depth and skin elasticity. Collagen's not directly measured in human studies because it's that would be too invasive. But one would think that you are affecting collagen if the wrinkles and elasticity are improved. Perhaps collagen's to some degree being improved as well.

There are animal studies showing that collagen levels are increased in other areas, other tissues like, like the joints, for example. I personally use Great Lakes I use both their unflavored form and their— I also like their vanilla-flavored form that uses some monk fruit, stevia, I can't remember which or both, in my coffee. So that's what I use. Kenny in the chat is asking if I can comment on the use of olive oil versus avoiding all oils in the diet. So olive oil, there's been many, many different studies just looking at giving people olive oil versus a placebo control, and there's a lot of benefits from— in fact, right now I'm drinking a matcha. Can you see that?

It's a matcha oat milk latte I made, and I added some olive powder that I— it's an olive powder from olive leaves from Mallorca, Spain. And there's a lot of polyphenols in the olives and olive leaves and olive oil. So I do think there are benefits to olive oil. When it comes to other oils, the ones that I really think, according to data, to avoid are oils that are high in polyunsaturated fatty acids like Omega-6. So that would be vegetable oil, canola oil, soybean oil, safflower oil. These are typically used for cooking oils, and unfortunately, because they are made— they have a high concentration of polyunsaturated fatty acids in them, they are very prone to oxidation, especially when you add heat. I mean, it's just like a no-brainer.

So the best oils to cook with would be, in my opinion, what I use is avocado oil, Or if I'm just doing a quick, you know, like a quick sort of sauté, you know, I'll sometimes even use olive oil as well. But those are the oils that I like to use and that I think are beneficial. Avocado oil is mostly made— both avocado and olive oil are high— they're pretty low in polyunsaturated fat and they're high in monounsaturated fat. Lisa's asking if I take berberine. No, I do not take it. But I, you know, again, it's something I've kind of considered playing around with. I just don't like changing too many things, you know, because when you're trying to measure biomarkers and stuff, it's best to change one thing at a time. I think I might try giving it to my mother.

And experimenting with her cholesterol and blood glucose regulation first. But I did, and because I have considered doing that, I did buy berberine from Pure Encapsulations. Owen asked what my opinion of microwave ovens are. I use them. It makes my life easier. And I don't think not using one is really going to have a significant effect on my mortality risk. I think I try not to stand in front of it when it's on, but I'm not like, you know, you kind of have to choose your battles, honestly. And it's just, I try to choose the ones that are going to have the biggest bang for my buck. You could really obsess about everything in, you know, like literally every single thing. And I don't know that that's necessarily good for your health. Sarah asks, hi, Rhonda.

Given the importance of blood tests and biomarkers, I think we're all searching for tracking data format that is easy to use, informative, private, and portable. How do you track your test results? PDF, Excel, WellnessFX, InsideTracker, another service or software? Any best practices to share? And actually, there was a related question on this as well, which was submitted by Okay. So, this question is by Libby, and Libby says, what do you think are the most important labs to request from my physician? I feel like MDs tend to order very routine tests until you start having a problem. What are important labs to have, either yearly or baseline info, especially as we age, in order to maintain health and avoid problems that could be caught earlier if we are tracking them sooner?

So, these are— These are 2 sort of related questions, and the reasons— the reason, in my opinion, that they're related is also because of what I use. So the question was, you know, tracking my— what I'm tracking with my biomarkers and stuff. I actually use WellnessFX a lot. I have the WellnessFX app on my phone, and because I order so much blood work through them, they have tracking software. And so that's what I use. I've considered trying some Insight Tracker and all that, but because it's just so convenient for me and it's like the less work I have to do, the more likely I'm going to do something. So I use Wellness FX and there's a variety of reasons I like Wellness FX.

I do like avoiding the doctor because I'm, you know, there are all sorts of hoops and things you need to jump over and regulations and doctors can only order certain tests. And if they don't have a reason to order certain tests, you know, not all physicians will order them. And there's all sorts of— like, it's just battles I don't want to fight. And like, I'd rather just pay for my tests, get them done, and get my data. And share it. You can share your data with your physician after. I mean, that's something you can— it's easily— you just, you know, bring your data to your physician. But, you know, this is the way I like to do it. The tests that I like to do at the very, very, very least, once a year, ideally twice a year, 3 times a year.

It is— the reason I do it is because it's a one and done. So you, like, it takes time to go and get blood drawn and do all that. And, you know, like, time is important, right? So if you can go and get a just battery of tests done, And and only have to go once and do it. It's a lot easier. And so I what I end up doing, and I've done this now for years, is I use the Wellness FX Premium package, and I don't have any affiliation with them, by the way. I just have liked their service for years and years and years, and so I use them. And the Premium package includes they do a variety of cholesterol. So they do total cholesterol, HDL, LDL, triglycerides, ApoA1, ApoB.

Lp, omega-3 fatty acids, they do it in red blood cells, free fatty acids, they do lipid particle number, and they do lipid particle sizes, and they do that for HDL and LDL. So they're giving you the breakdown of particle number and particle sizes for your lipids. So it's a really good sort of advanced cholesterol panel they do. They also do a lot of liver and kidney health. So they'll do the BUN, creatinine, the AST and ALT, the total bilirubin, albumin, total protein. And then they also do some hormones. They do DHEA, free testosterone, testosterone, estradiol, and SHBG, the sex hormone binding globulin. They also do some metabolic hormones. So they do cortisol, they do IGF-1, and they do insulin. And then there's a variety of— there's thyroid and blood sugar.

So they do glucose, HbA1c, they do total T4, T3 uptake, free T4 index, TSH, total T3, free T3, reverse T3, and free T4. And then they also do some inflammation. They do high-sensitivity C-reactive protein. They do fibrinogen, and they do homocysteine. And then they'll do like the complete blood counts, and so they'll do some advanced nutrients. So they'll do like your whole blood count differential, calcium, electrolytes, bicarbonate, ferritin, total iron binding capacity, folate, vitamin B12. They do red blood cell magnesium. They do your vitamin D, and then they'll do some women's panel as well. They'll do progesterone, follicle stimulating hormone, and luteinizing hormone. And so I like— that's like a big panel of tests you can do. There's a lot of tubes.

I mean, it's like 18 tubes that they do. So if you're sitting there looking at the phlebotomist or nurse doing it, you're like, whoa. But it's nice to get it one and done. You get a lot of data from it, and it's just really beneficial. Okay. So another question was asked by Kel, and Kel asked, what are your thoughts on infrared saunas that emit near-infrared and how it affects our subcellular melatonin production in mitochondria? Is this something that we could do if we don't get outside and get exposure from the sunlight often so that we can increase our subcellular melatonin production? So I think that sounds like a very interesting hypothesis. There's no evidence to show that infrared, you know, from infrared radiation from saunas will affect melatonin within the mitochondria.

Um, you know, so again, it's one of those things where I can't really speak to it because it's, it's really just theoretical. Owen asks what the best supplements are to consume to slow or prevent macular degeneration. Interestingly, there was a study I just came across a couple of weeks ago, and this was an animal study, but it showed that exercise, like moderate to intense vigorous exercise, slowed the loss of photoreceptor cells in animal models that had macular— like were predisposed to macular degeneration. It slowed it by 50%. So they lost 50%. I mean, they didn't, you know, 50% of their photoreceptor cells were not you know, lost, which I thought was just absolutely phenomenal.

I mean, so you're asking about supplements, but really lifestyle strategies should be the question, and exercise is probably at the top of the list. And then there's things like lutein, zeaxanthin that have been shown in several different studies to make a difference, as well as DHA from omega-3. And I just went through a variety of high DHA supplements at the start of this Crowdcast. Okay, this is an important question. So Elle asked, there's an article from UC Riverside that says the keto diet may not work for women. What are your thoughts? This will be— they will be studying the shift between sugar and fat burning in a new study. They also mentioned intermittent fasting.

Could you explain more about women, how men and women differ in metabolizing fat on a ketogenic diet and potentially intermittent fasting? So I just had Dom D'Agostino in town. He was on the podcast last Thursday. We filmed a 2.5-hour podcast. And so we really talked in depth. And one of the things, one of the topics that came up during that conversation was the animal research using ketogenic diets. The thing that was very interesting about this is that— so let's talk about this study with female and male differences potentially in ketogenic diet. So this is all— the basis for this grant that was given, you know, that's being granted to these researchers at UC Riverside, the basis for this is an animal study. And the animal study was in female mice only.

Sorry, no, the animal study was in female and male mice. But the female mice only gained more weight on the ketogenic diet, and male mice didn't. And when the female mice had their ovaries removed, they did not gain weight on the ketogenic diet, suggesting estrogen may play a role. Now this was the conclusion of that study. The problem is, is that mice will notoriously eat. If you put them on a ketogenic diet and you give them what's called ad libitum access to food, they will, for some reason, certain genetic strains and backgrounds will eat more food. And ultimately, because calories matter, calories in and out do matter, like they do, they will gain more weight because they will just overeat. And this is something that was That's been known. It's known within the scientific community.

So a variety of studies that came out a few years ago from Dr. Eric Verdin's lab and also John Ramsey's lab, they sort of simultaneously co-published studies on ketogenic diets. And in fact, the ketogenic diets were in both male and female mice. And this was something you can go back and listen to the podcast I did with Dr. Eric Verdin. This was like 2017 podcast. He talked about it in depth, but the the the female and male mice, what they did was they had to give what what Eric did was he put them on a cyclical ketogenic diet, and this is how he stopped them from gaining weight because he would he would give them like a keto diet like every other day or something like that. It was it was a cyclical diet so that they wouldn't overeat overeat. John Ramsey, he's at UC Davis.

What he did was he basically gave them fixed proportions so that they could not gain weight because they couldn't overeat. And so in a way, you end up having a ketogenic diet sort of in combination with— you're getting a little bit of the time-restricted eating element there because, you know, when these animals are given their food is when humans come and they come, you know, humans come only like at certain times of day. And so because they were given and not just given unlimited access to the food. There's a bit of time-restricted eating element there. But the point is, is that both male and female mice in both of these studies had an extended healthspan.

So they— although their maximum lifespan was not increased, meaning that, you know, it didn't extend how long the maximum amount of time that a mouse can live, which is something like 2.5 years, it did increase their median lifespan. So they were like— You know, I forgot the exact percentage, 20% or something. They were basically at any given point less likely to die from spontaneous cancer or from, you know, heart problems than mice that were on the control diet. So keto diets are not that bad for the female mice if they're extending their healthspan. And also their memory was dramatically improved in the female mice as well. So I'm a little concerned that whatever phenomena is being studied or measured in this study is actually a side effect of this overeating.

And maybe estrogen makes it even more pronounced. Maybe estrogen plays a role in it as well. Like, we don't know. So I don't know how relevant that is for women. Again, it's all based on animal data. And because we know animal data also shows that ketogenic diets, when done correctly, when they're not like overeating, that they actually do improve health of the female mice as well as the male mice. So I think that is a really important consideration. Jim is asking in the chat whether or not Wellness Effects uses the omega-3 test as defined by Dr. Bill Harris. They do measure the omega-3 index. As far as I know, they do measure the omega-3 index. So it's relatively similar. I don't know if it's exactly similar. I do like Bill Harris's test, and it's something that I would additionally do.

In addition to the Wellness Effects, the OmegaQuant is a pretty affordable test, and, you know, you can do it to kind of see where you're at in terms of your omega-3 index. But the Wellness Effects one does measure omega-3 and red blood cells as well. Elaine is asking in the chat, what supplements increase or improve low IGF-1? Honestly, so IGF-1 is really— it's predominantly regulated by essential amino acids. And ones that are known to increase IGF-1 are leucine, like some of the branched-chain amino acids like leucine, also methionine as well. So those, you know, eating meat, supplementing probably with even whey protein would be some ways to increase IGF-1 for people that have low IGF-1. Okay. So some more rapid-fire questions.

Christian asks, what do you think of epigenetic tests that show your biological age? I did a test recently and it showed my biological age is 15 years older than my real age. I feel great, so I'm a bit confused by these results. Interesting that you should ask this, Christian, because I'm having Dr. Morgan Levine on the podcast this coming week. She'll be in town on Friday. And she was a postdoc in Dr. Steve Horvath's lab. Steve Horvath is really, you know, the pioneer of the epigenetic clock, you know, aging clocks. And she developed the DNA PhenoAge, which is the test that can more accurately determine biological age.

We had a phone call, and so I'll know more about this next week when we talk, but she was saying that there are flaws with these consumer-available tests and that basically, She's working on improving them, but there was there she figured out some kind of background noise. Like there was some noise signal to noise ratio that was not quite dialed in, and so I wouldn't I wouldn't go too far into believing you know the tests of of your epigenetic age. I think I do think that a lot of these tests can also be flawed, and also until you can repeat them, the problem is some of them are so expensive, so you can't like. Like, doing a repeat test is— it can be quite costly as well. But it's always a good idea. I think I told you guys my telomere story where I did— I used it.

I did a telomere test and it measured my age as pretty much spot on as my chronological age. And then I did it 2 weeks later and it had me 20 years older than my other telomere age. Literally 2 weeks. And I'm like, it's impossible to age 20 years in 2 weeks. I mean, you know, some of these tests are really flawed, to be honest. Jay is asking, which lab does Wellness Effects use? They use LabCorp. Lisa asks, hi, Rhonda. I'd be interested to know your opinion about EMF. It's a hot topic right now, and I don't think I've heard you talking about it in depth. Are you concerned about it? If yes, what measures are you taking to limit the exposure? So I did cover EMF in depth in Crowdcast number 9. So you can go back and check that.

I'm mostly not overly concerned with EMF, and I'm not like freaking out and thinking about it. I don't think it's really like the thing that's going to increase my biological age. Out of all the things that I can worry about changing, I don't think that's the one. I try not to sleep with my cell phone next to my bed, you know, like I think that's a simple enough thing that I can do, but I do think that there's a variety of other factors to focus on that are actually going to affect the way you age, like low omega-3, EMF issues. I do think that in the blogosphere, you can find people starting to blog and talk about and podcast about these obscure things that sound like they should be something I'm concerned about. Oh, they're podcasting about it.

And to be honest, you have to look at the quality of evidence and you have to look at— people run out of material to talk about too. And so they just talk about things that seem obscure. And there's a lot of ways to hook people in and kind of get them hooked into something they think that there's something they should be concerned about. And In reality, it's not really a big concern at all. So EMF, so far I haven't seen data unless you're a worker in something that's being constantly exposed to really high levels. It's just not something that I think is a huge, huge concern. That's my take. I see mentions Vital Choice. I used to get my salmon, salmon roe, a lot of like, I get my sardines, things like that from there.

The company was just sold to 1-800-Flowers and no one seems to know if the suppliers will be the same. I'm wondering if you were aware of this. So I did look it up. I do still use Vital Choice. In fact, I did just order my favorite sardines and So far, everything seems to be the same. I mean, I'm not really— it would be surprising if they stopped using the same sustainable companies. But, you know, for now, I'm still using Vital Choice. Okay, Daniel asks, hi, Rhonda, do you have a protocol that you would put into play in the case that you were diagnosed with COVID So I did get COVID, and I presume it was Omicron because I got it when Omicron was going around everyone.

And my mother, who was boosted at prime, she was like prime booster level, she's the one who gave it to my son, who was sick for a day, and then he gave it to me. So I had it, and What I did, so my protocol that I did is I did liposomal vitamin C and I was doing that like a big tablespoon. And the brand, I have 2 brands I was using. Pure Encapsulations was the one I was using, but I also have another brand, it's Quicksilver. So I was using that, like I was doing that like every 2 hours. So I was just really trying to maintain high plasma liposomal vitamin C. I was taking zinc lozenges, and I did about 80 milligrams a day of the zinc lozenge. And of course, I was taking my vitamin D. I think I was getting about 7,000 IUs a day.

My omega-3, so I was doing 2 grams of EPA in the morning and 2 grams of DHA in the evening. I was also doing luteolin. I was doing 100 milligrams a day, and that was from Swanson brand. I was taking Mareva. So on the first day, I had a headache, and I had looked up some studies on curcumin, and I wanted to know if curcumin blunted the antibody response or, you know, it was things like that. And what I found was actually the opposite, that curcumin enhanced the antibody response. So, I felt more comfortable taking that. And moringa, like, I don't, you know, I'll get headaches not infrequently, but like, you know, with my cycle or something. And if I take about 1 gram of moringa, it'll knock my headache down pretty good. So, I did moringa. And then, I also was taking quercetin.

I think I was taking 250 to 500 milligrams a day. And then I also was taking melatonin. There's been a variety of interesting studies, like Cleveland Clinic put out a study where melatonin may help prevent or even aid in the treatment of COVID-19 due to its antioxidant anti-inflammatory effects. So there was like, there was an observational study that found melatonin was associated with a reduced likelihood of participants getting COVID by 28%, and actually among people that are disproportionately affected, so African Americans, they were 52% less likely to get COVID. But so I was taking 10 milligrams of melatonin at night, and then I held off from doing my vigorous exercise.

That's like, I didn't wanna have any stress on my heart, but after about day 3, of having it, I— maybe day 3 or day 4. I mean, and by the way, by this time I was— it was really one day that I felt really terrible, like the first day. And then after that, it was like runny nose and stuff. But I had— I did the sauna. I cranked the sauna down. I usually do like 186 degrees Fahrenheit, and I'll stay in there for like 30 minutes. I cranked it down to about 165 to 170, and I did steam. And I only stayed in there for like 15 minutes. I wasn't pushing it too much. And that was pretty much my COVID protocol. Once I tested negative, I then did intravenous vitamin C just to sort of eliminate any potential long COVID chances. And so that was kind of like once a week.

you know, for like 3 weeks, 3 or 4 weeks. Luwany is asking in the chat, why liposomal vitamin C? Okay, so check out our topic page on vitamin C. It is really, really good, and it shows a really nice graph as well. You can see that liposomal vitamin C, like there is a slight benefit with liposomal vitamin C in terms of increasing plasma levels. So, in most cases, you know, I don't know that it's necessary. You can also just take high-dose oral, like 3 grams a day, but I've noticed— so, I've done both, liposomal versus ascorbic acid, for example, and when I take really high doses, I'll do like 3 grams every couple of hours of ascorbic acid, and it can start to give me gas. And that's like, other people have noticed the same thing. And that doesn't happen to me with liposomal.

So, so it is kind of nice to be able to take the liposomal as well. Evan Thomas is asking what the rationale behind IVC potentially minimizing the risk of long COVID is. So you can get plasma levels, and again, this is also on our topic page. It doesn't go as much into COVID, but it talks about the rationale here, what I'm going to explain, and that is that when you— when intravenous vitamin C, you're going to get plasma levels that, of course, you can never achieve with oral ever. Like, you can't ever get them, but also that the intravenous vitamin C increases the levels of the oxidized form of vitamin C. So vitamin C goes between— I think there's like 4 cycles or something like that, like about 4, where it goes from a reduced form, and that's where it donates a hydrogen, and that's its antioxidant activity, and then it goes into an oxidized form, and then it can be reduced again, and then it oxidizes.

So it's like 4 times. Well, the oxidized form is dihydroascorbic acid. It's also called DHA, which is a little confusing because of the omega-3 fatty acid. But anyways— DHA. Yeah. The dihydroascorbic acid, you get really high levels of it with the intravenous vitamin C. And it basically, it releases, it causes the release of hydrogen peroxide from neutrophils. And the hydrogen peroxide is at high levels that it's actually, it kills pathogens. It kills any lingering pieces of virus or any of that stuff in there. without damaging normal cells. And, in fact, normal cells, it increases the antioxidant capacity.

So the normal cells become even better and more, you know, they work even better, whereas it's at the same time, like, it's basically, you know, selectively killing off pathogens and stuff and, like, any types of— it's stimulating things like macrophages to, like, you know, scoop up and eat away any types of, like, little pieces of viral RNA, for example. So that's kind of the rationale there. So William is asking in the chat about recent studies that have shown a relationship between viruses and autoimmune disease, specifically Epstein-Barr. In fact, I think even that one was associated with people who had COVID more likely to get long COVID as well, which was interesting. But also, it's associated with multiple sclerosis, Epstein-Barr is.

And I honestly— so I know someone that had— they were young. I mean, there was— this is like a teenage— this is like a 19-year-old, 18 or 19-year-old that got COVID. And then they had gotten Epstein-Barr. And that sort of like spiraled them into getting Just they were having a severe autoimmune attack, and their IgG autoimmune antibodies were elevated. They had long COVID and all sorts of things. And they did five, five or ten. No, they did ten IVC treatments, and they were doing ten grams each treatment. And I believe the treatment was once a week, and it. it seemed to really get rid of the long COVID, you know, side effects, and also their autoimmune antibodies sort of normalized, which I thought was really interesting. You know, again, that's sort of anecdotal.

But if you go to the topic page on vitamin C, I do think that the intravenous vitamin C can be beneficial for certain things. With respect to autoimmune disease, I think, interestingly, one of the most beneficial things that's been shown are ketogenic diets and/or fasting-mimicking diet and/or fasting, you know, fasting, intermittent fasting, or even doing a more prolonged fast, actually. It's— which is, you know, needs to be done under a physician's care, especially if you're talking about someone that actually has a disease like MS. I think ketogenic diets are safer than doing a prolonged fast. And that has been— there's been some really preliminary clinical evidence showing that ketogenic diets can help with alleviating some multiple sclerosis symptoms.

And then there's been animal evidence that's also backed that up as well. And then also just like, you know, taking care of the gut microbiome again. So, you know, in some cases, that is also where the intermittent fasting can come into play because it can help normalize, you know, certain bacteria do die off during a fast. And there's been some interesting data showing that it seems like you can kill off some pathogenic bacteria and you increase your beta-hydroxybutyrate levels, which seems to also maybe— and this is, you know, could— this is more theoretical, but I think people are looking at this, showing that it works kind of like butyrate in some respects in terms of gut health. So I'm focusing on that as well.

And then vitamin D, of course, has been shown to be hugely beneficial for people with autoimmune diseases and multiple sclerosis as well. Okay, so we're going to talk a little bit about some time-restricted eating stuff. I see some questions in the chat about that. So there was a study by Marley who asked, hi, Rhonda, Dr. David Sinclair suggests that The time-restricted eating benefits don't even start until 16 hours of fasting, but I thought anything after 12 hours would trigger autophagy. I also have heard Dr. Huberman mention that 16:8 was timed, picked out of work constraints rather than science, but his point was that no one tested 15:9 or 14:10 for the effects. What are your thoughts?

So, So, first of all, I would say that, like, saying something as broad as the time-restricted eating benefits don't start until 16 hours is a sloppy thing to say. There are so many different effects that occur that saying that they don't start until 16 hours is a very subjective and, in my opinion, sort of... random thing to choose. So I disagree with that. Now, you know, so there's so many factors at play here, the type of diet you eat, how much exercise you're doing. You know, people deplete their liver glycogen levels at varying, you know, rates. Some people can deplete it, you know, within 9 hours, and particularly people that are doing a lot of endurance exercise. There's also genetic factors that control this as well.

You know, when you deplete your liver glycogen, you start to, you know, that's when you start to liberate fatty acids from your fat tissue and in the liver, you know, fatty acid oxidation is occurring and you convert them into ketones, beta-hydroxybutyrate being the major circulating ketone body. And there's effects that are beneficial from that in and of itself. It is a signaling molecule. you know, activating brain-derived neurotrophic factor in the body. It's activating, it's, you know, affecting global epigenetics. You know, it's doing a lot of things. It's also a very easily utilizable source of energy, right? And so, again, I mean, that can happen as little as 9 hours in really, really physically active people. And most people, it takes around 11 hours.

You know, so there are benefits. : That can occur after, you know, not eating for even shorter periods of time. With respect to autophagy, now, I had Dr. Guido Kroemer on the podcast a few years ago. To this date, his study is the only study that I have seen in humans to try and quantify the minimum amount of time needed to detect autophagy. And that time was, unfortunately, it was 24 hours. However, you have to realize that that doesn't mean autophagy is not happening after 12 hours or after even 8 hours of fasting or even 4 hours. The thing is, is that whatever assay that you're using, you're only going to be able to detect, you know, whatever the sensitivity of that assay is, okay?

In people, they're using an assay that's, you know, of course, easier to do, something that can be scaled, you know. So there could be, you know, in some cells and some tissues, you know, and they're just looking in blood as well, right? We don't— we just don't know that no autophagy is happening after a certain, you know, number of hours. It is my— I suspect that even, you know, even in short periods of fasting, there's some minute degree of autophagy happening in some tissues, probably. And certainly when you're combining that with being physically active. So, you know, I would— again, it's something— it's just— it's sort of an unknown field. And it all comes down to sensitivity of assays and things like that.

And also, You know, like your NAD levels and NADH, like those levels, like even in between meals, NAD increases in between meals. So, you know, there's a lot of things going on during fasting periods and even short fasting periods. As you start to get into a more prolonged, longer, longer fast, you start to get more apoptosis, which is different than autophagy. You start to actually get cells dying, and that is Yeah. Can be beneficial, particularly when you're talking about eliminating damaged cells. So I just think that saying something like benefits don't start until 16 hours is— which benefits are you talking about? Benefits for you? Is this just your opinion? Because it sounds like opinion. That's what it sounds like to me.

It doesn't sound like it's something that science is backing up. There's too many different things going on when you're fasting. So that's one. Two, when it comes to the 16:8, and in fact, Dr. Satchin Panda is the one who published this data. He talked about it first on my podcast back in 2015. And what he showed was that basically all these caloric restriction studies and these animal studies, that basically that it was more that animals were getting fed based on the humans, like the postdocs and stuff, and their schedule, and when they were coming into the lab to feed the mice. And so it ended up being Like, you know, they were eating within an 8-hour window because that's when people were working within that 8-hour window.

And so we're going to talk a little bit now about, like, the fasting and circadian rhythm. And I thought— and Roman was asking this in the chat, but also there was a question submitted by Abigail. And Abigail asked, what role does seasonality play In the melatonin-insulin relationship? In winter, when it's darker for a longer time period, should we be eating in an even shorter time window? And conversely, in the summer, when days are longer, do our bodies, you know, should the time window, should it be changed, basically? I think I've talked— I don't remember where I've talked about this before, but it's a really good point.

I'm glad Abigail brought it up because there is, there is some evidence, observational evidence, that fasting blood glucose levels are higher in the winter than they are in the summer. And for people that don't know about the relationship between melatonin and, you know, blood glucose levels and insulin, I put together a video a couple of years ago And it's called something about late-night eating, like why you shouldn't late-night eat or something like that, or why late-night eating is bad. And in that video, I talked about some evidence that Dr. Satchin Panda had previously talked about in our podcast on how when your body starts to make melatonin, it shuts down the beta islet cells in the pancreas that produce insulin. It shuts them down.

And so what ends up happening is when you are eating in a more nighttime, you know, environment, when it's darker out, for example, in winter, then you are going to have a little bit more melatonin. And so, you know, people go to bed earlier in winter. And so if you still have the same eating schedule that you always have, like in the summer, You're going to be eating dinner when it's a little bit darker out versus in the summer when it's still light out, which means there's going to be a little bit more melatonin. And this is probably why if you if you take a random sampling of a person in the winter and versus in the summer, you're going to find higher fasting glucose in the winter because insulin causes glucose to be taken up into cells.

And so your fasting blood glucose is lower if your insulin response is working right. So I personally think. That people should adjust their time-restricted eating window to an earlier window in the winter. I do this. You want to make sure that you're eating before, you know, it's getting dark, and certainly at least, you know, 3 hours before you're going to go to bed. But ideally, you do want to eat dinner before you're starting to make more melatonin, making melatonin when it starts to get dark. And we do start to make melatonin when it's getting dark out, even with lights on. Like, there's some degree of it. It's not the same as bright sunlight. So thank you for bringing that question up. I think that is a really good question.

And I'm glad I, you know, was able to articulate that because I can't remember when I mentioned it. It's been It's probably been a few years, but it's important. Okay, Libby asks, in your most recent podcast, Dr. Ilinov mentions that you can use a blood glucose monitor to check your body's response to certain foods to help inform you as to how your own body responds to certain foods. What timings should I use, like intervals after eating, since I do not have a CGM, and what blood sugar numbers should I look for? So this is a good question, but it's also like it's not an easy question, you know, to give straightforward answers to because your body's glucose response will vary depending on the type of meal that you have.

You know, generally speaking, if you're eating a meal that is low carbohydrate, then you shouldn't see your postprandial blood glucose levels. Which you can measure, you know, I would say like 30 minutes to an hour after your meal. You know, 30 minutes would be probably a good time to measure, 30 or 45 minutes after a meal. And if you're eating something, you know, like, you know, some protein, dark leafy greens, or, you know, some vegetables that are not like You know, not fruit, then you know your blood glucose levels probably won't go above 100 and 110, depending on how big the meal is. So meal size also matters. What you really don't want to see is like I always set my alarm to like 120. That way I know if something's bringing me above 120, but that's a little bit you know unrealistic.

You know some people like you'll go above 130 or something, but you should also go back down as well. Um, there, I mean, a CGM is really cool to even just try out, and you can, you can, you can do that, you know, for even just a couple of months. And, um, I think that's something that's, you know, just worthwhile to even just try out for a couple of months because then you can do a lot of, you can do a lot of experimentation within that time as well. So, so that would be something to consider. Ernest is asking about the minimum moderate-intensity exercise per week and if sauna can count towards some of that data. Because sauna does mimic moderate-intense exercise, I personally think that it can count towards it.

It's my— that is my personal belief that it can count towards some of the moderate-intensity exercise. Allison's asking about hot tub versus sauna. Do you think that being in a low chemical hot tub at 104 degrees Fahrenheit could offer similar benefits as a sauna. I do think that they do. And, in fact, there's a variety of studies that have shown similar biomarkers being increased with hot tub as well. So, in fact, I've been doing hot tubs almost nightly. I would say 5 nights a week after my son goes to sleep, my husband and I, we like to go out in the hot tub.

And, We have like— there's a lot of dark skies around where we are, and so we get to see the stars, and it's a very nice, relaxing, unwinding time, and we get to get the heat stress, we get to spend time with each other, we get to be outside, hear frogs, and also it helps us sleep. So, I mean, it's just win-win-win. Allison also asked the question about lifestyle factors that can help with ApoE4, and I'm not going to go into too much detail on this, but like, honestly, Like everything that's a healthy lifestyle factor, you know, there's been so many studies showing that people with ApoE4 can totally modify their cardiovascular disease risk and their Alzheimer's disease risk if they exercise, if they have good sleep, if they are eating a healthy diet that's not like full of refined carbohydrates and, you know, super, super, super fatty meats all the time.

Taking omega-3, having enough fish is also a really important one as well. But I think, like, those are some of the main ones that really have been shown to really pretty much negate the negative risk that ApoE4 generates. Should we pulse it like rapamycin since it works via mitophagy or mitophagy? The studies all use it daily, but if it works via mitophagy, wouldn't it make sense to treat it the same as rapamycin? and only take it once per week? Also, other thoughts on Mitopure urolithin A? Okay. So these things are totally different. Rapamycin, I wouldn't even like talk about them in the same sentence. Like they're so different. So urolithin A is a compound that the microbes inside our guts produce after eating certain types of prebiotic fiber found in a variety of foods.

One of the best foods that have it is pomegranate. You know, this is something that our bodies in a way kind of make because the bacteria in our gut are making it. Like, this is something that's more of a compound that's, um, you know, made within our bodies. It, it, it does, um, induce something called mitophagy. For people that don't know what that is, it's very similar to autophagy, but it selectively is the getting rid of mitochondria, particularly damaged mitochondria. So it's kind of like cleaning up your pool of mitochondria within a cell and getting— you want to get rid of like damaged old mitochondria. So mitophagy or mitophagy is one way to do that, and urolithin A very robustly does that. And it is something, again, that is produced in our bodies from the microbiome in our gut.

So, it's not like this— it's not like rapamycin. Rapamycin is a drug. It is a drug that is not something that's natural to our bodies. It inhibits the mTORC, you know, part of the mTORC complex. And, yes, there's some evidence that rapamycin also affects mitophagy, but it does, you know, many other things. And the main thing that it's doing is inhibiting mTORC. Yeah. Rapamycin is like— there's a lot of negative side effects with taking, certainly taking it daily, like people that are— it's prescribed to people that are going to undergo an organ transplant to prevent their body from rejecting it. It lowers testosterone in men. I mean, it causes— it really does lower testosterone and it causes infertility in men. We've talked about some of the negative side effects of rapamycin.

I know people are interested in it for potential longevity benefits. A lot of this research is in animals, and it's certainly interesting research, and I am continuing to follow it. I'm very interested in that research. I personally am not— I don't think it's going out and taking rapamycin cyclically or taking it, you know, cycling it right now is a really good thing to do until we really know, like, you know, all the effects. And whenever you are perturbing a molecular pathway via a drug, there are always indirect effects that happen. And those things aren't necessarily known right away. And it's certainly— you have to be looking at it. And so if you're not biomarking it, you're not measuring it.

And let me tell you, in humans, we're really only biomarking things— like, we're not taking tissue samples of our kidneys, we're not taking tissue samples of our testes. We're not, you know, we're not doing all that stuff. And so you really just need to be really careful if you're going to start doing— I personally would not take rapamycin, and I don't think that it should be something that people take at this time unless they're prescribed by a physician. I do, however, think that it is an interesting potential way to perturb potentially lifespan and/or healthspan. We don't really know exactly yet. And, you know, but until we know more, I think that it should continue to be studied and with excitement. I'm pretty excited about that.

That's probably the top brand that makes urolithin A. And it's quite expensive, but I'm actually, going to start experimenting with it myself. So, that's my thoughts on that. Sybil is asking what sauna I use. So, I use a sauna made by Nordic Sauna, and it's a 2-person sauna. It's one that can just plug into any outlet, which is really nice. Finlayo also makes one that's That's a similar version of it, and I think they're they're really great. The one that Finlayo makes was like I think it was like the Hallmark. Let's see what series it was. Hallmark. Boy, I just I just can't remember. I used to have that, but now I have a Nordic sauna one, which again it's it's pretty similar as well. Oh, okay. So the one that was made by Finlayo, one of the Hallmark series. Okay, let's see.

There was another question. This one was submitted by Andrew, and he was asking about mushroom extract blends like Laird's mushroom extract. Whether taking it daily was something to be concerned about or if it should be only taken on occasion. He says, I saw concern raised that mushroom extracts can increase immune support in the short run but can have negative long-term effects by stimulating division of immune cells, which may age the immune system faster. My understanding is that immune cells only get so many divisions in a lifetime. So, um, I would say, you know, Personally, I do only take it on occasion. It's not something I actually take every day, but I'm not sure— that study might have been an in vitro study that you're referring to. I don't even know what study it is.

I would be surprised if it was an animal study. So, again, it's one of those things where, you know, dumping things on cells will show one thing, but doesn't mean that it's even remotely relevant to an animal, and let alone a human. So always something to keep in mind. But, again, it's always— you know, erring on the side of caution is also good. I would be so grateful for your thoughts on the best lifestyle interventions for osteoarthritis. Any research on reversing there? So there is some interesting research. First of all, check— again, check out our hydrolyzed collagen topic page because it talks about some research there using hydrolyzed collagen. In treating osteoarthritis. The other thing that was interesting was Meriva, which is the phytosomal curcumin.

Meriva was used in a couple of studies on osteoarthritis, and not only did it improve— and this was, I think, 1 gram a day— not only did it improve biomarkers of inflammation that are often elevated in people with osteoarthritis, But it improved like walking distance, you know, and functional like functional aspects of osteoarthritis as well. So those are the couple that I that I know off the top of my head. James has asked asked about the relationship between the appendix and Parkinson's disease. He says, I've read having the appendix removed can either increase or decrease Parkinson's disease risk. So people that have had their appendix removed are less likely to get Parkinson's disease.

And the thought, it's not really known why, but the thought is because the appendix actually may serve as a reservoir for buildup of the protein aggregates involved in Parkinson's disease are called alpha-synuclein. So alpha-synuclein aggregates accumulate actually in the brain in people with Parkinson's disease, and this can play a role in the loss of dopaminergic neurons in the substantia nigra. And what role the accumulation of alpha-synuclein aggregates in the appendix plays in Parkinson's disease. It's unclear, but clearly something is going on if removing the appendix is decreasing Parkinson's disease risk. There was a question by Gal on boosters.

Gal says, hi, Rhonda, I have not gotten a booster yet and I have been debating getting it or pushing it until the fall or next variant of concern. How effective are boosters? Since the Omicron numbers are going down, would you say this is a good move, or is it really even important to be boosted? So with the new Omicron variant, my opinions on vaccines, including boosters, have changed because the data has changed. So far, I think we've accumulated enough data now with Omicron to pretty safely say, one, Omicron is less virulent than Delta was.

Meaning, you know, you're less likely to be hospitalized, full stop, and for a variety of reasons, including the fact that, as most of you have heard, Omicron, the SARS-CoV-2 virus, is less likely to get deep into the lungs and cause lower respiratory problems, which is a major, major cause of mortality. So that's one reason. I mean, people are much less likely to be hospitalized than with Delta. They're much less likely to die. So that's all great news. And also, I think that there's enough data now to safely say that vaccines are not preventing a person from catching Omicron. In other words, they're not preventing the spread of Omicron variant. The Delta variant, they were— it was to some degree, but even that was pretty dramatically reduced with respect to the alpha and beta variant.

So I think that is my opinion that most older people, you know, when you start to get older, when you start to get above the age, if you look at some of the mortality data with older variants, it was like over the age of like 65, you know, those people might benefit from being vaccinated. People that are obese, type 2 diabetic, people that have a lot of comorbidities may benefit, but I'm not sure that young healthy people it makes much of a difference, to be honest, with Omicron variant to get boosted or be vaccinated. I think it's a personal choice. I'm not sure about being boosted all the time. I mean, I do think that my mother, who is older and isn't in the greatest health, she was boosted, and I was glad. Omicron for her, it was nothing more than a cold. It was really not bad at all.

So I am glad that she was boosted. I was not boosted. I had had my antibody levels measured previously to getting COVID, which I thought was, I think, was most likely Omicron, but my antibody levels were pretty low. They were like 140 or something like that. So, and for me, Omicron wasn't a big deal. And so I do, again, I think that maybe people that are really, really at risk, with comorbidities and stuff like that may benefit, but I just don't know that it's— I think it's one of those things kind of like right now, at least with Omicron, with the variant that we have that's circulating, that really seems to be a lot more mild, and the vaccines are not really stopping you from getting it.

They are to some degree reducing the severity of it, so people that are at risk for a more severe form, may benefit. But it's one of those things, kind of like, it's, in my opinion, like the flu vaccine. Like, people choose to get flu vaccines. My parents get them. I'm glad they get them. I never get the flu vaccine, you know. And so that's just, I think it's similar to that. I didn't say that COVID vaccines do not prevent COVID. They're not preventing the spread of it. Like, enough to really, I think, justify a mandate for it. It's working similar to a flu vaccine, if even. So maybe if someone is peak boosted, they may be less likely to get COVID than someone that is not vaccinated, but there's still a good chance they're going to get it.

So it's really not— Stopping the spread like it was with the Alpha, Beta variants. That was pretty phenomenal how that was stopping the spread, and it's not the same anymore. And again, Alan in the chat is talking about deaths per day, and like I said, people that are at risk are probably better off being vaccinated and boosted. Those are including people that are older, people that have comorbidities, people that are at risk, certainly people that are immunocompromised. diabetes, all that stuff. Like, my stepmom has diabetes. She's boosted and she'll get the next booster, and I think she should because she's at risk. So I do think that people that are at risk for severe COVID would do better with being vaccinated.

But I do think there is a personal choice there that I think people should choose whether or not they want to be vaccinated. I took VisBiome during my third trimester. She wants to know if there's another probiotic that does not have to be shipped on ice and stored in refrigeration. She's asking about Seed Symbiotic, which other podcasters like Rich Roll and Ben Greenfield are talking about. So, you know, the reason I took VisBion was because of the quantities of it. So we're talking like 450 billion bacteria. I think that the SeedOne by Symbiotic is, I mean, it's like orders of magnitude less than that. So I mean, it's kind of like a drop in the pool. I don't know that it's necessarily going to do anything, but it might. So, you know, I'm just not really sure.

when it comes to some of those probiotics that are just— the numbers of it are just so small when you're taking a little pill of it. It's just not— most of those things are just not doing much, to be honest. Like, you really have to kind of flood the system and even at that, it's still working predominantly through a flow-through mechanism. In other words, it's doing something as it's flowing through the gut but it's not like taking residence there. It's really hard. for bacteria to take residence in the gut. There's just not a lot of residential space there. So, you know, that's kind of the rationale behind the VisBiome is that it's just— there's a sachet of it and the numbers are just, you know, basically orders of magnitude higher.

Saying in the chat about their hospital having 24 cases of Omicron with only one full vaccinated person and only one unvaccinated or something like that. And they're saying they don't know how it's correct to say Omicron could be escaping variant from vaccines. So you have to realize that what you're looking at in the hospital is a very select sampling of the population, people that are going to the hospital I didn't go to the hospital. None of my family went to the hospital. Is is is that you're looking at people that are having a more severe COVID, and and people that are unvaccinated are more likely to have a severe COVID case. So you're going to end up seeing more COVID cases in the hospital, and and it doesn't mean that people that are vaccinated are not getting it.

It just means they're not going to the hospital. So you know you have to you have to realize that. You know, vaccines do lower the severity of COVID-19, and, you know, I think that's pretty clear, full stop. But I think that people that are young and healthy are less likely to have severe COVID-19 from Omicron versus Delta, and so they can choose to get vaccinated if they want, but, you know, I think that it's something that should be their choice. to be honest. I was vaccinated and my antibody levels were pretty low again. Would I have had a worse experience if I had no COVID? I might have. I mean, no vaccine, I might have. I don't know. But I do think that it is clear that Omicron is less severe than Delta and than the Beta and Alpha variant as well. But we've got new data.

We've got new data. You have to like, it's hard when people have spent so much time looking at old data and that's sort of ingrained in their head. It's hard to shift to new data, but like it has to be done. You have to follow the data. You have to follow new science. And I've been nothing but advocated for vaccines. And I still think, again, people that are at risk should be vaccinated. And I do think vaccines lower the severity of COVID COVID-19, but I also think we have to look at new data, and this new variant is already a lower— it's got a lower severity. Like, that's fact. It's a lower virulent variant, which is good, but it also just sort of, you know, it makes it— you don't force people to get the flu vaccine, like, they choose, you know, so it makes it a personal choice.

Like, okay, well, you should choose— whether or not you're going to get Omicron, whether or not you're going to get the vaccine. So I just want to make that clear that there's a lot of new data that have come out, and so you have to stop looking at old data because it's irrelevant, and you have to look at the new data. It's a completely new different variant, and there's a lot of new data showing that the boosters are not stopping people from getting COVID-19 in all— in most cases. Like, it can. Like, you can have people that won't get it, and that probably also has to do with the amount of exposure. So perhaps they were, you know, not in close contact with people for as long of a time to be having such a high viral load.

There's a lot of factors at play here into whether or not a person's going to get, you know, COVID-19. So too many factors there to really know everything, right? But I think when it comes down to it, I do think that you have to keep looking at the data. And it is my— looking at the new data, it is my opinion that Omicron is definitely less virulent. Fewer people are being hospitalized. It's less severe in most people, and that there are people that are still getting, you know, really sick and being hospitalized, and people that are at risk for severe COVID would do better off with the vaccine. That's clear. So they should choose to be vaccinated, but I don't think it should be forced on them. Liz is asking about boosters and long COVID. I don't know about boosters.

I know there was old data with other variants showing that COVID-19 vaccines do prevent— there's a 50% reduced chance of getting long COVID if you're boosted or vaccinated. And I'll tell you right now that I do know people that have been boosted that got COVID, probably Omicron, because it was when Omicron was, you know, it's pretty much dominant and they still got long COVID. So there's a certain degree of unknown, I think, where it's like, okay, well, you know, and this is all anecdotal, right? Like, I think we need more data with respect to long COVID. Like, that Long COVID takes more time. So we don't really have all that data yet. But, you know, so I look forward to that data when it comes out. People are— Elle is asking if I wear an N95 mask around others.

I don't wear masks at all, like, unless it's something I have to do in, like, a certain— like going to the doctors, if I go to the doctors. You know, I've had COVID. I've had, you know, I don't, I'm just, I'm just like, at a certain point, you kind of have to go back to your life. And so I don't, I'm not wearing masks. And if I didn't have COVID, I probably wouldn't be wearing a mask because the numbers are pretty low right now where I'm at. But I think looking at that is a good way to figure out whether or not, you know, you should wear a mask. Do vaccines lower Omicron viral load? That's a good question. I'm not sure I've seen the data. I haven't seen data on that. lowering the viral load.

Now, I do know that with Delta, there was a bit of— you had like, it was, there were some studies showing that the vaccines did not lower the viral load. And then there was other data showing that it might lower, maybe not the peak, but it would lower— basically, people were getting over it quicker. So, I mean, I think that also accounts for something. So it's possible that that's true. I'm not sure. That's a good question. That we have— I haven't seen that data yet. I haven't really seen data that's showing that it's lowering the viral load, that it's significantly lowering the viral load in people. And by the way, COVID-19 was not fun. I mean, it was not like the end of the world, but it was like, I'd rather not have to have dealt with it.

Unfortunately, I do think everyone's probably going to get it at some point. So you're better off being as healthy as you can. And, you know, if you want to, certainly being vaccinated probably also does help. So I think, you know, those things are good to keep in mind. But there's also a question of, like, we don't know what effect boosting yourself every 6 months is going to have long-term on our immune system. There are questions when it comes to, like, the success of Boosting constantly, so I think I think getting getting some of that data is important before jumping into this constantly being boosted.

You have to realize that just because I mentioned my antibodies were low, and you know antibodies are not the only thing that vaccines do, and because I was fully vaccinated, I also have T cell immunity, and T cells you know they last a lot longer, and they're more they're more involved in the. The systemic response to an infection. And so I think that having those T cells probably did help me from having worse symptoms, having a more severe symptom. So I think, you know, I personally, you know, even though I wasn't boosted and I'm not sure I'm going to be getting any boosters at all, especially, I mean, especially since I had COVID, but even before I had COVID, you know, it's, it's I felt like I had my T-cell immunity and I felt pretty confident with my T-cell immunity knowing that Omicron was less virulent.

So me having that T-cell immunity made me feel a lot better because I know that even though my antibodies were low, that I still had some protection. We've got about 6 minutes left of this Crowdcast and my bringing up COVID turned the rest of it into talking about COVID-19. Christine's asking about certain part of population being genetically immune? Yes, there is a certain population of people, there are certain genes that scientists are trying to figure out exactly what they are, but some people are immune to COVID. It's kind of awesome. I wish I was that person, but I'm clearly not. But people are definitely immune to getting COVID-19.

And so we should totally understand that because, you know, with the future, With our future of gene engineering technology and stuff, there may be something there with that as well. I think I went through all the Crowdcast questions for today. I hope you guys enjoyed it. I learned a lot. It was fun. For those of you wanting to re-listen, relearn, take notes, please go to your dashboard and you can find that at foundmyfitness.com/dashboard. We will be uploading the podcast there in about a week or so. We'll be sending out a summary email with links to the timeline where you can tune into the section that you wanted to hear.

You'll be able to rewatch the video on YouTube, and then also you can listen to it on your private podcast feed, The Aliquot, where you can just listen to it passively while you're driving or working out or whatever it is that you're doing. So with that said, Thank you so much, you guys, for all your support and for making these Crowdcasts so enjoyable for me, for making them educational for me, and just for being awesome. I really, really appreciate you guys. I hope you guys are enjoying your FoundMyFitness premium membership. I hope you're enjoying the aliquots and all the Q&As and everything. And I look forward to next month's Q&A. Make sure to submit your questions early. And with that said, I hope you guys have a great weekend and talk to you guys soon. Bye.