Dhru Purohit Show - A Masterclass On Reversing Visceral Fat to Increase Longevity and Reduce Chronic Disease with Sean T. Omara, MD, JD

Episode Date: October 2, 2023

This episode is brought to you by Beekeepers Naturals and ButcherBox. As we age and start to experience subtle shifts in our bodies, we might notice more swollenness in our joints and puffiness in our faces and generally feel more lethargic and less mentally sharp. These are telltale signs of chronic inflammation that could be linked to high levels of visceral fat—the “hidden fat” that’s stored deep inside our organs.  Today on The Dhru Purohit Podcast, Dhru sits down with Dr. Sean O’Mara for a deep dive into the dangers of visceral fat, what foods and lifestyle factors promote visceral fat production, and how we can take steps to lower our levels to prevent chronic disease and prolong our life span.  Dr. Sean O’Mara works with business executives, professional performers, and athletes motivated to optimize their biology through innovative techniques of performance enhancement. Dr. O'Mara was the founder of an innovative medical start-up in Minneapolis, MN, called Lantu, which focuses on health and performance optimization. Dr. O'Mara and his team used cutting-edge data analytics to glean insights to identify and leverage innovative biometrics of health, the human genome, and the microbiome. He has over a decade of experience evaluating and reversing chronic disease. In this episode, Dhru and Dr. O’Mara dive into (audio version / Apple Subscriber version): -What is visceral fat, and why is it so dangerous? (1:46 / 1:46) -Visual differences between healthy fat and visceral fat (10:35 / 7:25) -The top five diet and lifestyle factors that contribute to visceral fat (20:10 / 16:50) -The link between longevity and visceral fat (35:16 / 32:06) -Visceral fat vs subcutaneous fat in obesity and menopause (39:49 / 36:42) -Dr. O’Mara’s patient with TOFI (thin on the outside, fat on the inside) (59:11 / 55:20) -What makes a person susceptible to having a lot of visceral fat? (1:03:11 / 59:40) -The marbling of skeletal muscle tissue and risk for heart disease (1:22:11 / 1:17:52) -Study of visceral fat in sprinters (1:28:52 / 1:23:15) -How visceral fat impacts nitric oxide, blood flow, cognition, and hair growth (1:31:50 / 1:30:42) -Optimal level of visceral fat in the body (1:51:58 / 1:48:50) -Energy balance vs a whole-foods diet: which is best for reducing visceral fat? (2:01:49 / 1:56:47) -The link between visceral fat and the gut microbiome (2:03:30 / 2:00:42) -Dr. O’Mara’s take on alcohol (2:20:04 / 2:16:54) -Dr. O’Mara’s tips for sleep optimization (2:26:19 / 2:23:10) -Taking your health journey one step at a time (2:31:28 / 2:28:41) -The best way to exercise to reduce visceral fat (2:35:40 / 2:31:44) -Erectile dysfunction (2:52:20 / 2:49:12) -Best way to measure visceral fat (3:00:41 / 2:56:36) Also mentioned in this episode: -Dr. Sean O’Mara on The Minimalist Podcast -YouTube Link Go to beekeepersnaturals.com/DHRU and enter code “DHRU” to get Beekeeper’s Naturals' exclusive offer of 20% off sitewide. Right now, new members of ButcherBox receive New York strip steaks for a year PLUS $20 off your first order. Go to butcherbox.com/DHRU to sign up and use the code DHRU. Hosted on Acast. See acast.com/privacy for more information. Learn more about your ad choices. Visit megaphone.fm/adchoices

We hear about the common pathway of chronic disease is inflammation. And it's my clinical experience that visceral fat is behind all of that. I mean, it's got this association or causality yet to be proven in virtually every form of chronic disease. If you're curious about the dangers of visceral fat, this is the bad fat inside of us that we don't want. Today's episode, which is a master class on this topic, topic is absolutely for you. Welcome to the Drew Proet podcast. Each week we explore the inner workings of the brain and the body with one of the brightest minds in wellness, medicine, and mindset. This week's guest is Dr. Sean O'Mara. Dr. Sean works with business executives, professional performers,

athletes, and motivated individuals to help them optimize their health using advanced imaging technology, which we're going to be talking about on today's episode. He uses MRI screening and imaging to help people understand how much visceral fat is in their body and most importantly where this visceral fat is located. Visceral fat is not the belly fat that we can pinch on our stomach. It's actually the fat that is in our organs and is most notably known for being dangerous to our longevity long term if we have too much. But there are plenty of things that you can do to not only identify it, but to start removing it, including regularly incorporating sprinting into your workout routine. Dr. Sean talks about that and his whole list of

suggestions on destroying visceral fat on today's episode. Stay tuned for a fantastic podcast with Dr. Sean Omara. Dr. Sean Omar, welcome to the podcast. Glad to have you here. I want to talk about visceral fat. Help us understand what is it and give us a few reasons why it's so dangerous inside the body. Yeah, so a good name because people hear about visceral fat. It's often described other ways like deep belly fat, but some cool names that I like to refer to it as invisible obesity because it's kind of fat that you don't know about. So it's invisible. It's deep in your abdomen. Another term that I've heard that I'll give credit to is Carl Lenore's superhuman radio. He calls it radioactive fat. And so it's this fat, you know, from the concept that it actually has inflammatory properties.

It's not really radioactive, but it's the notion that it has the ability to influence tissues outside of itself. And the way it does that, Drew, is through inflammatory molecules, that it's constantly leaking and producing and sending throughout the body. So it's a proximity to the vascular system that allows it to be. distributed throughout the body. And then it has this untoward inflammatory effect and all the tissues. So keep in mind, chronic disease, we hear about the common pathway of chronic disease is inflammation. And it's my clinical experience that visceral fat is behind all of that. I mean, it's got this

association or causality yet to be proven in many cases to virtually every form of chronic disease. So one of the interesting things I like to let people think about when it comes to visceral fat is if you have a malady, a certain form of chronic disease, just go on Google or AI and put in the search term, whatever you have, comma, and then list visceral fat. The other technical term for it is visceral adipose tissue. Adipose means fat. So a variety of a term. Aterone, are used to describe visceral fat, but it is a really bad player because of its influence throughout your body. So I think that's a pretty good introduction to its association with chronic disease. And then anecdotally, I would like to share that I studied it for seven years for

the National Science Foundation, a grant that we received. And during that time, we looked at, in 6,000 people, their chronic disease, things that they identified as forms of chronic disease they were suffering. And as we focused on eliminating visceral fat in those individuals, all of their forms of chronic disease either got better or completely reversed. It was amazing as they got rid of visceral fat and to the extent they did. So sentimentology and conditions reversed better if you eliminate more of that visceral fat and only partially prove if you if you just eliminate to a little bit. So that was absolutely shocking to see that something as profoundly connected to pathology and disease was never shared with me in medical school. We only learned about it

through this study. But, you know, there's a lot of studies if you Google visceral fat and just like I invited people to go on Google or AI and look at its association with whatever condition they might be afflicted with. It's connected with so many conditions. It's been very well researched. The problem is I've never seen something so valuable in the research lane kept from practitioners, physicians. It's inexplicable how something as powerful is this by a marker is kept from medical schools. The curriculums and medical schools are standardized. I went to both a law school. I'm an attorney as well as a physician. And I remember there are good law schools and bad law schools. But in the United States, there is no bad medical school. And it's because all the

curriculum is set and they're very, very good professional schools. The downside to that is, because that curriculum is set and standardized. We don't have really good curriculum and not so good curriculum. So it's all kind of cookie cutter. And ubiquitous in all these medical schools is a lack of awareness about visceral fat and some of the other biomarkers that we learned about in our study for the National Science Foundation in addition to visceral fat. So it's a really, really interesting topic.

and I've thoroughly enjoyed it. It's become my passion to help people become aware of it so that they can identify and start eliminating it in their own lives. This episode is brought to you by beekeepers' naturals. We're getting into the fall now, which means that life is moving indoors. This inevitably brings more germs and more opportunities to start feeling under the weather.

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Drew, D-H-R-U, to get $20 off plus an entire year of New York strip stakes. And it's key that you said eliminating it, because you've put together a protocol, as you mentioned, you took a bunch of patients through this, so this grant that you received, and you've seen firsthand through imaging. We're going to be sharing a bunch of images here on YouTube. And for those that are listening on podcast,

I highly recommend you watch the YouTube version of this, which we'll put in the show notes below, so you can see a lot of these images, but we'll do our best to describe them. And so we'll be giving tips, strategies, and other things to eliminate visceral fat and to get at it at its root. But first, let's dissect it a little bit more.

You called visceral fat that rams. radioactive fat, that invisible fat. Now, many people are used to the belly fat they have or the fat on their arms. And visceral fat can be part of that, but visceral fat is also inside of the body. It's in between the organs. And you have a great image over here to show an example of what visceral fat looks like in a healthy person and also what it looks like in what would be considered, quote unquote, a normal person based on the statistics that we have. Can you describe these images and what we're looking at? Sure.

So there's two images here, image on the top and image on the bottom. And when it comes to MRIs of the abdomen and looking at visceral fat, what you want to do is have the healthiest abdomen as possible. And the characteristics of a really healthy abdomen is generally it's oval-shaped. So it's not protuberant. You don't have what you might imagine is what a dad bod might look like, a big barrier. belly, you want a more oval shape. So take yourself back to when you were maybe 14, 15 years old, and you had a very oval-shaped flat abdomen. That is the kind of abdomen you want to have even as

an adult. And you want to see mostly dark. So in this image here, you see a lot of dark structures. And so on an MRI, muscle shows up as dark, and so do visceral organs, like the small intestine, colon, and bone. So this is the vertebral body, and this, by the way, are the soas muscles, which are known as your core. So anybody watching that can see that, those are the buggers that hurt so bad when you do a core workout. And they're very important to health. Now, the white is, anytime fat is present and an MRI scan shows up as white, this individual here has very little white, so very little visceral fat, contrasting it to the individual. the bottom. So this this cane here is Assef, who's a friend of mine that I met at a gym, actually,

in Asana, and a great guy. And I bought him this MRI to help him out. I just paid for it in my own pockets to help Asif because he wants to go back and have poor kids in Bangladesh get educated. I'm like, gosh, I want to help this guy. And I could tell you had a lot of visceral fat, and he sure did. So this is a skin you don't want to be because it's mostly white. So if you ever get an adenal scan, an MRI scan, you're going to have a real hard time getting it red. So it's good that you're watching the podcast today so you can learn about it. So you want very little white and you want mostly dark. And Ossif is just filled with visceral fat. And then outside of his muskoture is what's called subcutaneous fat. So that's just fat underneath the

skin and Ossif has a lot of subcutaneous fat, but he predominantly is concentrated with visceral fat. And then Gabe, is a friend of mine in the Army National Guard, has very little visceral fat, and he has a nice, healthy layer of subcutaneous fat. So he's got a six-pack, and that's his belly button, and these are his back muscles, and these are his obliques. And you want to have nice, dark muscles with that, a lot of fat streaks in it. Ossif has these streaks of white in here. So this image here are both really important for your audience to understand the contrasting difference between healthy and unhealthy. We only see the outside of the body, but it's important, I think, to use an MRI to understand what else is going on in the inside of the body. And having

done this thousands of times now for people, it's very powerful to see what happens to somebody when they get to look inside their abdomen. It's almost like we can dismiss how we look in a mirror because we get accustomed to it. But when you, it's like a magic looking glass, when you see inside your abdomen, you get a perspective you've never seen before. You're not accustomed to it.

And so that's a really good chance for you to form new habits. And there's science behind this that if you change your environment and you're in a new environment, you can actually break habits and form new habits better just by being in a new environment. So I think what we're able to do is with an MRI, if you've never seen inside of yourself, it's a little bit like that, that you go in an environment that you've never seen before, and suddenly you can now break bad habits and form new habits. And that's what we did with all these thousands of people in the National Science Foundation. We basically got them in a new environment, took them inside their body, and they broke their bad habits and formed good habits that they'd never been able to do just looking at their old familiar space. Well, we're going to break down everything that you recommended for them, everything you do yourself.

In fact, this is a great opportunity to do your before and after of you being on this journey. Can we bring up the photo that you have of you? So here's your before and after. Again, if you're listening on podcast, we have the link inside the show notes to this image. as well that people can look at on our website, but describe it for them. And if you're on YouTube, you can see these before and after photos. So this is you on the left. Yeah. And what age is this? So I'm 48 here. And in this particular image, I look pretty much like any other 48-year-old. I could walk by you in a shopping mall. I could take care of you. I'm an ER physician at that

particular point full of time. I could take care of you. And you would not think anything of it. But what this face shows is the influence of visceral fat on my face. So it causes inflammation throughout your body and gives you this puffy, inflamed look to your face. And it's there basically showing we wear our health on our face, probably more than any other feature in our body. Our faces project and tell to our fellow humans how while we're doing at least. life. And really, how well you're doing it in life is communicated by how healthy you are. So I look very average, but unfortunately, I am not healthy in this particular image. And then 10 years, 11 years later, my image on the right, which is just about six months ago, shows the dramatic

difference where the face, the shape of my face, has become much leaner. Now, lots of people lose weight drew and it's really dependent upon the type of weight you lose. Maybe you lose muscle. And when you lose muscle instead of losing fat, you don't have a favorable reflection in the appearance of your face. In other words, you don't derive a beneficial improvement in the appearance of your face if you are losing the wrong kind of tissue. But if you lose, and particularly in the same applies with fat. If you lose visceral fat, your face looks much better than if you lose subcutaneous fat. So the MRI allows us to focus in on what is really harmful and what is beneficial. Superficial subcutaneous fat, and we can get into that maybe later, is actually beneficial.

And visceral fat is very bad. So my profound change here is based on my, you know, passionate seven years are researching visceral fat and focusing on eliminating it and myself. And so I like to describe for audiences, I don't look like I'm 16, but the shape of my face has returned to the shape that I formerly had when I was about 16 or 20 because I had at that age much less visceral fat. And I didn't have the influence of visceral fat deteriorating my face. So what I tell people is, you won't ever look like you're 16 again, but the shape your face can look more like you're 16 and 20. And so we should, you know, get or improve the shape of our bodies, improve the shape of our faces. And the capacity to have a healthier looking face corresponds to your ability to be a better

influencer. And that's part of our mission. Our mission in life is to live well and be able to influence other people to live well also. And to the extent you're healthy, you're better at being an influencer. For those that are listening on the audio, your face on the right hand side, which is you now, definitely feels more, more features. It's less puffy. It's less inflamed. It obviously is clear that you look at your face. There's a shift. But interestingly enough, and we're going to come back to it later, you actually weigh more in the after photo. You weigh 178, which is, I'm guessing your weight now, you're older and you weigh more, but you actually look younger and more youthful. We're going to come back to that in a second. But first,

let's talk about the basics. What are the top drivers of visceral fat? And why is it such an explosion of visceral fat in our modern day society? Yeah. So the big five things that we have found that contribute the most to visceral fat, based on our experience, with the National Science Foundation and using this MRI to evaluate it is first and foremostly processed foods. So when you eat a lot of processed foods and maybe I'll just pull up this image here to support that, that you contribute to visceral fat. So let's demonstrate for those watching here the elimination of processed foods. If you simply only eliminated processed foods and you didn't do anything else. So you want to

limit your confounders. In other words, we didn't do medications, we didn't do exercise, we didn't have this individual do a sauna, we didn't have them fast or anything else other than simply eliminate processed foods, processed carbohydrates in particular. And just to be clear, we're talking about ultra-process foods or we're talking about, because, you know, processed foods is a term can be kind of confusing to people. Some people will say guacamole's processed, right? But you're talking about first and foremost, ultra-process foods. Yeah. But then also it sounds like you're talking about some minimally processed foods, especially when it comes to certain carbohydrates, right? Like, are you talking about like

pastas and other things like that? Yeah, that would be included. So anything that really changes the form if it's not a natural process. So if you simply take an avocado and squash it and turn to guacamole, that's a pretty natural process. But if you were to take something, you're a like wheat, grind it up, add some oils, and cook it, that would be a lot more processing. So our guidance to individuals during the National Science Foundation was to only use natural kind of processed foods, you know, squashing, changing the form with some kind of mechanical event as opposed to cooking or adding other ingredients into it. So we instructed this individual to eat food in whole form.

So it would be meat and vegetables in non-processed form that he was allowed to eat. And he did that. And he had this amount of visceral fat on his baseline, meaning when he first got started. Yeah. And so you, just to describe again for the people that are listening on the podcast, you have basically a series of six images. And they go from week zero all the way to week 35. So this is a sequential imagery.

and the visceral fat here is this sort of yellow, whiteish imaging that's there, and you go week by week. You go week zero to two to five to 15 to 25 and 35, so you sequentially see. And then next to it, you talk about how much the amount of visceral fat is. And is that in the total body? Or is that in the abdomen region? Like week zero, it says 5.6 pounds. Is that the total body or is that just in that area? Just in the abdominal cavity. So the visceral fat would roughly correspond, include fat outside the abdomen around the heart. So that's organ fat too. But it's quantified in this particular image through software that was captured and limited just within the adamant. So this pinkish red color in the middle is your visceral fat. Your subcue fat is the yellow.

We tracked and paid attention to the visceral fat because the fibrill fat because that that is the more harmful substance. And yeah, sorry about that. I got it wrong. The pinkish was the visceral fat. Yeah. My apologies. Yeah, just adding some clarity to it.

So you can see from in just two weeks, even though you are not a radiologist and many who are watching this and able to see that, they can visualize that the visceral fat, the pinkish substance, has been reduced. And so that's an important observation to be aware of. and that happened just by this individual cutting out processed foods. But as you rightfully point out, over 35 weeks, this guy goes from having a dad body, he's 68 years old, and he also has muscle with fat infiltrating the muscle. We call that adverse muscle composition or myosteotosis, the technical term for it,

where fat starts depositing within the muscle of your body. and by a time 35 weeks are up, this guy goes from a dad bod to looking like a collegiate swimmer. Look, he looks like somebody in his 20s. He reduces visceral fat that much. And he actually improved his musculature, and he did so without any exercise. So the elimination of visceral fat was profoundly facilitated by the elimination of processed carbohydrates and food. So you ask what causes visceral fat, that's a big one. And then I don't have an image of it, but a second one we get into is alcohol.

So somebody that drinks, the more you drink, and I could throw, have you start pounding become, you know, this heavy, heavy drinker. We're not going to see visceral fat for a while. But the more you drink, the more your metabolism is burdened and your capacity. to have a healthy response to the caloric intake becomes compromised. And is that generally because people who are drinking more are sort of also drinking their calories, right? So they're also getting just total excess extra calories,

and that's contributing to visceral fat? Well, the calories do make a contribution, but it's really more of its metabolic impact. Alcohol, when it's ingested, behaves differently because of its biochemical. composition than any other forms of calories. So if you're ingesting fruit or rice or protein or meat or some other form, it's not going to have as much impact on your metabolism as alcohol. So we have our clients eliminate. We recommend that they either cut back, scale back on alcohol

or completely eliminated. And those that eliminated completely have better results in eliminating of visceral fat than those that continue to drink. And to the extent that you continue to drink, you become more resistant to the elimination of visceral fat. So somebody who comes back and has disappointing results between their scans, we will ask them about alcohol use. But for the most point, what's really interesting is people, when they get scanned, really are very, like I said earlier, very open to changing their lives more than any other time. So the or I. They do. And they say, you know, I've never thought about giving up alcohol, but now I see that stuff inside of me, and they give up alcohol. They give up processed foods. And the third thing that causes

visceral fat is impaired sleeping. So if they have a sleeping disorder, if they have obstructive sleep apnea, or they are apnic at night time, we bring this to attention, their visceral fat. Suddenly they get a lot more serious about using maybe their CPAP machine or going in and getting evaluated for CPAP or obstructed sleep apnea. Or they work on improving their sleep hygiene, you know, becoming more attentive to how they may be impairing the sleep. A lot of people don't value sleep. They see this huge amount of visceral fat that they have inside of them. And so, with, that awareness, suddenly they start going to bed earlier. They start cutting out all the stimulation and other things, and that we could do, you know, months of shows on sleep. But, you know,

suffice it to say that impaired sleeping has a major contribution to visceral fat. The fourth one surprises people, and it was a very, it was a very interesting conversation that you had with Dr. Lustig is about stress. So stress causes through the mediation of cortisol, the contribution and composition and deposition of visceral fat within the abdomen. And so individuals who unknowingly have stress in their lives or who have stress in their lives but simply tolerate or put up with it will be unfortunately accumulating unnecessarily. a visceral fat inside of them to the extent that they have it. Now, everybody's body is a little bit different, and some people respond to stress a little bit different. But to the extent that you can

eliminate stress, you will eliminate the composition or deposition of visceral fat inside of people. So it's really an important discussion for people to be aware of. And then the final point that we see is, believe it or not, and is, is, and it came a surprise, is, durational exercise, where we simply exercise too much. And so we see that people that are runners, and I'll pull up a nice scan of this, here's an MRI of somebody who's a marathoner who would run eight to 10 marathons a year. He had a lot of this visceral fat. within him, and he had this very small amount of subcutaneous fat. So we call these people with low subcutaneous fat on the outside tofies. So they're thin outside and fat inside. So this marathoner

was filled with a lot of visceral fat. So we see, and it's probably two things. One, it contributes to visceral fat when you overexercise, and the exact mechanism is not clear. But my theory is is probably through elevated reactive oxygen species, ROSs that go around that are associated with exercise. If you exercise too long and too much, you enhance these ROSs from being produced. And so another example of this happening is a really nice before and after scan and a 50-year-old executive of a company who came in and And he was having his repeat ad-Donnell scan, his MRI. So for the audience that's listening, you have a before and after.

It looks like they're taking about two months apart, right? Correct. And so on the left-hand side for this individual that you mentioned, go ahead. Yeah, so on the left side is an MRI image of his abdomen, and he's got a substantial amount of visceral fat within his abdomen. His muscles look pretty good. And he was a pretty healthy guy. He was doing a lot of healthy things, 58-year-old executive. And this was a repeat itself. I don't have the MRI before it, but it was disappointing and alarming.

So we asked him all the other contributions of visceral fat, and he assured us and we were reassured by his answers that he didn't have any of those other contributions. And here he disclosed to us that he was persisting in his running. He wasn't doing marathons. was doing 10-mile runs five days a week, so 50 miles a week, which is a lot of running. As a consequence of all the running, he had a substantial amount of visceral fat that was staying there, and what visceral distance running appears to do is makes the elimination of visceral fat refractory. So not only does it seem to contribute to visceral fat, but when you start doing things like cutting out processed foods and sleeping better, cutting out alcohol, and you're going to, and

And then you get, you have a harder time still getting the benefits of eliminating that visceral fat. So your body is resistant, holds on to that visceral fat more tenaciously if you're going to be doing distance running. So what we advocated and asked this guy to do was to substitute in for his distance running, sprinting. And so this guy went from being a distance runner to a sprinter. And he did so and just.

two months, it was actually a little shy of two months, and look at the dramatic elimination of his visceral fat. So this image on the right now shows a lack of white, and he has much more dark present within his adornal cavity. And then you can see the shape of his adjutant appears to be more oval, and he has a six-pack, and his muscles have increased. Nothing else changed in this true other than he simply substituted distance running for sprinting. And so we've seen this in numerous individuals who eliminate distance running and substituting sprinting. Distance running, long, like marathon runners, etc. They just stop running. They don't do any more jogging. We recommend that they just simply do sprinting. It's a completely different form of exercise. I mean,

it's hard to do. I'm a former distance runner. I ran across country. And, school. I love distance running. I could not stop. I will admit to anybody and the audience say I was addicted to my belief. I was addicted to running. I loved it. And I loved the endorphins it produced and I would run 70 to 90 minutes every single day. I could not stop doing this. And many people are like that. So for me, I stopped doing distance running. I start springing. I get my clients patients that work with me to do the same thing and dramatic improvement in the reduction of visceral fat when they start doing so. So just to recap, we have the elimination of processed foods.

We have the high reduction or elimination of alcohol. We have the doubling down on sleep and really making sleep one of the main focal points and prioritizations in your life. And of course, removing processed foods and greatly minimizing or removing. removing alcohol, both contribute to sleep. We have addressing the stress in our lives, and I have a few questions on that. I have a few questions on all these. And then the fifth one, which is people exercising too much, right? So let's start back up from the top. And before we get into processed foods, and I get a chance to ask my clarifying questions on all of these, knowing my audience

and the things that they're thinking about, remind us again, visceral fat and the elimination of it is not just about looking better. It's not just about having a more chiseled face or abdomen or other things. It's actually about reducing the amount of work that our organ systems have to do to process and function inside of the day, which is associated with longevity. Is that correct? Yeah, it is correct. And you're wise to point that out.

You know, our lives should not just be based on our looks. You want your lives to be reflected by the quality of your life. And to the extent that you can eliminate the disease process inside your body, you're going to live better. As a consequence of that fat being eliminated, you look better. But when it comes down to the most practical aspects to selling people on health, it's not just to look better. It's so you can live better.

When you live better, you can influence more people and have a more positive impact on our species, on our planet, and our time here on Earth while we're alive. So the absence of disease really is an important thing. And the presumption, unfortunately, for most people probably listening today, is the process of disease is expected to accumulate as you age. And that's not the case. It really isn't. As if you make informed choices, the majority of people are burdened today with an unnecessary amount of chronic disease. And so as they eliminate it through being enlightened about healthy lifestyle through your platform and other influencers that are doing

this tremendous service to humanity, to help people to become aware of both the need in how to become more healthy, we see disease processes leaving people. And so I'm passionate about the concept of challenging people that are older, that they don't have to continue to have disease. They can feel better. They can have an improved quality of life. And that is the expected a course of humans that, I think, defied many of our older ancestors for a long period of time. And today, with all of the contributions of bad food, stress, and chemicals and toxins in our environment, and really, I think you sum it up, and I have to mention, the microbiome being so attacked and depleted, we have just the highest amount of chronic disease we have ever seen

in the history of Homo sapiens today. And it continues to worsen. And in my opinion, it is the single greatest problem facing humanity more than anything else. And the reason why I say that is because nothing reduces human productivity more than chronic disease. Nothing costs more money than chronic disease. Nothing impairs the quality of living as much as chronic disease, and nothing kills more people than chronic disease. And who is talking about the biggest problem with humanity? Nobody. So I think it's important for social influencers to be discussing this huge problem. And I'd love for anybody to correct me if there's a bigger problem because I'll abandon this one and work on it because I'm a problem solver. But for the time being, I have launched.

on reversing chronic disease and I've centered in on visceral fat and these other biomarkers are associated with it so that in my remaining time while I'm on this planet and I'm alive, I want to do my part to work on the biggest problem, which is chronic disease. Well said. Is it fair to say that generally the more visceral fat you have, the more likelihood that you are obese? Is that generally understood that? visceral fat and excess weight or obesity have some correlation with each other? I think that's a fair assumption that a lot of people make, but I will tell you, as a practitioner in this particular space, it is not the case. We see many people who are patently obese,

who have an appearance of a large body and have very small amount of visceral fat. Wow. And so those individuals have a technical term, and we call them phoedies. So they're fat outside and they're thin inside. Which means that they have a lot of subcutaneous fat. Yes. But they don't have visceral fat. So what's going on with these individuals?

Yeah. What a great question. So there's a famous model who's on Sports Illustrated magazine. And she was quite controversial. I think her name is Numi or Numa. but she was a large woman, large girl. But if you look at her face, she has a very pretty face. Now, if we were to scan her, I would be willing to bet a substantial amount of some

sort of valuable thing to me that she has an abundance of subcutaneous fat and a paucity of visceral fat, not much visceral fat. And so if you have more subcutaneous fat and less visceral fat, you are going to be far healthier. And this defines, you know, anatomically what happens to different screen men and women. So women during their fertile years before menopause kicks in, tend to lay down more subcutaneous fat than men do. So they store their energy, their fat reserves, in the form of subcutaneous fat and not much. visceral fat. Men are the opposite. We tend to have much more deposition of visceral fat within us. And so as a consequence of a higher ratio of visceral fat to subcutaneous fat, we suffer more

disease. And so men have the capacity for having heart attacks in their 20s, 30s, 40s, and 50s. women typically do not have a heart attack until they reach their 60s because of their physiological difference that they have specifically with visceral fat being deferred until menopause. So most of their, again, fat deposition is subcutaneous fat. But once you hit menopause, if you're a woman, you start accelerating your contribution of visceral fat. And so nature is no longer conferring this protective benefit upon you when you were reproductively fertile. And now you become expendable sort of like us guys. Males are basically genetic contributors. We just contribute DNA. But women tend to have a greater importance to our

species when it comes to rearing children. And that's something that we see a lot of in multiple species. And so it's no surprise that our particular species has that. As much as we might like to share in those responsibilities and noble as it is from a species standpoint, nature says women have this. We're going to protect you. But then once menopause kicks in, you lose that and you start, you accelerate your visceral fat and you produce more visceral fat as a woman, menopausal faster than even men do. And so an interesting exercise, you're listening, is to go in your photographs, women, and look at your female ancestors and watch what happens to their face right around menopause at the age of 50 to 55. That's when they become less attractive and their faces take on more inflammation and they get puffier. And I'm just going to,

I'm going to hit you right between the eyes if you're listening because I want to exploit this in women. that is when the ugly button gets pushed. Oh, you might get a lot of emails. I know. I'm just letting you know that if you want, and most women, it's important to our species, women want to look attractive. And so when you start accelerating your visceral fat and you don't know about it, you're going to lose your appearance.

And it's important to women. You know, how your mind. This is guys who are ugly all along because they have so much of visceral fat. I think it's, I think with us guys, we're less concerned about maybe how, how, how, how, how we might look in terms of attraction except for maybe our, our physiques, our muskature. But to women, women, their faces are important to them. And during the Renaissance period of, of, of, of, of, of, of, of, of, of, many of the masters would paint women that were a little bit heavy, cherubic and use them as, as statues, figures for statues. because of the abundance of subcutaneous fat that they had and the estrogenic effect that would come from these fats and causing really feminine pretty faces. And then as they get older, they lose

that and their subcutaneous fat becomes replaced, starts going away, and women get thinner legs and they get big bellies. Now, women usually premenopausal have big thighs and, uh, abutics and they're more fertile looking in their appearance. So please don't think I'm trying to be critical of people's appearance and use that term ugly. I'm just trying to get you to aware of if you are concerned about your appearance, that you should be concerned about visceral fat. But it's not just appearance. It's because your appearance tells the story about visceral fat being present. And when you have a dramatic change at menopause, you should understand physiologically what is happening in your body. I would like everybody listening to be aware of visceral fat and work to

eliminate even throughout their whole life, but particularly when menopause kicks in, it's important for females to be aware of it. I think the larger component, obviously there's a lot in which you said there. One thing that we can see that's generally a societal trend in the Western world. And a hyper trend in places like Korea is the reliance on plastic surgery as people get older. Yeah. And much of what they're trying to do, whether or not we agree with this or not, is a lot of people who choose to go down the path to plastic surgery, specifically these surgeries that would change the look of their face in particular. They're trying to go back towards a more youthful look. They're trying to go back more towards a look where, let's say,

if we're talking about women, but also guys choose, some guys choose plastic surgery. In the case of women, they're trying to have their face look more like it did when they were younger. And generally as a society, right, whether we say that it's right, wrong, X, Y, and Z, there's no decision that's being said. People who go about that are trying to look more youthful. And you're sort of making the connection between youth and visceral fat. Now, also, what I've heard you say in other places is that generally, if you can avoid the rapid buildup of visceral fat, and if you can start reducing the visceral fat by focusing on these five things, which are important for women and men, all people, then you can actually preserve more of your youthfulness, men and women. Is that correct?

Like, if we look at a lot of our hunter-gatherer ancestors, or if we look at societies that are modern-day sort of nomadic societies that eat a little bit more traditionally, minus the fact that most of these societies spend a lot of time in the sun. So there's sun damage that's there, right? And many of these societies, too, the women that have made it that far, generally, a lot of these places, it's have as many kids until you can't have kids. I've spent time with one of these modern-day nomadic groups and in Kenya and that live on a very sort of traditional diet of milk, blood, a little bit of meat, things like that. And, you know, the women that have survived childbirth, because obviously there's a lot of

not access to health and infant mortality and women dying in childbirth is a very super unfortunate thing, even though a lot of people are trying to work on that. You know, they have like six, seven, eight, nine, ten kids, right? So their bodies have gone through a lot. Even still, many of the women that would be in that sort of category of menopausal, their faces look a lot more youthful on average than most of the quote-unquote normal people. This goes for men and women in these societies comparatively to what we see in sort of the Western world. Yeah, it's a fair observation, a lot packed in there. So I will say that I am troubled that I understand why women and other people attempt to improve their appearance through plastic surgery.

But I would point out as a physician and one who now specializes in health optimization, that when you change the outside appearance through some sort of a mechanical, surgical event, that you're not changing your health. You're changing the appearance of your face through some sort of plastic surgery. So you might feel better and to the extent that maybe you have a more positive emotional aspect about yourself, you may derive some benefit. But what if we were to accomplish that kind of an improvement in your face by eliminating inflammatory disease that was occurring within your body, visceral fat, such as the examples I showed in my own face and that I see in other people? then you would you would be able to glean and exploit leverage far more return on your investment

and eliminating that inflammatory chronic disease in your life. For sure. Then if you do plastic surgery. Yeah, we're not sort of talking about being against something. We're talking about the foundation of health that you're talking about. That true health starts from the inside out. We can't topically change our face and expect our health on the inside. change. I was more trying to save you a little bit from some of the statements that are there that

just saying that in general society, we value youth. And one way, maybe people have judgments on it, hopefully the combination would be that I don't care if people get plastic surgery. I don't care if they get Botox or other things. I just want them to be healthy on the inside. And more importantly, I just want them to feel good if they want to feel good. Eat whatever you want to. Right. Do whatever you want to. But I want you to feel good, which is my guess that you want people to feel good as well. I do. I want people to live the best quality of life and feel better. I think that's an important aspect to how you live and how you relate to other people. I mean, it's important. We are social creatures and we're meant to interact. And so I think we're in this together and want to have the

healthiest perspective about that. So lots of improvement that we can have in terms of our approach and our ideas behind that. So I want to go back to the Sports Illustrated model. Now, one thing I want to clarify is that would she fall into, right? We are talking about an individual. Okay, so we have the photo that's over here. People can see on Google images. Would this person be considered overweight or obese, right? Wouldn't she be just considered overweight? So technically, we do have a metric for a BCD and its body mass index of about 30. So we look at the relationship to height and weight and anybody that hits that particular category of 30 and above the average BMI body mass index is around 22. But here's the fallacy. I'm in the military. I'm still active duty

in the U.S. Army National Guard. And one of the things that we pay attention to are soldiers, contribution and we look at BMI. And so individuals that have a huge amount of weight may be because of muscle mass, which would be a far healthier contribution as opposed to individuals that have a lot of obesity from, say, visceral fat, they would be in very different forms of health and the ability to be mission ready and be functional. So the U.S. government, the U.S. military, has a vested interest in trying to have soldiers as healthy as possible, and they will separate people that have too much weight. But the question is, what kind of weight to they have? Is it muscle mass or is it inflammatory fat? So BMI is a poor metric. It is something to think about,

but then you have to delve into it further and analyze what is the actual weight. What is the abundance going on, fat or muscle. And then you have to ask, like with this particular model here, Yumi, you have to ask, is it what type of fat? Does she have an abundance or soldier have an abundance of subcutaneous fat, which has been shown in studies to be protective versus the inflammatory fat, which is shown to be either causal or associated with chronic disease? So visceral fat. And so the MRI ultrasound CTs, other modalities that allow us to take a look inside the body, become important to allow us to think about that. So I like to educate people on this biomarker of visceral fat,

and I like to tell them that there are different ways of looking at it. MRI, I think, is the preferable way because the advantages you get in resolution. and that the cost is the downside MRIs are expensive. MRIs are also safer because they don't use any radiation. So some people think MRIs use radiation, but they don't. They just use magnetic fields. CTs use radiation. X-rays use radiation.

Dexas scans use radiation. But there's a cost-benefit analysis to these kind of images. So if when we order an MRI, a CT, an ultrasound, any image as a physician, we have to think does the advantages of doing this test outweigh the cost of doing it? And that's basically what insurance companies will argue against a particular test. They don't think it's worth doing. But an MRI to look at Visceral Fat, while it won't be supported by an insurance company, if you're listening, you should pay out of pocket to get it done because the insurance company won't fund it.

themselves doesn't mean that it's not a good test and you wouldn't benefit from doing it. So you can order these MRIs and you would, if you're heavy and you might look like this particular model, you can have an MRI and see if like her you have an abundance of subcutaneous fat around your body or do you have a lot of visceral fat. And so there are people who are very thin that would be a modest frame. A lot of South Asians, people from my background, Indians, many of them are thin. I would have probably put myself in that category as well until I really started focusing on weightlifting, tracking calories on some aspect.

I was never overweight in my life. I was always actually skinny, but my body composition was off when I looked at my total body fat and I looked at also my muscle mass. I was essentially what our friend, Dr. Gabriel Lyon says, I would have been in the category of undermuscled. Yeah. And also, I have had an MRI done. We'll chat about that in the minute,

but I have not had one done to specific look at my fat composition and visceral fat. I did this pro novo scan. Oh, yeah. Okay. I don't know if we can pull out information from there and look at it. They don't have exact images that you can kind of hold in place and take a look at those parts of your body, like your abdomen or your heart. They just kind of give you this overlay. Yeah.

But they're working on adding that in the future. as something that people can pull in. I'm going to be talking to them, actually. So I think they're a pretty interesting company, and I applaud them for what they're doing. But I'd like them to think about looking at these biomarkers for the purposes of such as treating disease, but to reverse it. And what you're saying is that, and really,

I also want to say this. I didn't bring up this woman to talk about her looks as an individual. We're not here to pick apart anything. This isn't a gender-based conversation of women or this, men of that. We're using this as examples, and we're going through a few different things. And one of the takeaways that's there, first of all, is the reason that I brought up her, this model, who's actually very beautiful, is I was trying to get some clarity around, you know, would she be considered overweight or obese? Because my original question was, generally are people who are more

obese, have more visceral fat. And you said that largely that there's a correlation, but there are individuals that would seem, whether we use BMI or some other metric, that would be either in the overweight or potentially obese category, who actually have a lot of subcutaneous fat, right? The fat that we can kind of see and pinch and sort of jiggle on ourselves, but they potentially could have low visceral fat. And then you also have the opposite, and this is now me pointing at myself and my culture, where you have a lot of South Asians, especially in the United States in the UK and the Western world who are thin on the outside. They may not have a lot of fat that you can pitch outside of their abdomen. That's one thing that you generally still see.

But their arms are skinny. Yeah. Their legs are skinny. Yeah. Maybe even their face is a little bit skinny, right? Yeah. But they have a lot of visceral fat on the inside. So just based on how somebody looks doesn't exactly tell you how much visceral fat is going on. But if somebody has a lot of lot of abdominal fat that is probably one indication of them potentially having a lot of visceral fat. Is that accurate? Yeah, that's accurate. Maybe we'll just pull up this one image here that shows, I think, a pretty good example of somebody that is what we would call a toffee. So this individual is very thin on the outside. They have a small amount of subcutaneous fat similar to my colleague Gabe in the Army National Guard. Yeah, they almost have a slightly

oval shape, almost, right? Almost. Almost. Almost, and yet they have this abundance of white inside of them. So that's a huge amount of visceral fat. What's interesting is the individual when I pulled, showed him his scan. He knew what was good and bad because we went through some good scans and some bad scans before we pulled up his. And so when it came time drew to show him his scan, he actually became so emotionally upset that he passed out.

He fainted from the amount of fat that was inside of him. Why is that? Did he think that he was healthy? And then it was a shock to him. And when he woke up, I mean, he scared me. I thought he had a heart attack. Oh, shit. Yeah.

Yeah. I mean, it was terrified. In like seconds, I was like, God, I have no defibrillator. I have no IV. I have no epinephrine. I have no atropine. I got nothing, but my hands to thump on this man's chest. I was super upset at myself that having a clinic without a crash cart.

And so when he came to, you know, he was all sweat. and he woke up and I thought he was going to vomit and his lips were trembling and his voice was trembling and he said you know, Custin's, you know, he said, you just scared the, you know, basically the hell out of me. But he used a lot of expletives because he had this encounter with his insight that he had never thought about. And his previously, he just looked on his outside. He was pinching, you know, pinching the inch, you know, pinching an inch of fat on the outside, and he just, he had a little bit of fat on the outside, and so he thought he was good. And so, you know, he, the deception that was at work in his life was that he was healthy, and he realized,

and he said himself, he described himself as a fraud. He said, I realized that I have been a fraud, because I have thought for most of my adult life that I've been healthy, and this scan showed otherwise. So I like to tell that story and tell people about it because you won't get the inside look from just a Dexas scan or you won't get it from a laboratory report. I have never had a patient pass out on me from a laboratory report. I mean, it just doesn't have an emotional connection. But when I do these MRIs, it really does. It's the only time, you know, I hear the F-bomb repeatedly dropped. is when I open up these MRI scans on people and they see what is going on inside their body and it helps them to become aware of it. So Toffee is a real problem. Thin outside, fat inside. So if you would have looked at this individual from the outside, you would have said, like, great, he generally looks healthy. He is not overweight. He's not obese. He was not obese. In fact, he could have even been maybe a little bit thin. Yeah, he, you know, he was of modest frame. He just had concentrated a maximum

amount of unhealthy inflammatory tissue within his abdomen. But weight size and body, you know, in terms of dimensions, were very similar to other people that were far healthier. So let's talk about this person in contrast also to just the larger idea of somebody who might have a lot of subcutaneous fat, but low visceral fat. What are they doing that this, in this case, the quote unquote skinny person or the normal weight person has so much visceral fat, right? Going back to your list, we had processed foods, alcohol, sleep, stress, exercising too much. In the case of this gentleman that passed out and you putting his history together, what was he doing that contributed to so much visceral fat?

A lot of those things. So he ran a company and so he was very stressed out from that. He was doing a lot of drinking. So he had a lot of alcohol use. He was not sleeping well, so he had impaired sleeping. And his diet was horrific. He would eat a lot of processed foods, a lot of social events where he eat a lot of carbohydrates with people. And he didn't have a lot of any distance running, didn't have much exercise.

But when he did exercise, he did a lot of sitting. he did jog and then he did have impaired sleep. He was staying up and not sleeping well. So he had a lot of things. Women tend to be the ones that have more subcutaneous fat. And so my female clients typically will have a larger amount of subcutaneous fat and a smaller amount of subcutaneous fat. So there is, and it's worth pointing out, a different.

in the type of subcutaneous fat. So if we look at this adjambin, now I'm looking at the image back of the guy used to do running, and we're looking at is outside subcutaneous fat. And this is, I'll explain this, there's a black line that runs down through the subcutaneous compartment. Almost in like the sort of backside of the body. Yes, so this is the backside, and actually what we will call this. as the love handles.

So the love handles are this, you know, in the posterior part, and everybody, if you reach and want to grab your love handles, you know where to reach and grab. So in this individual here, this black line is called Scarpa's Fasha. So it's actually a membranous type of matter material that separates the deep subcutaneous compartment from the superficial subcutaneous compartment. But these, I like to describe the differences between the deep and the subcutaneous fat is like the difference between bricks and clouds, because deep subcutaneous fat is like visceral fat, true, because it secretes inflammatory molecules, IL-6, tumor necrosis factor, resistant, contributing

to insulin resistance, and cardiovascular disease. And the superficial subcutaneous compartment produces a muscle. molecule, it doesn't produce inflammatory molecules. It produces a beneficial molecule called adiponectin. And it's spelled just like, you know, it sounds adipo-a-p-o-nectin, N-E-C-T-I-N. And if you, you know, Google it, you can read about it, and it's protective against mortality and cardiovascular disease. So basically you want adiponectin, you want superficial subcutinous fat, you don't want this. Now, it's interesting to me is, and I'll just admit to you, I have probably looked at this scan several hundred times, but do you know what I've never noticed until right now being on the Drew Purit show is look at how he reduced his deep subcutaneous fat by spring. So it's like the inner layer closest to the body of the subcutaneous fat got smaller.

Got smaller. You just saw that and you're not even a radiologist and you're not a physician. And I'm just noticing it for the very first time after looking at this since 2017. So yet another, ladies and gentlemen, a reason to reduce your distance running and to get, now this is an end of one. I will point out that Drew and I just saw this together. So now I'm going to go back and look at my other scans where Sprinning was introduced and there were other confounders being not. introduced so that we can see. This was the original before and after that you brought up of the gentleman that did a lot of

long distance running. Yes. And then switched to sprinting. Sprinting. And the improvement that he saw on the visceral fat. And also this inner layer of fat, which you call again. Deep subcutaneous fat. Which is, of course, a good thing that you're acknowledging.

Yeah. So I think people need to be aware. And if you've never heard about deep subcutinous fat, don't feel bad. It's yet another thing that's not taught in medical. school, and there's not a lot of discussion about it. But, you know, I love, Drew, that you bring out these interesting guests and interesting topics to make people aware of it. And so I think besides visceral fat, if you're following this podcast, I would call to your attention deep subcutaneous fat and become aware of it. So it's the third mention of the type of fat that we talked about.

So we talked about visceral fat. We've talked about subcutaneous fat. We've talked about deep subcutaneous fat. And one other type of fat that I mentioned earlier was myomyostosis, which is an adverse composition of your musculature. And I'll just pull up this image. Here's an example of visceral fat in an MRI, lots of white and again, little dark. So if you're watching today, you don't want to have a lot of white. white and little dark. But look at the MRI scans associated with the adonal scans. These

MRI scans here in the right are his legs. So we always see a corresponding amount of fat deposited in the musculature of skeletal muscles in the legs where I like to scan. So just to be clear, we have a quadrant here of four images. The top is the before and the bottom is the after? Well, no, they're two separate individuals. Okay, got it. So the individual in the top has a lot of visceral fat and the individual below has almost no visceral fat. Just teeny tiny little, like it's a point in their abdomen, but also in their legs. In their legs. So I show two individuals, Adonel scans and their legs, how different they are. And the Adonel images couldn't be different. I mean, the one is almost all dark. I mean, if you look at his,

musculature is just he's wall to wall literally his his core is kissing his adenus rectus his six-pack and his back muscles are just beautiful they're enormous his core his obliques and he has no no deposition of fat within his abdominal muskature and no deposition of fat within his muscles so to kind of hit it home for the audience Drew I will describe this like filet mignon okay So there's no fatty marbling in the musculature. Now, the individual on the top, his scan is replete, just filled with visceral fat and his abdominal scan. And his legs are filled with all this white streaks that I like to call human marbling.

So the problem with these scans are they're both red as normal. So conventional radiology, the conventional health care system had nothing else to say, other than that these scans are normal. And they couldn't be further from normal. Because they don't have any abnormalities that they're looking for, like a tumor or something like that. Yeah. But wouldn't you like to know if you had that amount of visceral fat and this amount of inflammatory

fat going in your muscle? And when you also like to have the radiologist say, you know what? Like I told this guy. And you can follow him. He's on Instagram. is Mattadi, Emmanuel Matadi at Matadi, M-A-D-I in Instagram. He had the finest abdominal scan I have ever seen in my medical career, and I have looked at a lot of them. So Matadi is one of the fastest men in the world.

He's an Olympic sprinter today, and his legs are fantastically beneficial. So here's an illustration for the audience's sake. Now, there are those who are listening and not watching. I have two steaks up here, and these would be familiar to most people what steaks look like. Now, the image on the left is a steak that looks very lean. There's not much fat in it. It's very red, and you might, if it didn't have a shape, you might think it's filet mignon or tenorloin, but I think I'm not a, I eat steak all the time, but I can't tell you if that's a rib eye or New York strip.

I'm guess it's probably, I'm going to guess a New York strip, but whatever it is, it's grass-fed. That's the point is this animal was fed grass and was grass-fed and grass-finished. And the animal on the right was fed, wasn't fed grass. It was fed in abundance of grain. Many cows never even eat grass. They just eat grain, corn, soy. Cernels. Yeah.

Have you seen this? Yeah, they've fed molasses. You know, they fed candy. There was a truck that overturned on its way to a feed lot. You know, it's cheap, expired candy that's used as an extra sort of fuel source. And that was exposed? Yeah. Oh, wow.

Can you look this up? Actually, we got to bring this up real quick. Wow. So, yeah, red skittles spilling onto Wisconsin Highway headed for cattle feed. So basically, all these skittles were spilled out on the road. And then the police came and they're like, where is all this skittles going? Like, you guys are going to a candy shop? They're like, no, this regularly.

happens. We take old expired candy, which is a cheap source of carbohydrates. I don't know why I would be amazed at that. I know that we give them carbohydrates, but what's interesting is I had a client who came to me who was a veterinarian, and he informed me, and I love to share this on your podcast, because I didn't know this. He said as a veterinarian, he was a farm veterinarian, so he was for cattle. He took care of large animals. He said he never. was called for these animals. Never got called for them. And when you say these, you're pointing to the healthy meat, to the grass fed. So cows raised on grass, a species appropriate diet. He never got called because they were healthy. And he was, he made his money and was always called on grain fed.

So I like to make the point. That's the problem with humans today. We are not eating a species appropriate diet. We're eating foods that are rich, processed foods, the skittles, and it's tolerated, and it causes, you know, disease, and for us to have to go to doctors and have medical problems. So I turn myself around as an unhealthy 48-year-old physician by cutting out processed foods and eating more a species-appropriate diet, eating whole foods, and eating clean, and all my medical conditions left me. And so I am now feel a responsibility to advocate awareness and teach people what isn't being taught by other physicians the need to have healthier diets and to have a healthier lifestyle and going beyond just diet. We've talked about sprinting,

eliminating visceral fat. This animal isn't allowed to exercise. This one is. It's out in and pastures, and this one's in a CAFO confined animal feeding operation. So it's a lot less healthy. Yeah. Can I jump in real quick with a question again about processed foods, which is your first category. Again, eliminating or greatly reducing processed foods in the diet, I think most people that come on this podcast talk about that.

Here you are taking these things, processed foods, eliminating, removing alcohol, really doubling down on sleep, talking about the stress components, and making sure that we have stress solutions in our life and reducing excess sources of stress in our life. And then last one is not exercising too much, which a ton of questions on that, too. So on the processed food side, right, the question that I want to ask you is we already talked about the fact that you can have somebody who has a lot of subcutaneous fat, but still can be healthy. And you can have somebody who doesn't have a lot of subcutaneous fat, but could be very unhealthy because they have a lot of visceral fat.

And we talked about the gentleman who had a lot of visceral fat, but you looked at him and you might even thought that this person was healthy or maybe even skinny, right? And a lot of people think, oh, I want to look like that.

I would love to, you know, look that way. But they didn't realize that he has a lot of visceral fat until he came in for your MRI and he passed out, right? Yeah. So question for you, for the individual that is

on the outside, they look overweight, maybe even obese, but they have low, visceral fat, right? Which again, for everybody following along, that's a good thing, low visceral fat. In ideal world, you have low subcutaneous fat and you have low visceral fat, right? That's like an ideal world. Correct. But for those that are in that category that have a lot of subcutaneous fat, which would put them at overweight or obese, but low visceral fat, what's going on with them? Do they have some sort of genetic anomaly? Or is it that they're generally staying away from processed foods,

they're generally staying away from alcohol. Their sleep is pretty good. Maybe they're stress. They're not exercising too much in the way that you defined it, but they're still eating excess calories. Yes. So their excess calories is contributing to weight gain, excess weight more than what their body might need in their sort of base metabolism. So the body has to do something with it, right? Is that the idea?

Yeah, that is the idea. And I think people that are assuming too much, they're living. too abundantly and eating too many foods have a too large amount of subcutaneous fat. So there's the Goldilocks principle when it comes to subcutaneous fat. You want to have just enough to show, hey, I'm living well. I have a small reserve that will allow me to have an energy reserve, but I'm not carrying too much subcutaneous fat that my ability to run and defend myself, isn't being impaired. So I would submit, if, you know, if you're listening, you're a bodybuilder,

that you don't want to have a paucity or complete elimination of your superficial subcutaneous fat. You want a thin layer of it. And unfortunately, bodybuilding isn't really a sport of health. It's a competition where you reveal musculature, large amounts of muscle with the highest amount of definition. So they compete to eliminate subcutaneous fat, and unfortunately, that's not the healthiest objective for a sport to have, and they are ignorant or unaware of, I should say, is a nicer way of saying visceral fat, potential contributions. So the MRI with regard to people that are very thin on the outside in terms of their subcutaneous fat, but may have an abundance of musculature could reveal for a competitive bodybuilder the fact that belying that is a large

amount of inflammatory disease causing visceral fat. And so many bodybuilders have inflamed-looking faces as they continue to age and compete. They have larger amounts of visceral fat accumulating usually unknowingly inside of them and smaller amounts of subcutaneous fat. You see a lot of definitions, so it's not a healthy situation. But in their muscles, too, I would love to have a bodybuilder, and this image here I'm pointing to shows scans through the legs of an individual is 40 years old at the top, and they have very, no fatty infiltrates in their skeletal muscle, so they don't have human marbling. And an image below is a 74-year-old that has same condition. I just scanned a client of mine who's 78 and has the same kind of legs, no fatty infiltrates.

They've been very healthy in doing the strategies I shared with them. And this individual who's 74 here has visceral fat, or I'm sorry, fatty infiltrates in their legs. Their leg muscles are shriveling up from sarcopenia, and they have basically an abundance of fat within their legs. A lot of fat, very little muscles. Yeah. And here you're showing that no matter what age you are, you literally have an MRI scan of a 74-year-old that looks the same, if not even maybe a little bit better than the scan of a 4-year-old. But generally, they look the same.

They do. So this is how visceral fat and the reduction of it and reducing the internal marbling of you at any age can make you younger from the insulin. side out. Correct. And again, this association of visceral fat to these muscles and returning the images of MRI with a lot of visceral fat and how much fatty infiltrition and the skeletal muscles of the legs are important because just recently in the past three months, AI discovered through artificial intelligence and analysis of multiple studies that this adverse muscle composition or myosteotosis, fat within the skeletal muscle system,

doubles your mortality for cardiovascular disease. And yet that has been unknown and never shared with doctors. So Drew, we have physicians doing CTs and MRIs, probably hundreds of thousands of them a day are being done. And they're completely ignoring this. And so you're having these scans and nobody is bringing it to you. your attention that you have this dangerous fat being deposited within your legs and your arms. So these are done generally for joints and things, but the muscles are there to be seen.

And I just find it just inexplicable. Your speech. Yeah. Speech is. I can you get it out. That physicians aren't aware and don't bring this to your attention. So that's a clarifying question. Sure. So I think that's, that's an important statement, right? You said that people who have more internal marbling, which means more visceral fat, and you're showing an image on the screen over here, it doubles their risk of cardiovascular disease, right? Now, is that because of a correlative aspect that generally the more internal marbling you have, the more damaging you have to your heart, you're not eating well, you're not sleeping well, you're probably drinking more alcohol,

you have more stress? Or is there a direct connection to, to the fat and that there are excessed soft plaque deposits inside of the arteries. Like, what's the connection there between the internal marbling? Because you're showing the legs, but you're also saying that they have an increased risk of cardiovascular disease. So what's the connection? So good. So there are three types of muscles within the body, and we had to learn these in medical school.

And the three muscles are skeletal muscle. there's cardiac muscle, which is your heart, and the third type is smooth muscle. So smooth muscle line the walls, and they're the largest part of an artery, a vein, or a cardiovascular structure, some sort of vascular structure. The largest portion of it, the real estate, is taken up by smooth muscle. And so what I think is happening, I don't know, is the smooth muscle is also, having deposited within it, inflammatory fat that is compromising it. So as I eliminated my visceral fat, my image now, we're looking at a before and after photograph of myself, an image on the left and an image on the right, I eliminated my visceral fat, and I have, on the image on the right,

dramatically improved vasculature. And so you can see more prominent on my hand, my my veins are more plump, and the blood return, the important part of veins are they return blood that is poorly oxygenated and have less nutrient value from the tissues back to the heart where they can be re-octionated into the gastrointestinal system where they can pick up nutritional benefits. So my vasgature is very poor in the left, but also notice correspondingly that my muscle tone is very poor in my arms compared to the second image on the right. The after image.

Yeah, the after, exactly. And then look at my protruding adamant. So this is the abdomen of a typical 50-year-old, maybe a 45-year-old, has this. And look at the angle. There's a point right here where I'm pointing to, which is basically at the belly button. And that's the most protuberant point anteriorly. So it's sticking out. Now, look at my abdomen here. I've got a flat abdomen, and this is the abdomen, the shape of basically somebody who is 16 to 20, a flat abdomen. And so what happens is the inflammatory effect of visceral fat literally is caused in the muscles to decrease its performance. So it can't hold in your guts. And so my intestines now are, are, are, are, are,

more functionally withheld within my abdominal cavity versus here they're not and they're protruding out. And look at the dramatic change overall as my blood improved. I have much better improved looking skin. My profile is healthier. I don't know how the shape of my head changed so much, but it really did. And then my skeletal system, my posture, is significantly improved, you know, from improved blood flow. So when it comes to real estate, it's location, location, location, when it comes to health, it's blood flow, blood flow, blood flow. And then as we eliminate that visceral fat, we saw within the arteries of individuals, and now I'm looking at two images of a before and after of our arteries within the brain. This is called the Circle Willis, and these...

Is this an MRI or is this a different? This is an MRI, and we see that in the individual that was running 10 miles a day, 50 miles a week, the 58-year-old that cut out distance running started sprinting. These are his arteries. And we see here diminished blood flow. So the arteries that have dark flow here is where the blood is flowing good. There's a little bit of a plaque here at this location here in the middle, the middle cerebral artery. and then you see haziness distally to that where there's not as much blood flow.

But on the left side, we see a, and I say left because anatomically, that is his left already. He's laying down and his head's up here and his feet are towards us. So if the audience is saying, well, you know, Sean Amara is dyslexic, and I am, by the way, but I do have my anatomy correct. And this is a left MCA lesion. So he has a big plaque here that is impairing blood flow, and we can see it's poor in this segment distally to it. But the take-on point here, Drew, is in nine months. Well, this artery opened up here on this side, and the plaque was reversed here in the image on the right.

So in nine months— So he healed his lesion. He did indeed, and these were just from his participation in the study. with the National Science Foundation to cut out processed foods, to do maximum intensity exercise like sprinting instead of distance running, to eat food in whole form, to sleep better, reduce stress, and to use a sauna about 20 minutes, four to seven times a week. That was part of the protocol in the study? Yes, we recommend.

And not everybody was able to do the interesting thing about the study. And people are critical of it because they say, well, you know, you know, was 6,000 people, and lots of people, you know, lots of researchers would want to have the study results studied and peer-reviewed and over a long period of time. But here's what we did. I remember during this time when we were doing this, we got this grant from the National Science Foundation. They flew with my partner and I down to Washington, D.C. We were very excited, and they had a Google executive there. And he was sharing some of their moonshot projects, of the things exciting things they did. And one of the things that Google did is to ask the question,

how quickly can you get to your first prototype and start making changes? If you want to change and bring disruption in a beneficial way through technology and application, you can't afford to have long extensive research. And I think we're having problems in medical research because that's what we do. So what we did was, huh, let's scan people and see the difference between walking and sprinting or sprinting and running. Instead of doing a study for a year and a half, looking at 10,000 people at that, let's just study 5, 10 people and look at it quickly and see which ones are getting. And we just kept scanning them very quickly. So we got these insights that told us sprinters do better than runners and walkers do better than sitters. And people that eat processed

foods have visceral fat in two days. We could see it versus people that eat, you know, you know, healthy meats and healthy vegetables didn't get that. People that stayed up and studied and didn't sleep, we could see that impact in visceral fat. So we did a series, basically, of lots of little tiny, mini studies. And yeah, it's not going to get published in JAMA because we don't have large numbers over a long period of time. But we developed a lot of expertise, and now I can help to influence other researchers. They could go on and do those more extensive studies and use larger number of periods over a period of time.

But our purpose was to try to develop biomarkers for the National Science Foundation for the purposes of helping our country to reverse chronic disease and then to make money out of it. And that's something that's really important. If you cannot make money out of something, Drew, you cannot get it in, packed it into society. Money drives the wheels of commerce is what delivers care and service to humanity. And if you can't make money on something, nobody's going to buy it.

Nobody's going to sell it. So this would be considered more of like a proof of concept study. Is that accurate? Yeah, that's a good way to describe it. Yeah. So in research, there's regularly proof of concept studies, just to kind of say, hey, is there something here? Yeah.

And many of the big studies that we see out there in different categories, got microbiome, other stuff. If you trace the history and many of the past guests that we've had on the podcast here, almost all things, you know, start off with some proof of concept study, right? That doesn't mean that it's ready for publishing and peer review. It's just to show initial enthusiasm that something could be here. And then maybe those researchers go further or they pass the baton onto somebody else. Exactly.

So that was what you guys were doing here. Yes, that's what we were intending to do. And so I think many of our protocols and what we saw during this period of time represent rich future studies that we could look at larger numbers of people and watch. Like just these cerebral arteries, we only started scanning them, Drew, because people were self-reporting to us that they were more intelligent, their memories were improving. and they were more than just reporting it, they were questioning in a very kind of, I'll be honestly, an irritating way to us asking us why their memories were improving. What was it about visceral fat that allowed them to become more intelligent and improve their memory? And so out of 6,000 Adonal scans, you know, people that were scanning, we only did about 20 brains because it happened

towards the end of the study. And that's where we picked up. These arteries had lived. lesions that were reversing. And then during this time, you probably don't have an average resolution, but I have visible pulses now throughout my body. All my... You can see in your veins pulsing. Yeah, it's really my artery that's pulsating. And as a consequence, my arterial sites are now visible all over my body. If I lay down here, maybe at a podcast I'll show you, my belly goes up and down with my aorta. Now, that's good. You want to see blood flow, you know, going through your structures. Now, I call it today my human dashboard.

It's this visible signs of things that you can track. So, for instance, when I go out in the sunshine and I have my clients, patients go out in the sunshine with visible pulses that they acquire when they get rid of visceral fat, they eventually get visible pulses. when they go out and sunshine hits their skin, their endothelial cells start producing nitric oxide, and their pulses are enhanced, not the rate, but the magnitude of blood flow. The strength. The strength, or you could better describe as the amount of blood coursing through.

So the amount of blood being delivered to those tissues is enhanced. Doesn't that sound, ladies and gentlemen, like a good thing? Don't you want more blood flow to your tissues? So if you go out in the sun and you see these pulses become enlarged, not just faster, but enlarged, you reinforce the benefit of going out in the sun. This also happens when you sprint rather than just run. You see an enlargement and engorgement of that blood. When you use a sauna, you see the same thing happen as well.

And the fourth strategy we see is fasting. So when somebody does an extended fasting, their blood flow improves. So why is that beneficial is? Well, it's like driving a car. You need to glance at your dashboard to see where you go to facilitate safe and efficient, maximally efficient, effective operation of the vehicle. We have lost this, Drew. We have lost our ability to glance at it.

our bodies and derive that feedback that we need to optimize and reinforce what we're supposed to be doing. So I think visible pulses are all should be included as biometrics in addition to visceral fat and also the appearance of skin. There's another interesting, I will do it here, Turgar, where you pull your skin up on the back of your hand and it snaps back. Skin elasticity test. Yeah, well, they caught elasticity, and they say it's from collagen, you know, a lack of collagen, older people.

But you know what happens? If you go out in the sunshine, before you go out and you do that test, it will be slower and then you go out in the sun, it will snap back faster because of nitric oxide. So sunshine is, unfortunately, I think, demonized today. We're warned not to go out in the sunshine. and I know that it has the potential for cause and harm, but I think it's in people that are more vulnerable, that are less healthy, that that harmful effect of sun exposure is more problematic. But the healthy you are,

the greater capacity you have to exploit and leverage the sun. So skin turgur, elasticity, visible pulses, your nail beds, how well-perfused your nail beds are, they should be nice and pink. And your toenails should be nice and pink reflecting adequate perfusion. Our Chinese counterparts in Chinese medicine say that humans die from our feet first. And so very often, because it's the tissue furthest from the heart to actually perfuse, you see yellowing and thickening and disease going on within the nails and toes.

And you think about an 80 or 90-year-old typical foot, it's an unattractive, unhealthy appendage. But it doesn't have to be. If the 80 or 9-year-old lives a healthy life, they can deliver blood flow to those tissues, and they should have nice translucent. To toenails and fingernails should also be the equivalent on the hand. And toenails should not be yellow, should not be thinking. They should not be infected with onchymocosis from fungal and yeast in particle.

invasion and infection. And your feet, your toes should tell the story of how healthy you are, because it also tells the story. It corresponds to your body and to your face. So health is systemic, and you can look at any part of the body, and it will tell the story on how healthy somebody is. And so you can chase a particular disease that might be, in one particular area, but chronic disease affects your whole body. You know, going back to this brain image that you ever hear and also connecting it to these other proxies of health, you're talking about our nails, our feet, part of the takeaway that I'm getting, which again goes to your larger point. And I might have missed something in it,

so correct me if I'm wrong, is that generally the more visceral fat you have, the harder it is for all your body's systems to do their job. So in this instance where you had some lesions, in the brain, are you saying that there's actual visceral fat deposits in the brain that are preventing accurate blood flow? Is that accurate? I wouldn't describe it as visceral fat. I'd call it as, and again, it's my hypothesis that when fat is being deposited in skeletal muscle, it's also being deposited within the smooth muscle of the arteries to the extent that visceral fat is present within those adjuvant. So, but, Here's an interesting picture.

These two faces here are... So is it before and after of a young man? Yeah. So it's a client patient. And how long do you think it is between the before photograph and the after photograph to have this amount of improvement in their face? So on the right side, his face looks like the after photo. His face looks more chiseled, more sort of vibrant.

Looks like there's... Could be the shadowing or other stuff, but generally looks healthy. here on the right side. And on left side, his face, I would say, just generally overall looks more puffier. Um, you know, I know it's probably going to be less than what I said, but what is this? Three weeks? Three days. Wow. So in three days, somebody is seeing a dramatic improvement in the puffiness of their face. Yeah. So these photographs, I look at, I collect photographs a lot because I'm doing, uh, AI to, to look at photographs and interesting project. Um, this is, individual improved their face so much in three days. And what they did was, for the sake of the

audience, so that's what? My face did prove that much. They did a 72 hour fast. So they ate no calories for 72 hours. Now, if you're listening, don't expect that that's going to happen to your face in 72 hours. What happened and the reason, you know, to explain this profound effect is that this individual on the left had no visceral fat. They had eliminated. They had seen. They'd seen me about seven months before, had eliminated their visceral fat and then did a 72-hour fast. So a 16-year-old, a 20-year-old who has very little visceral fat who does a 72-hour fast will have that kind of a change in their face by eliminating their visceral fat versus a 70-year-old filled with visceral fat.

It just tries to do the same fast. They won't get that kind of benefit. And just to be clear, you're not recommending that the first step for people is a 72-hour fast. Not at all. And you're not saying that everybody all of a sudden is going to benefit from a 72-hour fast. You're simply articulating what? What? So the point I'm trying to make is that visceral fat anecdotally appears to reduce the benefit that you get from a lot of healthy practices.

In other words, the amount of visceral fat you have, we have found, impairs your body's ability to respond to the signal. So there's a paradigm called stimulus impacts an organism. The organism responds. An example of that is lifting weights. So when you lift weights, it's a stimulus. The impact on the organism causes a response, which is muscle hypertrophy. Well, the amount of visceral fat you have dictates the level of health in that organism and the response is produced. So the best example explanation for why a 70-year-old male who lists muscle, I'm sorry, lifts weights, does not produce as much muscle in response is because the 70-year-old has impaired their health by the accumulation of visceral fat, chronic disease.

But what if the seven-year-old eliminated their visceral fat? So I unfortunately don't have pictures of this myself, but I have photographs of myself without a shirt on age 55 and then a photograph of myself at age 59 or 60. I'm 60 today. And I have dramatic increase in my musculature. And people a lot of times challenge me, they think I do steroids or hormones or testosterone replacement or something. performance-enhanceder drugs. No, I simply have eliminated my visceral fat. So what happens as you get rid of visceral fat, it basically realignes you to a more youthful, and I would say more healthy response system. And so when you have a stimulus, you can respond better. So in other words, the point I'm trying to make is visceral fat acts as an impedance or a governor

on your ability to become more healthy. So you want to eliminate that visceral fat, that inflammatory substance inside of you. So as you start doing things like lifting weights, walking, sprinting, doing a sauna, you can accelerate or enhance your body's response. So the example I give to clients is my 17-year-old son, Aiden, and you, Mr. client, a patient who's six years old, if you lift the same weights, the same sets and same repetition, same amount as Aden, and you do that for six months downstairs in my weight room, you will have less results than Aden. And the biological explanation is not age. It's the fact

that Aiden has not destroyed his physiology from inflammatory, chronic disease, largely, you know, coming from visceral fat, and you have. But we see clients and humans that are older now, eliminate visceral fat, and then start getting muscle gains, start changing the face, the shape of their face, start getting visible pulses. The quality of their life is improving. Yes, their appearance improves, but your point is spot on. We do these things so that we live better, not to look better. If our goal was to look better, we would do plastic surgery by clothes. And what I described that is kind of the Earl Shib paint job. You just do a paint job on the outside of a car, but the car does not run any better. You want a well-running car that is going to serve your needs, carry you through,

and help you to enjoy as much as you can, every circumstance that you will face in the future, whether you'll benefit from it or suffer from it is guided the most by the health of your body. Is it fair to say in the case of your son, right, or when you were 17 or when I was 17? Generally, yes, we have less visceral fat, but also we have more, you know, growth hormone inside of our body. We have more stem cell production inside of our body. So there are a few other things. Vesceral fat is important too, but there are a few other things that might be going on at the same time. Yeah, I think that's a really good question.

But here's what I'd posit with. Please. What happens to those people that are in their 50s and 60s that haven't accumulated that visceral fat or who eliminated? Do they start getting more stem cells? Do they start getting more hormones? So let's take a look at this picture here. Let's look at these two legs.

So this is a picture of my leg on the left and my leg on the right as I developed a visible pulses and limiting visceral fat, look at the tremendous increase in the hair on my legs. Estimated by a hair surgeon, this is not an area of expertise I have, to be about 300% increase. So my explanation of this is that better blood flow to the stem cells around the follicles allowed for a greater increase in hair. The hair started growing again when I had a very positive. So you're saying the right side is the after. Yes.

After you're doing sprints and all of the changes you mentioned. There's quite a few of things involved. You're seeing an explosion in hair. Yes. It's a little tough to see because the one on the right is a different color configuration. But generally you can see that there's more hair that's there. And so you noticed an explosion of hair growth. Yes.

And we see this in client patients as they eliminate visceral fat. They get in particular visible pulses, which would indicate better blood flow to those tissues, that their hair on their legs. Now, the absence of those changes, in other words, people who are not getting rid of visceral fat and not improving their blood flow, the projected and natural state of the skin is to be glabrous, to lose hair. So if you think about a 90-year-old laying in a bed, they have very little hair on their legs and their arms, and oftentimes at the top of their head, because it's not just aging, but more effect of impaired physiology, less beneficial hormones,

more stem cell death. And so the question I like to ask is, is it possible, we could, and by eliminating on a widespread basis, visceral fat and improved blood flow, could we see alopecia, male pattern baldness, improve? And there's an interesting study that shows a correlation between heart fat and alopecia. This is an example of cardiac fat. So we have two MRIs here, and the image on the left shows two right and left lungs, and the middle of your lungs is your heart, and fat shows up, as we mentioned earlier, as white on an MRI, and there's a large amount of heart fats in this particular image, and this is the guy who just cut out processed foods and didn't exercise for one minute, and look at how much he reduced his cardio fat in the

course of just 13 weeks. So heart fat is, is inflammatory. It has a local effect right on the arteries on the outside of the heart, corner arteries transit on the outside of the heart. And they're, for that reason, advantageous to a cardiothoracic surgeon who could access them more easily without cutting into the heart and to do a transplant. But in autops, and studies, we've seen people where the artery has an unusual course, drew, where it goes into the muscle of the heart. And it's so it's interposed between the artery, is muscle, and then that cardiac fat, cardio fat. That segment where it dives down has segmental sparing from arthroscopic cardiovascular disease. So that heart fat has a local,

inflammatory effect and contributing to, at least in studies where it's been done, segmental disease. So heart fat is a bad player. Fortunately, we saw in all our 6,000 clients when we looked at visceral fat that those that we also scanned the hearts and we didn't do as many scans with heart as we did adaments. The cardiac, cardio fat, the fat around the heart, is reduced. as well as you get rid of that visceral fat. So a nice example, Asif, the very nice, my friend who's so nice, don't want to help the Bangladesh poor kids get educated like he's been educated in America. This was his, what's called a sageal view. So we're taking a slice up and down. This is his head

and Asa's feet are down here. This is his belly and these are his backs. This is his kidney. and right above his abdomen is his heart. Now, look at the large amounts of fat within his medial spinal region surrounding his heart, this inflammatory fat. It almost looks like a little glove or mitten around his heart. Yes. A glove of visceral fat surrounding it. So corresponding to, we always see visceral fat is to heart fat.

So, again, it's this consistent story that visceral fat and, chronic disease is systemic. It's not specific to just one particular area of the body. When we bother to look at the sinister effect of chronic disease, we see it all over. Just a couple more questions about sort of your journey and your body, right? What would you estimate? Because visceral fat, again, is taking us out of the idea of like BMI. There's people at all different levels of BMI.

people that look skinny, people that look overweight or even obese, that may have a lot of visceral fat or may not have that. What would you estimate, though, your body composition on doing like an in-body scan or a dexas scan or one of the traditional ones? What would you say your body composition is? And is there a total amount of visceral fat, volume of visceral fat in the body that is generally our target goal that we want to stay under. Yeah, great question. So the first part is I do use a body impedance scale. So I give my clients a cheap $20 scale that I get off Amazon. And I give it to them not for the accuracy of the readings, but to follow the trend. So generally, bioimpedance is another form that you can look at visceral fat, but you're never

going to get a direct measurement of visceral fat from biopetence. It's a calculated measurement based on muscle and fat that it's more accurately able to determine. So as you lose body weight and you're losing fat, they extrapolate from it based on average. gene how much visceral fat probably is being lost. So my clients who lose visceral fat, there's a wide degree of variance in bioimpedance between the reported amount of visceral fat lost in a scale. It's usually not as much as what is really lost when we do an MRI based on our focal strategies to eliminate that visceral fat. So bioimpedance is a, as a, as a, as a, helpful modality for tracking trends, but it is not accurate. If you think you're going to get a

good reading of how much muscle and subcutaneous fat you have in visceral fat from a $20 biopetance scale or a $60 biopetance evaluation in some fancy club, you're going to be disappointed or not you're going to be misled. You really want to spend, you know, your time and effort money on getting an MRI, which, you know, runs about $500. And then to your question about, or up to $1,000, to your question about the amount of visceral fat, I do get that a lot. You want none. I mean, ideally, you don't want any of this inflammatory fat within you.

You want to live as stress-free life as possible. You don't want to be, you know, drinking alcohol and impacting your metabolism. There's not a, sorry to interrupt, but there's not like a Goldilocks approach when it comes to visceral fat. I mean, there's a reason that our body produces, is there not some protective benefit to having a tiny bit? I've never seen it. It isn't. People think that it has a protective benefit. Your body produces it because it's the first earliest expression of things gone raw.

We saw it in children. Kids get visceral fat early on, unhealthy kids. and healthier children don't have it. And that continues. None. Some healthy kids have no visceral fat. And we've seen, I have some clients that bring your children to me. And they're filled with visceral fat early on.

And so it really turns on the lifestyle that you're living, whether you're an adult or a child. And you can stress out a child. You can, unfortunately, I don't have any examples of. of kids with alcohol consumption, but I'm quite sure if you started, that would be a ridiculous study. If that was happening, kids that were, and I suppose that there are kids globally that get into alcohol use at young age, but impaired sleep, and lots of processed carbs will cause these deposition of this inflammatory substance.

So, no, you want none. you want to eliminate it. I think it's hard. I mean, if you're going to ask me how much, how realistic is to, I think is probably the more practical question, how realistic is it to completely eliminate all your visceral fat? It's very hard. I have seen clients that have worked extremely hard get their visceral fat down to around probably four ounces.

I mean, that's a shocking amount of low. Is it the lowest you've ever seen in your scan? Is somebody that has that amount? Yeah, I would say about four, about four, yeah, less than half a pound. Do you have any estimation about, not that this is the goal for everybody, but just to give a reference frame? Yeah, no, it's how much visceral fat do you have in your body? Perfect question. So we wrote software in my first startup that was proprietary to evaluate visceral fat.

You can, by the way, there is free software software. to evaluate and quantify visceral fat out there. So it's open source and you're able to get that if you're involved in MRI and technology, you can get that and it's freely available to you. The interesting thing is we stopped using it because we never found a number helpful. And when we would tell people, as you remember some of the images we had up there earlier, quantified the visceral fat. The number didn't seem to influence. people as much as visualizing their visceral fat. So I, to answer your question, I probably have probably around eight to maybe 12 ounces of visceral fat within my latest scan of my abdomen.

But what I track is visualizing it rather than quantifying it because it's the visualization of that unhealthy expression of tissue within your body. that's going to pair you more and affect you more and allow you to change than some number. Otherwise, it becomes sort of like a laboratory study. And it's people that look at that visceral fat that changed their life more than if I were to give them just a scan and quantified it without allowing them to see it. So everybody, and by the way, there's studies on this too, Drew. Recently, even the past three years, a study showed that doctors, for all,

pathology that take patients and show them pathology inside their body via CT or an MRI or even x-ray, have a greater impact than being able to meaningfully treat and help somebody than if they just gave them the report. So, you know, we are creatures with senses. And to the extent that we engage our senses, we learn better. Smile, touch, feel. cite all of the senses, the ability to educate us and inform us and to be more effective in our world, allow us to do so through the senses better than if we just looked at a number. So when it comes to health, you really want to engage as much as possible the census and interpreting the data and whatever information you're looking at.

So I'm sure you're aware of all the different nutritional debates that are out there. one of the landscapes of one debate is that there are people that are traditionally described as individuals that believe that, you know, everything is sort of energy balance, right? The calories in, the calories out. Generally, most people that come on my podcast and the people that I look up to, they would say, hey, listen, yes, total calories does matter, right? You can overeat and gain weight, just like we were talking about the sort of healthy fat people that are still consuming excess calories, but quality of calories matters more,

but that doesn't mean that you can't write off total calories, right? So like they say that still total calories matter, but quality of calories. Now, part of what I'm hearing you say is that even when controlled for calories, let's say we had one group of people who is basically staying away from all processed foods in the way that you describe it, right? Kind of like, like the diet that you follow right now. They're not eating processed carbohydrates or other things. Generally, they're eating vegetables. You in particular do a lot of fermented. Not a lot of them, but the vegetables that you have, you choose to have them fermented. Correct. But you generally find vegetables are part of a healthy diet, right? I do. That's recommended out there. You get probably

most of your calories from meat and animal products. Would you say in terms of total calories that come from there. Correct. But again, your larger approach that you're sharing with your patients is stick to whole foods, right? And if you're going to process, you're really saying like a mechanical, like a blending or a mixing or other stuff, not a deeper refining of foods that are out there, which would include a lot of like the more processed and then eventually on the higher end of it, you know, everybody generally agrees, like let's stay away from ultra-processed foods. So what I feel like I'm hearing you say is that if you have a lot of, you have. had two groups of people. One group of people, even if calories were equated in both groups,

one group of people is sticking to your definition of non-process foods, whole foods, their diet, and also staying away from alcohol. Of course, the other lifestyle factors are there, too, prioritizing sleep, not having an abundance of stress in our life. And then, of course, you're not exercising too much, and you have some version of healthy exercise, which we're going to break down in a second. Then you have this other group that is eating still adequate level of protein, is having an adequate level of fiber, is still being controlled for calories. So both groups have their proper calories. But in this group B, the difference would be is that this group B is having some degree of processed foods as a regular part of their diet. Right. But they're still meeting their

protein goals and they're still meeting their fiber goals. What I'm hearing you say is that you would suspect that group B, even when equated for calories, even when equated for sleep and stress and exercise in both groups being the same, you feel that group B is going to have more visceral fat. Is that accurate? I do. I think that is the case. And I would also extend more than just to visceral fat. I would say that the group B would be less healthy. And so I would, ascribe to the group of people that are not in the calories in calorie out, strict application of caloric intake. I say the quality of the calorie is more important than the quantity of the calorie. And I would add in further application or fidelity to the point about quality

and say that it is likely explained, I'm quite confidently, by the difference. in the microbiome of the individual. In other words, the healthier somebody's microbiome is, there reflects their capacity for caloric intake and processing of foods. So, for instance, there are people that have a healthier microbiome, a different collection of microbes, who could eat even unhealthy processed foods, very sugary processed foods, like cotton candy, and not have the degree of impact either in visceral fats or in some sort of detrimental health consequence. And so the microbiome represents an area of importance for us to study and potentially leverage and utilize as ways of potentially treating or improving humans. an interesting study came out probably about seven years ago where they gave people brownies with

icing on them, and they studied these individuals' blood sugar response. And what they found is certain people were able to eat those ice brownies without any impact in the blood sugar. And what was determined in those individuals was specific shared microbes that they alone had that other individuals whose blood sugars went up did not have. And so there was active research to try to turn that particular species of microbes into a supplement that you could give people that would allow them to eat chocolate ice brownies. I got to imagine that there's other harmful effects besides just, you know, blood sugar going up. But nonetheless, if they're reasoning

trying to figure out a probiotic supplement that would allow to do that. But these microbes work better in vivo than they do in vitro, and they're very delicate. So I'm not sure that any time soon, they're going to be able to come up with that. But the bigger point is the healthier your microbiome, the healthy you are, and the healthier you live your life in terms of diet, lifestyle choices that you do, how you exercise, how you sleep, how much stress you put up with influences and dictates your microbiome, even your behavior, your interaction with other people, all go towards, you know, the level of health of your microbiome. So I like to share with on podcasts and within my client patients the need to live the health

life possible by making the best choices, and it comes down to this. You want to have the healthiest collection and diverse collection of microbes, beneficial microbes that you can possibly get, and the fewest amount of detrimental microbes in you and on your body that you can possibly try to objectify and pursue. So it's an area of a poor understanding. Lots of people don't understand the microbiome, haven't been taught about it, it's not, it's not, from a scientific standpoint, well understood even by researchers. I mean, we are just scratching the surface and our standing, the collection of the microbiome. There's somewhere between 50 and 70, maybe hot, even more, a trillion microbes that live within our gut. We only have 10 trillion

cells about in our body. So it's fair to distinguish between our ourselves and these microbes that we are more other organisms than we are ourselves. And yet I will say having talked so much about visceral fat that nothing is more important to your health and influencing your health than your microbiome. But the visceral fat, there is no better target to study and work with. And nothing will improve your health more than tracking visceral fat and eliminating it from your body. Now, with the gut microbiome, you know, we've had on individuals like Dr. Emron Mayer, who's one of the earliest researchers in this space, he's at UCLA, has a whole department and division in school that he's set up on it. And we've had other individuals,

like Zach Bush, who I've heard you talk about as well before. Lowell-Sack. Generally speaking, most of the people that are in the space of gut microbiome research and even like the American Gut Project would say that a couple of things that we do know are diversity of plant foods seem to be associated with diversity of gut microbiome, as well as fiber and total quantity of fiber in those target ranges that are there. I think the average American gets less than 15 grams of fiber a day, and I think that the target recommendations actually I'll have to look it up in terms of what's recommended. How do you feel about those recommendations? Well, I used to ascribe to them, and they seem very sensible, but, you know,

there's conflicting data. A recent study came out and showed that the amount of fiber and that was added to any individual's diet with impact on the microbiome showed higher levels, or I should say, no change in their markers of inflammation, and that there were actually in individuals that eliminated the fiber. They actually had lowering levels of markers of inflammation in that particular study. However, it was small. And so I was surprised by that, and I think we just need larger studies. And we need, it may be that you want to, I'm just going to posit.

it, you know, as a serious researcher, it might be the case that you want more higher quality microbes, a greater abundance of higher quality microbes than a sheer diversity because maybe that diversity brings in less beneficial microbes. It's possible that you're bringing in a larger amount of less favorable microbes. But I do tell my clients that they want a larger collection of diversity. I really do. And I tell them, for that purpose, to eat a variety of fermented foods. I tell them to go out and, you know, I say a good client patient goes out and buys 20 jars of ferments. An average client patient goes out and buys, you know, four to five. And a client patient that is not very motivated and has poor results buys one jar. And so I tell when it comes to the microbiome, I tell

I tell my clients, when you eat fermented foods, you want to think about Noah's Ark, small quantities of a variety of foods. And so I do generally feel that that is helpful guidance, but I remain very open-minded to the possibility that maybe less diversity and more abundance of truly beneficial microbes are what we might find out in the future is most helpful for humans. So one of the questions about this whole landscape of how to navigate this context of processed foods, and I'd love to go through alcohol, sleep, stress, and exercise to leave people with some practical recommendations for each. So one of the criticisms that is often given to the world of wellness, which obviously is everything lumped in. It's plant-based diets. It's carnivore. It's

people in between. It's the Mediterranean diet is that the more restrictive you make a diet, the harder it is for people to follow. And I think that's been shown in multiple long-term studies that people reference. So if we tell people to not eat and we have them shoot for eating no processed foods, like only eat a diet like a whole 30-dense. diet, which is generally how I eat because I feel good that way, right? And it's been years of dialing it in. And I will eat. I was in Vancouver this weekend with a buddy of mine and my wife. And I wanted to try this croissant from a bake shop. And because generally I don't restrict myself because I don't have cravings for these foods, I bought one. I had half of it. And I thought, well, I got the point and

I'm good. Like, I don't need more than that, right? Like, I got the point. It tasted great. It was awesome. It was a fun experience. I had it with my coffee and then I moved on. It's not going to set the tone for the rest of my day, but I also don't worry, whereas in the past, I generally used to worry when I was younger that, oh, eating one dessert is going to throw me off because I'd see a lot of advice from people that were out there that said, sugar is the enemy. Sugar is going to destroy your body. Sugar is this, sugar is that. And as I learn more and more, I realize if the foundation of my health is good and looking at my lipids, doing my blood work, looking at my MRI, which I haven't done your version to look at my visceral fat.

I want to come in. We'll tell people, you know, maybe I'll film that. I'll go down to your clinic over there. Awesome. I'd love to film that and show people me going through it. Opting in optimizing my body composition and still working on that. I definitely grew up skinny fat and I'm still working towards having a better body composition and adding more lean muscle mass.

and even getting my advanced heart screening done through like a clearly scan and seeing that I have a super low soft plaque buildup inside of my heart. Obviously, I'm 41 years old. I want to keep it that way for the rest of my life. Yeah. So I've generally seen that even I can get away with eating a little bit of quote unquote processed food here and there. I'm not eating at McDonald's on a regular basis or ever really and still have overall be in the optimal capital. for my fasting insulin and other things. So I know I'm lumping in a lot of things together, but this is really an opportunity to provide clarification. You know, you were sharing that you want people to stay away from processed foods. Do you see it as sort of a spectrum? And do you

see that people also can generally eat maybe some processed foods and still be healthy individuals? I do. And, you know, at the risk of maybe oversimplifying it, I think there are people that can eat processed foods, have the croissant experience, and maybe even fairly often and not get themselves in trouble. But on the other spectrum, or I'll even say that they can do it all the time, but on the other end of the spectrum are some people, many of whom are like some of my clients, who if they even take one little croissant, a little bit of one, they will be afflicted with cravings. I call it start circling the drain. They'll just start binging and go down and they will gain a rapid amount of fat, usually it's visceral fat, and they'll have a much different experience than you.

So what is the difference? The difference in my opinion is the microbiome again. And what happens are there are people that have a suboptimal. They don't have as strong of a microbiome. And so when they get exposed to those kind of type of foods, that it feeds carbohydrate-loving microbes, of which there are species. Humans have macronutrients that are essential to our existence or protein and fat and not carbohydrates. But I will say that there are species of microbes that are essential have those simple sugars. They need them to survive. And so I think they have the capacity for influencing the host that they reside within. So I reach out to people and I like to educate them.

If you are somebody that you are suffering from a lot of cravings, that you know when you eat these kind of foods that you become afflicted with it, then I would suggest that you don't beat up on yourself and think this is you. and try to, you know, blame yourself for all these cravings and understand that the microbiome isn't completely mapped out, and it's very likely the case that residing within your gas intestinal tract are species of microbes that are dependent upon these simple sugars, and they're influencing the host that they live in because it doesn't make sense. They don't have the capacity to leave the host and go out and find dinner if you're not going to feed it to them. So they're wired into you and create these cravings for it.

So what do you do? I recommend to those individuals, stop feeding them. They die usually in hours, minutes to hours. And if you cut off the food supply, they die. Then you have to worry about making sure that you have intact within your microbiome the capacity to be resistant to them because they're, you know, ubiquitous. But every time you get to Walmart and Target and touch a shopping cart and elevator button an escalator handrail, you're going to be exposed to other, you know, pathogenic,

obesogenic microbes that are going to eventually get into you. So I help people to work with them to eat fermented foods to help populate their gut with good beneficial microbes that will help them be resistant to these craving ones. And very often the case, people that try that strategy incorporating fermented foods into their diet are able to resist the temptations that might afflict them. And so my explanation, a bit long-winded to why you could eat that croissant and other people. Typically, as younger people, can eat croissants all day long and not gain weight and suffer from these cravings is a difference in our microbiome.

And so the microbiome represents a black box for us to learn more about. And I think in the future, FMTs, fecal microbiotic transplants, will be potential sources for us to impact and help provide people effective quicker treatments to help them with some of the challenges they're having that I think are attributable to a suboptimal microbiome, that we're still only figuring out. So FMTs, microbiome, optimization, and getting started earlier by just eating fermented foods in your diet is a really sensible, in my opinion, a strategy to help people become more healthy. Great. Thanks for that clarification. We could probably do a whole other episode on just that, and I'm excited to have you back on to do that. Let's provide some value on the other four areas that you

broke down, not that you haven't already touched on them, but a few clarifying questions. So we already talked about processed foods, and generally, I think you would agree moving away from ultra-processed foods for a lot of people, if they're still eating that, is going to help them across the board. And definitely most people should see a shift in visceral fat inside of their body and shifting more towards whole foods. And then there's going to be some personalization inside of there that people are going to have, that they're going to have to figure out. And you've shared what your diet is.

We haven't deep dived on it here, but, you know, you have other podcasts. We've gone really deep on it, like the minimalist and a few others that we'll link to in the show notes. alcohol, right? Let's talk about alcohol for a quick second. Did you grow up drinking and do you drink now? I did grow up drinking. I was relatively late. I don't think I hardly, I maybe drink once or twice before as legal age and then I drink when I was of legal age and I continued to drink, but I was never a heavy drinker. And today, I don't drink at all. I, for most of my journey, which has been 13 years, and I describe as a journey, I drink for most of that time period, and I would drink modestly about a glass of wine maybe four times a week, not much.

That's pretty mild by a lot of people's standards. But two years ago, I completely gave it up. The more I read on studies and saw the impact of alcohol, I determined that it was probably more problematic for me than it was beneficial. And many clients have told me a shout out to Alex Huberman's podcast where he discussed alcohol. Andrew. I'm sorry. Yeah, Andrew, not Alex. Andrew. How he informed, I think, very effectively his community, how problematic alcohol was. A lot of people have just walked away from it and have never felt better after they did so. So today I don't drink at all. I have been dry for over two years and I do to feel better myself and every client that has done that has reported the same thing. Nobody, interestingly,

has ever returned to drinking and said, you know, I feel like I have to do that. But part of that, and I've heard that other places, part of that is I think once you become more healthy, your capacity for doing those kind of things become, one, easier, and two, more sustainable. And I think if you try to give up alcohol maybe as just one strategy without really being healthy enough, I think you're going to have a harder time both maintaining that and benefiting as much from it. So I think it's part of the discussion in health. I like to say that health is a journey and people ought not to think about it as a light switch where you have to do it's binary and you have to do it. It's either this or that, black or white.

What is binary in black and white is a decision that you want to be healthy. I mean, that is important. And once you start from there, then you enter in on a journey that everybody's journey is different. But what you want to help define that is you want to get better and you continue to get better and you have a hunger and desire to learn about that. And then I think it can happen in a more natural and a more sustainable way. If you're doing this artificially for some other purpose or for other people and not for yourself and not understanding that when you are more healthy, you enjoy a better quality of life, then I think it becomes much more difficult.

difficult to your earlier points about sustainability. Yeah, I've shared multiple episodes about how I never really drank growing up, never got into it, didn't see the point, then got really into health and was like, okay, alcohol is the exact opposite thing that I want to be drinking. And then I had a friend that opened up this really great restaurant in New York, which they made a whole documentary about on Netflix called Pure Food and Wine. And then for the first time, I was like, oh, cool, like wine is great. like let me have some a little bit here and there and that was also this is maybe now almost 15

years ago 18 years ago um there was a lot of sort of you know still that propaganda that was out there about resveratrol and hey red wine and you know you weren't really hearing a lot about the blue zones and sort of the incorporation of alcohol but you were hearing that oh yes here's a good amount of alcohol that was there but the thing that always confused me was that that standard statement from doctors, which is, hey, yeah, drinking is healthy and it can be part of your life and it can help you live long, everything. But if you're not drinking yet, doctors don't recommend you start. It's like, what? Those two things actually like completely cancel each other out. Yeah. And so over the last year in particular, I went all out last summer for my 40th birthday,

took a bunch of my family and friends to Italy. We all celebrated. We're having wine pretty much like every day, multiple meals together. Came back and just, felt so puffy and got serious about a string training program that I was doing with a local group here in LA called Ultimate Performance. And part of their protocol is removing alcohol when you're working out with them. And so I did it, which was not hard for me at all whatsoever because I wasn't even, I was what you would call a barely social drinker prior to that Italy trip. I would have maybe one to two glasses of wine a month.

maybe if there was a bunch of birthdays that were there, maybe four glasses of wine in a month, and even probably half of them, they wouldn't have been finished. So in removing alcohol, I felt like even at the level that I was drinking, which was very infrequent, I still felt so much better. Yes, I was also working out as well too, and I was doing all their behaviors, so you can't just say it was just alcohol in itself. I have been transparent with my audience that it doesn't mean that I'll never have a glass of wine. I had a glass of wine this weekend with friends. And immediately I saw my sleep,

you know, not the greatest the next day. And that means more to me than anything else. And so it felt like, okay, cool. That was cool. I'm glad I enjoyed it. I had it with friends. And I'm back to not having alcohol again. So I've shared a lot about that in my own journey. It's this dry wave that we're seeing is so exciting to get so many more people just decoupled from the hold and the tax that people are paying with alcohol without even knowing it. Right. All right, let's go to sleep. What are one, two, or three top recommendations that you have for people who want to improve their sleep and feel like it's off because they know that not only are they feel, not only are they going to feel better that day, the next day, but it's actually going to be one of the key pillars to them

reducing visceral fat. Yeah, so that's really great question. So I will start with my own anecdotal experience. One of the things that I've noticed is as I've become more healthy and I've adopted healthier strategies and purpose to become more healthy and just am more healthy, it feels so much better. I've become exquisitely sensitive to the influence of particularly sunrises and sunsets. And so as a consequence, when it comes to the sunset as the sun starts going down, it is though a drug has kicked into me, and I have got to get to that bed. And then the opposite happens in the morning as the sun starts to come up. I'm wide awake and very vigorous. So what I would share with people is the influence of light. And I think

the capacity for light to have a measurable effect on you. you and to also be influenced you is guided by your health. So it's very difficult, my opinion, to have an effective strategy about sleep just doing one or two things. It's best not done in a vacuum that you understand that your health plays a huge role. And so you should really come at it from a holistic standpoint that health and sleep are connected. to each other, and to the extent that you become more healthy, you sleep better, and to the extent that you become, you sleep better, you become more healthy. And so a few basic guidelines I give my clients is you got to stop with the unnatural. Instead of eating like processed foods, eat food,

and more natural, holistic form. Instead of influencing your brain and your body with unnatural light, you know, exploit the benefit of natural light, sunshine. And then at the night time, another source of natural lighting that I've moved to are candles. And I like beeswax candles. So at nighttime in the Armara household, we are dimming our lights. We have, we have pink Himalayan salt lamps, and we have beeswax candles. And it is, it is like a somnolic drug that kick. in and it just eliminates all the stimulus that otherwise is competing, you know, with our natural circadian rhythms and interfering with that. And so I acquaint my clients with the unnatural artificial exposure that we're constantly being attached to. And then with it, neurogenic exposure from

electronic devices, cell phones and iPads and laptops and TVs. And even reading, you know, if you read read at nighttime that's too stimulating. So you try to ease into the evening and make a departure from all the busy stimulus and artificiality that is otherwise in abundance and people aren't aware of. So those few basic steps are important. And then eliminating, you know, not eating directly before you go to bed, trying to eat earlier in the day. that your gastrointestinal system is less burdened by food as much as possible.

And then I do think that some supplements are interesting to think about. I think magnesium helps people. Generally, it's the number one nutritional deficiency. So I have my clients supplementing with magnesium. it is the most commonly deficient nutritional deficiency in the world, really. And so magnesium and used with potassium in general, I think are beneficial to also help and maintain good benefits to other minerals. I like ancient salts.

So I find them beneficial for sourcing of minerals that we don't otherwise have access. to our ancestors of all drink water, glacier waters, river water, stream waters, there were much more beneficial and abundant and minerals that we get today. So I think there's those lack of nutritional valuable substance, electrolytes, and minerals that are also been. And just to jump in here, sorry to cut you off, it's not that you're giving this checklist to every single one of your patients and saying they've got to do all these things. You're partial. talking about where you are in your health journey. Like you said, it's not an on and off switch. You're not telling people immediately tomorrow you have to do all these things, but you are

being honest and transparent about your life, your household. I also find it fascinating that you're doing these things with five kids and a spouse. I'm sure that it's been a journey over a period of seeing which ones to include. Even me getting my, I don't like candles at night, but I do dim the lights. And my wife is always a second that she sees me picking up my blue light blocking glasses and putting them on, she knows I'm going to start yawning. And it like starts to set my nervous system to start getting quiet. And it's like, okay, it's that alert that it's like time to get ready for bed. And she's like, don't put them on yet. I'm not ready to go to sleep. And so we always had that little internal battle. But, but I always appreciate, but I want to make

the distinction for the audience that I want the guests to all share honestly how they go about things. And from what I hear from you, just knowing who you are in senior content, it's not you're giving people a list of 30 things that they have to do to get right to optimize their sleep. Even prioritizing their sleep, having that circadian biology exposure of the morning sunlight, dimming the lights a little in the evening, not being on devices too late, and just getting away from processed and ultra-process foods, that alone is going to be improving. And alcohol, of course, is going to be improving your sleep quality. Yeah, absolutely. And, you know, there are a lot of people that sadly try to do too much or take on something in extreme, and then they have a bad experience. And so the consequence of that is that

they may abandon their original, very beneficial interest in trying to become healthy. Right. They're trying to do too much. Yeah. That's always the fear that's there is that when people listen to every podcast, including my own podcast, we think that we have to do everything. and really, I actually really enjoyed your interview that you did with a minimalist that was there because so much of what you were sharing is that we just have to get a few of these core things right, right? The workout, the working out and the optimal amount, which I'd love to jump to next, staying away from processed foods, sticking to mostly whole foods in our diet, right?

Getting in some fermented foods along the way and, you know, not having that ongoing chronic stress from every category of our life, of course, of us are going to have some level of stress that's there. Those enough people see, you know, these aren't superhumans that you're showing the before and after on the scans for the MRI. Their normal average everyday people who came into your clinic, got their scan done, saw that, had that moment of like, oh shit, I have a lot of visceral fat. I need to do things. And you showed by just focusing on the basics, even just in a few weeks, people are seeing dramatic changes that are there. Yeah. Yeah. It's really, I think, an excellent point. It's not only that

a lot of people make the mistake of trying to do too much, they may try to do one thing too hard. Yeah, they go too hard into one category. Yeah. And or just one little tiny thing. Like it might be, you know, exercise, just doing just all that extreme. Can we talk about exercise? Because you have a lot of thoughts on that.

So give us your protocol, right? Give us your protocol because one thing that I want to make sure that we have the distinction on is that sometimes people hear. that, oh, too much working out is detrimental, and you have examples. Again, these are sort of n of ones. You haven't published a study on it, but you're showing long-distance marathon runners. You're showing people who are running 10 miles a day, which is not, you know, 99.9% of our population, that's even listening to my podcast is not even doing that much exercise, right? They're still struggling to get there, you know, 150 minutes a week or whatever, 100 and whatever minutes that's a recommendation. So,

You're saying extreme running, extreme long distance running, marathon running on a regular basis, that is where you saw the buildup in your own sort of data set of individuals building up a lot of visceral fat. But generally, you still recommend that people shoot for strength training at least two to three times a week. Yeah, so when it comes to strength training, everybody wants kind of a number. We always have this preference and I get it a lot, my followers, my clients. that come to me. And what I tell them is nature likes variety. So mix it up. Sometimes you'll, you'll work out once a week. Sometimes you'll work out seven times a week. Sometimes you won't work out

for three weeks. You know, nature likes variety. But humans love schedules. I mean, we just want to go and do our three times a week workout. Now, I think there is generally, you know, a benefit to kind of having a certain framework. I like to tell people, you know, have a given idea, because otherwise if you get too much variety, you may miss the sweet spot that you're trying to get to. Yeah, it's harder for people in the beginning when they're trying to build a habit. A lot of variety just kind of puts them all over the place. I think in beginning, that is, that's where, you know, some structure and the benefit of

having some general idea to get closer to the Goldie locks. approach. So I would say from my own experience, my benefit and with clients and people I work with is I try to work out about three times a week. And I don't exercise very long. I exercise in a very intense manner. I like to get in, crush it, and get it done. And I think from an ancestral standpoint, the two type of exercises that I'm fond of saying that have been most beneficial important to humans are sprinting. The ability to invade a predator or to catch prey or to respond to a threat is extremely advantageous, how fast you could literally run. And secondly, your ability to defend yourself or to overcome prey or a predator. So your capacity for

fighting. So today, it's impractical to suggest to patients or humans to go out and get involved in fights. There's obviously consequences to doing so. But you can exercise in a manner that might emulate a fight. And if you look, and this is what we did. You're telling me I need to go fight somebody? Yeah. If you look at nature, what they do is they have these conflicts. And there are, you know, very intense physical confrontations. And so they're short and they're tense and they're over and infrequent. And humans are kind of the exception where we exercise for a longer period of time. And I formerly was a police officer.

And I have been in physical confrontations where, you know, in law enforcement, you have to take people to jail that don't want to go to jail. And I marveled, I mean, my entire uniform career as a uniform police officer, three years. I was in many fights, but they all went pretty good. I, you know, we had lots of backup, and, you know, the bad guy went to jail or a bad girl. And but when I got out of the army, I went back into law enforcement and was a reserve deputy sheriff to feed some adrenaline junkie needs that I had. And I had the occasion to get in a fight with a very bad guy that was very dramatically different. I was by myself, and it was the fight for my life that few humans ever have. And it lasted about three minutes, and it was absolutely horrific.

And I thought it was dying because it was going to die. And I thought I was dying during it because I was trying so hard, fighting so hard. And it took me days to recover from the physiological challenge that my body went through. And so the anecdotal experience of going through that allowed me to reflect on the tremendous difference that our ancestors had. That would have probably been fairly typical for many of our ancestors of old. But today, if you ever see anything like that. But that's what happens out in nature. And so I say to my patients and followers, you want to try to have an intense struggle without getting hurt. You don't want to fight somebody, but you can do pushups and pullups and weightlifting

to exhaustion to get you closer to that. And sprinting. Springing is a great way. Yeah, talk about sprinting. Why is it that so many of the MRI scans that you showed were people that were before and after sprinting. What is it that sprinting does to the body? Yeah. So sprinting has a, has a dramatic effect and the most dramatic effect in the shortest period of time relative to any other exercise. And in studies where they looked at one recently, 10 forms of exercise, they looked at the release of molecules that get created in forms of exercise. And one of the interesting things that is like what molecule gets created most in abundance. And what they found was a molecule called lacfi, which is a combination of lactate and phenolalinine. It's a hybrid molecule. And it gets produced. And

the highest abundance, number one molecule that gets created in exercise. And they looked at specifically the form of exercise. And what they found was the one form of exercise that produced the most amount of lack of weight, which causes you to burn fat and build muscle generally favorable physiological characteristics you want more muscle and less fat and particularly visceral fat is sprinting. And the one at the bottom of these 10 forms of exercise. The second one before I go to the bottom was weightlifting or resistant training. So that one largely would probably, in most people's minds, be maybe one of the most beneficial forms of exercise, but superior to weightlifting, resistant training is actually sprinting. But at the bottom of the list of these 10 looked at was actually running. So running produced

the least amount. And so as a consequence, when we exercise, we create these messaging molecules, these myocons that go out. They're released in our exercise, our muscles that are engaged in exercise, and they send messages in tissue further away, not just regionally. They also message and involved in physiological processes and the muscles that are engaged in the exercise. But they travel to tissues further out in the body that aren't necessarily involved in that particular exercise. And they tell those tissues to do things. So these mild kinds are very useful and helpful. I think we're going to learn more about them. And generally, I think it's a good thing to be involved in type of exercise. It's going to build tissue that you are in most dramatic need of.

of, and that is your fast-twitch muscles. It is the fast-twitch muscles that are most aligned with the quality of life that you live. At the end of your life, it is fast-twitch muscles that allow you to get up and out of a chair unassisted, that are going to allow you to correct yourself when you're falling, that are going to allow you to pick up things like your grandchildren or groceries or something that you need to do and to be able to get up and go to your car and have lunch with your grandchildren or friends. And it's not the slow twitch muscles. Now, if you want to run fast for a long period of time and that's important to you, then at least be informed about the fact that you're going to have to do so at a sacrifice of these fast twitch muscles. It's not

completely black and white. But studies show you either engaged in exercise that builds one and diminishes the other, and it does diminish the other. It's not like it's neutral. Or you have to have a switch and do the other approach to it. So for me and for my clients, I try to tell them that you probably need to be thinking more about that you want to have a higher quality of life and you want to be able to enjoy that better than its fast twitch muscles. And so sprinting and weightlifting are going to be more beneficial than you running. And the other downside to running, which I think is worth pointing out is if you look at marathoners and ultra-marathoners and people do a lot of distance running, they're small. They don't have as much muscle tissue. And I'm not

complaining about their appearance, but they're losing that muscle mass. And simultaneously to chronic disease is a loss of muscle mass. Whether you, you're exercising or not, sarcopenia, which is the loss of muscle mass and muscle performance, is a real scourge in our country, and not enough doctors are talking about sarcopenia. In fact, recently, I had a client share that he had lunch with a chief of medicine from a very prominent hospital. I'm not going to say where the hospital was, but everybody knows this hospital. And the client was talking about sarcopenia. And the chief, the head medical doctor, said, what is sarcopenia?

I've never heard of it. You see the problem here? Yeah. So we got this huge, you know, manifestation of chronic disease, sarcopenia. And many here are listening to Drew probably don't know about the declining loss of muscle mass and declining muscle performance. It's not just that you're losing muscle, but the muscle does not perform as well. And so that is an example of what happens in people when they get older.

Their backs are crooked because they're erect aspining muscles. The muscles allow your back to remain erect are compromised, and they're not performing as well because sarcopenia is starting to afflict you. So, yeah, I think exercise is hugely important, but you know, you ought not to rush out there to Drew's point and my point, and embark on this single, wild, crazy investment into much excessive exercise or even just one particular form of exercise. You want to have a variety of different things and make sure that when you start something, that you're guiding principles that you want to get better, not that you need to have dramatic overnight change or immediate change even in a week,

because it's the goal here, sustainability and improvement and not dramatic overnight change. Yeah. And for some people, that's literally going to be that they're living a sedentary lifestyle. They're sitting for more than six hours a day, right? They're getting less than, you know, 6,000 steps, right, which is, I think the CDC says anything less than 6,000 steps is basically a sedentary in their sort of definition. obviously it could be, you know, varied for other people's definitions. So for them, it could be just even getting 10 to 15,000 steps a day and starting off and getting more and walking barefoot more often, right, which I know you're a huge fan of. And we've talked about in the podcast for other people who have a lot of the basics or maybe

had it one point in time and lost it now doing strength training a couple times a week, right? Two to three times a week. And getting in one or two hit workouts, right? could be the next stage for them. And for people who are pretty regular with those things, maybe the next stage is to start incorporate some sprinting, as you're mentioning. So you have to figure out where you are on the scale and stack up appropriately. But obviously, it's clear from all the MRI studies, MRI images that you showed,

that sprinting in particular seems to be very powerful at attacking that visceral fat inside the body. Yeah, it really is. I think it's a very attractive form of exercise. And, you know, anecdotally, what I hear from a lot of my followers, and I have more followers than I have client patients, that they routinely say that it just gives them a vitality and a vigor. Sprinting. Yeah. Yeah, I feel awake when I do it.

I don't do it enough as, you know, you're kind of talking about incorporating it. But you feel awake. You feel really alive. Yeah. Now, I think it's really important. if you're listening and you're a little bit older, like in your 40s and maybe even in your 30s, that if you have been sedentary, you must be aware that, you know, springing, if you haven't done it in a while, that you're very much at risk for an injury. You can strain a muscle, pull a muscle. And in many cases,

it can be weeks or months or even more, like years to recover from that injury. Just recently, I don't know if you caught in the news, I think it was Kevin Hart, the comedian, took up a chance. challenge at a, and I forget who it was, but somebody famous, challenged to a sprint. And so he went sprinting. I shouldn't be laughing, but he's a funny. He's a comedian. And I'm thinking about all the funny stuff he said about this. And also not so funny stuff. He actually tore his abdomen. Ouch. I don't know exactly what tore. He went too hardcore, too quick. He did. And, you know, he said, because I wanted to be the fastest and he used a bad word at the barbecue. And so you got to realize that you, if you haven't done sprinting, you know, I would recommend that you work with a personal trainer and start in a very slow manner and be careful.

And to put you at, you know, I'd just like to make the point, too, that, you know, if you had that kind of an injury, you know, because you sprint, you would have been eliminated from the gene pool, you know, 100,000 years ago. if you got an injury, you know, from sprinting, you would, as a result, live a life where you wouldn't allow yourself intentionally to accumulate chronic disease that would beset you with an injury like that. And that force on nature that previously existed for hundreds of thousands of years on our species is called selection pressure. And it's the influence from nature in our lives that would motivate an individual human to live the healthiest life possible because it improved your quality of life and kept you in the gene pool. Literally survival.

You're not saying that we just want to sprint for the sake of it. It's actually important to our vitality. In the past, it was actually part of our survival. Yes. Today, it's really not so much of our survival, but it's more of our thriving ability. Right. Yeah, that's a good way to describe it. Right. So kind of like, not that I'm trying to be politically correct, you're not saying that if you can't sprint, you really shouldn't be here. It's more an indication to say that, look, you know, don't be afraid of injury, slowly work yourself up, work with a personal trainer and get to a place where you can sprint because that's a reflection of a lot of things that are important. It's going to be a reflection of your VO2 max, which we know is correlated with long-term health. It's going to be a reflection of your ability to have decent and good biomechanics inside of the body, right, and have some symmetry and how you run and things

like that. And a whole host of other things. So sprinting is one marker of, and again, if you can't do it and you haven't been doing it, slowly work yourself up is just another indication that this is something that we should be able to do. It's kind of like when we have a cardiologist on this podcast saying that, look, if you're a male and you suffer from a rectile dysfunction, obviously their heart goes out to you and we don't want anybody suffering from this besides the fact that it's embarrassing if people are in a relationship there's another reason why is that if you have erectile dysfunction it's a direct reflection of your endothelial dysfunction so it's one of the first indications that you have heart trouble as well so if you are reliant on a viagra

a cealis or some other medication that's out there sure fine you know we're not going to demonize these medications that are out there, but it's an indication that there's a deeper issue that's going on. If you can't sprint, we need to work on that because there's a deeper issue that's going on. That's a really good point. And, you know, on ED, rectile dysfunction, it's really, you want to be sexually active. It's very beneficial to your health. And when you, when you have a rectile dysfunction, it is a reflection of a larger problem. And what we saw in our clients as they got rid of visceral fat, erectile functioning returned. And the dependence or reliance upon medications to assist the capacity for maintaining an erection was reduced. But another interesting

phenomena that happened I've talked about a few times is when a young male has an erection, of course, they reach the age of adolescence maturity and erectile functioning, you know, starts taking on new and important roles. They have a throb to their erectile. kind of a bounce from the pulsedile blood flow into into the to maintain that erection. That bounce is lost as you accumulate chronic disease. So the first sign of erectile functioning is not the loss of the erection, but actually the loss of this throb. And so what is happening now with clients as they lose visceral fat, they get their erectile functioning back and then they get this bounce back, which is an important feature.

They literally get their bounce back. Yeah. Yeah, it's kind of a an interesting way to describe it. But so if you're listening today and you have an erection, but if you think about when you were in many cases, people can't remember it because it slowly goes away. It's very interesting. 16 to 18. But when you get it back, you'll see it and you're like, now I remember. I did have that.

And it starts off very slow. It's a little tiny bounce. And then it gets much more pronounced. So the more you reduce the visceral fat. Yes. And I think really what's happening, and probably you may lose a lot of that visceral fat. And your ability to heal takes some time. It's not just the loss of visceral fat, but the improvement in your stem cells, in your blood flow, and your hormonal endocrine system.

Exactly. All these things in context and are consequences, beneficial consequences of the elimination of this chronic disease process, visceral fat manifestation. And so these things happen in composition and collectively with each other. But erectile functioning, I think, is an important one. I would love to see if there's a female counterpart to that. Reproduction is an important aspect to our human existence. And fertility is an important part of the discussion. we see improvements in sperm count, how fast sperm cell swim, and how straight they are as people

eliminate visceral fat. And I've had clients that have been infertile in their 60s and go back and get their wives pregnant, younger wives, through reduction of visceral fat and semen improvement. So there are many, many aspects to health and the quality of life beyond just your how you might look, how you might feel. Health is a very, very interesting, but an important target and hit that home. The decision is binary. You want to get healthy, but it's a journey, and nobody should have a sense that they've got to do everything at once.

It's something that you want to embrace and do in a steady way that is sustainable, and you're going to benefit from it. Yeah, most people are going to listen today. And on the list that you mentioned, stress, alcohol, processed food, sleep, exercising too much, which is not most people that probably listen to this podcast. They're going to pick which one they might feel inadequate on. You know, usually people have a gut intuition. Yeah.

And they might decide, you know what, I still, I'm still doing a lot of alcohol. And even though my diet is pretty dialed in, I think my alcohol intake is a little high and or maybe too high and that's impacting my sleep i want to focus on that and that's your first domino right you put a little bit of attention on that you try to dial it in you look up the best practices you listen to other podcasts that are out there other episodes we've done and you start to feel like you've made progress you build up what researcher bj fogg who's been on this podcast before it calls tiny habits you build up these tiny habits that all amount to bigger things all in the pursuit of destroying visceral fat inside of our body so that we can live longer and be healthier.

Sean, this has been fantastic. I so appreciate you coming to L.A. and us having this discussion. We met on Instagram through a comment and us getting tagged in it. And I looked up your work and I felt like, wow, we really have to have you on to learn all about how damaging visceral fat is. And I want to acknowledge you because you provided a ton of insights for our audience, not just about how damaging it is, which is super key. Half the problem is understanding how bad the problem is. But you also gave us action items on how we can take steps today

to improve our health. Give a little bit of a lay of the land of your world. If people want to get this MRI, you actually do it at your clinic. Yeah. So I do have a practice where I work with individuals who are motivated to try to improve their health and have the means and ability to come to Minneapolis to get the scans. A lot of people want me to work with them in their home state, but I'm a Minneapolis, Minnesota licensed physician, so I can't practice medicine across state borders. And so they have to come to me in Minneapolis and the Twin Cities. I am working to expand my clinic practice down to Florida. And so hopefully in time, I'll have a second location be able to to work from. But people can find me on Twitter, X, Instagram, and YouTube, all under at

Dr. Sean Amara, D-R-S-E-A-N-O-M-A-R-A-R-A-R-A-R-A. And I have a website, if you're really interesting working with me, is just D-R-S-E-A-N-O-M-A-R-A-R-A-com. And then I'm on quite a few different podcasts, and different opportunities to address people. My passion is trying to help people reverse chronic disease and improve their health. It comes from my own experience of having a very unhealthy body and then being able to enjoy the benefits of improving my health. And now as a physician, I want to be able to do that. And I realize that people in the social media space outside of conventional health care

have such a critical role in doing that. And especially you, I mean, your content, I was blown away by the quality of content that you're producing, the people that you had in your podcast, and you typify true, what is right about social media, the capacity to introduce, you know, really beneficial content to people that otherwise conventionally wouldn't have access to it. So I'm really, really happy and thrilled that you invited me to be. able to share in your mission and I'd be happy to come back anytime. Amazing. Well, we'll definitely do a part two and dive more into it and maybe even some audience questions. One more thing. For instance, if somebody can't work with you, do you

generally recommend that people try to find a physician in their area that would be willing to, you know, usually you need a prescription to go in, you know, to get an MRI done? But then the question is that do those doctors know how to interpret the data? Yeah. So really good question. And I do get that individually, but so many people will be listening today. So you have to get a physician to order the MRI. And so a physician order is required, and you can start with your primary care doctor. And I tell people to say, don't go in and try to expect the insurance company. It's usually going to be out of pocket.

Out of pocket. It's about $500 to $1,000. So you're going to pay cash for that. And then I have videos, lots of videos on MRIs. If you watch today's podcast that Drew and I talked about, you'll have a good idea just being able to read your own MRIs. You want very little, you want less white and more dark as the basic principle. And then look at other MRIs on the Internet. And then I have YouTube videos on my own YouTube channel that talk about how to read and interpret your own MRI.

And it seems funny, but, you know, doctors aren't doing it. And so I have a radiologist who's working with me now, and I have about seven other doctors, and I'm slowly educating about this. But it is going to be a while. So take a look at my YouTube channel and try to get your own MRI. And if you're able to come to Minneapolis and you're motivated, or maybe Florida in the future, I'd be happy to consider having you as a client patient. Amazing.

Maybe one day in the future also you guys do some sort of telehealth coaching. which isn't practicing medicine, and people can sign a waiver and say, hey, listen, you're not my doctor, you're not giving me medical advice, but they can do a console with you. I know a lot of doctors that kind of do that. Yeah, I think we're talking about it. I'm a startup now, so we're involved in that. It's all being built. Well, Sean, you're doing it all. People will stay in touch with you. We have the links to all your show notes that you mentioned. Obviously, for people that are listening, check out the YouTube for all the images that we talked about and the links to your social media and podcast as well, podcast is coming soon, but the YouTube channel that's out there right now so you can

follow Sean on YouTube as well. Thank you so much for coming. I appreciate you and this podcast wouldn't be possible without people like yourself putting out your story. So thank you again. Well, thank you again, Drew. Hi everyone, Drew here. Two quick things. Number one, thank you so much for listening to this podcast. If you haven't already, subscribe, just hit the subscribe button on your favorite podcast app. And by the way, if you love this episode, it would mean the world to me. And it's the number one thing that you can do to support this podcast is share it with a friend. Share with a friend who would benefit from listening. Number two, before I go, I just had to tell you about something that I've been working on that I'm super excited about. It's my weekly newsletter. And it's called

Try This. Every Friday, yes, every Friday, 52 weeks a year, I send out an easy to digest protocol of simple steps that you or anyone you love can follow to optimize your own health. We cover everything from nutrition to mindset to metabolic health, sleep, community, longevity, and so much more. If you want to get on this email list, which is, by the way, free and get my weekly step-by-step protocols for whole body health and optimization, click the link in the show notes that's called Try This or just go to Drew Perot.com. That's D-H-R-U-P-U-R-H-I-T-com.com.

click on the tab that says, try this.