Barbell Shrugged - How Your Cardiovascular System Improves Metabolic Health w/ Dr. Nathan Jenkins, Anders Varner, Doug Larson, and Travis Mash #783

Episode Date: January 29, 2025

Dr. Nathan Jenkins is the new labs analyst for RAPID Health Optimization. He was previously a tenured professor of exercise science, and has worked for many years as a nutrition coach with over 1000 clients to date. Dr. Jenkins blends evidence-based practices and real-world experience, with academic expertise in lifestyle modification for chronic disease prevention, and a passion for helping clients optimize body composition and develop sustainable health habits for longevity. Work With Us: Arétē by RAPID Health Optimization Links: Dr. Nathan Jenkins on Instagram Anders Varner on Instagram Doug Larson on Instagram Coach Travis Mash on Instagram  

Shrugged family, this week on Barbell Shrugged, another banger from one of our awesome friends that works with us here inside Rapid Health Optimization, Dr. Nathan Jenkins. He has a PhD in cardiovascular health, how it relates to metabolic function, dysfunction, I should say, and he does a massive amount of work inside Rapid with us on all things, kind of the visible side of things, training, stress, sleep, lifestyle, as well as the hidden side of the analysis on labs, lifestyle, and supplementation, nutrition. So he really is an integral part to our team. And today on Barbell Struggler, we're talking about cardiovascular health, a little bit of deep dive into the lab side of things, as well as his real specialty. He was a professor at University of Georgia actually really

funny because every time you see that you're expecting somebody to say go dogs I know I did which is I actually think I make that terrible joke twice now that I've said it now and in the show but if you enjoy all of this make sure you head over to RSA lab.com that is the signature program here inside rapid health optimization where you can take a deep dive into all things lab, lifestyle, performance, the testing and analysis that we will be doing on you. And if you are very interested and you would like to schedule a call, you can do it all over at aretelab.com.

That's A-R-E-T-E-L-A-B.com. Friends, let's get into the show. Welcome to Barbell Shrugged. I'm Anders Warner. Doug Larson. Coach Travis Smash. Nathan Jenkins. Dr. Nathan Jenkins.bell Shrugged. I'm Anders Warner. Doug Larson. Coach Travis Mash. Nathan Jenkins. Dr. Nathan Jenkins.

That's what we're going to call you today. Typically. That sounds good, man. Thanks for having me. We got the PhD on here today. Today on Barbell Shrugged, we're going to be talking about cardiovascular health. And specifically kind of starting this thing off, getting into metabolic health, type 2 diabetes. And one thing that's super interesting

about cardiovascular health to me is anytime, or I would say it's like the highest level. What do people always say? I need to work on my cardio and have no idea why they need to work on it outside of, they think they're going to like go run better. Um, but that's, that's probably like just scratching the surface on exactly what they need to be understanding cardiovascular health for and depth that we're going to be getting into today. And I'd love to start just kind of understanding as far as like metabolic health, type two diabetes, things that we're seeing, um, you know, population wide, how does cardiovascular health, health, uh, kind of start to scratch the surface on the like health optimization side or, uh, living a

better life, um, on the metabolic health side? Yeah. Well, I'm one of the things I'm really fascinated about is, uh, the connection between metabolic health and cardiovascular health. It's been a long time, uh, in my university training, my graduate training, and also as as a back in my academic career i was a professor for a long time at university of georgia nearly a decade um and one of the main nobody even said go dogs in that when he said that's like it's like what you're supposed to say right yeah yeah go dogs it's a sort of disappointing year for us but we've you know uh well it ended in a disappointing way. It was a good year, but, um, yeah. Uh, so as far as that connection between metabolic and cardiovascular health, um, trying to improve your cardio and, and being more than just like, you know,

trying to run better and stuff, man, it's, it's literally, um, kind of a, it can come to a life and death thing. It is, uh, something that absolutely plays into our overall longevity. Um, so for example, I think I heard a recent podcast where Dan was talking about this too, and it bears repeating, um, something like around, um, fasting blood glucose concentration of, um, once you start to get above like 85 milligrams per deciliter, there's sort of a linear relationship between cardiovascular mortality. So like you might be at like a 95, which is in the normal range. Anything under like under 100 is still considered clinically normal. But there's a sort of a quantifiable linear relationship between cardiovascular outcomes and fasting glucose concentrations,

just use that as one of many metrics that we could talk about. For example, even within that normal range, we begin to see a marked elevation in cardiovascular risk. So it's really important, I think, to be thinking about optimizing our metabolic health. It's not just glucose, but like insulin and all of the sequelae that come from when these things are out of whack, it gets into oxidative stress and inflammation and immune system inappropriately activated and all of these things.

Gut health, you fill in the blank and there's a metabolic connection to it. And again, for a long time, that interest for me, because it turns out the thing that actually kills the most people is a cardiovascular either event or disease. And so that's where I go way, way, way back to when I started my training.

I was like, well, A, I'm really interested in the cardiovascular system. I'm interested in blood vessels, but what's a really important problem to focus on as far as like somebody, that's something I advise I give people going into grad school or whatever. Find something that's really actually important problem to focus on as far as like somebody, that's something I advise, I get people going into grad school or whatever, but I find something that's really actually important. Right.

And to me, that seemed like a pretty important problem to spend a lot of time and thought on is that connection between metabolic health and cardiovascular health. So. Yeah. One of the everybody that's been listening to the show for a little while knows that I just went on like a year long journey to running a really fast mile or trying to at least. And in that process, the idea of running and cardiovascular fitness and VO2 max, you can't really help it. You go through a whole year, you're thinking a lot about your cardiovascular system. And I started creating the framework in my brain of like

doing the, when, you know, there's kind of like the, the high intensity sprinting side, there's like a VO two max training side. And then a lot more on the, uh, just call it like zone two side of things. Yeah. Yeah. Break those into three, three main groups and really thinking about the speed and efficiency of how well my body is pumping blood and oxygen to the muscles to be able to use them. And, um, when I think now about kind of that, that zone two slow thing, I really think about it more of just like speeding up the kind of the intensity that my, my body is processing blood, like just getting good at practicing moving blood faster. And when you're looking at like a, the VO two max training,

that's like trying to get your body to train like a Ferrari. Like if you're going to, you got to be able to see how long you can push your system to be as efficient as possible. And you start to get really good at it by training that. And then the sprinting side of things kind of being like, how do we just overload the system as quickly as possible so that we're really like in, in like a weightlifting terms, like building like a one or a two rep max so that everything else from a five to an eight to a 10, 12, something along those lines, like is just an easier and done at higher percentages of that bigger numbers. Um, when, when you think about, um, kind of like developing that system, how important is it to be in like, or are they equally balanced and training from high intensity sprints? Do we need people really nerding out on like the, the podcast that they

heard where it's like, you have to do three bouts or four bouts of VO two max for 45 minutes. And it has to be in this heart rate. Like how do you kind of coach people in each of those and understanding what's really important for being healthy? Yeah. Well, yeah, I think my first thought is it really depends on the goal. Um, and like, Andrew's your goal of getting as fast as you can at the mile is sort of a different goal than being overall health, overall healthy. But I think think it's different but there's a lot of overlap and it's probably more similar than it is different my my view on like let's talk about metabolic health in the context of exercise um and you alluded to this in your description i

think that was really cool like you got the the one engine the one so we got these different metabolic engines right the different metabolic pathways you got the phosphocreatine pathway you got the glycolytic pathway. You got the oxidative pathway. And they're all sort of different engines that our body uses to produce fuel. And my personal belief for optimal health, and one of the key words in the name of the company is rapid health optimization is that an optimal exercise protocol will develop the capacity of all of those systems to some degree. Now that's,

that's sort of for overall health. Absolutely. And so like that sort of baseline, so we're like, I don't, I don't, it's not the word, but let's, let's use it for analogy, but going back to the engines thing sort of like your, your ability to idle and maybe ramp up to some significant degree. That's your oxidative system. That's like that zone two. That's hugely important. That is your foundation for sure. That's how we train such that like a practical application that I like to think about is why do I do zone two?

Why do I include that in my program from a longevity and health standpoint? Well, I don't want to be at my VO2 max. And when I'm, so I'm a little over 40 now. And I think I like to think in terms like 20, 30 years down the road. I don't want to be what should be a zone two stimulus, like getting up out of this desk chair that I'm sitting in and walking across my house

to go let my dog out after this call. I don't want that to be a zone four zone five activity. Right. Yeah. So now I, I, a big part of my, my training now is to do a lot of what's in my, my zone two capacity. Now to sort of keep that main sort of maintain the foundation of my, of my metabolic fitness. And then you get into the, you know, the higher zones and you get into the intervals with the VO two max training and the, and the hot top end sprint intervals, the Ferrari drag race kind of stuff.

To a certain degree for health, for sure. And we absolutely program that for our clients, right? Every week they're getting some dosage of that. we sort of go up and down in terms of our emphasis with the different components of our, of our metabolic fitness, depending on the individual's goals. Like, so somebody has got a real competitive goal. Like I want to run a mile in under six minutes and then, well, geez, we're going to do a lot of top end stuff each week. And, you know,

a lot of time at that way above threshold. And a lot of it too, is just adapting. Like that's really, you want all of those engine, those, those energy systems to be at high capacity yes it's primarily an aerobic component but you're doing a whole lot of glycolytic uh work at that and those you know uh in an effort like that it's going to hurt the entire time and you got to get used to a lot of those trainings between the years just being uncomfortable that entire time too so um yeah it's all of it. So I love all this stuff. Yeah. I'm curious if you have some degree of vascular damage from, from many years of inactivity and poor nutrition habits,

et cetera, uh, as you begin to implement more and more healthy lifestyle choices and even better food and getting better shape and more cardio and all the things are, are you really reversing any of that or are you just like slowing down the progression of it from there on out that's a great question your your vascular system that's a great question doug um and there's a lot of sort of debate in the literature on i'll start specifically with atherosclerotic cardiovascular disease. That's something I've followed quite a bit. The evidence, as I understand it, is that all of us have some degree of atherosclerotic. That's the presence of plaques in your arteries.

It is very, very difficult to promote regression of the plaque through exercise alone. There's been a lot of studies on like in animal models and looking at human subjects through exercise intervention alone. It does not seem, I'm going to go ahead and say evidence points to it, not being all together that likely that you're going to see a lot of plaque regression is probably not possible. But just that's without like any other

intervention there's like a lot and there's purely from exercising exercise yeah um there but it can stabilize the plaque uh progression there isn't in this in the human clinical data on this is from uh trials where they look directly at the plaque over a period of time like say anywhere from six weeks to six months of an intervention. And we could see evidence of stabilization of the plaque. Like it may not get worse, but including with like

high intensity interval training, some really cool studies is particularly coming out of Europe using a technique called IVUS, intravascular ultrasound, where they put an ultrasound probe in the vessel and kind of get this 3D rendering of the vessel.

Some really cool stuff from that. But yeah, not a whole lot of evidence of actually regressing the plaque um but through other maneuvers like nutritional intervention and that typically includes weight loss maybe it's uh some evidence of regression and then uh certainly with certain pharmaceutical interventions uh statins and so forth. Again, evidence is mixed. Not every study shows this. And I honestly have to look at the very latest to see what the current consensus is. But, you know, you see certainly in the literature, some reports here and there of plaque regression. Probably not complete reversal, not completely like, oh, my God, the artery is clean.

But, you know, significantly favorable clinical outcomes in terms of the plaque regression plaque morphology another big thing is plaque stabilization uh the plaque can stabilize and even if it does the the amount of plaque in the vessel doesn't change so much uh the plaque can take on a morphology where it's where it'll get like a fibrous cap on the top of it and uh become less prone to rupture and it's's really the rupture of the plaque and the dislodging of a blood clot, of a thrombus that typically is the cause of most myocardial infarctions, most cardiac events. And the vessel can become less prone to that with lifestyle and some pharmaceutical intervention.

So before we go on, I want to answer the question with the second part, as far as like exercise or nutrition or any lifestyle modification, I was just talking about a very specific, but also really important case of like what happens with the plaque. All that being said, it's also true that studies have shown significant improvements in vascular health and other like peripheral vascular health health a lot of a site that's common to look at for vascular health is sort of a somewhat of a proxy for the whole body is the brachial artery um the the dilatory capacity of the brachial artery or also um start to look more and more vessels of the legs so the popliteal artery is a common site to look at

and that's important because that's's the vessel that supplies blood flow to the working muscles during most forms of exercise, like walking, running, cycling, whatever have you. Those, and also the microvasculature, small vessels. We have lots of measures that I won't get into for that. By and large, exercise training, nutrition, improving your diet, all that good stuff, reducing oxidative stress reducing inflammation uh a lot of those indices of both large vessel and small vessel health in the periphery of the body are very amenable to to lifestyle changes so and that in the last few minutes has been uh a condensed version of a course i taught at the university on cardiovascular

physiology and pathophysiology. Right. So like, and I like to compartmentalize it in terms of like the vessels that supply the heart and where you get the atherosclerotic cardiovascular disease, it's like kind of truly a life and death situation and also systemic vascular health. It's not always the same answer. It depends on where you look throughout the, throughout the arterial tree, as we like to put it. So it uh yeah that's a lot uh sorry so complex answer but basically we should be doing the things that we know that are good for us

because that's going to be good for your cardiovascular system yeah 100 so so does the plaque build up piece and then you can you can have a piece of plaque kind of break off and then it ends up like giving you some type of peripheral vascular issue as it floats down to the smaller arteries of of the limbs and legs and then you have that you have the um your coronary artery issues and then you have brain issues where you could have some type of of a stroke right those kind of like if if something breaks off then it's you're in trouble uh if there's a thrombus then and if it's large enough it's that at some point so like as the arterial tree goes through its various branches, right, the diameter of the arteries gets smaller and smaller and smaller. And so you got a blood clot that's floating through and it may go through the large pipe, the conduit artery just fine. And you get to what we call the first order arterials, maybe just fine.

Second order is starting to squeeze through and then the third order arterial, then you're stuck, right? Or, you know, just depending on making that up as I go. But at some point you're going to get to a pipe that's too small to accommodate that chunk, the grombus that's floating through. And then anything downstream of that, anything distal to that and that is subservient to that vessel's blood supply, we're going to have an infarct, which is what we call the death of the tissue, or at least a lack of blood flow supply and deoxygenation of the tissue. And the worst case of this is death of that tissue.

And if that's in the coronary circulation, that's bad news. If it's in the cerebral circulation, that's a stroke. And if it's in the lower, so this is a big problem in peripheral arterial disease and atherosclerotic disease of the lower body. You can get an infarct of the cat. This is what, this is also very much correlates with metabolic disease, coming back to the original topic of conversation, right? Type 2 diabetes and peripheral arterial disease really really track together so you get uh you see a lot of uh the lower limb amputations in the cases of diabetic peripheral arterial disease so you've got really poor circulation and a lot of oxidative damage to begin with

and then you get the acute event is that infarct of the lower limb and and there's really no hope for the tissue to heal so the best thing that the medical care team can do for that patient is to cut it off. I remember my grandfather dealing with a lot of that. Like he would get a little blister on his foot. Like, you know, he was a farmer. He had this huge, we had a 600-acre farm in the deep Appalachians. He would be driving his tractor all day and they come home and you just get a blister that would just turn into the, it would just be the grossest.

Yeah. And like, it would be months. I mean, I'm trying to deal with it. And sometimes you end up in hospital and it's just terrible. Yeah. It's terrible. It's awful. And it's, it can be, they can be painful. They can also be, if there's a neuropathy there they may not even feel it um so and then a lot of times these kids i talked to um several i i know in this in my area several vascular surgeons and they'll be like yeah the uh you know this patient didn't even know that they had the this wound that was sort of festering and not healing and

then they said one day they'll go in and it's like wow too little too late and we gotta cut this thing off man so it's yeah it's really awful stuff it's really awful it's always seemed wild to me that type 2 diabetes seems like this thing where if someone comes to me or just like a regular person is oh yeah my uncle's diabetic everyone's like ah yeah bummer you know like but like it's like it's almost like it's not that big of a deal it's like it's like common enough to be um i was probably to put this like no one thinks it's almost like it's not that big of a deal it's like it's like common enough to be um i was probably going to put this like no one thinks it's a good thing but nobody's like terrified of it like if you get cancer you're fucking terrified of it but if you get diabetes can't see my face when you say it that's terrified if you got if you got some other

random disease and someone said oh i've never heard of that what happens and they go oh you have to amputate my feet or i might go blind people go holy shit like that's a big deal but like when someone says they're diabetic they go oh that's a bummer it's so normalized that if you just said the symptoms only yeah people be like yeah what do you do you'd be like well you got to go for a run you literally but you're gonna you know you gotta actually control it yeah you gotta come back from that you just people just won't yeah yeah let's actually talk about that like you can't really technically on paper like cure it but it's like it's very manageable at least like very manageable with with many interventions can we just like run through a list of like like the

top things that you actually have control over that you could do to move the needle and kind of control that that disease state yeah well i'm actually i actually believe that for a large swath of cases um it is it is reversible as long as the pancreas is still able to produce to produce insulin um then it is it should be largely reversible um and and there is now like in the last few years, the American Diabetes Association has sort of come out with an adjusted position stand where it's like type 2 diabetes is actually a – they define in the setting in which it can be – it can go into regression or – I have to double-check the language.

They shy away, I think, from using the term cure. But – and again let's i mean we can talk about definitions that if we define a positive diagnosis of of type 2 diabetes is the hba1c of 6.5 well it's possible to get your hba hba1c below that right um and then again yeah well you can absolutely like people if you're at 7.2 with lifestyle intervention, which again, going back to Doug's question, it's things within your control. Without medication and the insulin, the pancreas is still, the beta cells are still producing insulin. Yeah, so yeah, the things in your control.

The lifestyle stuff, man, it's the physical activity and it's the nutrition. Usually it's, not usually, it activity and it's the nutrition. Um, it, it usually it's not usually, it's almost always, uh, a big problem is again, within someone's control is excessive caloric intake, typically typified by excessive, simple carbohydrate consumption that is, um, that's causing dysregulation of, uh, you know, glucose control. And so that's reduced. So first thing is if you're drinking any of your, uh, your, your calories in particular, drinking your carbohydrates in the form of simple sugars, well, just replace that with diet Coke or water. That's a step number one. Um, and that will go a long way to getting your caloric excess under control, getting back towards calorie balance,

and also getting the excess of glycemic load into your body and more in keeping and matching with what your metabolic output actually is, which is really what we're after. So that's one. And then two, move more. The skeletal muscle contraction is the best way to get glucose out of the uh out of the circulation um which again type 2 diabetes or excessive glucose in any context diabetes or pre-diabetes or otherwise is a problem of of uh more fuel than we need

so increase the need rev up the engine man uh and so that and it doesn't have to be going back to i think it was anders asking about like which of the metabolic uh my interpretation of it was which of the metabolic systems do we need to be firing on man maybe it's zone two will still be a significant glycolytic or uh glucose uh utilizing activity for sure i mean a lot of it will be used aerobically but yeah if you've got it, then the muscle will use it and it'll take a bloodstream. So you got to tell sugar where it's supposed to be used, not just sit there. Yeah. Yeah. So yeah, the sink is the problem is the sinks are full, right? The, uh, the muscle sink is full. Uh, if you're not, if you're, if you're sedentary and the liver sink is full, so

it's just, uh, there's just like traffic jam in the, in the circulation. We need to get that out. The best thing to do is just to move. Right. So, um, and interesting, it's all, I know this is, this will probably be common knowledge to a lot of the listeners of this, of this podcast, but, um, in case not, it turns out, it's the exact same transport mechanism, uh, between insulinimulated glucose uptake by the muscle and contraction-stimulated glucose uptake. They both involve the same receptor. It's called GLUT4.

You can use insulin to get the GLUT4 receptor on the cell surface, or you can contract the muscle and get GLUT4 receptor on the cell surface. There's slightly different initial pathways, but in the side of the cell, they converge and it becomes sort of more or less the same mechanism. And so even in the context of insulin deficiency, you can still get that glucose out of your circulation is the bottom line. So going back to like,

if somebody gets a diagnosis of diabetes, it's like, oh, well, maybe it's no big deal because they can just get on for the first line of defense is like metformin and there's all these um second and third line defenses and ultimately you know it's insulin but still even that is not looked at in the societal level it's all that big oh you got insulin you're fine you got exogenous insulin um what if you didn't actually need to use or you could reduce your dose just by contracting your muscles a little bit, right? And so, yeah, there's a lot within your control when it comes to glucose control.

And we're talking in the patient population now, regardless of where they are on the disease progression, even at advanced stages, there's a lot within your control to mitigate disease, even if it's not reversible at that point. Yeah. mitigate disease, even if it's not reversible at that point. So, yeah. Earlier, you made a comment about, about something that Dan has said on the show many times about once your glucose is above 85, for every point above 85, I believe the exact number there is you're 6% more likely to become type two diabetic. And so if you're out of 95, you're 60% more likely to be type two diabetic, even though you're not even technically on the type, you're not even on the pre-diabetic list, which is a hundred, which is above a hundred rather. It's very interesting how we kind of have these, like these lines in the sand where it's like, you're fine over here. And then you're like, you're not fine over here, as opposed to like

the spectrum of like, you're on your way and you probably should do something while you're on your way. And I kind of attacked the problem much, much earlier. Aside from, aside from blood glucose, like are there any other markers where you could like very clearly see that you're, you're on your way to having a bad time with your metabolic health? Of course there's many, but like what are the top markers and like what, what are like the, the numbers that you would pay attention to before you've crossed over like the medical line oh yeah um well dude that's it's a great point this gets into the difference between like of how a physiologist kind of looks at some things and how clinicians and i don't want to shit on clinicians clinicians have to have diagnostic

criteria then it becomes like a binary yes no right and that's where like the 100 and up comes from for glucose and that's where uh that for like that that line between normal and pre-diabetic right but the fact is physiology is not binary like that it's linear a lot of times i mean there's some there are some things that can operate like a threshold phenomenon but a lot of these variables are absolutely more like more linear and that is the nature of the biology here and it's really interesting that there's this disconnect from a clinical standpoint on that so anyway just kind of uh that's something i think about all the time um and i appreciate so much how dan and you guys and this company thinks on a more linear scale like like let's look at each data point or variable for what it is is

it something that we need to be paying attention to, even if it's in quote unquote, the healthy range or not? But yeah, some other metrics, man. The other one that comes to mind is, it's very much related is the A1C because there can be a spurious, like fasting glucose reading due to like, say you didn't get a good sleep that night. Maybe you did have a bigger meal than usual and you got a little bit of residual.

You know, a single measurement of fasting glucose is not sufficient to make a big deal about anything. But the A1C, man, that's the average of three months of overall blood glucose, right? That's due to the fact that it's a permanent modification of your red cells and the lifespan of a red blood cell is about four months. And so it's the way it works out as far as turnover rates and everything. It's regarded as like a three-month sort of average glucose or a reflection of your average blood glucose over the previous three months. So that's another, man, that's a good one. So that can circumvent the issue of, well, what if this is an outlier if I just look at my single one-off reading? And then some other ones that I would look at are glycemic responses to, and what I mean by that is the change in blood glucose following either like a standardized meal or just like throughout the day.

So that gets into, I'm not going to sit here and advocate for continuous glucose monitors for everyone, but like if somebody has got concerns about their blood glucose, um, whether it's a one-off or maybe more than one off, uh, fasting blood glucose concentration, or A1C is a little higher kind of borderline. You're getting into like the 5.5, 5.6, 5.7 range, pushing up on that 6% number, then maybe just like get some strips. You can, you know, health insurance companies

tend to cover them. Or even if not, they're not terribly expensive, just like the CVS or whatever. Just get some blood glucose strips and eat your normal food, eat your normal meal and see what is my glucose response to my normal diet, like my normal breakfast meal, my normal lunch meal. And a good number, I mean, the American, the International Diabetes Federation recommends that our post, what we call our postprandial,

our blood glucose concentrations after any meal, regardless of what it's composed of, should never really exceed about 140, which sounds kind of low because the clinical guidelines go way above that, or other clinical guidelines, I should say, go above that. So if you're at any point, like that two-hour mark after a meal, that two-hour, well, I would say between one and two hours, if you're exceeding 140 milligrams per deciliter on a regular basis, uh, in a postprandial state, then, then that could be some signs of, of some problems, specifically insulin resistance of the, of the body's tissues, like the muscle, um, and, and liver and so forth. Um, postprandial is mostly muscle driven and yeah, that's a good sign that again it circles back to the same shit like we need to be working out we need to be moving we need to be exercising right

and also you can also there's two ways then all the other just finish the thought um reduce the carbohydrate content of that meal is probably in excess of what you need um yeah right so so are you gonna ask doug no i was no i was one i was curious i was gonna say just in you know being from the mountains like man i'm gonna make sure i send this to every family member i have it's just like it's so rampant like yeah you know i've grown up you know growing up my uh my mother's always been worried about me because my grandfather had it and you know eventually took his life and my grandmother on the other side had it and eventually took her life but i've never had to even it's never been close it's just like dude

yeah uh are you remind me match are you in north carolina virginia no north carolina yeah that's what i thought you live in is it what part of asheville area brevard no no asheville is actually a lot nicer than where i I'm from near Boone. Boone? Oh, yeah, yeah. Yeah, yeah. I'm from Asheville called West Jefferson. Okay. I know Boone. Yeah, I love that. You live in one of my favorite parts of the entire country. It's awesome. Yeah, it's beautiful. And similar in my family, I was born and raised, I don't sound like it, but I'm born and raised in the state of Georgia. Oh, yeah. And my, my whole family is very similar story. I mean,

um, heart disease and diabetes, quote unquote, runs in my family. Right. And like, it's, and it's always just,

I grew up here and it's like, oh, your genetics are working against you. Hell no. We should be eating genetics. Come here. And you'll know, right?

Like every night, gravy, gravy on everything like absolutely we had green beans from the garden but chicken fried everything I saw on Instagram did you know that you can chicken fry

an egg I saw somebody chicken fry an egg with the breading and everything and in the inside the egg the yolk was still like running it looks freaking good I almost might try it thing and in the inside the egg the yolk was still like running it looks freaking good thank god i almost might try it i almost might try it actually to perform versus like you know the mountains you just you need to enjoy and you know like the whole family i mean we were just all

like every day at like 5 30 like not just my immediate but like my grandfather grandmother cousins aunts uncles stay that daily ritual single day yeah like it was so good man but yeah like and nobody leaving there feeling good though yeah like yeah chocolate gravy you've ever heard of that my grandmother the most delicious stuff in the world but that's that's way up way up yonder in those mountains kind of thing yeah bro i think you're right from you wouldn't even be able to communicate my wife dug in his nose my wife what do you even get out of the car where i'm from like i was like hey let's go walk around she's like hell no i'm not getting out i want to see it i want to come visit come visit i'll take you just get you get your accent back real quick uh yo i want i want to jump in on a

comment that you made earlier about about movement um you were saying that uh you have you have glute four transporters that are responsive to insulin but they're also responsive to muscle contraction they they kind of go from the inside of the cell to the cell membrane and pull glucose into the cell. That's a good thing for many reasons. So I think it's very common nowadays for people to fall into the trap of still leading a fairly sedentary life.

You're on your laptop all day. Like that's what I do most of my work these days is just sit at my desk on my laptop and then I go train for an hour. And I feel like I'm a pretty healthy person. Even if I was like sedentary most of the day, but I got my one hour workout in that still doesn't really check the box all the way for like, for, for movement. There's that checks the box in my mind for exercise, but it doesn't really check the box for movement. There's gotta be more movement throughout the day. Um, so, um, a, I want your thoughts on

that. And then B for, for people that, um, especially doing damage control on like Thanksgiving dinner and things like that, or you're going to a birthday party, you know, you're gonna eat a bunch of junk or whatever it is like, uh, how do you use movement to kind of mitigate the downside of days where, you know, you're going to be eating not so well oh yeah uh great great questions um where does which one do i want to tackle first man because they're both really good let's go i'll start with the first one which is um essentially like you're working out so you're checking the box i'm working out but basically maybe not getting other a lot of other movement in really easily dude gets jacked never hits 10 000 steps correct yeah i was gonna go to steps uh i was gonna go to steps i man i've

been that's something i've been experimenting with personally i mean we can talk about the science but also think listeners value like personal anecdotes from from folks like us and i'm just gonna give mine i started paying closer attention because okay my thought process was i'm going to go back to the sort of the end of 23 um i had i've always for the last five six years maintained pretty decent body composition at that point it's getting pretty damn lean um you know or 10 10%, 12% body fat, um, and sort of sustaining that. I would take that. Yeah, no, it's good. But like, I, I just like, I'm also, it wasn't,

and there wasn't any marker that I said my glucose, I had to look at it was, was at the time, but it was fine. But I, I just like, man, I want to do more. Well, I was getting more and more into running. So I started to pay attention to my steps in that way, but just like day also, just like that daily basal activity, um, trying to do more of like walking my dog.

Sometimes like the poor guy walking twice a day. Um, I've got a little boy. He was about 18 months at the time. He's coming up on three now, but you know, we, we play outside as much as we can and try,

try to accumulate steps that way. And so I started monitoring like my proxy, my metric for all that was steps for me the more i can get up to about 20 even including up to and above 20 000 steps in a day almost universally the better i feel um now that's really anecdotal right and that's very nebulous i don't have a concrete metric for that but just like if i just rate myself feeling i'll give you like um feelings of energy even though i'm burning more energy but just feelings of like sort of mental energy brain power lack of brain fog um like all that stuff like i'm moving closer to like closer to 10 out of 10 on the scales almost it's kind of a linear relationship

my basal like what i try to maintain about 12 to 15,000 steps in a day, it's been hard because it's fucking cold right now. But in the, in the summer, spring and summer months when I can, and that, that doesn't, I will say that does include, like, if I go for a run that it's, I'm tracking on my watch and I'm not going to subtract out the, some people are like, oh, if you're going for a run, that doesn't count. Well, I count those. So anyway, man, I think, and I have to think that that is a, well, I will tie it back to the metabolism thing. If somebody is already checking all the boxes on their nutrition and on their training, frequency, volume, intensity, hitting, getting all the, that dosing, right.

But there's still, maybe they want to optimize their glucose and it could be any other metric, but that's an easy one that we can kind of keep with the theme. Say they're tracking it like 93, 92, 91 and still want to get back down. Like they've got the Dan Gardner mantra etched in their brain and it's stressing them out. Well, I want to get back to the 85 because I want to get that 6%, every 6% that I can get, I want to get it, right? Well, maybe steps, maybe daily activities is a lever to pull. And so it's been a while since my last checkup was in August. I got another one coming up in May around my birthday. I'll be curious to

see. I hope I'm, I hope I'm in that, like in the eighties at least. Right. Um, and not, and not in the nineties. Um, and I will, I do think that that's, uh, again, the, the, the, the daily activity, the daily steps thing, if you're already checking all the other boxes, then that's a really good one. And that's an area for improvement or for growth. The other caveat that I want to give at the same time, I don't mean to talk out of both sides of my mouth, but this is just from work with a bunch of my nutrition clients over the years. Telling somebody to move more, to walk more when they're already fucking maxed out in terms of like all this life commitments and stressors like they've got they got three kids

they got a job they're driving their kids everywhere so like for activities and stuff like oh i guess i gotta get my so i'm gonna wake up at 4 a.m and and just make myself miserable and stare at a white cinder block wall on my treadmill in my basement let's that let's not work like we gotta like be realistic here and and weigh the benefits and drawbacks with all these different maneuvers so i wouldn't like sacrifice sleep for the important point like um i actually think if possible figuring out how to play things go just kick it with your kids like that's like the easiest that's the easiest way to not

have like that's that's actually the part of the zone two conversation that drives 100 is how many people really have 45 extra minutes three to four days a week to just sit on a rowing machine and go slow and go at like 120 beats per minute no No, but like playing with my son is my zone too. Like it can't be. Absolutely. If I look at my watch. It's like a soccer ball. Yeah, yeah, yeah, yeah, yeah, yeah.

And the parents out there, one of the biggest things, we kind of joked around, I think, on some of our weekly group calls at times, like there's a whole meme about the alpha dad and all that kind of stuff. Well, you know, one of the ultimate uh alpha dad yeah i think and and i we're we're cutting the same cloth because i'm totally that way too oh yeah um but we need a team party i want to see who's yeah yeah no there's no no shirts ever uh when other when other especially when other dads are around right oh yeah but flex sure but truly though like one of the things that i think about using my fitness

for is to not sit there i don't want to be one of these dads it's just they're watching i want to fucking participate like we had our first ever snow in georgia like in five years a couple weeks ago and i will say this, all the, all the parents in the neighborhood were actually active. They're playing with it. I love to see it. But I'm like,

and yeah, I'm like right there with all the kids, like going down the, down the slats, going down the Hill and next to neighbor's house and all that kind of stuff. If my son's in the pool in the summer, I'm in there with them and not,

I don't want to be sitting there getting my suntan. Right. I'm in there with it. Right i don't want to be sitting there getting my suntan right me too i'm in there with it right exactly like it's parenting like kids are freaking active they're running everywhere that's a huge opportunity to get some to get some activity in so if you participate participate versus spectate that's that's an easy choice right um and then maybe you don't need to stretch yourself out about getting on the rover and all that. I think that always comes down to the environment that you are building around yourself to succeed. I just, I just became a farmer like a month ago and it's,

Oh, congrats. Yo. Okay. That sounds pretty alpha. Yeah. It's gangster, man.

I was climbing trees with a hatchet last weekend, chopping down stuff so I could build hunting stands. Are you kidding me? The dude just overnight turned into something. Testosterone. I'm not making it until I make it. Totally faking it. But when you are up moving and wheelbarrowing and like,

in the suburbs, you're like, I don't want to do that yard work. When this, when you like design your life, that that has to be done, um, you're going to find 20,000 and you're not even, you don't even think about it. It's just, uh, you're constantly doing things. You just have like a, it's like a job to do on a daily basis. It's just, you chose this life. And now every Saturday, Sunday, Friday afternoon, whatever it is, it's like you're hitting 15, 20,000 steps in the afternoon and you don't, it's just built into your life. Yeah, man.

My favorite days are in the summer when, so if I had the schedule allows spring and summer schedule allows, like I can get wake up in the morning, get a CrossFit workout in, maybe go for a run and then do yard work all afternoon. And those are my 25,000 step days. And that's the best. And if you want to give up like 60% of your money, you can move to San Diego and you can walk forever. Yeah. You can do, you can do all this shit year round. Yeah. Yeah. Yeah. I was just talking to someone about San Diego this morning.

I love that city. It's the greatest. the greatest that's actually uh i can't afford it it's on fire right now they're right like no that's la la i thought i thought they both were okay i knew la la's like oh man it's not good yeah um yeah that that was really uh living in san diego was actually like a turning point in life where it was like i have to go do all these things like the sun is so perfect there that you just it's amazing and then you just become addicted to it you can't and then it disappears for like january and february in north carolina and i'm like where did my happiness go yeah yeah it's really bad it's a piece of my life yeah it's tough even here in georgia it's better it's way better in georgia than other but i lived in m here in Georgia, it's better. It's way better in Georgia than other places.

I lived in Maryland and Missouri for a while. It's way better here. Yeah. But still it's rough. I can't, I'm ready for the spring to come back, man. That vitamin D,

that sun. I know, I know it's a good, it's not bad here. Cause it's like, it's like 40 to 60 days of cold before the shirts come off again. That's, we can wait. We can wait. That's not even, I can handle can handle it. It's not even a, it's not even a quarter. Yeah.

I thanked you for being the guy who goes shirtless, you know, even at 32 degrees. No. Here's here's where 40 degrees is like to cut off. If you're going from 20 to 40 off, that feels good is off. If you're going 60 to 40, carp's off. If you're going 60 to 40, you're frozen. Completely frozen.

I actually had a client that lived in Alaska and she told me that coming out of the winter, they will, as soon as it hits like 34 degrees, they're all out sun tanning. They lay out.

They're all naked. They're like at the beach. They're just, give me some of that sun because it's been dark and cold. Yeah, yeah, yeah. They haven't had any happiness in a long time. And then all of a sudden, it just, it's there. Bro, on Sunday, we got trapped. We just decided to do a day trip to Boone and got stuck in a snow.

So we had to spend the night. Couldn't get back. Oh, my gosh. It was terrible. And when we left, following Monday when we left, it was nine degrees. And when we got home, it was 27. That's a big difference. Like 27 felt great.

I was like, man, let's go lay out in the sun. It's awesome. It's 25 here today or was this morning and all this Georgia people are crying. Doug, you asked the second question about like a big meal and what to do with how the, how the movement kind of plays into that. And that's a, I actually love that question as well. Yeah. Wrap on that for a second.

Yeah. We're taking down to the end of the show here. We've got a few minutes. Give me, give me your, your high level two minute answer that sure um the best thing you can do especially if you've had a significant glycemic load in your meal a lot of carbohydrates either healthy or otherwise most of the time i think in this context we're talking about otherwise you know cake you know whatever um the best thing you can do is move. Um, so that's a little bit of research we did. And, uh, as part, part of a much larger body of work. Um, so to give credit where it's due, it's a pretty big field on this, but one of the best

ways to manage what we call postprandial glucose excursions or big spikes in blood sugar following a, uh, carbohydrate rich meal is if you time it ideally between about 15 to 45 minutes after the meal, go for that, go for a walk or any kind of movement. But most of the studies just use walking because it's practical. Like that after dinner walk that you do with your family in the, in the evenings when it is nice and not 25 degrees outside, like we're talking about there's some,

maybe there's some sort of innate biological drive to like prevent diabetes or something from it i don't know but it turns out so if the graphs on this stuff is so cool and i wish this was a this isn't a if this is a video podcast i didn't come prepared to show it but um the the way i'm going to talk with my hands for for you guys because you can see me like the way the glucose curve after a meal looks it's like it goes up and up and up and up and if you time that the walk after uh to to begin about 15 to 20 minutes after the meal um it'll the glucose literally reverses and starts going back down um and and that that's sort of sustained as long as you walk for um and some of the studies we did we played around with anywhere from 15 to about 50

minutes and that 50 minute walk in particular was an interesting one where we broke it up into 10 minute bouts like go for a walk for 10 minutes and then hang out we had them just stand there and rest for three minutes just to kind of break it up because 50 minutes of walking for someone with type 2 diabetes uninterrupted was kind of daunting um but man that almost that really did a nice job of normalizing the glucose response and kept it from reaching those really dangerous high levels of postprandial glucose um and that's really important too because that postprandial glucose spike the magnitude of the spike that how high the glucose gets after a meal is very very um what's the word it It's a significant insult, significant toxic dose to the cardiovascular

system to the vascular endothelial cells throughout the body. So that's a great thing to do, man. Just go for a walk after a meal. That's probably more than two minutes, but yeah. As long as you train right afterward, you're more or less fine. Like, yeah, well, I think about all the time. Like if you go, if you think about like what a workout drink is, oftentimes it's protein and sugar. Yeah. Yeah. Yeah.

I mean, it's like you're intentionally putting sugar in your body during workouts or right before workouts or potentially right after workouts. And intra intra workout too. Like that's what I like for clients to do is if, if, especially if it's like a strength training session or you're broken up a little bit, drinking a this is very different than the diabetes conversation but like that's when you're uh taking in carbohydrate while you're using your muscles so you're actually never allowing the chance for like glycogen well even if you do get glycogen stores depleted you're not getting a reduction in blood glucose which is problematic for performance um but same kind of

it's the same biology absolutely um but like yeah in the case of an excess carbohydrate consumption from a from a big meal from a birthday cake or whatever it is um yeah you can mitigate that that cardiovascular insult that is a massive glucose spike it's the same biology when we shift gears and look at the performance side of things. We're trying to optimize, uh, carbohydrate availability for both the workout itself and also starting the repair process,

post-workout stimulate muscle protein synthesis and all that good stuff. Um, and usually you take that right along with like some whey proteins or that the, you know, the carbohydrate, that glucose is sort of co-delivered, co-transported as facilitates also the delivery of those amino acids for muscle

growth and repair. Yeah, man, it's all this muscle contraction combined with nutrient availability is, is, is a great thing, both for performance and for, for optimization, optimization of some of these health parameters too. So it's pretty cool stuff. Where can people find you, my man? Yeah, I'm on Instagram at Dr. Nathan Jenkins that's all one word and that's pretty much where I hang out I don't have a

TikTok I got a personal Facebook page but yeah that's the best place go Travis Mash not yet not yet mashley.com Oh, yeah, yeah.

The new homie at the helm here. Okay, so Mashedly.com. Read my articles at Jim and Weir. Or if you're local, try out North Carolina. Come see me rise into our sports. There we go. Douglas E. Larson. Right on. My Instagram, Douglas E. Larson. Nathan, appreciate you coming on the show, brother.

Man, thanks for having me. It was a lot of fun. Yeah, we're going to do this again soon. I'm on Instagram, Douglas C. Larson. Nathan, appreciate you coming on the show, brother. Man, thanks for having me. It was a lot of fun. Yeah, we're going to do this again soon. I'm Anders Warner at Anders Warner, and we are barbell shrugged at barbell underscore shrugged. And make sure you get over to rtalab.com. You know what that is? That's the place that you can find out more about our signature program, RTA, inside rapid health optimization. All of the lab testing, the performance analysis, everything health

optimization and performance optimization inside rapid health. That's a lot of optimizations. A lot of optimizations. I know. But hang out. This is what happens, Travis, when we have new things to talk about on the show. I'm not as like rapping. It's freestyle.

rsa.lab.com. Friends, we'll see you guys next week.