Q&A #35: Time-Restricted Eating and Muscle Loss—Plus Pregnancy Nutrition

Hi everyone. Welcome to Crowdcast number 35 in our Crowdcast Q&A series. Wow, 35. That's pretty awesome. For those of you that are new, I just kind of want to start it out— start out and let you know how these Q&As work. Typically what we do is I will go through a few deep dive questions. These are questions that My team and I will spend some time doing some research on digging into the details. And so I will go into some of those details. I usually do a few of those questions. And then I, at the end of the Crowdcast, I will do a bunch of rapid-fire questions. So these are answers that I can answer in like either a single word or a sentence or maybe a few sentences. So each Crowdcast, it kind of varies.

Some Crowdcasts require a lot of deep dive, and so we go really deep into a couple of topics, and I'll have fewer rapid-fire questions. Other Crowdcasts will be a mixture, and some will be a lot of rapid-fire questions. So this one, I think you guys know I sent out an email that I'm going to be covering up front some of the recent time-restricted eating studies and questions that I've gotten about those studies. And so I'll start with those and then we'll go into a few other deeper dive questions that were submitted about the non-nutritive sweetener allulose, also about supplemental apigenin, which— so those questions were from previous Crowdcasts that I did not get to.

That's another thing to keep in mind is that if I don't get to your question, I do archive questions and go back and answer questions that I think are— that a lot of people want to know about or I haven't covered before. But also, you can just submit the question next time as well. So, you know, submitting the same question also will increase the chance that I get to the question as well. So we're going to start with the time-restricted eating questions. And most of you should be familiar with what time-restricted eating is. Time-restricted eating refers to eating all of your calories within a restricted time window so that you allow your organs some time to rest from digestion. And this would be a fasted state.

So typically, according to Dr. Satchin Panda, time-restricted eating refers to 12 hours or less, eating your food within a 12-hour or less time window. So let's get to the first question, which was about a recent study that was published in the New England Journal of Medicine, and the study claimed that there was no added benefit for time-restricted eating compared to caloric restriction. In other words, they concluded that time-restricted eating had no added benefit on top of caloric restriction, which in my mind is a terrible, terrible way to state things, for one, because the endpoints that they looked at were weight loss. That was the predominant endpoint. And there were a few metabolic endpoints, which we're going to talk about. But let's talk a little bit about the study.

First of all, both of these groups were undergoing caloric restriction. So they were eating fewer calories than they normally would. The study population was from China. So actually, most caloric restriction studies, people reduce their caloric intake by about 25%. This study was really robust. They had people reduce their calorie intake by 35%. So there were 2 groups. One group was instructed to eat ad libitum. In other words, they were instructed to eat whenever they want, but they had to have a certain number of calories, which was, again, it was a 35% reduction in their normal food intake. The other group was told to eat all of their food within a certain time window. They were to be done eating by 4:00 PM. In other words, they were They were constricted to an 8-hour feeding window.

So they were eating all their food within 8 hours and then not eating food for 16 hours. And so I'd like to point out a really important point here, and that is that all the study population, the people that were divided into 2 groups, all of these people at their baseline ate ate within about a 10-hour window, 10 to 10.5-hour window, which is time-restricted eating. Okay? So people already were eating within a restricted time window, and then the treatment group was told to eat in a 2 to 3-hour less window. So basically, the study was you had everyone eating 35% less calories, which obviously is going to have a robust effect on weight loss. And then they had one group and said, okay, well, you eat, you know, 2.5 to 3 hours, you stop eating 2.5 to 3 hours earlier than the control group.

So not, in my opinion, ground, you know, shattering when you're actually comparing time-restricted eating to time-restricted eating. But with that said, you know, the TRE group, I'm calling it the TRE, but it's TRE plus caloric restriction. They didn't lose— okay, so, all right, let me take a step back also. Typically in time-restricted eating studies, and we're going to get to this in a minute, like what time-restricted eating is really beneficial for, it's not necessarily weight loss. In fact, time-restricted eating, you're not supposed to necessarily cut out your calories. You're not supposed to like really stop eating, you know, meals and stuff. Some people do that because they are really trying to lose weight, so they're combining caloric restriction with time-restricted eating.

I practice time-restricted eating. I do not cut out calories. I do not cut out calories because I do not want to lose weight. Time-restricted eating, when you look at weight loss studies, if people aren't really cutting out calories, they only really lose up to about 5%. There's only like up to 5% weight loss. It's not a really huge amount. So there's a ceiling with that. So with that said, When you're looking at, you know, these groups that were compliant with the actual caloric restriction and time-restricted eating, the weight loss in the caloric restriction and time-restricted eating group was about 20.2 pounds. And the caloric restriction group only was about 19.6 pounds or 8.9 kilograms.

So the time-restricted eating group plus caloric restriction did lose a little bit more weight compared to the caloric restriction group only, but it wasn't much. It was about 1.8 kilograms, and it wasn't statistically significant because it was only trending. But here's the thing, the study was not powered to detect statistical significance between the 2 groups. It was powered to detect a difference between weight loss from baseline in response to time-restricted eating. And, you know, the reason I point that out is because if you want to detect statistical significance, you have to power the study correctly. But there was no pilot studies that were done previously that combined caloric restriction and time-restricted eating.

And so if this study wanted to actually detect a statistical difference between 1.8 kilograms, they would actually need a larger N. Now, with that said, 1.8 kilograms is not a lot. It's not a huge difference. I mean, it's not like, you know, but the point is, is that headlines would have been different. And I think this is also a really good time to talk about statistical significance. It's a real pet peeve of mine, like a real one. There was actually a publication in 2019 in Nature where 800 different scientists signed a petition to get rid of statistical significance. And let me tell you why. Because plainly speaking, statistical— the p-value that's been set for statistical significance has been set at 0.05. It's completely arbitrary.

And what statistical significance is, it's not supposed to tell us whether or not the difference between something or a treatment is real. It's supposed to give us confidence that it is. And so many people, it's like, I think many, many scientists don't know anything about, like, understand statistical significance at all, because they always boil it down to whether or not the effect is real. Like, you can't— so, like, if— so in this study, statistically, the p-value was 0.11 instead of less than 0.05. So although it did not meet statistical significance, it, you know, it came pretty close. And so basically, there was only an 11% chance there was only an 11% chance that this was occurring because of chance alone. To me, that's like, oh, it's probably not occurring because of chance alone.

The way the p-value was set up is they want it to be that there's only a 5% chance that this is occurring by chance alone. Do you see what I'm saying? Where it's like, really, this isn't about an effect being real. It's real. It's about our confidence in it, right? And so I just think that, like, you know, If you talk about p-values, p-values represent the probability of getting a result assuming that there are no differences between 2 groups. In this case, if we repeated this experiment, we would expect to see the results only 11% of the time assuming there's no difference between time-restricted eating plus caloric restriction and caloric restriction alone. So again, it's like, you know, so there's an 11% chance that this is happening by chance only and that it's not a real effect.

To me, that's pretty damn small. So I just want to, like, point that out to people because I see so many scientists basically because there's no statistical significance, they're saying, nope, this effect is not real. That is not what statistical significance shows. It absolutely does not tell you whether or not an effect is real. It tells you how much confidence you have in it. So there's my little rant for the day. Really, there's nothing special about a p-value being 0.05. It's It was absolutely arbitrary. People could have chose— it could have chose— we could have chose a p-value of 0.1, or we could have chose it of 0.001. I mean, you know, so really it's just arbitrary. Okay. So back to the study. I think the real big limitation here is manifold, actually.

One, we're looking at weight loss, which again is not something that time-restricted eating, if you're not restricting calories is really going to show. Again, I said, you know, 3% to 5% weight loss typically occurring if you look at most time-restricted eating studies. The caloric restriction group ate within a 10.5 to 11-hour window. Okay, that is time-restricted eating. Anything less than 12 hours is time-restricted eating. And if you look at Dr. Satchin Panda's data, most people are eating in a 15-hour window. Okay, this study took a group of people that were eating in a 10-hour window. I eat— people ask me, do you do time-restricted eating? I say yes. And you know what my eating window is? It's 10 hours. It's 10 hours. That's my eating window.

So that's a big, I think, drawback to the study. And again, I mentioned it actually wasn't powered to detect statistical significance. And even, you know, again, the statistical significance thing is like, it's so annoying to me that people use that as whether or not an effect is real. It's not supposed to show that. It's supposed to give you confidence. And like I just said, the p-value in this study was 0.011, which means there was only an 11% chance that the effects in the caloric restriction plus time-restricted eating group, meaning that the 1.8 additional kilograms of weight loss, was due to chance.

So if you were to ask me, hey Rhonda, if you think there's only an 11% chance that something's occurring because of chance, Would you have confidence in something that it's occurring because it's not due to chance? I would say yes. Ask yourself the same question. All right. Some of the other metabolic parameters that were looked at were insulin disposition, triglycerides, systolic blood pressure. They were all significantly better, not significant, it wasn't statistically significant. They were all much better in the caloric restriction and time-restricted eating group, but the confidence intervals were all over the place. Again, statistical significance doesn't mean an effect isn't real. It's just our confidence in the effect. So with that said, I disagree with all the headlines.

And I think we're about to get into some other details about what the benefits of time-restricted eating are. But I hope you guys actually understood what I was saying there because I think it's really important. And again, look. I'm not saying the 1.8-kilogram additional weight loss difference is anything to like scream about. What I'm saying is that, you know, there was a difference in weight loss. There was an 11% chance that it was only due to chance. And on top of that, there was improvements in triglycerides, both systolic and diastolic blood pressure, and insulin disposition. Again, the statistical significance— it was not statistically significant, but the study wasn't powered to detect statistical significance. They messed up. They messed up.

from the beginning, from the beginning. And then on top of that, we're talking about comparing time-restricted eating to time-restricted eating. Honestly, so what? The treatment group stopped eating like 2.5 to 3 hours before the control group. Come on, really? Uh, you know, I just, I just think it's honestly, it's a little bit laughable. Um, but with that said, caloric restriction is a very powerful way to lose weight. It's a very powerful way. And people that do want to lose weight can absolutely lose it with caloric restriction. Time-restricted eating is not equated with caloric restriction.

People that are so obsessed with caloric restriction and are obsessed with weight loss as the only thing, only endpoint to look at, get really hung up on this whole, it's all due to caloric restriction. Well, you know what? Weight loss is largely because of caloric restriction. And people that are doing time-restricted eating to lose weight end up skipping meals and they are caloric restriction. and their weight loss is probably mostly due to it. Okay? I will say that. But we're going to dive into what else time-restricted eating covers and why it's not all about calories and weight loss. Another question. And this question has to do with losing muscle mass. And it kind of comes down to what I was just saying.

The question was, and this was submitted by, you know, more than one person, so I'm not calling out all the names, but it's, will time-restricted eating make me lose lean muscle mass. If people naturally skip meals or cut calories while they're doing time-restricted eating, then it's possible they may also be cutting down their protein consumption, and this could affect muscle mass. So I do think it's really important. A lot of people do end up skipping breakfast. I don't necessarily think that's a good idea. I don't skip breakfast, and we're going to talk about my meals. There was another question submitted about my meals. I don't skip. I practice time-restricted eating and I do not skip meals, but I'm not trying to lose weight.

I think for people that are doing time-restricted eating, it's important to realize it's not about meal skipping. It's about eating in accordance to your circadian rhythm. It's about eating within a designed time window so that you can allow your organs to rest. We'll talk about that in a minute. So, you know, if you are someone that is trying to lose lose fat and lose weight, it is a good idea to cut down on calories, and caloric restriction can help with weight loss. But it's also important to not cut out protein because that can affect muscle mass. So that is something to keep in mind. Now, there was, um, there was some other things about like muscle mass, you know. So there was a study that was published in, in JAMA Medicine. I think it would— I think it was 2020.

And they reported that basically— so look, let me tell you about this study. This was like, here's the thing about publishing studies with large Ns, like, you know, over 100 people. It makes headlines because it's a large N, okay? And so everyone's like, oh, this is real, this is real. But for anyone that's ever been involved in a clinical trial, okay, so I was involved in several clinical trials during my postdoc. We were doing a lot of work on these micronutrient-dense bars. They were called CHORI-bar at the time. But, you know, there were several ongoing trials, you know, that I was a part of. And I can tell you that compliance is huge. And if you don't check back with these people routinely, they're not going to follow— they're not going to follow the treatment.

They're not going to do it. And so this particular study, Basically, it had, you know, the participants only— basically half of the participants didn't interact with anyone in the study except for the first sign-up. And what that tells me is that those guys weren't doing time-restricted eating. Those guys, they weren't— I mean, like, if you're not, like, checking back in, like, you're done. And, you know, it was sort of, in my opinion, negligent for the people, the authors of this study, to publish the data anyways, even though they knew Participants did not interact. There was one interaction, one, and that was original signup.

To me, it's really like, we would never, you know, when we were running our clinical trials at Kori, we had to, like, come up with things like, okay, people had to bring back their empty wrappers, you know, otherwise these people weren't eating the Kori bar. They weren't eating these micronutrient-dense bars. If you didn't interact with them, there was no way to know that they were being compliant. It's actually a really important issue. So I really think it's kind of sloppy for someone to— oh, and by the way, the signup was online. It was an online signup, and half the people never interacted after that online signup. And you're going to tell me those people did time-restricted eating for 12 weeks? Not a chance.

It is really hard for people to make behavioral changes, let alone, like, if they don't even interact with you for 12 weeks. And then you're going to take their data and just say, oh yeah, that's what they did because they signed up for it online. 12 weeks ago. I mean, do you follow what I'm saying? It's kind of unreal. So anyways, to me, that study was, you know, it was basically a wash, and I don't really, like, find— I don't take it seriously because you just can't analyze data from a sample population that never interacted with you and did an online signup, and that was it. Okay. So I think that the basic question about losing muscle mass is important.

We know that other studies with time-restricted eating, when protein consumption is not cut out and resistance training also is done, muscle mass is not lost. So again, like, really important to not cut out protein, to really not cut out meals if you're not looking to lose weight. You know, there's no need to have to skip a meal. So the next question is, does eating all my calories early in the day have any benefit compared to eating them later in the day? So eating early, eating, doing all your feeding window earlier in the day, it's often referred to as early time-restricted eating or ETRE, you'll see, or ETRF. So metabolism does change throughout the day. I've talked about this before. You know, there's studies published on it.

When healthy adults eat the same exact meals, the same caloric content, the same macronutrient content, I mean, the exact same meal for breakfast, lunch, and dinner, and you measure their postprandial glucose response, it's the lowest after breakfast and it's the highest after dinner, even though the meals are 100% identical. And that really probably has to do with the melatonin production. So melatonin is something that we naturally start to produce. Later in the day, our levels start to go up and melatonin binds to— it binds to receptors on the pancreas and basically signals the pancreas to stop producing insulin. Insulin is needed to take glucose up into our muscle tissue, into adipose tissue. So that means glucose doesn't get taken up into our other organs.

It stays in the bloodstream and this can lead to elevated blood sugar levels. I think that alone is reason to try and eat food earlier in the day, more, you know, correlating more with our circadian rhythm. And for those of you that want to go back and listen, I think my most recent podcast with Satchin was the Clubhouse one we did. And he goes into a lot of detail about circadian rhythm and what it is and why it's important and how it relates to our eating schedule as well. And I'm going to kind of echo some of what he says with my answer to the next question, which is— the question was submitted. It says, I already have a healthy BMI. Will time-restricted eating be more harmful than helpful?

And I think this, again, has to do with the real goal of time-restricted eating is not to lose weight. It really— like, you don't lose that much weight if you're not cutting out calories, okay? So let's talk about someone who isn't trying to practice caloric restriction While they're doing time-restricted eating, time-restricted eating does not mean you have to restrict calories. I practice it as I said. I do not restrict calories because I do not want to lose weight. That's not the main thing. So really, I think don't calorie restrict, don't protein restrict if you are not trying to lose weight, and obviously exercise, you know, as well.

So and Sachin has said this: a big part of time-restricted eating has to do with repair and, for better or less of a word, rejuvenation, repair processes. So, like similar, and he explained this in the podcast, similar to how your brain repairs itself during sleep, your brain has to be unplugged. It can't be processing all this information and cognition occurring for it to repair. It has to be unplugged. This happens when we sleep, and this is when our brain repairs itself. Similar to that, all the cells in our body, all the organs in our body, They have to be unplugged from outside input to repair. The major source of outside input that influences almost all of our organs is food because when we eat, it changes the nutrient levels.

It's changing— basically, all the cells in our body have to break down nutrients. That's metabolism. Metabolism is happening in every cell in our body. So the cells are doing all this work. They have to interconvert all the molecules. That we're getting from food. It changes our hormones. So we need to have a period of not eating so that our organs and our cells can repair. So to me, this is a big reason why, in combination with the circadian component of metabolism that I just talked about with melatonin levels naturally rising at night and that affecting metabolism and affecting the way our body is processing glucose. That is why I practice time-restricted eating.

And so I think that a lot of people that are really obsessed with weight loss and coaching people to lose weight, they get— they're sort of— they've got these blinders on and everything is weight loss and everything is calorie counting. And look, calorie counting, again, is really— it's phenomenal for weight loss. Like, if you want to lose weight, restrict your calories. But that's not the only damn thing that That's important for health. Okay? It's a very important one. If you are overweight and obese, the first thing you need to do above anything else is lose weight. Like, that's the first thing. But there are a lot of people that are not overweight and obese and are also looking to improve health. So please keep that in mind. So that means how many hours are we actually not eating?

And Satchin, I got, you know, Satchin really went into detail. on this in the last podcast I did with him on the Clubhouse podcast. And he talks about how basically you— okay, so how long do you need to go without food, right? People will think, oh, if I eat within 8 hours, then I'm going without food for 16. That's not exactly how it works, right? So we want to know how long to go without food so that we can have repair processes working, right? Where we're not digesting food, we're not interconverting all these molecules. So according to Satchin, after about 5 hours, our intestines, they might actually take several hours to absorb the nutrients, and then they send them to our liver and other parts of the body.

So that means if you finish eating dinner at 6 o'clock, you need to add 5 hours because your stomach will still be working, your intestines will still be working. So by 11 PM, maybe even later, That's actually when the repair processes start. So again, that means basically the hours that you are not eating. So for example, let's say you're eating all your food in an 8-hour window, that you have to then— so you're fasting for what you think is fasting for 16 hours. You have to subtract 5 hours from that because even though you stopped eating within this 8-hour window, there's an additional 5 hours of digestion occurring, right? So the unplugged, that part I was talking about, doesn't occur until 5 hours after the last bite of food, approximately.

So then you're talking about really 11 hours of repair if you're basically fasting for 16 hours. So I hope that makes sense to you guys. You know, I don't want to spend like— I could spend like several more hours talking about this, but I know you guys want to hear about other questions as well. But I think that unfortunately, there's a big push, contrarian types of, you know, the contrarian stance and the, you know, calories in, calories out. I think people really kind of get obsessed with that. And anything that's contrarian will make headlines and headlines get people fame, they get people funding, they get, you know, so really it's It's important to keep in mind that you can't always listen to the headlines that you're hearing.

And it really is a disservice to public health because a lot of people read a New York Times article that basically said time-restricted eating doesn't work. First of all, that study didn't show anything about time-restricted eating that worked. As I went into, they were looking at weight loss and both groups were essentially time-restricted eating. I mean, it was like they missed the whole point of time-restricted eating. The point— Whoever says the point of time-restricted eating is weight loss, like, you know, I mean, it can be. You can use time-restricted eating to lose weight if you cut your calories, but I just think that it's gotten to this point where it's become this battle and this war, and it's kind of like, let's take a step back here.

Let's just process and think about things, okay? So. I will move on. I hope you guys appreciate and understand what I'm saying here. And also, please continue following Satchin Panda because he is a wealth of knowledge. And nobody cares about public health, no scientist cares about public health more than him. And it's really been a big disservice to have such Salacious headlines out there saying that time-restricted eating does nothing better than caloric restriction. You know, it's just people don't understand it, and they're going to read that headline, and they're going to stop doing it, and it's not going to be good for people's health. All right.

So the next question was submitted by a few people, and we talked about— I talked about how I was going to cover this last time, and the question is related to allulose. And allulose is a newish non-nutritive sweetener. And people have been asking if it's safe, if there are positive or negative effects. So we did a little bit of a deep dive and I'll tell you, I mean, there's just like the literature on this is so scant. I was actually quite shocked. So allulose is naturally found in small portions in fruits and vegetables. It's about 70% of the sweetness of glucose with about 5% to 10% of the calories. So it's keto-friendly, so to speak. The mechanism is most of it is actually excreted unmetabolized into the urine by the kidneys.

There was one meta-analysis that showed when 2.5 to 10 grams of allulose were given during a 75-gram glucose challenge, it decreased blood glucose levels by about 10%. Okay. So it's interesting because it seems like it may have a positive effect on blood glucose levels. But, you know, again, there's just too few studies to make any really confident statement, in my opinion. Other studies have shown that it lowers blood glucose levels when it's added to meals. So it inhibits the enzymes in the gut that break down complex carbohydrates. So that leads to decreased absorption of those carbohydrates. So the FDA has approved it for human consumption. There's really not— I haven't seen in the literature any adverse events reported in the studies that were evaluating safety of allulose.

But the longest study that I could find was about 3 months. And the dose of allulose used was up to 45 grams per day. Weight loss, there are really no human studies showing that allulose is effective for losing weight. There's currently one ongoing study. So in my mind, it's one of those things— okay, I'm going to give you guys my real opinion here. I cautiously now, you know, I feel like— so stevia or stevia, however you like to say it, that was like all the rage, you know, 15 years ago. It's still used, you know, quite commonly used. And there's, you know, some animal evidence that it may affect hormones like testosterone, lowering it. The animal studies, it's like, okay, they're using quite large doses. It seems almost impossible for humans to consume. But you never know.

Maybe there's some small, insidious type of effect that may accumulate over time. Is it going to affect a developing fetus? I don't know the answer to these things. There's always the— in the back of my mind, there's always the little fear of, okay, in 20 years we're going to find out actually probably you're changing your hormones and not good. So there's always, you know, like I'm using monk fruit right now. I use monk fruit instead of stevia. And the same thing goes with monk fruit where it's like there's just not enough evidence to know with certainty that it's not doing something potentially harmful, changing something in the microbiome, in the hormone, like hormones or something.

So I think that you're always— there's a certain risk associated with consuming non-nutritive sweeteners on a daily basis, I should add. I think the important thing here is on a daily basis. If you're doing some baking and it's like, oh, I bake a cheesecake for holidays and for special occasions and I use monk fruit, great. But are you using— are you putting it in your coffee every morning? Are you putting it in— are you consuming it every day? Because then there's some things might change here. You know, I think that, I think that that's something to keep in mind. So with allulose, that's pretty much all I have. Like, there's not a ton of evidence on it. It seems to be fine. But again, you never really know until we get more data. So here's— this was another question.

It's been submitted a few times by people. And this question that was submitted multiple times by different people had to do with supplementation with apigenin. So the question is, is apigenin supplementation worth it? Is there any human evidence that it's good? What's the bioavailability? I guess there's been some podcasts talking about it. So apigenin is— it's a compound that's found in some foods like celery, parsley, oregano. You can find it in spinach and onions and also chamomile tea. But there's been some recent interest in supplementing with it. So there was a 2019 review that summarized human evidence of apigenin. It was titled The Therapeutic Potential of Apigenin. So they looked at Alzheimer's and Parkinson's disease.

So there was a formulation containing apigenin applied twice a day for 2 years that showed improvement in cognitive function in humans. There were some animal models where it reduced the formation of beta amyloid plaques. There was some apigenin-rich gel that was made from chamomile tea that was effective at reducing pain, nausea, vomiting, these things caused by migraine headaches in a randomized double-blind placebo-controlled crossover study. There's been some human evidence for anxiety and depression. So a chamomile extract containing 1.2% apigenin caused— it resulted in improvement in depressive symptoms. 500 milligrams of chamomile extract, which again has apigenin, 3 times a day improved anxiety symptoms, reduced body weight, and lowered blood pressure.

In animals, there was increased brain-derived neurotrophic factor and a decrease in IL-1 beta, NF-kappaB, and TNF-alpha. Another study with osteoarthritis, when it was given 3 times a day topically, it improved pain. There's some animal studies again showing it helped delay the onset of cancer in mice who were then predisposed to the cancer. It inhibited cancer metastasis. Again, these are also very, very high doses. So there was also some animal studies showing it lowered blood glucose levels. It improved insulin sensitivity. There's no human data on this, however. So these human studies that I mentioned, they were all phase 2 clinical trials, meaning they were really composed of only a couple dozen carefully selected participants.

Until larger phase 3 studies with more— a more heterogeneous population of participants is done, I don't think you can vouch that supplementing with apigenin is really going to do much of anything. I do think that eating the foods that are high in apigenin are good. But I'm currently not convinced that I need to start supplementing with it. So that's kind of my take on it. I saw a few questions in the chat that were pretty interesting. So I'll go ahead and take a moment to address some of those questions. So one question had to do with mitophagy or mitophagy. And this is the clearing away. This is something that also occurs when your mitochondria are not processing substrates. You know, so basically, you want to, you know, during a fasted state, when we're talking about repair processes.

So mitophagy does occur. Someone was asking whether or not you wanted to pulse the autophagy, or if you wanted mitophagy. To happen, you know, every day, or if this is something you wanted to pulse. And they were referring to urolithin A, which is something that is formed from other compounds that are particularly high in pomegranate. And urolithin A does stimulate mitophagy. So I honestly think that you actually, you want repair, you want mitochondria to damaged mitochondria to be cleared out every day. Like, this is the type of repair process that you actually want to be happening on a daily basis. So I don't think it's necessary to have to pulse urolithin A. I do, by the way, my husband and I have now been— we've been— my son loves pomegranate. I mean, he absolutely loves it.

So instead of buying these pre-made, you know, cups, that have the single-use plastic, which I totally hate. We've been getting pomegranates and even though it's a pain in the butt, we've been getting the pomegranate arils out ourselves. And then we've been taking this, like, the rind part, like, I think pith maybe it's called, the white part, that's really, really rich in some of the flavonols and polyphenols that are converted into urolithin A. And we've been making smoothies out of them and just adding like a little bit of strawberry to it. It's a totally bitter-tasting smoothie, but it's like, I think it's just like amazing for the gut. And I think it's a really good source of urolithin A. And so, that's something that we just recently started doing.

And it's also way, way more cost-effective. I mean, some of— there's like one supplement out there called Mitopure, which I did order and try out. I didn't really notice anything from it. But it's so expensive and I just like, I just don't think people, it's not like sustainable for people to be able to afford that. It's really expensive. So I'm really excited about the pomegranate as an alternative, making those smoothies with the white part of the pomegranate, like underneath the skin, the part that you're actually getting the arils, the seeds out from, that white part.

There's another question about So having to— in the chat, someone was asking about— James was asking about any recommendations for consuming antioxidant anti-inflammatory foods around exercise to avoid blunting hormetic effects. Any difference between resistance training and cardio training? So I do want to point out here that, like, there's no evidence that eating foods that are high in any type of polyphenols or flavonols are blunting exercise-induced adaptations. The studies that show that come from supplementing very, very high-dose supplemental antioxidants, mostly like vitamin E. So it's not ever something that I've really ever been concerned about, even worrying about, honestly. So the next question was submitted by Hillary. And Hillary asks about protein intake for longevity.

She says, I know you may have discussed this before, but now David Sinclair is saying our needs are very low for protein and he's considering becoming vegan. Many others believe in high protein intake, especially as we age, to keep muscle tone and promote longevity. Wondering where you fall on this question. So I have answered this question in other Crowdcast Q&As before. We are, by the way, working on getting all of the timelines categorized for you guys on the dashboard, on your FoundMyFitness dashboard, so that you can search back for Crowdcast Q&As and see what was covered. So this will be beneficial for all of you guys, but also for me as well, so that I can then search back and find where I had already talked about this. That way I'm not too repetitive.

So I'll briefly touch on it again, but I have— again, I've gone into detail on this topic actually in more than one Q&A. And I will say that I do think, particularly as we age, increasing protein intake becomes more important. There was a study that showed a high-protein diet, even without exercise, preserves more muscle mass than a low-protein diet. And this was especially true for elderly men. In other words, like your dad, your grandfather, if they're not doing resistance training, they're losing muscle mass. They're losing it every day. And losing muscle mass increases frailty, and frailty is associated with a higher chance of mortality risk, you know.

So I think, you know, it's very important to keep in mind, especially people that are— as you start to hit 60, 65, and over, Like not cutting out protein. Really, it's really important to not cut out protein. But if we're talking about, you know, we're talking about, you know, just a person that's younger than 60, I think it really depends on a lot of factors. When you're hearing about this protein and longevity, you're hearing about a combination of animal studies and observational studies. We've talked about the observational studies. The observational studies mostly have to do with cancer. And it's basically animal protein versus plant protein because animal protein, you're getting more protein, you're getting more of the essential amino acids.

There's a higher cancer risk if you consume more of the animal protein, but only in people with an unhealthy lifestyle factor. People that don't have unhealthy lifestyle factors have the same cancer risk as like people that are eating plant protein. So people that are not obese, that are not sedentary, that are not smoking, that are not binge drinking, excessively drinking. they're eating animal protein and they have the same cancer risk. So again, it's like you got to look at the details. You have to look at the details here. Animal studies, a lot of studies have done protein restriction where they've got like an animal model for cancer. And if the animal has a tumor, then restricting protein will extend its life.

Well, that's obvious because when you eat dietary protein, particularly essential amino acids, you activate IGF-1, which is a growth factor signal, which is really Great for muscle, great for the brain, not good for cancer because it allows cancer cells to overcome other mechanisms that would otherwise kill it. So I think that there's just a lot to consider here. I'm not too concerned about eating protein because I'm again, you know, I think if you're physically active and you're not overweight and obese, you know, eating protein is not a huge concern. I think exercise is like the most important thing that's to consider here. Am I exercising? Am I obese and overweight? If you're obese and overweight, like, you need to lose the weight. Like, you need to lose weight.

You can do caloric restriction. You know, there's a variety of ways that help lose— there's a variety of ways to get into a calorie deficit. And I think, you know, skipping meals helps with— is easy for people to do. And exercise on top of that helps because you also can burn more calories. The combination of those two really helps. People lose weight. Some people can lose weight on a ketogenic diet. A lot of people end up also calorie restricting on a ketogenic diet because you can only eat so many foods. You know, so there's that aspect as well. So I just think that like being obsessed with protein and going vegan, if a person's unhealthy, then, and they're not going to try to like become healthy. In other words, they're not going to become physically active.

They're not going to try to lose weight. They're going to keep smoking. Then probably you should be a vegan. Like, it's probably better. It's in your best interest. But if you're not someone that's smoking and, you know, obese and someone that's not sedentary, then I'd, you know, keep working out, keep exercising, you know, and I think that probably not the best to just eat all day, every day red meat. But, you know, eating protein, I don't think is something that's going to take years off your life. So David Hanson in the chat is saying that apigenin is being taken to reduce CD38 so that NAD levels in seniors will be higher. I'm not sure that that's really going to happen. I think one of the best ways to increase your NAD is to exercise and to do time-restricted eating.

Your NAD levels go up in between meals. Your NAD levels go up in a fasted state, like they do. I think another way to really increase NAD is to lower DNA damage. One of the biggest factors that sucks NAD is having to repair DNA damage. So, you know, making sure that you're getting all your micronutrients, that you're exercising, that you're keeping all those repair processes in check, I think is another good way. Now, you know, the apigenin to activate the CD to reduce the CD38. I mean, like, I don't know if that's really happening in people. There's just not evidence that it is. Yes, and John's mentioning in the chat alcohol. Alcohol is another— like, alcoholics, like, deplete their NAD+. So basically, like, reducing alcohol intake is another way to increase your NAD+.

Okay, so this was a question submitted by Andrew, and Andrew asks, how much salt or sodium do you recommend consuming daily for optimal health? The Dietary Guidelines for Americans recommend 200 and— sorry, 2,300 milligrams daily, but it seems like a lot of research supports consuming 3,000 to 4,000 milligrams. Many processed foods are full of way too much salt, and so I think there's There's actually a manyfold problem that we're going to discuss in the answer to this question. One is that, obviously, I think people are eating processed foods, which are high in sodium, and so high sodium can become a biomarker for an unhealthy diet because of people that are basically eating out a lot, eating packaged foods that are really high in sodium.

There is a link between sodium intake and high blood pressure, but this is mostly found in people that have a single nucleotide polymorphism in the SLC4A5 gene. For those of you that have done a 23andMe or an AncestryDNA, run your genetic tool— I mean, run your raw data through our genetic tool, and it'll tell you whether or not you have that SNP, because we have data on that one. But it is important to keep in mind, and I never see people— there's been a sort of push against this whole sodium is bad for you from some people, and I don't necessarily agree with everything they're saying. There's generalizations, and I don't like generalizations. Is that as people age, their sensitivity to blood pressure-raising effects of salt and sodium increase.

And so sodium reduction in the context of a healthy dietary pattern may really benefit older adults, especially those that are at increased risk for high blood pressure or cardiovascular disease or even kidney disease. So it's not like this one-size-fits-all thing, you know, where like, oh, salt's not bad, everyone should eat lots of salt. Well, actually, like older people don't Older people do become sensitive to it. Like, that happens. That's a real thing. There are situations where people that are exercising excessively, particularly a lot of endurance training and/or sauna, sauna combined with it, they can sweat out a lot of sodium chloride, and that can lead to hyponatremia. So headaches, nausea, vomiting, those are muscle cramps, fatigue, those can be side effects.

So people that are doing a lot of endurance exercise, doing a lot of sauna, and the combination of the both, probably should increase their sodium intake. Honestly, I think people are getting enough sodium. I think they're getting enough sodium. They're getting enough from every— it's everywhere in foods. It's just everywhere. The actual adequate intake for sodium is 1,500 milligrams a day, but for salt, it's 3,800 milligrams a day. I think people get these things confused, the difference between sodium and salt, which is sodium chloride. So the adequate intake for salt is 3,800 milligrams a day. For sodium, it's only 1,500 milligrams per day.

I actually think the real problem is not that people are eating— I think that people— I don't think the problem is that people are eating too much salt and that's what's causing blood pressure problems and cardiovascular disease in most people. I think the problem is that they're not getting enough potassium. There is a sodium-potassium ratio that is extremely important for for blood pressure, for cardiovascular health, for renin-angiotensin system. These sodium-potassium ion channels in our cells are regulating this. And potassium, the adequate intake for potassium for men is 3,400 milligrams a day. For women, it's 2,600 milligrams a day. Almost 96% of the US population does not have adequate potassium intake.

Look at your foods that you're consuming, look at the potassium levels in them, and, and see if you're meeting that adequate intake. You're probably not. And so because sodium is working in conjunction with potassium, when that ratio is off, that throws off the systems, that throws off blood pressure regulation, it throws off the renin-angiotensin system, it throws off things. So I actually think It's a lot more productive to focus on consuming foods that are high in potassium, and those food sources—I mean—you can find online. You can do searches. Nuts are a good source. Pistachios, especially avocados, are a good source of potassium. Potatoes are a good source. Bananas, spinach that's cooked, lima beans are a good source. Squash, really.

I mean, these are the foods that are high in potassium, and they're the foods that most people are not consuming. So I'm not sure if that's exactly what you wanted to hear, but that's my two cents on. on sodium. Any idea why a person would have chronic low sodium? I mean, there are some SNPs that regulate that. And so, like, some people sweat a lot. They have, like, a sweating problem where they're, like, they excessively sweat with even just a little amount of activity, like walking somewhere. I actually have a friend who has this. And so, they lose a lot of sodium chloride through their sweat, and so, they have to keep replenishing with electrolytes or it becomes dangerous. So, there are situations where people have these SNPs in genes that do this.

Phil is asking in the chat if I have any thoughts on a possible synergistic effect between sulforaphane and sauna in terms of detoxification. So there's really different mechanisms that are being activated between these 2 types of stimuli. So with the sulforaphane, you're activating the phase 2 detoxification enzymes and you're inactivating the phase 1 biotransformation enzymes. And both of those things are happening through activation of a genetic pathway called the NRF2 pathway. And what that essentially means is that deactivating the phase 1 biotransformation enzymes is deactivating enzymes that can convert things that are pro-carcinogens into carcinogens. So it's— so we, you know, we're exposed to these things when we cook meat, when we cook, you know, food.

I mean, like heterocyclic amines, these things, like, you know, our bodies kind of detoxify this stuff and they do it through a variety of mechanisms or They can also convert it into something more harmful. And so, what NRF2 activation does is basically stops enzymes from converting something that could be potentially dangerous into something that actually is dangerous. It also activates the phase 2 detoxification enzymes, lots and lots and lots of those, glutathione, probably one of the main most well-known ones. And so, you end up excreting some compounds like benzene, acrolein, things that you can be exposed to from breathing in air pollution. Or eating cooked food, but you're also increasing antioxidant activity like glutathione. So that's happening with sulforaphane.

With the sauna, you're sweating out a lot of heavy metals, like cadmium is a big one. And I really think that's important because you actually excrete cadmium through sweat. Yeah. Like, I forgot the exact number. It was like 100-fold or something more than urine. And so, you want to sweat. You want to sweat to get rid of cadmium. And cadmium is in everything. It's in chocolate. It's in tea. I mean, it's just— it's in foods and stuff that we're eating that are even beneficial for us. So, if you can sweat, you're going to get rid of that cadmium, and that's a good thing. Diane says, I am a 68-year-old woman who has benefited from 10+ years of hormone replacement therapy. She mentions a book and wanted to know if I can cover this topic.

And I just wanted to say that, yeah, I would love to cover hormone replacement therapy on a podcast. So, you know, it's not going to happen like in the next 6 months or anything like that. But I think I'll probably start looking into an authority that's that covers this topic and then try to reach out to them and have them on the podcast because I would benefit tremendously from learning from an expert. Okay. Jessica says, Aloha, Rhonda. Could you share what a day's worth of meals look like for you? I'd love to know some examples of breakfast, lunch, dinner, snacks, desserts that you have on a typical day. I'd also love to know some of your favorite recipes that you haven't yet shared online.

I've seen your smoothie recipes, salmon roe stacks, etc. What are some other go-tos that provide optimal nutrition? Okay. So like I said, I do time-restricted eating and I don't— a lot of people that do time-restricted eating for whatever reason decide that they're going to skip meals. So they'll skip breakfast to increase their fasting window. I don't do that. I eat breakfast. I don't skip dinner. I don't skip meals for the most part. I have done that and I occasionally, if I'm trying to do more of a let my organs rest kind of deal, then I will do like a one meal a day, but that's not something I do every day. I mean, it's one of those things where I do that occasionally and it's more of the trying to have more of a repair rejuvenation process happen. So it's not like a daily routine.

Typically for my breakfast, I always try to go high protein, high protein, and I combine that with something that I would consider gut health promoting. So examples are, I usually do either boiled eggs or I'll do scrambled eggs, and I'll do my scrambled eggs with some arugula and a little bit of feta cheese, or I'll do some scrambled eggs with some spinach and cheddar cheese. But I usually try to do high protein. And then I'll combine the eggs with either a kefir smoothie with some berries, or I'll combine it with a kale berry avocado smoothie. So most of the time I'm having eggs and some kind of smoothie, either kefir or a kale berry. And the kefir one also has berries. So the berries are in both of the smoothies. So that's it.

Like this morning I had scrambled eggs, with a little bit of cheddar cheese, and then I had some kale, blueberry, strawberry, avocado collagen powder smoothie. So that's my breakfast. Like I said, mostly I focus on the high protein, so I'm doing the eggs. Lunch, lunch I sometimes do high protein, or sometimes it's kind of low protein and it's a little more of a snack kind of thing. So it depends on like what I'm doing. Sometimes I'll do lunch, I'll have like sardines and an avocado. I definitely, if I'm doing like a keto round, I do sardines and avocado for lunch. I also— or mackerel. I do mackerel as well. Or sometimes I'll do like that canned wild Alaskan salmon. So I'll do that with some lemon. Or I'll do some nuts and apple slices and like a little bit of cheese with the apple slices.

Or sometimes I'll do quinoa salad with some spinach and some— Maybe some broccoli or something in there. And then for dinner, dinner is also protein and veggies. So for dinner, if I had a salad for lunch, then I'll do grilled veggies for dinner. If I didn't have a salad for lunch, then I'll probably do a big salad for dinner. But I always have either grilled veggies or a salad on the side. And then my protein examples include, I'll bake some salmon in the oven. I usually do wild Alaskan salmon, or I'll do some Cod sometimes, or mahi-mahi sometimes. Most of the time I do salmon. And then I also do chicken kebabs. I'll do some chicken kebabs or chicken thighs for my protein source for dinner. Or I'll do— sometimes I'll do a filet mignon.

So, or, you know, sometimes I'll stir fry my chicken with the veggies if I'm doing the grilled veggies. But again, it's mostly like a protein veggie Combination for dinner for me. Paul's asking how many eggs in a breakfast. For myself, it really it really depends. Like if I'm not, if I'm gonna also do my lunch and stuff, I usually just I'll do like three three eggs is good for me. Now my husband does four; he's bigger than me. So Jane's asking if you do three meals, how do you do TRE? Like this is my point. Like this is my point. Like, you don't have to skip meals to do time-restricted eating. Like, it's not like that. I think somehow on the internet that got popularized. And I don't— I guess it's just easier because you don't have to then think about timing.

And so it's like, you know, like if you get up at like the same time every morning and, you know, eat breakfast at the same time every morning, then You know, figure out when you when you know if you want to eat within an eight hour or ten hour window, figure out when you have to eat your last meal, and then you can eat three meals within that time window. You don't have to skip meals. Time restricted eating does not mean skipping meals. It does not mean skipping meals. That means that's caloric restriction. When you skip meals, that's caloric restriction. You're restricting your calories. You're not eating enough food. So I really I think that you know you have to. You have to kind of keep that in mind, that time-restricted eating does not mean you have to skip a meal.

Maybe people do that for convenience, you know? I, like, I just don't, I don't quite know. For me, I usually eat, I usually eat breakfast at 8 o'clock in the morning, and then I have dinner at 6. Like, I'm a little bit, like 5:30. It's like 5:30 to 6. I'm usually done around 6. You know, there are times that I cheat and I am, you know, I eat a little bit later than that for social reasons and that's just fine. But that's my— that works for me. And if you're eating from 8 to 6, like, there's plenty of times to eat 3 meals. I mean, there's no reason you have to cut out, you know, 3 meals for that, right? So I really think that Please, please keep in mind, time-restricted eating does not mean meal skipping. It does not.

Meal skipping is more equivalent to caloric restriction because you're restricting your calories. You're not— you're skipping a whole meal. You know, it's not like time-restricted eating has to do with eating your food in a restricted time window so that you give your body time repair, so that you're eating more in line with the circadian rhythm of your metabolism. Those sorts of things. Roman's asking about egg yolks for choline. We're going to get into that actually in just a minute. Hi, Rhonda. I think a lot of us are interested in receiving some kind of updated pregnancy protocol. Like if you were pregnant now, what would you do differently or what supplements would you add? Also, if you could give some practical tips for those of us who do not have access to the supplements you used.

a choline supplement that's not available outside of the US, also a DHA phospholipid supplement. So I think one of the things I might do different is I would add some pomegranate juice to my pregnancy protocol. I mean, there was a study that I just tweeted a couple of days ago where pregnant women were given either a placebo calorie-matched controlled drink or pomegranate juice. I think it was like 8 fluid ounces, if I recall. You can go back on my social media and check. But I mean, it improved brain connections, it improved visual development. I mean, it was beneficial for infants. So I thought that was pretty interesting. And it certainly wasn't harmful and it was better than the placebo group. That might be one thing I would probably do differently.

For people that are trying to get choline and are worried about like not getting a good supplement, what honestly what I did during my pregnancy is I was eating, I had eggs every single morning for breakfast. Like every single morning I had eggs during pregnancy and egg yolk is really high in choline. So Yeah. 3 to 4 eggs will provide like 400 milligrams of— it'll give you like 400 milligrams of choline, like what was done in the randomized controlled trial in the women that basically were supplementing with choline and then had children that had scored better on intelligence quotient tests and stuff like that. So I think the eggs, egg yolk, so 3 to 4 eggs, I think is absolutely a good supplement for a choline supplement.

I think for the DHA supplements, you know, getting— just getting a high enough dose of omega-3 is really good. And some of the high DHA quality supplements that I've looked into that if I were not taking my friend's supplement that I get, N-Pure 3, that I would take: Sealicious, AMB Well Incorporated, CytoMax, Aqua Omega High DHA. If you're in Europe, San Omega GmbH. And if you're in Canada, CanPrev. Those are, those are the high DHA supplements that I would suggest if, if I were wanting to take that. So I'm going to put this in the chat for you guys. Okay, there we go. Those are the high DHA supplements that are, that are high in DHA and actually like third-party tested. High in DHA and also have a low— a total oxidation lower than 10. So the next question was from Hillary.

Hillary says, I'm wondering if you have suggestions for skincare for aging wrinkling skin, particularly with too much youthful sun damage. I know you've mentioned one product from Cellbone that you love, but what does it actually do? Is there research on reversing damage through internal or external sources? Would love to know what has been researched. Thanks. Okay, so with respect to the topical serum I use from Celebone, it's called pH Neutralizer. It's full of sodium lactate. It's got willow bark, hyaluronic acid. It just has a bunch of good stuff in it. And one thing it does do is it has an immediate skin plumping effect. There's hydration that happens. And so I do think that even someone that has had sun damage would benefit from having that on their skin.

And while it's on your skin, your skin, it really does plump up. It helps hydrate it. So that's something I do think that would be beneficial. It's really one of my favorite products. I've been using it since 2012. I mean, it's been 10 years. The other The other things have to do with internal sources. So hydrolyzed collagen powder, I've mentioned this before, we have a topic page on it. It's— there's a whole section if you look at the table of contents on skin. And there's studies like randomized controlled trials that have shown women that have taken hydrolyzed collagen powder have improvements in skin wrinkle depth, in skin elasticity, you know, all those sort of measurements of youthful skin. And this isn't compared to a placebo.

So please check out our hydrolyzed collagen topic page on foundmyfitness.com topics pages. And then go to the table of contents and click on the skin section and you can read all about it. I really think it works. I've noticed a difference when I, you know, stop taking it. So I do try to add it in something, either a smoothie or in my coffee or something. I've also been using some of the collagen water. You can buy some powder that you can add to your water as well. It tastes a little bit better, but again, it's back to that monk fruit problem of daily consumption. So, you know, you just never can win, right?

The other thing that's really been shown to improve, you know, wrinkle depth and skin elasticity and things like that is some of the polyphenols present in chocolate and specifically in like cacao powder. And so I use CocoaVia for that reason. So, and I'm going to get into CocoaVia in a minute in a little more detail, but what, and what I use, but like cacao powder is another, is another, I think, option as well. Merrilee is asking in the chat, how does hydrolyzed collagen work when it gets broken down into amino acids? To get into the body. It's wild that it reforms this collagen and goes to the skin with taking it orally. So if you again click on the hydrolyzed collagen topic page, we talk about this.

There have been animal studies that have radiolabeled hydrolyzed collagen powder, fed it— or hydrolyzed collagen peptides— fed it to animals and then followed it in the body. And intact collagen peptides make its way to like the joints, for example, and stuff. They didn't follow skin in that study, but But there's intact collagen peptides that make it through to other parts of the body. So again, hydrolyzed collagen topic page. It's a really good topic page. Like, we've really gone in depth on these topic pages. So please, please check that out. Luis is asking if CocoVia is available in Germany. I would check Amazon Germany because it's available on Amazon. So that would be your best bet, probably.

Is asking about urolithin A in vivo conjugation of urolithin A to urolithin A gluconide dramatically hampering its activity. I'm not aware of this, Xavier, but if you want to submit it as a deep dive question, I'd be interested in looking into it. Is asking if CoQ10 is okay to take while pregnant. That's a it's a it's a really interesting question because there have been some studies showing that some polyphenols like the ones in cacao are beneficial if taken during the first trimester of pregnancy, but can be detrimental if taken in the third trimester. And personally, I I really I didn't take cocoa via during pregnancy. Now I did once in a while drink. some hot cocoa, but I wasn't going crazy, and I certainly was a lot more cautious during my third trimester.

Can you give your thoughts about the 2 major trials on omega-3, the REDUCE-IT and the STRENGTH, where the first trial, which used purified EPA, showed incredible benefits, and the other one that used both EPA and DHA and stopped early showed no benefit? Chad, please, Go back and check out my podcast with Dr. Bill Harris. We talked about those 2 trials and the differences in tremendous detail. So I highly, highly suggest that you go back, go to the Bill Harris episode page and click on the timeline. You'll see in the timeline where, where, if you don't want to listen to the entire like 2-hour podcast, if you go to the timeline tab, You can find where we start talking about this because we have it documented in the timeline. It's really good. And Bill is the expert, hands down.

And so I really, I don't want to spend time just going, hashing over exactly what he already said. Go back and listen to that podcast, please. And you submit questions in the Ask a Question tab at the bottom of the Crowdcast screen. So for the next upcoming Q&A, which is Q&A number 36, You would go down there and you would click on the Ask a Question tab at the bottom of the screen and then submit a question there. Where you guys are now, where we're communicating, this is the live chat. This is not where you submit questions for me to do deep dives. This is where you submit questions like while I'm here online and we talk. This is how we communicate in the live Q&A. So the next question I've gotten Some shape or form. This question was submitted by Aaron.

Aaron says, "Is electrolyte supplementation something to be considering when combining time-restricted eating with sauna or exercise, where you're sweating a lot?" Mostly every day during the middle of my fast, I'll be undertaking some activity that I will sweat a lot. And after watching Andrew Huberman's podcast episode on salt and hydration, it got me thinking about necessity of electrolytes in what I imagine. Is a very common case for a lot of your listeners. Um, I want you to just keep something in mind that there, there are a lot of podcasters that will be promoting podcast, um, products. They get paid to do that.

And, and so sometimes if something's getting talked about, like, you know, like there's an electrolyte product or something that's sponsoring the podcast, just keep that in mind. Like the being objective and unbiased is It's a little bit challenging when you have a product you're trying to, you know, sell, and the more you sell, you get like a percentage cut of it. So I'm just— and that kind of pertains to the next question as well. I don't think it hurts to replenish electrolytes. I do think a lot of the electrolyte drinks out there and packets or whatever, they all contain either stevia or monk fruit. A lot of them contain stevia.

And again, it's one of those things like every single day, if you're doing it in your coffee, if you're doing it in your electrolyte drink, if you're doing it in your water, if you're— I'm like, how much of this stuff are we getting? What is it doing? I mean, you know, in small enough doses, it seems to be fine, but like, is there some kind of little insidious thing we don't know about? And I'm not trying to make you scared. I'm just telling you the way I think about it. The way I think about these non-nutritive sweeteners is I think you can get tricked into thinking, oh yeah, they're safe. Oh, they show this good thing. So I'm going to just consume it. I'm going to consume it every day and maybe even multiple times a day.

Like, we don't have studies showing that, you know, consuming it every day, multiple times a day, it doesn't have a negative effect. Like, you're kind of going on faith there. So it is something to keep in mind. I don't often— I mean, I will sometimes consume electrolyte supplements after I do endurance and a sauna. These days, mostly I get a green juice, and a green juice has my sodium chloride, it has my magnesium, it's got the stuff I need. So I'm not like consuming the non-nutritive sweetener and all that stuff. So that's kind of my go-to, honestly, to be frank. So there's another question. I've gotten this question so many times and it's about Athletic Greens. And the question was, would you address taking Athletic Greens?

I think once in the past you didn't like it because of the blue-green algae. It's endorsed by Peter Attia, David Sinclair, Andrew Huberman, and more. And so I'm wondering if it would be a good idea to include it in any other greens powder daily. Again, Athletic Greens pay— they pay podcasters to advertise their products. Okay. So Please keep that in mind. Just as a, you know, something generally speaking, when you start to have people talking about it and they're sponsored by it, I mean, it is a potential COI, conflict of interest. Not necessarily, but it's just something to keep in mind. I've looked at Athletic Greens. I've looked at it. I've looked at the ingredients. Like, there's nothing special in it.

There's nothing special in it compared to like taking a high-quality multivitamin, to be honest. Like pure encapsulations. They have all the alpha lipoic acid in it and ubiquinol. And again, the amount of it in the Athletic Greens, it's like in some proprietary mixture and probably it's a very low amount. I see a negative effect with Athletic Greens because in addition to nothing special, it contains both chlorella and spirulina, which are blue-green algae, microalgae. They're blue-green algae and They contain microcysteine and it's a problem. I stay away from all— anything that has spirulina and chlorella in it, I stay away from it, which sucks because sometimes I'm like, oh, I want that cool smoothie, but nope, it's got spirulina. They're contaminated with that stuff.

And so I just— I don't think it's good to take every day. And people have reached out to them and asked them for their data and they won't give it. They won't give their microcysteine data on it. It. And I find that to be a little suspicious. So I personally, I just, I think it's, I frankly think it's like, there's nothing about it that's special at all. People are talking about it. It's created buzz. Athletic Greens has found that they can have podcasters advertise it on their podcasts and they do well because it gets buzz generated and stuff. So that's my thought. David submitted a question. David says, hi, Rhonda, you've talked about how hard it is to get into actual ketosis, yet other people like Dale Bredesen talk about a mild ketogenic state.

Does that make any sense or have any benefit? Like, is ketosis an on or off thing, or is it a matter of degree? Just as an example, I have a friend who thinks she's on a ketogenic diet just because she eats a lot of keto snack foods. Okay. Oh man, like there's nothing worse than keto snack foods. Like keto snack foods are the absolute worst. Nobody should eat them. Like don't eat keto snack foods. They often contain refined sugars, by the way. Like my mind is blown away by how many people do not read the nutrition label and they look at the— it says keto, this is keto, and It's basically— it's got added sugar as well as a bunch of other things in it. It's essentially got no nutrition. So I would stay away from keto snack foods. I think mild ketosis is good.

And I do think Dom and I really talked a lot about this in the podcast I released a couple days ago. It's a 2.5-hour podcast with Dr. Dom D'Agostino. Really, really great podcast. Go take a look at our timeline tab on our episodes page on the Dom D'Agostino page. You will see, I mean, just we cover so much ground. And he talks about mild ketosis and talks about, you know, over the years how he's kind of— he started out with like this real hardcore ketogenic diet and like over the years now he sort of modified it and he follows more of a modified high-fat, low-carb diet where he's in a mild ketosis state. And he does this also with the addition of supplemental ketones. Again, supplemental ketones usually have the sweeteners. I'm going to keep putting that back in your head.

But I do think mild ketosis is great. And so, you know, but maintaining mild ketosis also, I think the best way to do that, and I was able to maintain mild— I was trying to get into deeper ketosis to kind of test my limits as well. But I have now found on repeated occasions that I can eat a diet where I'm eating a lot of high-fat foods like avocado, salmon, walnuts, macadamia nuts, olive oil, olives, and fish, sardines, and then also eat vegetables. And even if I do a sautéed spinach, which has a lot of vegetables, it'll kick me out of deep ketosis, but I will still be in mild— I will still be 1 millimolar and above. I'll still be like in mild ketosis, and I do think there's a benefit for mild ketosis.

There's a benefit in and of itself, and this kind of takes us back to the beginning of our Q&A with the time-restricted eating and differences with caloric restriction. You know, I think one of the things that people don't think about is that when you are in a fasted state, you know, when you're undergoing that metabolic switch. Which Dr. Mark Mattson has coined the phrase and talks about. Like, essentially, you're shifting your metabolism from burning carbohydrates to burning fatty acids and using ketones as fuel. Beta-hydroxybutyrate, the major circulating ketone body, is interesting. It's interesting because it's not only providing an alternative energy source, for many other cells, including your brain cells. It's also a signaling molecule that is changing epigenetics.

It's changing the activation of genes. It activates brain-derived neurotrophic factor. I mean, it's, it's also been shown to basically make mitochondria spit out less reactive oxygen species. So your mitochondria become more Effective and efficient. And so, it also has been shown to like lower inflammatory biomarkers. I think that beta-hydroxybutyrate is interesting. And if you think about what it takes to get your beta-hydroxybutyrate levels elevated, you know, you have to deplete your liver glycogen stores. You have to not have food and deplete them. And that typically happens anywhere between 11 to 13 hours. And depends on a person's carbohydrate intake. It depends on a person's physical activity, but I think there's a benefit.

I think there's a benefit to having some beta hydroxybutyrate elevation every day, and we do have a topics page on beta hydroxybutyrate, so go check it out. We'll be adding to that topics page, but I'm I'm I'm very interested in somehow, and you know, like I think that. The time-restricted eating is one way to help get there. I think additional ways are exercise with the time-restricted eating and also sort of, you know, eating a diet that is, you know, it is more rich in healthy fats and healthy protein and healthy carbohydrates. So you're not— you just— you're eating more fibrous plants and less— You know, refined junk. So I do think there's a benefit there for that. All right, a few more rapid-fire questions. One was another one was from both James and Leech Leechy P Turner.

They ask, as in your interview with Tony Robbins, what stem cell therapy did he use? Tony went to Panama. He went to the Panama Stem Cell Institute, and he received treatment from Dr. Neil Riordan. MJ asks, what brand and dose of sublingual zinc do you use when dealing with an illness? I use Life Extension. I think their dose was like 20 milligrams. Their zinc lozenges, I think, were about 20 milligrams. If someone were funding you to do a study, what hypothesis would you test? I would test the effect of an 8-hour eating window, time-restricted eating window, with when you're not skipping meals, you're not, you're not skipping protein, so you're not like doing that severe caloric restriction, but you're just doing within a time hour, 8-hour window, what effects it has on autophagy and mitophagy and mitochondrial function and beta-hydroxybutyrate levels and, and gene activation from those levels as well.

Quite a few supplements are now available in liposomal form in order to improve bioavailability. Is it preferable to take poorly absorbed supplements like curcumin or berberine in this form? If so, is there a way to know appropriate dosage since studies on efficacy and safety have typically been done on non-liposomal formulations? She says, I am trying to take liposomal— a liposomal form of berberine, but I have no idea how to determine an appropriate dose. I would— with liposomal supplements, it's a really fine balance. To be honest, I think it's better for nutrients like like you're trying to take at an onset of illness, like liposomal vitamin C, where you can raise your blood levels higher than if you were to just take regular ascorbic acid.

Liposomal glutathione because glutathione without liposomal form doesn't you can't absorb it. Like it doesn't get it. It doesn't get transported into cells. Liposomal curcumin. This is often referred to as Meriva. I think this has been shown to be more beneficial if someone's taking it for like pain reduction, like osteoarthritis or inflammatory cytokine reduction as well. I'm not sure I would go overboard on liposomal. I wouldn't take liposomal berberine. I wouldn't go liposomal for like all sorts of compounds and stuff because again, as you pointed out, Like there's differences in dose and, you know, berberine, honestly, it's one of those things that you do want to be very careful with and follow what studies have shown and not like deviate from that.

So I wouldn't, I really wouldn't go crazy on that. Rob asks about sulforaphane not being listed on the topics page. He says it would be nice to have an authoritative summary on sulforaphane benefits and are you still taking sulforaphane? So Rob, this is in the works. We will be having a sulforaphane topics page. I think that what we'll initially release won't be like the most comprehensive ever, or like we'll never get any— we'll never release it because there's always something you can add. But we are actually actively working on that topic page. So that should be soon. And I do still take Prostaphane, which is the active form of sulforaphane. basically one of the most active forms of sulforaphane that you can find. Hi, Rhonda.

Just wondering if you changed your skincare routine during pregnancy. Did you use the Cell Bone Neutralizer, any face or body moisturizers? What about sunscreen? Are you concerned about nano mineral sunscreen particles? I used the Cell Bone— my Cell Bone Serum throughout pregnancy. I didn't do body stuff. I didn't apply a bunch of body lotions and stuff like that. I did sometimes use a sunscreen. I mostly wore big hats, but the sunscreen that I used is no longer— it's sold out everywhere. It was John Masters Organics, and it was a zinc oxide formula. So, I mean, I do think pregnancy is a time to be careful with all sorts of topical applications of things. And so if you're pregnant in the dead middle of summer, vitamin D is a great thing.

And I don't think that one summer without massively applying sunscreen to your body is going to really affect your health. And in fact, it's probably better to be more cautious about what's being absorbed into your bloodstream and what's crossing over into the placenta as well. Okay. We're about to wrap up this There's a few more rapid fires I'll answer real quick, and then that'll be the end of this Q&A. So the next question was from Rebecca. Rebecca says, hi Rhonda, you've mentioned that refined sugar intake can contribute to skin aging. Can you talk more about this? If the mechanism is related to excessively high blood glucose, would eating sugar after a high-fiber, high-protein meal help blunt the effects over time?

It is actually related to— To sugar intake, Rebecca, but mostly through the formation of advanced glycation end products. And I do think because advanced glycation end products form when blood glucose is elevated for a longer time period, that if you do reduced blood glucose levels, so exercise would be another way to do it, like immediately after meal, like go do some double unders or go, you know, go do a hill sprint or something. Something to get the blood, the glucose taken into your muscle would be ideal. And I think that would be one of the best. There was a study that showed that physical activity reduced like skin wrinkles by like some crazy amount, like 20 to 50%, somewhere like that.

And I do think some of that has to do with the fact that people that are physically active are lowering their blood glucose levels at any given time through the physical activity because glucose is being taken up into muscle and therefore advanced glycation end products, which kind of cross-link collagen and end up— you end up losing collagen elasticity. And so I think that if you can avoid that, your skin's going to look better. I am homozygous for the MTHFR. 1298 gene. My homocysteine is high at 14. My doctor says to take 1,000 micrograms of methylated folate. Is that the right amount? What brand do you recommend? Do you take it? So first of all, I cannot give medical advice. Please, please listen to your physician. I can tell you I do not take 1,000 micrograms of just methylated folate.

I do take my Pure Encapsulations. I don't have— I'm not homozygous for that same SNP, by the way. So it's not necessary for me. The folate that I do take, I do get some methylfolate, but it's also in the form of folic acid. It's a mixture, and that's from my multivitamin that I take, which is One by Pure Encapsulations. My mother, however, is homozygous, and I do give her, in addition to her multivitamin, she takes 1,000 micrograms of methylfolate from Pure Encapsulations. And Rebecca says, how far apart Should you separate vitamin C and vitamin E supplementation from exercise?

Again, most of the studies that have involved blunting effects of supplemental antioxidants have been from high-dose vitamin E. In fact, some of the— almost every single study with vitamin C included vitamin E, high-dose vitamin E, and the ones with vitamin C alone didn't have an effect. You can find this on our vitamin C topic page under the exercise section. We have a whole section on our vitamin C topic page, goes into detail on this. So I don't take high-dose vitamin E. The vitamin E I get supplemental is only in my multi, which is about 30 IUs. That does not blunt exercise-induced adaptations. It's like 400 IUs is what does it. It's just an enormous amount. So I'm not too obsessive, but I usually take my vitamins.

I usually have about a 5-hour separation between my my vitamin intake and exercise. Rapid-fire question. What is your take on giving children 5 and 3 years old vitamin D K2 by Thorne, which has 2 drops of 25 micrograms vitamin D, which is 1,000 IUs, by the way, it's 1,000 IUs of vitamin D and 200 micrograms of vitamin K2? Again, I cannot give medical advice, but it's my opinion That 2,000 IUs a day for a 3 or 5-year-old may be too high. I think 500 IUs is what I gave my son when he was 3. I was giving him 500 IUs a day of vitamin D. And then now that he's 4, I give him 1,000 IUs of vitamin D a day. So I think 1,000 IUs is pretty good for the body weight of a Of a 4 and 5-year-old. So I think that's it. And I want to thank everyone for submitting questions and for attending these Q&As.

I really, really, really enjoy them. If you guys enjoy these Q&As, these Q&As support— they support the podcast, they support the videos that we put out, they support our topic page articles we put out. So please, please tell your friends, tell your friends about these Q&As if you really enjoy them. Help me spread the word so that, you know, we can continue supporting the content that we put out for free and that we try to do our very best at doing. So thank you again so much. I will talk to you guys next month. I'm giving a keynote lecture at the Metabolic Health Summit in Santa Barbara this coming Thursday, May 5th. If you want to attend that lecture virtually, You can use— there's a code. Patrick is the code, my last name. You can get 20% off the virtual link.

It's at metabolichealthsummit.com. And I'm giving a presentation on something I've never presented before. So it's going to be fun. It's going to be a new presentation. So I'm really excited about it. And in fact, as soon as I get off this call, I'm going to go through my, my talk because I put together my slides, but I haven't practiced it yet. So hopefully we do good. With that said, thank you so much, everyone. I hope to see you all next month, and we'll talk soon. So bye.