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

Episode Date: July 4, 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

Shrug Family this week on Barbell Shrug. Physiology Friday is back. Dr. Nathan Jenkins is coming in to talk about your cardiovascular system and how it improves metabolic health. That's right, you mature meatheads out there. Cardio is the thing that makes you happy and keeps you really healthy. As always friends, make sure you get over to rapidhealthreport.com. That is where Dan Garner and Dr. Andy Galpin are doing a free lab lifestyle and performance analysis. And you can access that over at rapidhealthreport.com. Friends, let's get into the show. Welcome to Barber of Shrugged, I'm Anders Warnor.

Doug Larson, Coach Travis Mesh. Nathan Jenkins, Dr. Nathan Jenkins. That's who we're gonna call you today. Typically. That sounds good, man. Thanks for having me. We got the PhD on here today. Today on Barber of Shr, we're talking about cardiovascular health

and specifically kind of starting this thing off, getting into metabolic health, type two diabetes. And one thing that's super interesting about cardiovascular health to me is anytime or I would say 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 gonna like go run better. But that's probably like just scratching the surface

on exactly what they need to be understanding cardiovascular health for and the depth that we're gonna 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 population-wide, how does cardiovascular health kind of start to scratch the surface on the health optimization side or living a better life on the metabolic health side?

Yeah. Well, one of the things I'm really fascinated about is the connection between metabolic health and cardiovascular health. I spent a long time in my university training, my graduate training, and also back in my academic career, I was a professor for a long time at the University of Georgia, nearly a decade. And one of the main connections- Nobody even said, go dogs in that when he said, it's like what you're supposed to say, right? 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 literally kind of a, it can come to a life and death thing. It is something that absolutely plays into our overall longevity. So for example, I think I heard a recent podcast where Dan was talking about this too,

and it bears repeating, something like around fasting blood glucose concentration of, 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 the normal range. Anything under like under a hundred 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, there begins, 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 the sequelae that come from when these things are out of whack and 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, I am 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 has something to advice that give people going into grad school or whatever. 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 question 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 high intensity sprinting side, there's kind of like the the high-intensity sprinting side there's like a vo2 max training side and then a lot more on the Just call it like zone two side of things. Yeah, the rubic base. Yep. 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 when I think now about kind of that zone two slow thing, I really think about it more of just like speeding up the kind of the intensity that 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. When you think about 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. 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 healthy. But I think it's different, but there's a lot of overlap and it's probably more similar than it is different. My view on like, let's talk about metabolic health in the context of exercise.

And you alluded to this in your description. I think that was really cool. Like you got 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 there's, my personal belief for optimal health in this, you know, 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 for overall health, absolutely.

And so that baseline, so like, idle is not the word, but let's use it for analogy, but going back to the engines thing, sort of like your ability to idle and maybe ramp up to some significant degree, that's your oxidative system, that's zone two, that's hugely important, that is your foundation for sure. That's how we train such that like 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? I don't want to be at my VO two max. And when 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 with my dog out after this call. I don't want that to be a zone four zone five activity. Right. Yeah. So now call, I don't want that to be a zone four, zone five activity. Right? So now, a big part of my training now is to do a lot of what's in my zone two capacity now to sort of keep that, sort of maintain the foundation of my metabolic fitness. Dr. Andy Galpin here. As a listener of the show,

you've probably heard us talking about the RTA program, which we're all incredibly proud of. It's a culmination of everything Dan Garner and I have learned over more than two decades of working with some of the world's most elite performers, award-winning athletes, billionaires, musicians, executives, and frankly, anyone who just wanted to be at their absolute best. Arate is not a normal coaching program. It's not just macros and a workout plan.

It's not physique transformation and pre and post pictures. Arate is something completely different. Arate is incredibly comprehensive and designed to uncover your unique molecular signature, find your performance anchors, and solve them permanently. You'll be working with not one person, but rather a full team of elite professionals, each with their own special expertise, to maximize precision, accuracy and effectiveness of your analysis and optimization plan. Arrate isn't about treating symptoms or quick fixes. It's about unlocking your full potential and looking, feeling and performing at your absolute best, physically and mentally, when the stakes are the highest.

To learn more, visit arretelab.com. That's a-r-e-t-e lab.com. Now, back to the show. And then you get into the, you know, the higher zones and you get into the intervals with the VO2 max training and the hot top end sprint intervals, you know, that the Ferrari likes like 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. But we sort of go up and down in terms of our emphasis with the different components of our metabolic fitness, depending on the individual's goals. So somebody's got a real competitive goal, like, I want to run a mile in under six minutes. Then, well, jeez, 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 adapted. 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 work at

that. And those, you know, in an effort like that, it's gonna hurt the entire time. And you gotta get used to a lot of those trainings between the years just being uncomfortable that entire time too. So 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 many years of inactivity and poor nutrition habits, et cetera, as you begin to implement more and more healthy lifestyle choices and eating better food and getting better shape and more cardio and all the things, are you really reversing any of that? Or are you just like slowing down the progression of it from there on out?

To what degree can you prepare your vascular system? That's a great question, Doug. And there's a lot of sort of debate in the literature on, I'll start specifically with that atherosclerotic cardiovascular disease. Something I've followed quite a bit. The evidence as I understand it is that with, when we 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 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. It's probably not possible. But just that's without like any other intervention. There's like a lot of, and there's a whole from exercising exercise. Yeah. There, but it can stabilize the plaque progression.

And this in the human clinical data on this is from 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 IVIS, 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, but through other maneuvers

like nutritional intervention, and that typically includes weight loss, maybe some evidence of regression. And then certainly with certain pharmaceutical interventions, statins and so forth. Again, evidence is mixed. Not every study shows this. And I honestly have to look at it to the very latest to see what the current consistency is. But you see certainly in the literature, some reports here and there of black regression,

probably not complete reversal, not completely like, oh my God, the artery's clean, but significantly favorable clinical outcomes in terms of the plaque regression, plaque morphology. Another big thing is plaque stabilization. The plaque can stabilize and even if the amount of plaque in the vessel doesn't change so much, the plaque can take on a morphology where it'll get like a fibrous cap on the top of it and become less prone to rupture. And it's the really the rupture of the plaque

and the dislodging of like a, of a, 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, less prone to that with favorable, with, with lifestyle and some pharmaceutical interventions. 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. A lot of site that's common to look at for vascular health is sort of somewhat of a proxy for the whole body is the brachial artery, the dilatory capacity of the brachial artery, or also started to look more and more at the vessels of the legs. So the popliteal artery is a common site to look at. And that's important because that's the vessel that supplies blood flow to the working muscles during most forms of exercise like walking, running, cycling, whatever have you.

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, a lot of those indices of both large vessel and small vessel health in the periphery of the body are very amenable to lifestyle changes.

So, and that in the last few minutes has been a condensed version of a course I taught at the University on cardiovascular physiology and pathophysiology. And I like to compartmentalize it in terms of the vessels that supply the heart and where you get the atherosclerotic cardiovascular disease, it's 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 arterial tree, as we like to put it. So it's, yeah, that's a lot, sorry. So complex answer, but basically we should be doing the things that we know that are good for us because that's gonna be good for your cardiovascular system. Yeah, 100%. So does the plaque build up piece and then 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 the limbs and legs. Then you have the coronary artery issues and then you have brain issues where you could have some type of a stroke, right? Those kind of like big three areas. If something breaks off, then you're in trouble. If there's a thrombus and if it's large enough, 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 arterioles, maybe just fine. Second order, start 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 the, at some point you're going to get to a pipe that's too small to accommodate that, the chunk, the brombus that's floating through and then anything downstream of that, anything

distal to that, that's, and that is subservient to that vessel's blood supply, we're going to have an infarct is what we call it, the death of the tissue or at least a lack of blood flow supply and deoxygenation of the tissue and in the worst case of this is death of that tissue. And if that's in the coronary circulation, that you're, you know, bad news, if it's in the cerebral circulation, that of that tissue. And if that's in the coronary circulation, that you're, you know, 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, this 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, you see a lot of 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 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 grandmother 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 600 we had a 600 acre farm in the deep Appalachians. He would be driving his tractor all day and they'd come home and he'd just get a blister that would just turn into the, it would just be the grossest wound. And like, it'd be months of him trying to deal with it. And sometimes it ended up in hospital and it was just terrible.

Yeah, it's terrible. It's awful. And they can be painful. They can also be, if there's a neuropathy there, they may not even feel it. So, and then a lot of times, I talked to several, I know in my area, several vascular surgeons and they'll be like, yeah, this patient didn't even know that they had 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 got to 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 two 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, I was sorry 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- People listening in their car can't see my face when you say it, that's terrified. Terrified of it. But yeah, like, if you got, if you got some other random disease and someone said, oh, I've never heard of that. What happens? You end up going, 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, it's a bummer. No big deal. Like, if you just said the symptoms only. Yeah. Yeah. What do you do? You'd be like, wow, you got to go for a run. Literally. But you're going to, you know, actually control it. Yeah. You got to eat more protein. You can come back from that. You just, people just won't. 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. These types of things are very manageable with, with many interventions. Can we just like run through a list of like the top things that you actually have control over that you could do to move the needle and kind of control that disease state? Yeah, well, I'm actually, I actually believe that for a large swath of cases, it is reversible. As long as the pancreas is still able to produce insulin, then it should be largely reversible. And there is now, 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, can go into regression or I don't know, I have to double check the language. They shy away, I think, from using the term cure. But, and again, I mean, we can talk about definitions. If we define a positive diagnosis of type 2 diabetes is HbA1c of 6.5, well, it's possible to get your HbA1c below that, right? And then again, yeah, well, you can absolutely like people, if you're at 7.2 and with lifestyle intervention, which again, going back to Doug's questions, things within your control, without

the medication and the insulin is there's the pancreas is still the beta cells are still producing insulin. Yeah. So yeah, the things in your control, the lifestyle stuff, man, this is the physical activity and it's the nutrition. Usually it's not usually, it's almost always a big problem is again within someone's control is excessive caloric intake typically typified by excessive simple carbohydrate consumption that's causing dysregulation of glucose control. And so that's reduced.

So first thing is if you're drinking any of your calories, in particular drinking your carbohydrates in the form of simple sugars, well, just replace that with diet Coke or water. That's step number one. And that will go a long way to getting your caloric excess under control, getting back towards calorie balance and also getting that the excessive 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 circulation, which again, type 2 diabetes or excessive glucose in any context, diabetes or pre-diabetes or otherwise, is a problem of more fuel than we need. So increase the need, rev up the engine, man. And so that, and it doesn't have to be going back to, I think it was Andrew's asking about like,

which are the metabolic, my interpretation of it was, which are the metabolic systems do we need to be firing on? Man, zone two will still be a significant glycolytic or glucose utilizing activity for sure. I mean, there, a lot of it will be used aerobically, but yeah, if you've got it available, then the muscle will use it and it'll take preparation. So you got to tell the people where to go. You got to tell sugar exactly where it's supposed to be used, not to sit there. Yeah. So yeah, the problem is the sinks are full, right? The muscle sink is full if you're sedentary and the liver sink is full.

So there's just like traffic jam and the circulation. We need to get that out. The best thing to do is just to move, right? And interesting, this will probably be common knowledge to a lot of the listeners of this podcast, but in case not, it turns out it's the exact same transport mechanism between insulin stimulated 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, 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 we can just get on the first 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 we can just get on for the first line of defenses, like metformin and there's all these second and third line defenses. And ultimately, you know, it's insulin, but still even that is not looked at in the societal level is all that they, oh, you got insulin, you're fine. You got exogenous insulin. Well, what if you didn't actually need to use it 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, there's even at an advanced stage, there's a lot within your control to mitigate disease even if it's not reversible at that point. So yeah. Uh, earlier you made a comment about, about something that Dan has said on the show many times about, uh, once your glucose is above 85 for every point above 85, I believe the, 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 2 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 100 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 you're 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. Yeah, yeah. And kind of attack the problem much, much earlier. Aside from blood glucose, like are there any other markers

where you could like very clearly see that 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 are like the numbers that you wish to pay attention to before you've crossed over like the medical line? Oh yeah.

Well, dude, that's a great point. This gets into the difference between like 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 that 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, 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, that's something I think about all the time. And I appreciate so much how Dan and you guys in this company thinks on a more linear scale, 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

as to A1C because there can be a spurious 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. A single measurement of fasting glucose is not sufficient to make a big deal about anything. But the A1C man, that's average of three months of overall blood glucose, right? That's due to the fact that it's a permanent, you know, 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's got concerns about their blood glucose, whether it's a one-off or maybe more than one-off fasting blood glucose concentration or A1C is a little higher kind of borderline, you're getting into like the 5.5, 5.6, or a one C is a little higher kind of borderline. You're getting into like the 5.5 point 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, but just like the CBS or whatever, just get some blood glucose strips and, 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, it's the International Diabetes Federation recommends that our post, what we call our postprandial, or 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, but there are other clinical guidelines that go above that. So if you're at any point like that two hour mark after a meal, that two hour that between well, I would say

between one and two hours if you're exceeding 140 milligrams per deciliter on a regular basis in a post-prandial state then that could be some signs of some problems specifically insulin resistance of the body's tissues, of the muscle and liver and so forth. Post-prandial is mostly muscle driven. And yeah, that's a good sign that again, it's, it's, it's starting back to the same shit. Like we need to be working out and need to be moving. We need to be exercising. Right.

Um, and also you can also, there's two ways. They don't have the other, just finished the thought, um, reduce the carbohydrate content of that meal is probably in excess of what you need. Um, right. So, well, sorry, you're gonna ask Doug? No, I was, no, I was one. I. Well. So you're going to ask, Doug? Now I was now I was curious.

I was going to say just being from the mountains, like, man, I want to make sure I send this to every family member I have. It's just like it's so rampant. Like, you know, I've grown up, you know, growing up. My my mother's always been worried about me because my grandfather had it and 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. Are you, remind me, Matt, 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 when I'm from near 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 state of Georgia. Oh yeah. And my whole family is very similar story. I mean, 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. Yeah, hell no. We should be, genetics come here.

You'll know, right? Like every night, right? Yeah, this gravy on everything. Like, absolutely. We had from the garden. But check everything. Yeah, you can do. I saw I saw it is 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 run. It's, it looks freaking good. 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, you know, like the whole family. I mean, we were traditional, like every day at like 530.

Like not just my immediate, but like my grandfather, grandmother, cousins, aunts, uncles, every single day. And like, it was so good, man. But like, and nobody leaving there feeling good though. Yeah. Like chocolate gravy. You ever heard of that? My grandmother made chocolate gravy. That's the most delicious stuff in the world. Yeah. Chocolate gravy. You ever heard of that? My grandmother made chocolate gravy. The most delicious stuff in the world. That sounds like a southern thing.

Way up yonder in those mountains kind of thing. Yeah. Bro, if I took you where I'm from, you wouldn't even be able to communicate. My wife, Doug and Anna's noses, my wife, won't even get out of the car where I'm from. I was like, hey, let's go walk around. She's like, hell no. I'm not getting out of here. I want to see it. I want I was like, Hey, let's go walk around. She's like, hell no. I'm like, get out of here.

I want to see it. I want to come visit. Yeah. Come visit. I'll take it. Just get your, get your accent back real quick. Yeah. 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 Glut4 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 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 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. So A, I want your thoughts on that. And then B, for people that, especially doing damage control on like Thanksgiving dinner and things like that, or you're going to a birthday party, you're never going to eat a bunch of junk or whatever it is, 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? Cause 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 on working out, but basically maybe not getting a lot of other movement in. Really easily, dude gets jacked, never hits 10,000 steps. Correct. Yeah, I was going to go to steps.

I was going to 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 folks like us. And I'm just going to 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. I had, I've always for the last five, six years maintained pretty decent body composition at that point.

It was getting pretty damn lean, you know, 10%, 12% body fat and sort of sustaining that. I would take that. Yeah, no, it's good. But like, I just like, I'm also, it wasn't, 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 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 to,

try to accumulate steps that way. And sort I started monitoring like my proxy, my metric for all that was steps. For me, the more I can get it up to about 20, even including up to and above 20,000 steps in a day, almost university, 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, all like, all that stuff, like I'm moving closer to like, closer to 10 out of 10 on this, almost 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 your two 10 out of 10 on this goes almost kind of a linear relationship My basil like what I try to maintain about 12 to 15 thousand steps in a day. It's been hard because fucking cold right now But in the summer month of spring and summer months when I can and that doesn't that I will say that does include

Like if I go for a run that it's I'm checking on my watch and I'm not gonna subtract out the Some people 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's already checking all the boxes on their nutrition and on their training frequency, volume, intensity, getting all that dosing right, but they're still, maybe they want to optimize their glucose and it could be any other metric, but that's an easy one that we can then 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 that 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 I'd have to, 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 in that like in the eighties at least, right? And not in the nineties. And I do think that that's, again, 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 about 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 the life commitments and stressors. Like they've 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 just make myself miserable and stare at a white cinder block wall on my treadmill in my basement. Let's not, that's not work. Like we got to like be realistic here and and weigh the benefits and drawbacks with all these different maneuvers. So I wouldn't like to sacrifice sleep for it. That's a massively important point. I actually think if possible figuring out how to play things. No, just kick it with your kids. Like that's the easiest way to not have like that's that's actually the part of the zone to conversation that drives us 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, but like playing with my son is my zone too.

Like it can't be. Absolutely. It's like soccer ball. 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 good things about- This is the ultimate alpha dad. Yeah. And we're caught from the same cause because I'm totally that way too. Oh yeah. Cool.

But- We need a team party. I want to see who's the true Alpha. There's no shirts ever. Especially when other dads are around, right? Got to flex. But truly though, 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 that's just there watching. I want to fucking participate. We had our first ever snow in Georgia like in five years a couple weeks ago.

And I will say this, all the parents in the neighborhood were actually active. They're playing with it. I'd love to see it. But I'm like, and you know, I'm like right there with all the kids, like going down the slats, going down the hill and the next to the neighbor's house and all that kind of stuff. If my son's in the pool in the summer, I'm in there with him and I don't want to be sitting there getting my son tan. Me too. I'm in there with him. Right.

Exactly. Like it's parenting. Like kids are freaking active. They're running everywhere. That's a huge opportunity to get some activity in. So if you participate, participate versus spectate. That's an easy choice. Right. 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 became a farmer like a month ago and it's... Oh, congrats. Yo. That sounds pretty alpha. Yeah, it's gone. Congrats. Yo, I. 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. Chess Austin. Faking it until I make it. Totally faking it.

But when you are up moving and wheelbarrowing and like, 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, you're going to find 20,000 steps and you're not even, you don't even think about it. It's just, you're constantly doing things. You just have like, 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. You don't, yeah. Built into your life. Yeah, man. My favorite days are in the summer when, so if I, if 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 the shit you're around. I was just talking to someone about San Diego this morning. I love that city. It's the greatest. It's actually... I can't afford it. It's on fire right now there, right? That's LA.

I thought they both were. I knew LA was the best. LA's lights out, man. It's not good. Yeah, that was really... 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 become addicted to it and 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, 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 places. I lived in Maryland and Missouri for a while. It's way better here. Yeah. But still, it's raw. I can't. I'm ready for the spring to come back, man.

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

Yeah. And as I thank you for being the guy who goes shirtless, you know, even at 32 degrees. Now, Here's where 40 degrees is like to cut off. If you're going from 20 to 40, that's off. That feels good. to cut off. If you're going from 20 to 40, tarp is 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 just, give me some of that sun because it's been dark and cold. Yeah, yeah, yeah. And they haven't had any happiness in a long time.

And then all of a sudden it just, it's there. Bro. It's all relative. 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, finally Monday when we left, it was nine degrees. And when we got home, it was 27. It was, that's a big difference. Like 27 felt great. Yeah. I was like, man, let's go, let's go lay out a sun. It's like 27th of great. Yeah. I'm like, man, let's go. Let's go. Uh, lay out a son is Ross. It's just 25 here today or was this morning and all this Georgia people are

crying. Doug, you can ask the second question about like a big meal and what to do with how the, how the movement, uh, kind of plays into that. And that's a, I actually love that question as well. Um, yeah, wrap on that for a second. Yeah. We're taking down to the end of the show here. Uh, we got a few minutes. Like give me, give me your, your high level two minute answer to 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. And most of the time, I think in this context, we're talking about otherwise, you know, cake, you know, whatever the best thing you can do is move. So that's a little bit of research we did. And as part of a much larger body of work.

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 post-cranial glucose excursions or big spikes in blood sugar following a carbohydrate rich meal is if you time it ideally between about 15 to 45 minutes after the meal, go for a walk or any kind of movement. But most of the studies just use walking because it's practical. That after dinner walk that you do with your family in the evenings when it

is nice and not 25 degrees outside like we're talking about. Maybe there's some sort of innate biological drive to prevent diabetes or something from it. I don't know. But it turns out... So the graphs on this stuff is so cool and I wish this was a... If this is a video podcast, I didn't come prepared to show it, but the way... I'm going to talk with my hands for you guys because you can see me, the way the glucose curve after a meal looks is it goes up and up and up and up. If you time the walk to begin about 15 to 20 minutes after the meal, the glucose trend literally reverses and starts going back down. That's sustained as long as you walk for. 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. But man, that really did a nice job of normalizing the glucose response and kept it from reaching those really dangerous high levels of post-prandial glucose. And that's really important too, because that post-prandial glucose spike, the magnitude of the spike, how high the glucose gets after a meal is very, very, um, what's the word? It's a significant

insult, significant toxic dose to the cardiovascular system, to the vascular endothelial cells, um, 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, um, yeah, as long as you train right afterward, you're more or less fine. Like, yeah, well, I think about it 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. I mean, it's like you're potentially putting sugar in your body during workouts

or right before workouts or potentially after workouts. Like an intro, intro workout too. Like that's what I like for clients to do is 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 taking in carbohydrate while you're using your muscles. So you're actually never allowing the chance for like glycogen, even if you do get glycogen stores depleted, you're not getting a reduction in blood glucose, which is problematic for performance. But same kind of, it's the same biology. Absolutely.

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, yeah, you can mitigate that, that cardiovascular insult that is a massive glucose spike. It's the same biology when we're talking about it, and we shift gears and look at the performance side of things. We're trying to optimize carbohydrate availability for both the workout itself and also starting the repair process post-workout, stimulate muscle protein synthesis and all that good stuff.

Usually, you take that right along with some whey proteins so that the carbohydrates, 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, muscle contraction combined with nutrient availability is a great thing, both for performance and for optimization of some of these health parameters too. So that's pretty cool stuff. Where can people find you, my man? Yeah, I'm on Instagram, uh, at Dr. Nathan Jenkins.

Well, that's all one word and that's pretty much where I hang out. I don't have a tick tock. I got a personal Facebook page, but, uh, yeah, that's the best place. Oh, it's about the end, right? Isn't it? Oh, Travis. Mass. Don't not yet. Not yet. All right. That's place. The thing's about to end, right? Go Travis, smash. Don't not yet. Not yet.

Not yet. All right. Yeah. Mashley. I charge. Oh, yeah. Yeah. Well, you hold me at the helm here. OK. So smashly.com. Read my articles at Jim. We're here.

Well, if you're local, try it. North Carolina can see me rise into our sports. There we go. Douglas C. Larson. Right on my Instagram. Douglas C. Larson. Right on. My Instagram, Douglas C. Larson. Nathan, appreciate you coming on the show, brother. Man, thanks for having me. That was a lot of fun.

Yeah, we're gonna do this again soon. I am Anders Varner at Anders Varner and we are barbell shrugged at barbell underscore shrugged and make sure you get over to rtalab.com. That is the signature program. Inside rapid health optimization where you can go and experience all the lab lifestyle performance testing analysis and coaching to help you optimize your health and performance and you can access all of that over at

aratelab.com. Friends we'll see you guys next week.