Q&A #34: Is Dark Chocolate Heart-Healthy—and What Does High Lp(a) Mean for Heart Risk?

Hi everyone. Welcome to Crowdcast number 34, where you guys submit questions and I try to answer them to the best of my ability. For those of you who are new, I typically go through and look at questions that were submitted. I look at the top voted questions and I try to look at all the questions and answer questions that have not been answered before. Answer questions that I think I've been asked before through several different channels, and also questions that I'm interested in doing a more deep dive in. So for example, a question today that I didn't actually see on time or get to had to do with apigenin. And so I plan on covering that in next month's Q&A. So while everyone's question may not get answered in one Q&A, just realize I do archive these and go back.

to previous questions as well. So I do a few deep dives where I talk about, you know, some of the literature more in depth. And I also do some rapid-fire questions. And in fact, this time around, we have quite a few rapid-fire questions. These are questions that I can answer, in some cases, in a single word, but often in a sentence or even just a few sentences. So— We'll go ahead and get started. I usually start with the deep dive questions and end with the rapid-fire questions. And I also take questions in the live chat, which I see people are already posting some interesting questions. In fact, I'm going to start with one of those questions because I thought it was a really good question. And Robin asks in the chat, hi, is there any evidence folate supplements increase cancer risk?

A friend with recent cancer removed folate because they read about this, but her homocysteine is quite high. I found conflicting data when I did my own research. Thanks. So the reason why I think this is a great question is because it is very confusing. There's often a lot of nuance when it comes to science. And with respect to folate and folic acid and cancer, there's a few things to keep in mind. So first of all, typically Folic acid is the oxidized form of folate. Folic acid is something you'll find in most supplements, not all, but most. And the reason for that is because it's more stable. So, if you're eating a big plate of spinach, for example, you're going to be taking in the folate form, which is the reduced form. So, the oxidized form is folic acid.

And one of the major differences between folate and folic acid— with respect to humans is bioavailability. Folic acid is much more bioavailable than folate. So if you're taking a supplemental folate, then you're not going to be getting as much folate as you would if you were taking folic acid, which by the way gets converted into folate. So that's a big difference. With respect to Cancer, there the nuance there is that there have been a couple of studies that have found taking folic acid if you already have like a cancer in the gut, like colon cancer, that can possibly accelerate cancer growth. And the reason for that is because folate is a It's required to make a precursor for one of the nucleotides for DNA. And cancer cells are rapidly dividing. They're growing really fast.

And so they like folate because they need it to make new DNA, to make a new cancer cell basically. And so that could be a potential concern with someone who already has cancer. However, someone that does not have cancer, actually not getting enough folate can lead to cancer. And the reason for that is because that same concept that you need folate to make one of your— to make your DNA, to make new DNA basically. And when you don't have enough folate, your body puts a nucleotide from RNA in there where it's supposed to be thymine residue. It turns into uracil and that like can cause a mutation. So I think the reality is that getting a lot of folate from foods if you already have cancer would be ideal.

Perhaps supplementing with high-dose folic acid may not be a great idea for someone that has actual diagnosed cancer. But I wouldn't generalize that and say, oh, I shouldn't ever take a folate or folic acid supplement. Because that's just not the case. In fact, becoming deficient or insufficient in folate can actually lead to cancer. So John G is asking about a related question in the chat. Would you stop taking your multivitamin if you're already diagnosed with cancer? Obviously, I am not giving medical advice here, and please, please talk to your physician. If you have cancer, talk to your oncologist about these questions. You know, they'll be able to answer them much better than I would.

But for me personally, I would probably be very careful about, you know, some of the types of vitamins I would be taking. Like, I wouldn't want to have high-dose folic acid. If it was a high-dose folic acid in my multivitamin, I would change multivitamins. I wouldn't want to have high-dose vitamin E either. So I would be very cautious about what I was supplementing with if I actually had cancer. So the first deep dive question that we're going to dive into was submitted by Evan, and Evan was asking, what are my thoughts on dark chocolate? There are supposedly many potential health benefits, but I often wonder if some can be quickly outweighed by the saturated fat content. How much is too much?

And then he linked 2 papers that he recently saw, one involving mTOR inhibition and one involving protection from UV light. So let's talk about the study that Evan linked with respect to eating chocolate significantly protecting the skin from UV light. So this was actually a study from 2009. So it's been, you know, over a decade. In this study, eating 100 calories of Belgian chocolate, dark chocolate, every day for 12 weeks was shown to significantly improve the skin's protection from UV radiation compared to conventional dark chocolate. So remember, this is Belgian Belgium dark chocolate. The authors accredited the results to the high levels of flavonols found in the Belgium dark chocolate. So these flavonols have both antioxidant and anti-inflammatory effects.

The authors also report that Belgium dark chocolate is processed in a way that preserves more of the flavonols. So for example, Belgium dark chocolate has 600 milligrams of flavonols per serving, Compared to conventional dark chocolate, which only has 30 milligrams. Really quite a big difference. And to be honest, I, after looking at this study, was, you know, I basically think that I should be looking for Belgian dark chocolate. It seems like that might be a really good winner with respect to types of dark chocolate to eat. The study with respect to mTOR inhibition, so remember mTOR is a growth signal. It's very important for protein synthesis, for maintaining and gaining muscle mass, for example. But also on the flip side of that, it is a growth signal for cancer cells.

And so much like IGF-1, there's sort of a fine balance where you don't want full-stop mTOR inhibition. Maintaining and building new muscle is extremely important for longevity. So, you know, full-stop, mTOR inhibition is not a great thing. But people are interested in, you know, somewhat lowering mTOR through various different mechanisms. So in this specific study, theobromine, which is an alkaloid found in cocoa, it was given to rats for 40 days. And of course, all these animal studies, for the most part, you're finding you're going to find that they're really high dose, and so the relevance for humans is still kind of questionable because it's like well, how am I going to get you know so much theobromine a day?

You know perhaps supplementation, but then it's like what are the side effects? We don't have long-term studies, so there's a lot of things to sort of balance out. It's interesting nonetheless. So the body weights and food intake. Between the control rats and the theobromine rats were the same, which suggests that theobromine's ability to inhibit mTOR was not due to eating less or losing weight. So the mTOR was inhibited in the liver and in the brain. I don't know, honestly, if you really want to inhibit mTOR in the brain. So But that doesn't mean that eating chocolate's bad. It just means I don't know if megadosing with theobromine is the way to go for someone wanting to improve their healthspan.

There's been some other studies looking at health benefits of dark chocolate, including decreased prevalence of metabolic syndrome, stroke, cardiovascular disease, diabetes, less anxiety, lower blood pressure. And these are all clinical studies. Most of these studies have patients or participants consuming around 30 grams of dark chocolate per day for a month. In contrast, chocolate that is more processed and doesn't have as much of the cocoa in it, so, you know, milk chocolate, for example, does not have the same effect. And in fact, in some cases, can have the opposite effect on metabolic syndrome and cardiovascular disease. So shifting gears and kind of talking a little bit about saturated fatty acids in chocolate. So saturated fatty acids.

You know, for the longest time were thought to be bad for heart health. And we've talked about endlessly in these Crowdcast series how the data is very conflicting and saturated fat isn't necessarily bad, full stop. There's a lot of other contributing factors such as refined carbohydrate intake and the effects on the particle size of LDL or low-density lipoprotein. Lipoprotein particles. So, you know, there's a lot of different nuance there. And in fact, the American College of Cardiology just recently published in 2020 a statement. And they basically said, the recommendation to limit dietary saturated fatty acid intake has persisted despite mounting evidence to the contrary.

Most recent meta-analyses of randomized trials and observational studies found no beneficial effects of reducing saturated fatty acid intake on cardiovascular disease and total mortality, and instead found protective effects against stroke. Although saturated fatty acids increase low-density lipoprotein, or LDL cholesterol, in most individuals, this is not due to increasing the levels of small dense LDL particles, but rather larger LDL particles, which are much less strongly related to cardiovascular disease risk. It is also apparent that the health effects of foods cannot be predicted by their content in any nutrient group without considering the overall macronutrient distribution. In other words, the other foods that you're eating as well.

So whole-fat dairy, unprocessed meat, and dark chocolate are rich in saturated fatty acids with a complex food matrix that is not associated necessarily in and of itself with increased cardiovascular disease risk. So that's kind of what I have for you guys. I'm not particularly concerned about saturated fat from chocolate, you know, as much. There is some interesting observational evidence, and I haven't quite— I haven't dived into this in depth, but I plan on it. And also having my team look into it, and that is looking at saturated fatty acid from different food types. So, for example, fatty red meat versus dairy versus chocolate versus butter, and perhaps like the palm oil, coconut oil.

There's some potential, like I've seen some some other scientists suggesting there may be some differential effects of the saturated fat from these different food types. So I'd be— I'm going to be diving into that to see if I can find anything myself. Christine is asking in the chat about consuming 30 grams of dark chocolate while pregnant or breastfeeding. I actually stayed away from consuming excess levels of dark chocolate while pregnant because there is some— there are some Very preliminary observational data that there may be some effects on the developing fetus. Breastfeeding wasn't an issue, but I really stayed away from too much. I just had a little bit of dark chocolate during pregnancy. L is asking about processed meat like bacon. We're going to talk about that in a minute.

There was another question regarding processed meats. Jeffrey's also asking in the chat about, isn't a bigger problem with chocolate being cadmium exposure? High consumption of chocolate almost guarantees high exposure to cadmium. Yes, there are certain brands of chocolate that are high in cadmium. You can look up the Consumer Lab report. They do a lot of third-party testing analysis on a variety of dark chocolate bars, dark chocolate cocoa mixes, like anything you can consume with respect to it being dark chocolate. And they look at cadmium as well as, I think arsenic is another one they look at. So, you know, there is data available to choose what type of chocolate that you would like to consume.

The other thing to— and this is also really interesting, that there are like heavy metals are excreted through a variety of pathways. So either sweat or urine. Cadmium is one of the heavy metals that is predominantly excreted through sweat. And if you, if you look up my recent review article I published on the sauna increasing healthspan, there's a section, a little small section there on how the sauna increases the excretion of specifically cadmium by like over 100-fold. So there, you know, there's something to be said for people that also are exercising and using the sauna because they are getting rid of these compounds that could potentially lead to cadmium, you know, accumulation. Yes, Ashley is also stating in the chat about Trader Joe's.

They like— I would never, ever, ever buy any dark chocolate from Trader Joe's. It's insane. I actually— there was a time when I was a postdoc that I loved— there was like one of these dark chocolates that I used to get from Trader Joe's, and it was like cheap, affordable, and it tastes good. It was 85% And that brand is— it just has unbelievable amounts of cadmium. Like, it should be like banned. It's like, it's to me disgusting that Trader Joe's is selling all this. You know how many people shop at Trader Joe's and are eating their chocolate? So please avoid Trader Joe's dark chocolate. It's like the worst. But thankfully, at the same time that I was eating the Trader Joe's cadmium-filled chocolate, I was doing the sauna. Like, you know, 5 days a week.

So that makes me feel a little bit better. So people are asking all about different types of chocolate in the chat. I really suggest signing up for ConsumerLab. I do think that the Lindt, the Swiss chocolate one, was a good brand. But surprisingly, you'll find even— you'll find a brand that says it's, you know, good, but then there are different types of bars made from the brand vary as well in terms of their cadmium. And I think it just also has to do with where the chocolate, where the cocoa beans were sourced from. So that's also something to keep in mind. And as we'll talk about in a minute, I actually consume CocoaVia. So we'll talk about that. We'll talk about that in a minute as well. All right. So I'm going to move on to the next deep dive question, which was from Mark Marketa.

And this was kind of a question that I hadn't really covered before. So I thought it was quite interesting. Okay. So she asked, hi, Rhonda, I am 46 years old and I feel like I'm losing my mind. I started doing some research and I feel like it might be perimenopause. There is no helpful information coming from doctors. They all dismiss my claims because I still have my period. I would very much like to know what the science says about hormones, when and how their fluctuation affects women my age. What tests should I get to confirm? So menopause is defined as an absence of periods for a full year, and it occurs at a median age of about 51.

The years leading up to it are called perimenopause, And are perimenopausal, and they're characterized by symptoms of irregular menstrual cycles, hot flashes, mood disturbances, sleep changes, cognitive changes, and vaginal symptoms. During reproductive years, a woman's hormones normally fluctuate in a cyclical fashion that corresponds to her menstrual cycle. So estrogen slowly rises until there is a surge in follicular stimulating hormone and luteinizing hormone. Around day 14, then you have your egg, which is then ovulated, and then your follicular stimulating hormone and luteinizing hormone fall quickly. Meanwhile, estrogen and progesterone continue to rise until day 24 when the body realizes it's not pregnant.

Then estrogen and progesterone fall quite quickly to what your pre-cycle levels are, causing premenstrual symptoms. So premenstrual symptoms last a couple of days before menstruation. And then the whole cycle repeats. And so you don't— you only have, you know, these premenstrual symptoms for a very short period of time. But as a woman approaches menopause, the follicle stimulating hormone and luteinizing hormone spike as usual, but now there is no ovulation of an egg, and estrogen and progesterone do not rise, and follicular stimulating hormone and luteinizing hormone stay elevated. So the lack of estrogen and progesterone are The main culprits for perimenopausal symptoms and can leave women with basically premenstrual symptoms for years. It's quite terrible.

There are a lot of treatments that can, you know, help ease this process, such as hormone replacement therapy. We've talked about that in the past. There is considerable risk. So you can refer back to the previous Crowdcast where we talk about those. The diagnosis of perimenopause is ultimately based on a history and symptoms. So there's no tests that are really needed for a woman over the age of 45 who has not had a period for over a year. But basically checking follicular stimulating hormone and the HGC levels could be useful when there's a history basically and the symptoms are not clear. So in perimenopause, the follicular stimulating hormone is elevated. And the HGC is also really important to rule out, of course, pregnancy. So that's kind of the breakdown of perimenopause.

We do have on our website a topic page. I'm just pulling it up on black cohosh. Or did it— Or maybe I haven't posted it yet. Oh, we haven't posted it. Okay. So we'll be posting that because we did write one. So that'll be something interesting as well to look and see whether any of these sort of herbal supplements do have any effect on improving perimenopausal symptoms. So that could be a question for next time. And also when that article is released, we'll send you guys a message about it. Okay, Nikki asked, how detrimental are high apolipoprotein B and lipoprotein A? So lipoprotein A is also known as Lp. It is a protein cholesterol particle in the blood similar to LDL or HDL. Lipoprotein is not the same as ApoA. People often confuse the two, and they're really not the same.

So just keep that in mind. ApoA is different from Lp. So lipoprotein, or Lp, it's the whole particle that also includes ApoA and ApoB protein on it. So high lipoprotein, or Lp, is bad. High lipoprotein A levels are associated with a higher risk of coronary artery disease, heart attack, stroke, and aortic valve stenosis. The mechanism for which lipoprotein A particles are consumed, they're consumed by macrophages, and then they become these foamy macrophages. And these foamy macrophages form plaques in your arteries by depositing into the vessel endothelium and then releasing all these oxidized molecules that recruit other foamy macrophages to add to the plaque. So this like vicious cycle. of plaque formation, basically.

Also, lipoprotein promotes clot formation by interfering with plasminogen, which is the body's most potent clot-busting protein. So typically, interestingly, if you look at like a standard doctor's, you know, what their recommendations are, what's considered normal, quote unquote normal, are lipoprotein levels below 30 milligrams per deciliter. Ideally, you want them below 10. This could change as we learn more, but really, the average person's lipoprotein is below 10 milligrams per deciliter. About 25% of the population has less than 4 milligrams per deciliter, and about 25% of the population has more than 30 milligrams per deciliter concentration. So there is a dose-dependent association between lipoprotein levels and cardiovascular disease.

So the Biobank study found that for every 20 milligrams per deciliter increase of lipoprotein, the risk for cardiovascular events increased by 11%. Here's the unfortunate thing. Literally like 80 to 90% of A person's lipoprotein levels is dictated by genetics. After the age of about 5, for the most part, apolipoprotein levels remained unchanged throughout life, more or less. I mean, there are— we'll talk about in a second, a few lifestyle factors that might very minor— may have a very minor effect on changing levels, but it's— Extremely milder. So statins don't usually work against apolipoprotein A, and so people that do have elevated lipoprotein A levels, the the alternative I think is the PSK3 inhibitors. The PS sorry, PSK9 not PK3. The PSK9 PS PCSK9 inhibitors.

They're the new cholesterol-lowering medications that do lower lipoprotein. They're extremely expensive, but I do think that people with extremely elevated lipoprotein may actually qualify to have that, to use them basically. Otherwise, you have to pay out of pocket. So that's— That's the unfortunate thing. Now, I mentioned there's a few lifestyle factors. So Mediterranean diet, which is really high in monounsaturated fats, it includes a lot of fruits and vegetables and fatty fish, olive oil, nuts, those are avocados, those are high in monounsaturated fats. That's been shown to improve apolipoprotein A. The DASH diet, which is kind of similar in a lot of respects to the Mediterranean diet, more or less. It's got a lot of vegetables and fruits and lean meats, nuts, and beans.

There's also, you know, quite a bit of evidence that actually just eating a diet high in vegetables, fruits, and nuts may honestly make a modest impact on Lp levels. So there was a study showing that a diet high in vegetables, fruits, and nuts may decrease it by 24%. Now, this was a very small study. It was only 10 people. But Nonetheless, considering how absolute doctors are about apolipoprotein A being dictated by genetics, I find that study promising, and I certainly think someone with a genetic cause of elevated apolipoprotein A would be better off doing as much as they can in their diet to see if it has an effect on their apolipoprotein A before seeking alternative treatments.

There was also another study that showed, interestingly, flaxseeds and the fiber in flaxseeds can basically lower Lp levels by about 7%. Now, this was a 6-week study of about 38 people. And there was another follow-up study that found that the flaxseeds Can decrease LPA by about 14%. I used to eat flaxseeds for the fiber when I was in graduate school. I had a lot of gut issues, and it was like a miracle cure for me. I would literally take a shot of the flaxseed and chase it down with water. The problem with doing it that way is that a lot of the The fiber is is not it's basically the insoluble fiber, so it's kind of just moving stuff through you better. I then started to ground it up in my smoothies, and it does it does sort of change the consistency of the smoothie a little bit.

But again, it like it was sort of a miracle cure for my gut problems when I was having them back when I was in graduate school. So this was about 10 years ago. So I was kind of surprised and interested to find that the fiber in flaxseed was also beneficial for Lp. Now, I don't have any problems with my Lp. There's no genetic risk for me and mine are below 10%. But nonetheless, I thought that was very interesting. Eating nuts, pecans, almonds, walnuts also may modestly reduce Lp. So I thought those were all sort of interesting lifestyle factors that may help. Ashley's mentioning in the chat about the MIND diet, which is basically— it's basically like the Mediterranean diet plus extra leafy greens and more berries. And I agree with Ashley that it's pretty awesome.

In terms of having neuroprotective effects on the brain, it's just generally a good diet to follow. And more and more these days, I'm trying to follow a Mediterranean-like diet. And when I cycle a ketogenic diet, I'm trying to make it more Mediterranean-like. So I found that that basically I could do salmon, sardines, avocados, nuts. And then some leafy greens. And if I supplement with the Keto Start, the Keto Start ketone salts that are really good and Dom D'Agostino had recommended to me, that it really does help me sort of stay in ketosis more even when I'm getting additional leafy greens as well. Market is asking where to get Lp levels measured. I mean, you can ask your physician to measure them. You can also do something— I use WellnessFX.

I do WellnessFX for everything, and they measure it even with their most basic baseline test that they do. I typically do their, their, their most expensive one, which it used to be called the Performance, but now it might be called the Premium one. It's like the biggest panel one that they can do. That's typically what I do. Sharon's asking about an update on my keto diet. So the first round of my keto diet was— I think I did tell you guys about it. And I wasn't doing any supplementation with ketone salts. And so I ended up losing quite a bit of weight because I was basically just skipping meals because I couldn't find— it was like, well, I can't eat anything because it'll kick me out of ketosis. So I ended up doing a lot.

I was doing a lot of fasting, sort of, you know, it wasn't intentionally. It was unintentional, you know. But it was extremely difficult to do. And I've been doing a lot of traveling lately. So I haven't been doing my ketogenic diet experiment again. But I've decided now to cycle it. So I'm going to probably try to do it at least You know, maybe perhaps every two months, or you know, maybe start with that and see if I want to do it every other month. But I did, I did do a little short experiment when Dom D'Agostino was in town. We recorded a podcast together about a month ago, and I found again that the supplementing with the ketone salts, which you know, I put them in my water, and it's kind of sweet tasting. They use monk fruit, but. I do find that it helps me stay into ketosis better.

So I'm super interested in all the effects on the brain, and you guys are really going to like the podcast that we did. Gal's asking me to clarify lipoprotein percentages in comparison to the number on our test. I don't know what the number on your tests are. Most tests will tell you the numbers that I just talked about, like milligrams per deciliter. So I would check back and see what those numbers are. There's also another really interesting calculator. It's called the ASCVD calculator. We'll put a link to it in the show notes. It's basically— it can be useful in determining like a lot of like your— basically your cardiovascular disease risk. And so it's kind of a cool calculator to use that you guys can check out. Okay. So the next question is a little bit quicker of a question.

It was submitted by Natalie. Natalie was asking, should those who have had their gallbladder removed take bile salts with fatty meals? So basically, your liver will still produce bile to digest fatty meals. The only difference is that you don't have a gallbladder to store it. So your gallbladder will store bile salts that are made by your liver so that when you eat an enormously fatty meal, like if you were on a ketogenic diet, for example, that you'd have enough bile salts to digest the fats. So if a person without a gallbladder eats too many fatty foods too quickly, there will not be enough bile salts to digest because you don't have the stored bile salts in your gallbladder. And in that case, that could cause symptoms of upset stomach or flatulence, loose stools.

So that would— if you're someone that's eating an extremely high-fat meal and you don't have a gallbladder, it might make sense to use bile salts to supplement with them. But if you're someone that's eating a MIND type of diet or Mediterranean, type of diet, then you probably are not getting a huge bolus of fat all at once. You know, you're not, you're not basically overloading your liver's ability to produce the bile salts to digest them. The other thing to consider is that if you don't have a gallbladder, fat-soluble vitamins like vitamin A, D, E, and K, omega-3, that basically you might want to supplement those You know, with not too high of a fat meal because you may not absorb it as well.

All right, so the next deep dive question was from Steve, and Steve asks about my take on the shocking meta-analysis on statins that was just published in JAMA. Okay, so this meta-analysis was published last month, and it pooled the data from 21 different randomized controlled trials to evaluate how well statins reduce the risk of all-cause mortality, heart attacks, and strokes. The results were limited because of large heterogeneity between the studies, and the average follow-up time was only 4.4 years. What they found was a 0.8% absolute reduced risk Or a 9% reduced relative risk with all-cause mortality. So in other words, during the 4.4 years follow-up, 9.7% of the placebo group died while 8.9% of the statin group died.

Heart attacks, there was a 1.3% reduction in absolute risk for a heart attack with statins and a 29% relative risk reduction. In other words, 5.8% of the placebo group had a heart attack, while only 4.5% of the statin group had a heart attack during the 4.4 years. Again, pretty modest reduction. And then strokes, there was a 0.4% absolute risk reduction and a 14% relative risk reduction. So 3.3% of the placebo group had a stroke, while only 2.9% of the statin group had a stroke during the 4.4 follow-up years. These numbers are a little more modest than earlier statin studies. So I think that's kind of the big shock. But there are a couple limitations to the studies. And that is one, there's a lot of heterogeneity between these different 21 studies. So lots of different study protocols.

Going on here, lots of different demographics of patients. And also, the follow-up on average was a lot shorter than previous studies. So it was only 4.4 years. And some of the studies that were in the randomized controlled trial only had a follow-up of like 1.9 years. So it's really not enough time to capture the rare outcomes like death or heart attack or stroke. So Typically, you want to look at like 10-year follow-up. You want to— a 10-year follow-up is something that is going to be a more reliable time frame to actually capture that type of death, heart attack, stroke, you know, all-cause mortality-related death.

So, you know, the other thing about this study that was interesting was that it didn't— that they did not find an association between the amount of LDL that was reduced by statins and their outcomes of death, heart attack, stroke. So it's unclear why that is, but it really may be that LDL is not a good biomarker for cardiovascular disease and heart attacks. And we've talked all about this before, and I just mentioned it a moment ago, that really LDL, like, you know, there's all different types of LDL and sizes and shapes. And honestly, you know, the big large buoyant LDLs are good. And so if you're just looking at LDL, then you're probably not capturing the bad part, which is the small dense LDL.

So my thoughts on the study are honestly that, you know, I think over the years I've always sort of advocated dietary lifestyle changes. And so, you know, this kind of just kind of adds to that. Of course, there are some people that really are— they do benefit from statins. And so— You know, that shouldn't be ignored. But I think it all also comes down to better biomarkers and understanding the biology better. And that, you know, that basically means that doctors should probably stop prescribing statins after a person comes in once and has elevated total LDL. Not even that, sometimes a doctor will prescribe a statin when they haven't even directly measured LDL, they're just They're calculating it based on their total LDL.

So I just think that we need to have some changes with respect to testing and diagnostics and, you know, who's considered at risk and how we measure and what we're measuring. Becca's asking about in the chat if I'm aware of any lifestyle factors that affect stroke risk. So some of the, off the top of my head, some of the 2 most robust that I'm aware of that I've read about are sauna use. And omega-3 from marine omega-3 fatty acid intake. So those are 2 off the top of my head. I personally, looking at some of Bill Harris's data, we did an Aliquot talking about dose. It seems like most people can benefit from 2 grams of marine omega-3 fatty acids per day. And with the sauna stroke risk, the most robust stroke risk was found for 4 to 7 times a week at around 174°F for 20 minutes.

20 minutes was a— it had to be greater than 19 minutes basically. Okay. Another question was from Heather and Heather says, is celery some sort of magic Bullet that we should be eating lots of. I have seen multiple people advocating juicing it and eating it for health. So I chose this question because I thought it was a good opportunity to bring up a couple of probably not well-known points. So the first is counterintuitive, and that is that. Organic celery makes a natural pesticide called psoralen. And psoralens, when you take in enormously concentrated amounts, like if you're juicing organic celery, they're potentially carcinogenic. So farmers and stuff, there's a concern with them because they're exposed to so much of it.

So believe it or not, when you're juicing celery, you may actually want to not have organic because you're getting large quantities of the sorulins. And then the question is, well, why would you even want to juice celery? Celery is high in a compound. I sometimes— it's like a xeno— it's a xenohormetic. Or a xeno— like it's involved in xenohormesis. It's called luteolin. It's also known as a flavonoid. It's really high in celery, but it's also high in parsley. So you might just want to juice the parsley instead of the celery. Or if you're going to do celery, just maybe not just— don't do just straight celery juice where you're just getting— I mean, if anyone have— if any of you guys have juiced celery, I mean, you'll know you're getting lots and lots of celery in there.

You can just add a little bit of celery to your green juice, for example. But luteolin has been shown to decrease the activity of genes involved in inflammation. So there is a study involving about almost 67,000 women, and the women with the highest luteolin intake had a 34% decrease in cancer incidence compared to those with the lowest luteolin intake. Luteolin has also been shown in a variety of animal studies to decrease cognitive decline. So mice that were given luteolin in their diet had brains that functioned much like their younger counterparts. I'm personally right now, I'm supplementing with Life Extensions. It's called like Cell Renew or something. It has about 136 milligrams of luteolin in it. So supplementation is obviously another, you know, potential way to get luteolin.

Sharon's asking if organic parsley is safer than celery. Yes, it doesn't have the— it doesn't have as high— the high sorolans that celery has. Interestingly enough, that my mentor Bruce Ames published that article back in like the '90s where celery was like It was coming up as a mutagen, like more than even pesticides were. But it's really only organic celery. So organic— well, non-organic celery has a modest degree of them as well. But because the pesticides applied to the celery, the plant has to make less of them to ward off insects and stuff.

So— So basically, I mean, I wouldn't worry about eating organic celery because you're not going to be eating like— if you ever— like if you don't have a juicer, if you go to a juice place and watch how much celery they put into the juicer to make celery juice, you'll see like it's a lot. It's a lot. And if you're drinking that every day, like I don't think it's a problem if you're drinking it once in a while. But, but, but it's just, it's a potential concern. It's just, it's something to be aware of. You know, I don't, I wouldn't, you know, freak out so much. But I, I try not to just drink straight organic celery juice. And I did drink celery juice when I had COVID. But I was also supplementing with luteolin as well.

And that was, that was to help with, you know, some of the neuroinflammation. And also there are some very preliminary evidence that it could help with people that had lost their sense of smell as well. Okay, so the next question was about stevia or stevia, and I've covered this before in other Crowdcasts. I'm not going to get too much into it, but Sharon asked, what are your thoughts on stevia? While it's beneficial as a sugar substitute and may even increase insulin sensitivity, I've also seen some studies where it might affect hormones and the gut microbiome. Other than stevia, are there any other sweeteners that you feel are safe? For example, monk fruit or even honey. Stevia is about 300 times sweeter than table sugar. It has a glycemic index of 0.

The effect on the gut microbiome in animal studies has really been shown to be negligible. There are some effects in animal studies of stevia on testosterone. And, but the studies, those studies are using, you know, levels of stevia that again are just not, there's no way humans are going to be taking. I mean, you'd have to eat nothing but stevia all day, every day. With that said, I was a little concerned about the study. So, so I, I prefer monk fruit over stevia. So far, You know, so monk fruit's only like 150 to 200 times sweeter than table sugar. Also has a glycemic index of zero. It's really unknown, if any, what effects on the microbiome. It's also really unknown. It's kind of new-ish.

So, you know, I still with hesitancy am, you know, using it where, you know, I'll buy some like Easter chocolate. That has monk fruit in it, you know. But I'm waiting, you know, there might be some data that comes out again that's like, oh, it affects hormones. We just didn't, you know, we didn't have that data yet. So it's an open book, in my opinion. So far, monk fruit seems to be my choice. But I'm sort of, you know, keeping my finger to the pulse to see if any evidence comes out that will Convince me otherwise. Honey would be an alternative, but honey does contain sugar. So I mean, it all comes down to you know what you know what you got it you got to pick and choose your battles right? So at this moment, I'm using.

Honey, allulose, again, we could do a deep dive on that if you guys want to submit that question for next time around. I've seen a little bit of evidence on it. Well, it might be beneficial, but again, it might be another one of those things where it's still kind of new, where you just don't know if there is an effect on something like hormones. We don't know. But if you guys want to deep dive, submit the question please for next month. Rebecca asked about sauna temperatures. She said, you know, so she wants to know for saunas like in gyms that don't get up to 174 degrees Fahrenheit, is there a recommendation? For duration, and also the same with hot baths or hot tubs. So typically, all the studies that I've referred to have been at least 174 degrees Fahrenheit for 20 minutes, right?

And that's sort of the duration and temperature. When I used to use saunas at the gym, the gym saunas that I was using, they were getting up to like 165 degrees Fahrenheit, you know, 160, 165. And I typically stayed in there for 30 to 40 minutes. So I was very— I'm very heat adapted. You know, some people like don't start out that way. And so you have to listen to your body. Like, you want to get uncomfortable. You know, your heart rate will start to elevate and you'll start to feel that uncomfortable feeling. But you don't want to get out immediately when you're uncomfortable. So do push past that a little bit as much as you can. But your body, you'll reach a point Where it's like, okay, I feel like this is too much. That means get out. You really do have to listen to your body.

So that's sort of my guideline for the 165 or 160-degree Fahrenheit saunas. I was typically doing probably around 30 minutes. And again, if you're doing it, if you're at the gym and you're doing it right after a workout, you've already elevated your core body temperature. So, you know, in some cases, you may only stay in there for 25 minutes. With respect to hot baths, the studies that have looked at some of the biomarkers like heat shock proteins, BDNF, they typically were what you would find a jacuzzi. Most jacuzzis, the typical temperature is 104 degrees Fahrenheit. To be honest, I think some hot baths that people do are hotter than that. But the duration in the 104-degree Fahrenheit hot bath was 20 minutes.

And this is pretty much close to shoulders down submerged, which can be quite difficult to do because you do get hot. And so that's the duration and temperature of like a hot bath. Okay. Before I start all the rapid-fire questions, there's one here that didn't make its way down, so I'll just do this one rapid-fire question, but we'll get to those in a minute, and that has to do with spices. So Bob says, spices are a rich source of polyphenols, but also a potential source of heavy metals. Is there a way to strike a balance? I would avoid any spices that are sourced from Bangladesh. That is the major source of heavy metal contamination in spices. And then in addition to that, like I mentioned earlier, really just sweating is a good way to strike a balance.

Like, you do excrete heavy metals from sweat. Okay. So the next question had to do with cocoa via. I mentioned when we were talking about chocolate. That I supplement with CocoaVia, and SC was asking, why do I take it? Are there certain benefits that I take it for? And what product do I like? So the CocoaVia, it's basically, it's got like a really high concentration of the EGCG, which is the flavonoid Found in cocoa plants. It's also found in green tea. It's really high in cocoa plants, though. Cocoa via the reason I use it is because it's very concentrated, and there's been a variety of clinical studies that have looked at cocoa via specifically. So, for example, there was a I don't want to get I've covered this in previous previous crowdcasts.

You know, it's it's been a couple of years, so I'll I'll talk about it a little bit. But there's other Crowdcasts. I think Crowdcast 11 may be one that I covered this in more detail. Elderly patients that had peripheral artery disease that drank a beverage with— it was like a Coca-Cola beverage. They were able to walk up to 46 yards further in a 6-minute walking test. And this was due to increased blood flow to their calves and improved muscle function. There was another randomized controlled trial with CocoaVia where in a dose-dependent manner CocoaVia improved or increased circulation even with as little as 80 milligrams, but 800 milligrams had the most robust improvement. It increased circulation and improved blood pressure.

So systolic blood pressure was improved by 5 points and diastolic was improved by 3 points. Another one showed improvement in cognitive function. So this was a single dose of 450 milligrams. And the 450 milligrams— now this might have been cocoa polyphenols, but, but, you know, those are found in CocoaVia. And this was shown to increase blood flow to the brain. And specifically to the dentate gyrus, which is the part of the hippocampus that's associated with memory. So the increased blood circulation also translated into protection from cognitive decline. So honestly, there's just— and there's more and more studies like this. So the CocoaVia, it's also like extremely low cadmium levels in it. I like their memory capsules. And also their Cardio Powder.

Their Cardio Powder is, it's like a hot chocolate with no sugar in it. So it's very bitter tasting. But you can, you know, put a little bit of— you either take a shot of it or put a little monk fruit in it or something. All right. So there were a couple of questions with respect to NMN, nicotinamide mononucleotide. So, um, we'll talk about that. So Jackie says, are there any clinical trials that show consuming 100 milligrams of NMN and resveratrol powder per day is detrimental to the macula? I saw as a concern on ConsumerLab, but I haven't been able to find any additional information on it. There was a related question from Marley about my episode with Tony Robbins. He was quite excited about NMN. And I gently noted that we don't yet know if it gets into other tissues yet.

Have I updated my feelings on NMN? And because it seems to be incredibly popular now that Tony Robbins and David Sinclair are promoting it widely. So my thoughts on NMN are still quite similar to what they have been, which is honestly that There's really no evidence that NMN is increasing NAD levels in the plasma yet, or certainly not in tissues other than the liver. We have a couple of topic pages. We have one topic page on NAD, and there's a section on NAD boosters and supplementation. And I really— and we also have a topic page on NMN, and we have one on nicotinamide riboside, NR, both of which are these NAD precursors. So honestly, you know, I think there's a lot more enthusiasm. I know that Tony Robbins, when he was on the podcast, was talking about a specific formulation of NMN.

That a company that him and David Sinclair are associated with are developing. And it's a more stable NMN molecule that allegedly does get into tissues. There's no data. That's just, you know, by word of mouth. So, you know, this is something that will not be a nutraceutical. It will be something that has to be prescribed by a physician. If it turns out to, you know, be awesome. But that's a big if. We don't really know yet. I would say, you know, honestly, I got I got pretty excited from one animal study with the NMN where it seemed to like improve tissue aging. And the the reality is is that if the NMN, which actually in the animal studies did increase NAD+ in plasma and also in the liver. Perhaps there's an indirect effect on other tissues like the brain.

I've seen one human study with NMN. It was a Japanese study. And essentially, all it showed was that it was safe. They were looking at things like elevated bilirubin or Creatine, blood glucose levels—they're all within the normal range. I don't know why they didn't measure NAD. They measured plasma concentrations of nicotinic acid metabolites, which were elevated. Makes me think that NAD was not elevated, which is why they didn't talk about it. So the highest dose they did in that clinical study was 500 milligrams. So I just think right now, like. There's a lot of excitement about something that, you know, there's like a couple of animal studies that are giving extremely non-translatable doses of NMN to animals with some improvements.

There's also a cancer study where NMN accelerated cancer growth. So it could be that NMN will turn out to be something. It could be that it won't. It could be that this new pharmaceutical, which is a stabilized form of NMN, turns out to be something, or it could be that it won't. Like, I just don't see data to say either way that it's super exciting or that it's super dangerous. I'm personally not supplementing with either of them. Perhaps I will change my mind when more data comes out and you guys will say, oh, Rhonda, I've been missing out for months. I could have been supplementing when it was all fine. But, you know, I just don't know. And so I'm just sort of waiting around for some more data, to be honest. And I do think that there's other ways to increase NAD+. Exercise is one.

Intermittent fasting is one. So those are some other potential ways to increase NAD+. And also, I think if you look at our topic page on NMN, NAD, you know, it's very informative. And so I think you guys might learn a lot. And I really recommend you go through our NAD page, our NMN page, and our NR page. We have topic pages. We covered them really in depth. I haven't seen any more follow-up cancer studies. There may still be in progress. A lot of times these studies take a while to do. And then I'll tell you that science took a big hit with COVID because like, you know, people couldn't go into the lab and do their research for like a year. And then everyone was shifting gears and trying to work on COVID. And so I think now we're starting to get back into the swing of things.

But I mean, there was a big— there's been a big hit in terms of new research coming out and a lot of projects were delayed. So, So, I'm hoping that, you know, we get back to like our normal science cadence here with new studies. John's asking about apigenin. I did mention that I wanted to cover this in depth in the Crowdcast next week. So, John, if you could go and submit the question on apigenin for next month. If you don't, I'll probably remember to go ahead and do it anyways, but I do want to cover apigenin in depth next month. All right. I got to move on. The next question was about coffee beans. And the question was, can you please discuss coffee bean quality and what to look for when selecting a coffee brand?

There are some companies that discuss mold and mycotoxins and claim that their coffee is superior or cleaner than others. This, of course, comes with a higher price and coffee selection is very limited. Should I be concerned about small coffee shops that roast in-house or should mold and mycotoxin be a concern at all? What coffee brands do you like? Okay. So I guess we could start off with mycotoxins. I am not worried at all about mycotoxins from coffee beans unless they are green. Coffee beans. Green coffee beans are subject to much, much higher levels of mycotoxin than regular coffee beans. Regular coffee beans are like— their levels are so low that I just am not concerned. I don't even think it should be talked about.

And to be honest, there is just an overabundance of literature showing People that drank coffee for 4 weeks had reduced levels of DNA damage. Mycotoxins, like you'd be damaging your DNA. Coffee, drinking coffee is associated with a reduced cancer risk, reduced cardiovascular disease risk, type 2 diabetes. If mycotoxins were even worth a thought, that would be reflected in the literature, and it's just not. Now, too much caffeine could be something to be concerned about, but I think there's been a lot of marketing around mycotoxins that create an unreal concern that make people think that, oh, there's this thing I should be concerned about that no one knows about, and if I buy this specific brand of coffee, then I don't have to be concerned about it.

And I think it's a really kind of— crappy, to be honest. So I'm not concerned about it, and I'm certainly not happy about making a false claim that it's really a health risk when that— it's just the levels are low, and there's just been no evidence that drinking coffee is any risk at all with respect to mycotoxins. Again, the green coffee beans, which no one's— like, no one's using green coffee beans. That's like, you know, if you're out there like chomping on those, then I would be a little bit more concerned. With respect to types of coffee beans, the polyphenols are really what you're looking for in them. And the polyphenol content is much higher in coffee robusta beans compared to the Arabica— Arabica— Arabica— I don't know how to say it— beans.

But The coffee robusta, the problem is, is that it's robust. It can be bitter tasting. It can be not as good tasting. And so for that reason, I like to look for coffees that combine the 2 types of beans. I personally like Cafe Lavazza. Their Coffee Crema has a mixture of both the robusta and the Arabica. So that's kind of what I look for. But if you really want like that robust polyphenol effect, then you might want to try out a bunch of brands of coffee robusta. I've tried some that are terrible tasting, but again, it's like dopamine hit from getting the polyphenols and knowing that the bitter tasting is also probably associated with more polyphenols. I'm going to hit up some rapid-fire questions after this last question from Luana asked about spermidine, its role in autophagy.

How do I consume it? Any preference between natto or wheat germ? So spermidine is high in— we'll talk about foods in a second, but natto is high in spermidine. And it's been shown people that eat natto have higher blood levels of spermidine after eating it. Okay. Spermidine is— it's a polyamine and it's a very powerful acetyltransferase inhibitor. So it inhibits the protein acetylation, which is required for autophagy. It's been shown in animal studies to increase autophagy and reduce protein aggregates. It's increased the lifespan of short-lived mouse strains and it's increased the healthspan of long-lived mouse strains. Dietary supplement spermidine also seems to have cardioprotective effects in aged mice.

There's been a variety of observational studies showing that people that consume foods that are higher in spermidine have improved brain function and improved cardiovascular function. And also, it's been shown to induce autophagy. In tumor cells, in normal cells. So spermidine is definitely an interest to me. I am not currently supplementing with it yet, but I may consider. So right now, I'm getting spermidine through my foods. And the question mentioned a couple of foods that are really high in it, so natto and wheat germ. Okay. Wheat germ is really high in it. So that's about 2,440 nanomoles per gram of wheat germ. And so if you do eat wheat germ, that would be a great source of it. Natto is also another source of it. Natto does not taste great.

Most people don't like eating natto, but it has anywhere between 600 to 1,000 nanomoles per gram. So wheat germ, by far the best, highest. There's some other sources. So salted salmon roe, which you guys know I consume, it has about 670 nanomoles per gram, which is pretty equivalent to natto. Another one that I eat is pine seeds. Pine seeds have about 429 nanomoles per gram. Another one that I use is amaranth, amaranth, a grain. It's got 623 nanomoles per gram. And then broccoli is also pretty high. Broccoli has anywhere between 250 to 560 nanomoles per gram. So those are the foods that I basically choose to eat to get my spermidine. And they're quite high in spermidine. Sharon— sorry, Marketa is— or someone's asking about matcha brands to consume. I actually use Harney Sons matcha.

I really like their matcha. So let's do some rapid-fire questions. Another question from Luani about urolithin A from Mitopure, which is prohibitively expensive, which it is. Quite expensive. Can you share why you decided to take it? What do you think about other pomegranate extracts? Do they help with mitophagy or muscle recovery? So just very quickly, you know, urolithin A is produced from compounds found in pomegranate. It's done— this is done by the gut microbiome. Obviously, there's lots of differences between people's gut microbiome composition.

And so That can vary with respect to, you know, converting urolithin A from the pomegranate precursor, such as, you know, doing pomegranate extract, which is why I chose to do the urolithin A. There's been just a lot of studies looking at how in animals it can basically improve muscle function, brain function, autoimmune disease. There's been some human studies where. A variety of doses anywhere between 500 milligrams to 1,000 milligrams a day improved mitochondrial health. There was no negative side effects as well. So this is often due to the clearance of damaged mitochondria, so mitophagy or mitophagy basically. And it's often accompanied by mitochondrial biogenesis. The growth of new mitochondria.

So I would say the best way to potentially get urolithin A in your diet would be to eat pomegranate, the arils, the little seeds, the arils. Those are good, but really the best source of the polyphenols, the precursors to Urolithin A are the white part that those little pomegranate seeds are attached to. It's very bitter tasting, but honestly, if you really want, if you really like, it's much cheaper to go out and buy a whole pomegranate, cut it open, and eat that stuff. Now, the pomegranate arils themselves, they are good for you, but they will increase your blood glucose levels a bit. I don't know that it's like the worst thing in the world.

But you can also eat that white part that they're attached to, which will not increase your blood glucose, but it will be hard to eat because it tastes terrible. It's very bitter. But that's actually what's really high in the precursor to urolithin A. Now, again, people's gut responses are different. So, you know, some people may eat that and convert more urolithin A than others, but you'll still, you know, potentially be getting a good amount of urolithin A for a much cheaper value. Okay, rapid fire. Leonie asked about sparkling water. Is it okay to drink during an extended fast? I don't see why not. Owen asked, what type of olive powder do you consume? I consume Dos Alquimistas olive leaf powders, and I use their olive dust. That's Dos A-L-Q-U-E-M-I-S-T-A-S.

In a recent Q&A, you explained why you don't take N-acetylcysteine, but I went looking for it and I couldn't find it again. Perhaps a topic page? Yes, we are going to do a topic page on it. The reason I don't take it on a daily basis is because it showed that it could increase lung cancer in mice that were just normal mice. So that was kind of a red flag for me. Hi, Rhonda. I'm a 48-year-old woman, slim with no health issues. I want to try 16:8 TRE for longevity. I'm very concerned about a loss of muscle mass and weight. I exercise twice a week in the afternoon. To preserve muscle mass or even increase it, what do you advise? Do you skip dinner or breakfast or any other considerations?

Honestly, I can't give medical advice, but I will say that I have Personally practice it, and also there's been some studies looking at people that do resistance training while doing TRE, and if they do resistance training, they do not lose muscle mass. Also, the sauna as well is what I incorporate because sauna does help prevent muscle atrophy. And then I don't you don't necessarily have to skip meals with with doing TRE. You can just condense your meals into a smaller eating window. And so, you know, there is an aspect of actually doing caloric restriction that may be associated with negative effects on muscle mass just because you're also not getting as much protein.

And so that would be another option where you're actually just eating all your meals, but you're eating them within a shorter time window. In your interview with the Sonenbergs, you mentioned you A test by the Viome. Do you recommend this test? I, I, I think the Viome tests are all right. They're, you know, they, they have a lot of health recommendations on there that are not all right. They're like not really grounded in science. Like they just full stop tell people to stop eating broccoli and stop eating this. And it's just like, it's just not really grounded in science. So, you know, it might be beneficial to look and see if you have profile that's associated with an abundance of, you know, bad bacteria.

Like, I think things like that could be beneficial, like looking at actual species of the bacteria in the gut, but like actually taking their health advice and recommendations, I wouldn't. Is there good evidence for people over 60 to take apigenin and quercetin for improved healthspan? So far, I have not seen evidence. But as I said, I will be doing a deep dive into apigenin, which there's very little clinical evidence. I found a vitamin K2 supplement with MK-7 and MK-4, but the dose is 500 micrograms. MK-4 and— 500 micrograms of MK-4 and 100 micrograms of MK-7. Should I take less than daily to get closer to the 45 micrograms per day that you talked about? I don't think it's a problem, honestly, taking the daily amount, the 500 micrograms and 100 micrograms. I don't think it's a problem.

ApoE4 gene variant. I was hoping that you can comment on the risk factor related to Alzheimer's disease development if you test positive. for one allele or one variant of APOE4, also if you test positive for 2. So the Alzheimer's risk for one APOE4 allele is 2-fold. The Alzheimer's disease risk for 2 APOE4 alleles is 10- to 15-fold. Rebecca asks about processed meats. General guidelines say to eat processed meats in moderation. Is that solely due to the preservatives? In them like sodium nitrate? What do you think about the nitrites naturally occurring in celery powder? Many companies are using— sorry. Yeah, nitrites used in celery powder. Many companies are using them. So nitrites, nitrates.

Celery powder has nitrates with an A. In bacon and ham and lunch meats and all that, you'll find nitrites with an I. Nitrates are different. They're naturally occurring in a lot of plants. And when you eat them with the plant, the plant also has vitamin C with it, and it prevents the nitrate from being converted into the carcinogen, which is nitrosamine. Nitrites, on the other hand, do not have that. So nitrites are— can be converted into nitrosamine, which are carcinogens. It's really not known whether or not It's the nitrites in the processed meats or the heterocyclic amines, which are also carcinogens. What— it's just not known what the cause is with processed meats and them being so unhealthy.

But I do think trying to consume them in moderation, even if it's nitrite-free, is a good idea. There was a question about parental health before conception. How many months before conception should a woman and her partner quit tobacco, cannabis, alcohol, caffeine to resolve any nutrient deficiencies or any abnormal biomarkers? I know this is going to sound harsh, but like, with the exception of— I think that when you're trying to conceive, You should cut out the alcohol and caffeine for sure. But other stuff, honestly, one year, I think one year is like— and the reason for that is I know it's kind of intense and it's my own strict kind of protocol, but there's just been some studies, for example, women that had insufficient folate, It took it took a year of supplementation with folic acid, which is a lot more bioavailable than folate, to to really help prevent the neural tube defects that can occur from deficiency.

One year—that's a long time—and it's kind of surprising that it took so long. So I think I think that you know the the tobacco I would actually tobacco. You know, it all depends on how old you are. Like, if you're smoking tobacco, if you're consuming tobacco, like, you should stop, like, now. You know, I think that stopping tobacco as soon as you can, preferably it would be many years before conceiving. If it's not possible to do it many years, I would say, you know, my golly, at least one. At the least, for sure. Another question from Leonie about sauna blankets. Some of them are labeled as heating up to 176 degrees Fahrenheit. Is that hot enough for a benefit? I do think that it's potentially— you could get some benefits from using a sauna blanket at 106 degrees Fahrenheit.

Oga's asked a question about Berkey fluoride filters, which seem to release aluminum oxide in the process. Berkey claims aluminum oxide is not water soluble and should be safe for ingestion. What's your opinion on the matter? So I no longer use the fluoride filters from the Berkey. I still do use a Berkey water filter. But I don't use the fluoride. I don't have— there's not really high fluoride in San Diego. I cut— the reason I used them, it was during pregnancy because fluoride, that's the period of development where fluoride can be pretty risky. I basically have done heavy metal tests and never have I had aluminum be elevated at all, like even remotely concerning. And I have used Berkey fluoride filters for many, many years.

So that made me feel better because you'd expect that my aluminum levels would be high if I was getting an enormous amount of them. Also, I think that looking into getting a reverse osmosis filter instead would be an option. In fact, I'm looking into this as well. Aluminum is something that you do excrete quite well through sweat. In fact, aluminum is better excreted through sweat than urine. It may be that that's why my aluminum is not high because I sweat so much with the sauna. I don't know. But I do know that my aluminum levels are not high. I've had them measured before. So thanks for pointing that out about the fluoride filters. It is a concern for people that are using the fluoride filters.

You can still use a Berkey water filter to filter out a bunch of other stuff without using the fluoride filters. Cameron asks about my long COVID friends, how they're being treated, any promising therapies. Most of them for like POTS and chronic fatigue syndrome have been using IVC, like multiple rounds of intravenous vitamin C. Lots of sauna use, and then lots of salt. They've been doing lots of salts, like electrolytes, and eating pickles, and literally just taking salt, and it's really helped with their POTS syndrome. Sharon wants to know, I would appreciate hearing your habits when you eat out. For example, how often do you eat out? When do you eat out? Or when you do, are there any things that you won't eat?

You know, so again, people like— part of eating out is the enjoyment of not having to cook. And, you know, not everyone lives in an area where they can go to a restaurant with grass-fed beef or, you know, wild Alaskan salmon. Or wild fish. I try to avoid, you know, the farm-raised fish and the regular, you know, non-grass-fed meats and non-pasture-raised chickens. But to be honest, if you eat out so rare, it's not a concern. It's just not a concern. The concern is if you're eating out all the time and then you're always eating these things. It's a little more concerning in my opinion. So that's typically what I do. And I have my favorite restaurants that do have grass-fed and wild fish. So if you can find those restaurants, great.

But if not, there's bigger concerns to worry about than that. Uwa asks about geriatric pregnancy, I guess, what she's calling geriatric pregnancy. So people that are 40, 40-ish-year-olds, you know, any additional risks that they can mitigate them, you know, for optimal pregnancy. Definitely, if you're trying to get pregnant and you are older, I would say that cut the caffeine out for sure immediately. And really just getting a great prenatal vitamin that has— and this kind of goes into another question from Lisa about Choline levels as well. So a great prenatal vitamin that you're that you've been getting enough folic acid for at least a year, as well as omega three. You know, taking two to three three grams a day of omega three is also really beneficial.

But you know, other than that, it's just really just doing everything you can to exercise and. And be as healthy as you can does really help. But the caffeine is a big one as well. Choline also. So finding choline that is from sunflower lecithin is kind of hard. Pure Encapsulations makes a good one. So there's a— Pure Encapsulations makes a sunflower phosphatidylcholine. It's about 550 milligrams in 2 different capsules. Yeah. So honestly, 1 capsule a day is equivalent to what some of the studies found with about 300 milligrams a day of phosphatidylcholine improving intelligence in children, mothers that supplemented with it while they're pregnant, particularly during the third trimester. And avoiding BPA and all the alternatives. I can't emphasize this enough.

Like avoiding plastic containers, avoiding canned foods that are lined with plastic. A lot of the acidic foods can draw out the BPA into liquids more, like tomatoes, tomato paste, for example. Anything that's heated, like let's say you go to Trader Joe's and you get their Chicken noodle soup, and you know that they have well. That chicken noodle soup was poured into that plastic container hot, and so like all those packaged foods in those plastic containers—you never think about this—but the they—I was thinking about this during pregnancy because I was so obsessed. But like basically all that stuff was you know a lot of these foods that are that are meant to be heated, which of course you might think oh I'm gonna.

Dump my soup into a bowl and I'm not going to heat up the plastic container, obviously. But what about when they poured it in there? Like they cooked the soup. You think they waited for it to cool down before they put— they probably didn't. So really just being fastidious and thinking about anything in plastic. Like was it potentially put in there, heated up? Because if it was, you're getting 100-fold more BPA, 100-fold. That is enormous amount. So that's a big one to consider during pregnancy. Margaret is asking in the chat why caffeine is so bad for pregnancy. It basically causes an early miscarriage, like the blastocyst can't implant. into the placenta. And you would never even know it, but you just won't get pregnant. And that happens more readily with age.

And then there's been some studies coming out that caffeine consumption is now associated with ADHD, which I talked about many years ago. And I said, there's no evidence for it. However, it's possible. And that was a concern of mine. So I think that avoiding caffeine during pregnancy is the best thing that you can do. I just supplemented with a lot of smoothies. I did berry smoothies, things that made me feel good with yogurt, strawberries, and blueberries and stuff. And caffeine health also affects in vitro fertilization as well, all that stuff. So I would cut out the caffeine. And it's both men and women, by the way. It also affects the sperm. Stacy's asking if I give my little one probiotic supplements, and if so, what age should I start him on? I do not give him probiotic supplements.

He's never— he's 4 years old. He's never had antibiotics. I breastfed him until he was almost 3. His microbiome is like amazingly awesome. So there's really no reason that he needs— now if, if I did give him probiotic— I mean, sorry, antibiotics, I may consider doing probiotic supplementation. But I don't. Nordic Naturals has a good probiotic supplement. It's like a little packet. And I think it's sweetened with monk fruit or something and it tastes good. And so That would be an option. All right. Last rapid-fire question was from Judah about cooking oils, like canola oil and seed oils like that. He says that the genetic— our genetic report said that his diet should be higher in polyunsaturated fat, have a higher ratio of polyunsaturated fat to saturated fat.

So basically, that doesn't mean increased cooking oils. Polyunsaturated fat are found— they're found in a variety of fish, so even fish oil, and also in nuts. Nuts and seeds are a really good source of polyunsaturated fat. So getting a dietary source of polyunsaturated, like an unprocessed Dietary source of polyunsaturated and monounsaturated fats. It's good. So again, nuts, seeds, fish, olives, olive oil, avocados—those would be good sources of both polyunsaturated and monounsaturated fat. Ernest is asking if I need more than one to two servings of fermented foods a day. I don't think so. I think that's great if you're doing that. I keep my my sources.

Typically the kefir, and I also do the Bio K yogurt, the normal one, the plain unsweetened, and it's a really great source of probiotics as well. All right, everyone. So that wraps up this Crowdcast number 34. Thank you so much for submitting all the awesome questions, and thank you so much for All of your support. I really, really, really couldn't do this without you guys. We are moving forward with all our videos, and we have a lot of topic pages that we haven't even released that are now live. I'll be doing a big post on that soon. And I hope you guys enjoy these Crowdcasts. I enjoy them a lot. I really, really enjoy them. I learn so much. And so I'm so happy to see that a lot of people attend them live. You can listen to them again on your dashboard.

You can go to your dashboard at foundmyfitness.com/dashboard and you can listen to it right on the dashboard, or you can also download your private podcast feed, which is where we release our weekly, almost weekly aliquots episodes and where we post our Crowdcasts after we have them live. And also we do our Normal episodes as well. And then you can also watch the video again on YouTube. We're going to send you guys out an email. We usually send it out within a week or so after recording, and we have a nice little timeline summary with some links as well. So make sure you guys check all those out, and I will talk to you guys next month. Submit your questions early in the submit a question section, not in the chat section, please. The question and answer section.

I do scroll through and try to get to all the questions that I can. Hope you guys have a great weekend and I will talk to you guys very soon. Hope you guys listened or watched our cold exposure video that we released a couple days ago. It was a pretty good one. More stuff coming out really, really, really soon. So look for that and talk to you guys soon. Bye.