Dhru Purohit Show - The Biggest Warning Signs That You Have Fatty Liver and What To Do About It

Episode Date: January 6, 2025

This episode is brought to you by LMNT and Fatty15. By conservative estimates, over half of Americans suffer from insulin resistance—a pathway that can lead to numerous chronic diseases. Fortunately, this is not a one-way street; we have the power to change course and protect our long-term health.  Today on The Dhru Purohit Show, we bring you a special compilation episode featuring Dhru's conversations with leading experts on the dangers of insulin resistance. Dhru sits down with Kristin Kirkpatrick and Dr. Ibrahim Hanouneh to discuss an epidemic affecting one in four people: non-alcoholic fatty liver disease (NAFLD) and its connection to insulin resistance. Kristin and Dr. Hanouneh highlight the most significant risk factors for fatty liver disease, including metabolic dysfunction and diabetes. They also delve into how ultra-processed foods, excessive sugar consumption, and sedentary lifestyles contribute to the rise in NAFLD cases. Additionally, Dr. Morgan Nolte explains why weight gain and insulin resistance are becoming more prevalent and shares actionable strategies to improve our relationship with insulin. She breaks down how insulin resistance changes as we age and emphasizes the transformative power of optimal fiber intake, quality sleep, stress reduction, and strength training in maintaining metabolic health and achieving an ideal weight. Kristin Kirkpatrick, MS, RDN, is a celebrated author, speaker, and accomplished dietitian with over 25 years of experience. She is a dietitian at the Cleveland Clinic Department of Wellness & Preventive Medicine.  Dr. Ibrahim Hanouneh, MD, is a gastroenterologist and hepatologist specializing in liver disease. He served as Chief Gastroenterology Fellow and associate staff at the Cleveland Clinic and later contributed his expertise to Minnesota Gastroenterology and Mayo Clinic in Minnesota. Dr. Morgan Nolte is a board-certified clinical specialist in geriatric physical therapy. She recognized a need for preventative education and care that focuses on reversing risk factors instead of just treating symptoms. That led her to focus on developing online courses and coaching programs that help adults reverse insulin resistance for long-term weight loss and disease prevention. In this episode, Dhru and his guests dive into: Why we need to focus on insulin resistance (00:00:05)  Biggest warning signs of fatty liver disease (2:04) Role of the liver (6:48) The pathway that leads to fatty liver (9:53) Myths about fatty liver and the major culprit of fatty liver disease (13:12) How non-alcoholic fatty liver gets in the way of our long-term health and chronic inflammation (18:32) Why insulin is crucial (25:06) Why insulin resistance changes as we age (31:27) Toxic traits that damage mindset (39:31) Pillars of nutrition (46:00) Optimizing muscle mass for those in the healthy baseline (51:51) Importance of sleep on your appetite (55:46) Strength training and stress management for optimal insulin levels (1:02:51)  Also mentioned: Regenerative Health Book This episode is brought to you by LMNT and Fatty15. Right now, LMNT is offering my listeners a free sample pack with any purchase. Head over to DrinkLMNT.com/dhru today. Fatty15 is offering an additional 15% off its 90-day subscription Starter Kit. Go to fatty15.com/dhru and use code DHRU to replenish your C15 levels for long-term health. Learn more about your ad choices. Visit megaphone.fm/adchoices

Hi everyone, Drew Prode here. Today we're talking about a dangerous condition that over half, half of the United States suffers from. And with most other countries, either worse or not behind. I'm looking at you, India, and the Middle East. They're all struggling with insulin resistance. According to top experts, insulin resistance is the leading cause of the biggest diseases of our time, including type 2 diabetes,

heart disease, certain types of cancers. It definitely plays a huge role. and Alzheimer's disease, which some folks, including many of the people that have been on this podcast, are calling type 3 diabetes, insulin resistance, type 3 diabetes, and Alzheimer's, they're all in the same bucket. It's also a big part of what contributes to belly fat and weight gain. For sure, you need excess calories. But when a lot of those calories are also contributing to insulin resistance, you're going to pack on more belly fat. And the thing about insulin resistance is that it destroys.

it eviscerates one of our most crucial organs, the liver. We don't always think about the role that the liver plays in our body, yet the liver has a role in every metabolic process in the body. And in today's compilation episode, I talk with authors, Kristen Kripatrick and Dr. Ibrahim, the co-authors of a book called Regenerative Health, discover your metabolic type and renew your liver for life. In this compilation episode, we discussed the function of the liver

as well as how insulin resistance and poor metabolic help drives fatty liver disease. If you've ever heard the term, it's a little bit elusive. It's not fat necessarily that contributes to fatty liver disease. It's the same things that contribute to insulin resistance. We're going to talk about that in today's interview. And I also, in this compilation episode, talk with Dr. Morgan Nolte about the role that insulin plays in the body, particularly as it relates to weight gain. Let's dive right into my conversations with Kristen Kripatrick and Dr. Ibrahim.

Something mind-blowing that I've learned from your work over the years is that most people that have fatty liver disease don't actually know that they have it. That's why the two of you call this a silent epidemic. Now, before we get into what it is, I'd love to start off with what are some of the biggest warning signs for somebody listening today, knowing that. knowing that the vast majority of people that have fatty liver disease don't know they have it, what are some of the top warning signs that somebody listening today might be struggling with it or is on their way to struggling with it? Kristen, do you want to jump in first? Yeah, let me jump in.

I would love to. And thank you for having us today, Drew. We're so honored and privileged to be on the show. You know, I think sometimes when I think about what my patients come to me with, it oftentimes is fatigue. And like I always say, who doesn't have fatigue? So fatigue can mask a lot of different other conditions, but a lot of times people will come to me and say, just really feeling down. I'm really feeling not myself.

And it's only after they go see their physician that they find out maybe their liver enzymes are elevated, things like that, that we might start to pinpoint it. And I think the reason for that, and Dr. Hannanay can talk a lot better to this point, is that really the liver is so resilient. It speaks to its resilience. And it's not going to give you a lot of kind of the like, hard. signs in the first few stages. You can go a long time without feeling some of the more aggressive approaches to, I'm feeling this and I must have fatty liver. So for me as a dietitian, a lot of times my patients are coming in saying, I'm just tired. Maybe my skin's not great. I don't know what's going on. Maybe nothing, but what do you think? And then once we delve a little bit deeper,

we can see that they're at risk for non-alcoholic fatty liver disease. Dr. Hannanay, when somebody comes to you, especially at the later stages, and we're going to break down all the stages, your top foods to support and feed the liver, and also the most fascinating thing that I saw in the book, which is the four metabolic types. You know, the people listening today, they're going to want to understand these four metabolic types and which one they are so that they know how to support their liver. But when somebody comes to you in the later stages, what are some of those warning signs that they've been struggling and they're dealing with fatty liver disease? Yeah, thank you very much for having us.

Fatty liver disease, like you indicated, it's epidemic. You know, it's very common. You look around you, you look at your family members. One out of four people have fatty liver disease. Just think about that for a second. One out of four people you're going to meet today have fatty liver disease. This is very common. The problem, this is a silent disease until too late in the game,

until you have, God forbid, liver cirrhosis or liver cancer or there is need for liver transplantation. We don't want to wait, obviously, that long. The key is to detect fatty liver disease early on and reverse it before it's too late in the game. And because it's silent disease early on, because it doesn't have symptoms, the key is screening. And on that note, I would say if you do have metabolic risk factors, specifically type 2 diabetes, you need to be screened for fatty liver. You need to ask your doctor, do I have fatty liver? If you have high blood pressure, if you have high cholesterol, if you are overweight, if you have family history of fatty liver disease, if you have sleep apnea, polycystic ovarian syndrome, very common. You know, those are the signs in my mind to get screened for fatty liver disease.

early on, you know, before it's too late in the game. Because when it's too late in the game, you know, it's difficult to reverse it, quite frankly, and it will lead to significant symptoms such as jaundice, yellow eyes, sometimes distension in the abdomen, occasionally bleeding from the GI tract, affect mental status, et cetera. We don't want to wait that long. We want to find it earlier. Let's start off with an analogy of explaining fatty liver.

disease, but by explaining how important the liver is, you know, in the book, which is fantastic, by the way, we have the link in the show notes to pick up a copy. In the book, you talk about how the liver, if you are imagining a city that you are flying over, the liver is the public utilities, the public work utilities, and that's the role that it plays in the city. Kristen, can you take that analogy further and explain it to our audience just so they understand just what the role of the liver is. And then we'll talk about how fatty liver disrupts the liver's function. Yeah. So the liver is involved in essentially every metabolic process that the body has. In our first book, Skinny Liver, we used a Rodney Dangerfield quote in the very beginning of it.

And we said that the liver kind of is always screaming out. I'm not getting any respect. All the respects go into the heart, into the brain. And rightfully so, they're important organs as well. But the liver really takes care of every single process that we see from a macronutrient standpoint. So, for example, when we look at sugar and we look at our consumption of carbohydrates and what happens to insulin, to glucose, to the stored form of glycogen, the liver plays a role in making sure that our blood sugar is constantly at a balanced level. And it adjusts it as necessary. And oftentimes we don't think about the liver being part of that, right?

We think about the pancreas and we just think about insulin. But the reactions that occur with blood sugar management are all tied back to the liver. When the liver feels that there is too much sugar or they can't use the sugar, then the liver is going to store some of that sugar as fat. So it also has a role in lipid metabolism, in cholesterol. So when we're eating fat, it has a role in how the breakdown of fatty acids are as well. And then from a protein perspective, the liver is involved in making sure that amino acids can be convert it into energy. So as a dietitian, you know, the kind of 101 of what I learned over 20 years

ago, the basics are that our macronutrients, our carbohydrates, our protein, you know, our fats, all of that somehow has to get converted into energy. And that's what we use as fuel. The liver plays a role in that conversion factor in every single one of these things. This is why it's so linked to things like heart disease, like type 2 diabetes, etc. But really from a metabolic process. This is why we refer to it. It's kind of like the main thing that makes everything go, that makes everything communicate to one another. All of those organs are important, the heart, the brain, but the liver is what is making everything actually function. I actually, if I may add, there is another analogy which I use with my patient. I call the liver

TSA gate. You go to the airport, you got to stop by the TSA, you know, before he gets in. Same with the liver. Anything comes to your body has to stop filtered by the liver before it gets in. You know, the bad guy's out, the good guy's in. And what happened when you have fat liver disease, your liver is overwhelmed. There is so much fat, inflammation, et cetera. So some of the bad guys are going to get in. And that's going to affect your body. That's going to lead to fatigue, you know, sometimes pain in the right upper side of your belly,

and then eventually, obviously, liver damage liver cirrhosis. So now that we know the important role of the liver, and we'll come back to it to dig in it a little bit deeper, help us understand fatty liver. What is actually going on in the liver that is causing it to malfunction and lead to a whole host of other issues down the line? Yeah, I can take that one. And, you know, just to make it simple, you know, fatty liver is, as the name implies, it's fat in the liver. If I show you a picture of fatty liver, you will see literally a whitish kind of, you know, liver with a lot of fat in it. And what happened if you have fat in the liver for a long period of time, that fat will break down. And when the fat breaks down causes inflammation.

The inflammatory cells will come in and get excited, and that's going to cause inflammation in the liver. And when you have inflammation over long period of time, that will leave some damage. some scarring tissue. We call it the medical term fibrosis. And when the scarring tissue, when fibrosis builds up, that will eventually lead to cirrhosis of the liver, which obviously can affect the function, the engine inside the liver, which leads to liver failure and need for liver transplantation. So when you start to understand that it's literally fat in the liver, these sort of like fatty

deposits. One of the things that you both talk about in the book is that the term itself is a little misleading when it comes to unpacking what the hell is causing this situation in the first place. You think fatty liver and immediately most individuals think, oh, okay, I guess it's the fat that's inside of our diet. Kristen, from a dietitian's perspective, help us understand why that idea is misleading and what the real culprits are, not that there aren't. many there are many and we're going to break those down but what is the major culprit of fatty liver yeah so i would say um a mal like looking at our metabolism in terms of how our blood sugar is managed let's start with that so insulin resistance anything where we are overloaded as we typically are

in the american diet with sugar with refined carbohydrates this is what is really leading to the up the storage of fat within the liver that then replaces healthy liver tissue. So yeah, fat is definitely, and fat has a role in it, but not as great of a role as sugar does. So I look at this as when we look at sugar and we look at the comparison to fat, really, it's similar to what we saw in heart disease, whereas years ago we would think that saturated fat was the main culprit for heart disease. And if you just cut saturated fat, you're going to be fine. you're not going to get heart disease.

Then we realized, based on research that came afterwards, and even an alteration of our dietary guidelines, that it was sugar, and it was an influx of too much sugar that then gets stored. So sugar is really the main culprit. This is why we took such a hard stance on looking at the carbohydrate content and some of our dietary patterns,

which we can talk about later. But that's really what we're looking at. And I want to add one other point. Non-alcoholic fatty liver disease also has nothing to do with alcohol. And I think that's the other thing that we typically see. Someone will come in and say, well, I don't drink anything. I don't understand how I got this, right?

But they might have some other risk factors. They might have an increased waste size. They might have insulin resistance, pre-diabetes. All of those things put them at risk. Yeah, I mean, I see it in my practice all the time. You know, there is a stigma with liver disease. When somebody has liver disease, it's like, like Kristen said, Well, wait a second.

I've never had, you know, significant alcohol. How come? You know, when you say liver disease, people think alcohol. But really now the most common cause of liver disease is by far fatty liver associated with metabolic risk factor, diabetes, you know, overweight, high blood pressure, high cholesterol, you know, those kind of things. And on the note of the name fatty liver, I agree, it's really good point. It's misleading. You know, people think if I eat fat, I'm going to get fatty liver. Makes sense.

Well, it's wrong. If you eat carbs, you will get fat, you liver. If you eat too much sugar, you will get fat liver. The problem is with sugar, not with fat. And true, I would love to add that. So when we wrote the book, right? When you write this book, you have all the research in the world. And then sometimes research comes out after that.

So one of the things that came out after that was really interesting was all of the liver-associated organizations actually changed the name from non-alcoholic fatty liver disease to metabolic associated dysfunction fatty liver disease. So it really saw the importance of the metabolic dysfunction end of it and taking away some of the confusion that a consumer might have or some of our patients might have that this is just related to fat or it's just related to alcohol. The metabolic dysfunction was now put in as one of the titles for how we look at this disease, which actually increases the accuracy of how we all look at this. Yeah, and it's a big part of what you both wrote in the opening is that since your first book

that was there, skinny, skinny liver, was that the name of me? Skinny liver, yeah. There's so much science that's exploded and you've incorporated in there. And that's also a big part of how you've come up with these four metabolic types that we're going to get into in a second. Now, before we get there, one of the things that I want to get a chance. to touch on is that when you have fatty liver disease, non-alcoholic fatty liver disease, or this updated term, which is a mouthful, but can you repeat it again, metabolic?

What was it called? Dr. I'll let you, you'll say it absolutely correctly. I'll have a word off. Yeah. You know, the metabolic associated fatty liver disease. They're trying to find a new name. The new name actually fits diagnosis of inclusion. It's associated in metabolic syndrome

rather than a name of exclusion, non-alcoholic, it's something else. So it's metabolic associated fatty liver disease. It's fatty liver associated with metabolic syndrome or metabolic risk factors. Okay, so for the purpose of this interview, I might still refer to it as non-alcoholic fatty liver disease. I think a big takeaway when people follow your work,

listen to your interviews, see the book, is that it's not that this problem, is just isolated to the liver. This impacts every aspect of the health of our body and our longevity as well, which I know is something that my audience is very interested in. So can you talk and I'll run through, we maybe run through a few categories that you've broken down in the book, talk about how fatty liver disease, non-alcoholic fatty liver disease gets in the way of our long-term health and interrupts the function of other organ systems.

Yeah, I believe to start, I guess, the conversation there, the most common cause of problems of death, if you will, in people with fatty liver, is not liver disease, believe it or not. It's cardiovascular events, meaning heart attack and stroke. Meaning, unfortunately, we lose most patients with fatty liver disease, not because of their liver disease, but because they get heart attack and stroke. and stroke. And the reason why, because it turns out fatty liver is a risk factors to get heart disease and, you know, heart attack and stroke. So it's not just a liver disease. It's a multi-system disease. It affects other organs. Another important point here, fatty liver is associated with increased risk of cancer. Certainly liver cancer, but also other kind of cancer outside the liver. You know, recent studies from Europe show that patients with fatally but disease are associated with

increased risk of chronic cancer, less cancer, for example. And so that's what it's stressed the point that it's not just a liver disease. It's really a multi-system problem. No, that's super helpful. And another area that this ties into, Kristen, I love for you to chime in on this, is that you mentioned that a lot of your patients come in in the early stages and they might just think, I just have fatigue. Sure, there's a lot of reasons why people would struggle with fatigue, but in some instances,

and based on the estimates that are there, right around 30% of the population, at least here in North America, is dealing with fatty liver disease, non-alcoholic fatty liver disease. But there's another one, just like fatigue, this idea that they are dealing with some level of chronic inflammation. So what's the connection between non-alcoholic fatty liver disease and chronic inflammation that could be impacting the whole body? Well, so number one, it is how the liver is impacting the rest of the organs, the ability for the body to be in a state of homeostasis.

So being able to be in a place where the body is happy. The other thing we look at, though, is we really delved a lot into looking at things like waist circumference. And I know we'll get into that a little later. One of the things we refer to when we see someone who is carrying a lot of belly fat, a lot of fat in the midsection that is close to organs. We refer to it as kind of like this cytokine storm. So we know that when we have fat in the midsection,

we're more likely to have insulin resistance. We're more likely to have that fat be what we would refer to as active. And that then increases inflammatory factors within the body. So if we look at a very high level and look at inflammation as the base of any disease, whether that's a mental illness or a physical, disease. We know that it's some place down the line the liver is playing a role. Now, we do have some instances where someone might develop fatty liver disease and does not have belly fats. It's more rare. A lot of times what we see there, which Dr. Hannanay could talk more about is

more genetic abnormalities. But we do know that when the liver starts replacing fat with this healthy tissue, it no longer can take these processes that I detailed at the beginning of this. So being able to manage blood sugar, being able to manage our lipids, being able to convert the amino acids, and being able to make sure that we don't have too much ammonia in the system from protein sources, etc. Any place where that system goes wrong, we run the risk of having inflammation occur. So we're of course talking about systemic chronic inflammation that's unresolved. That then can lead to chronic disease. Now let's turn to my conversation with Dr. Moore. Morgan Nulte to further break down the connection between insulin resistance and chronic inflammation.

As you all hear, Dr. Nolte explains the role that excess insulin plays in weight gain and shares her four-pillar plan for a low-insulin lifestyle. Let's listen to it. Why is insulin such an important part of this conversation and how does it take the idea that it's all just about calories in and calories out and really expand it? It's not that that's not true, as you mentioned, you know, but it's actually there's a lot more to the story. So what would you like to share about insulin? I think I want to approach this interview as if somebody has never really heard about insulin or insulin resistance. And I want to build a really strong foundation for them to understand it. And then we can kind of go deeper throughout the interview. So insulin is a

hormone made in your pancreas. And it is absolutely vital for our survival. It has a lot of different functions in our body, but the primary one that I focus on is blood sugar regulation. And as you know, continuous glucose monitoring is a hot topic right now. And the glucose that we're monitoring is actually a downstream effect of how well your insulin is working, how sensitive you are to insulin. So when you eat, like a high carbohydrate meal, for example, your, the carbohydrates are broken down into glucose in your blood, right? But your body doesn't like high blood sugar. So it has to release insulin to move the blood, the sugar from the blood into the cells to be stored. So insulin's role is to move blood sugar from the bloodstream

into the cells for storage. And that's why I call it the fat creation and storage hormone. So insulin has two primary roles, regulation of blood sugar, fat creation and storage. It also have has other roles, but those are the two primary ones relevant for this conversation. And a beautiful example of that is a type one diabetic. So people with type one diabetes, they don't make their own insulin anymore. So their pancreas isn't making insulin. So if they eat a high carbohydrate meal, their blood sugar is going to spike and it's going to stay elevated. It can't get into the cells to be used for energy or to be stored. to be used later for energy.

And so type 1 diabetes used to be called the wasting disease because people would literally waste away. They would eat, eat, eat, eat, eat, they'd be thirsty. They had plenty of available energy in their cells, but it couldn't, in their body, but it couldn't get into their cells because insulin wasn't there to unlock the cell for the energy to get in.

And so once insulin was created, and a type 1 diabetic could then, object themselves with a proper amount of insulin, then it was now a survivable condition. So that's a really beautiful example of why insulin is crucial for our livelihood. We can't survive without it. But the problem comes when our levels of insulin are elevated too high for too long because insulin is an inflammatory hormone in excess. and inflammation is kind of like the root of all chronic disease.

And so when your insulin levels are high, that's going to trigger more fat creation and storage. So from a calorie standpoint, we can talk about this a little bit more. I think this is a good place to put it in. We've been taught about the macronutrients, right? We have carbohydrates, we have proteins, and we have fats. Those are the three major macronutrients. Carbohydrates have about four calories per gram. Proteins have about four calories per gram and fats have about nine calories per gram.

So traditionally, women are taught, men are taught, you need to eat a low calorie diet to lose weight. You need to be in a calorie deficit. So what do they do? They reduce the fat in their diet because fat's the most calorically dense. So then they're left eating a bunch of vegetables. And if they're smart, also a bunch of protein, but not a lot of fat. So that's the caloric model, but from an insulin model, if you're looking at like a chart of time and then the insulin response, carbohydrates at four calories per gram have the highest insulin response.

We're talking starches and sugars. Now protein will actually reduce that, excuse me, fiber, the other type of carbohydrate will reduce that insulin response. But for people who are trying to follow this low fat diet to lose weight, if they're having like snack well cookies and ritz crackers and all of these carbohydrates that are low in calorie, they are spiking their insulin, spiking their fat creation and storage hormone. So protein has a moderate impact on insulin and then dietary fat has almost negligible. So it's almost reverse, you know, from a low fat to a higher fat diet. And protein really needs to be the staple of the diet.

so that we maintain lean muscle mass. So again, focusing on calories in, calories out, all calories are created equal, you are losing so much valuable insight on how to actually fuel your body for long-term weight loss. Because when we're focused on that, you're focused on how can I eat in a way that keeps insulin low. So that's going to be prioritizing healthy fats, protein and fiber, and including starches and sugars if you want strategically. And also building and maintaining. lean muscle mass as you age.

Because when we're talking about glucose after a meal, for example, when you're eating a high carb meal, it has to go somewhere. Like, where does that glucose go? Well, your muscle tissue is a really big repository for glucose. And the more muscle mass you have, the better insulin sensitivity you can have. And the easier your weight will stay off. So it is a much bigger conversation than just how do I lose weight? or, you know, eating a low calorie diet.

It's really about how do I eat in a way that keeps my insulin and inflammation low and also supports healthy muscle mass so that the weight that I lose can stay off. You know, one of the things that you are really good at explaining is helping people understand, especially women, as we age, our relationship with insulin can change a little bit. So you first talk about how important insulin is. when it comes to sustained weight loss and also, of course, living a low inflammatory lifestyle, excessive, elevated, chronically elevated insulin being connected to inflammation. Now let's talk a little bit more about aging and how that plays a part into this.

Absolutely. Well, I think especially for women going through menopause, they know that that is kind of a volatile time for their hormones. And a lot of women are like, oh, I gained weight because of menopause or menopause is causing me to gain weight. I'm like, no, it's not. Menopause is a date on the calendar one year from your last miss period. So blanketly blaming menopause is not helpful. But understanding the hormonal changes that go on during menopause that cause you to gain weight during menopause and specifically for a lot of women, they're gaining belly fat. They might notice that the belly fat that they have is getting firmer.

or harder, that's indicative of more visceral belly fat, which is more unhealthy, more inflammatory than the subcutaneous fat that's under the skin that you can pinch with your hands. So women during this menopausal phase of life, they very well may be noticing 20, 30 plus pound weight gain in the years surrounding menopause, even though they're like, I'm not eating any differently. I'm not exercising any differently. I'm having some menopause symptoms, but I should not be gaining this weight. And as a woman, I think it's wise of us to go back in time and say, well, when else did you gain weight in your life without really changing what you were eating or how you were moving?

And there's two other times, puberty. So when a girl goes through puberty, she's going to gain weight. But then also really telling one is pregnancy. And so if you're looking at how does insulin change during a woman's pregnancy, insulin goes up during pregnancy. Insulin resistance goes up during pregnancy because the body is trying to gain weight. So lo and behold, if we look at what happens with insulin as a woman goes through menopause, it goes up. And the reason is because when a woman goes through metapause, her estrogen levels essentially plummet over time. And estrogen is an insulin sensitizing hormone, which means you need

less insulin to maintain stable blood sugars. And if you need less insulin, that's going to cause less fat storage. But as insulin drops, or excuse me, as estrogen drops going through menopause, that baseline level of insulin will go up. And that's why women are experiencing more weight gain, even though they're not eating differently, even though they're not really exercising differently, their insulin has gone up because their estrogen has gone down. And another really important key factor at this stage of life is, well, your body needs estrogen, not just for reproduction, but for your brain health, your bone health, your skin health. It's more, it's important. It's not just a reproductive hormone. So when your ovaries stop making estrogen, then there's two,

and like two organs that pick up the slack. So the adrenal glands, which sit on top of the kidneys, will start to make more estrogen, but also adipose or fat tissue will start to do the estrogen production. So now, not only are you having more fat because you have higher levels of insulin, but that fat becomes more valuable real estate because it's producing estrogen and it becomes harder to lose. And one of the big things that women overlook when it comes to weight loss is stress management. And especially in this midlife range, they might be, getting the kids out of the house or having young grandkids, a lot of times they have aging parents, and that's causing a big stress on their life. They're in the thick of their careers

or they're nearing retirement. That's a stress. The adrenal glands are also responsible for stress hormone production. And so if the adrenal glands are just pumping out the cortisol, pumping out the stress hormone, two things, right? The first is they have less capacity to really optimize estrogen production so that your body relies, even more on your fat tissue for that estrogen. So stress management, if you can bring that cortisol down, you can kind of allow the adrenal glands to pick up even more of the estrogen production to make the body more comfortable releasing some of that fat tissue.

But the second thing is think about what cortisol does. Cortisol is your stress hormone. And back in the day, if you were faced with an enemy or a tiger is a common example, and you had to run away, that's a stress on your body. So when cortisol is released, that causes your blood glucose levels to go up so that your muscles have available glucose to soak in when they're contracting and you're running away. But the problem with modern-day stressors, like a sick parent or an angry boss,

is you're not really moving your body to utilize that glucose. So cortisol goes up because you're stressed. Your blood sugar goes up in response to the elevated colds. cortisol, anticipating you to fight or flee the situation, but you don't. And so if muscles aren't soaking that glucose in, the only other way it can get into the cells is through insulin. So that's a kind of a double-edged sword on stress in midlife, especially for women, is if their cortisol is going up, their insulin's going to go up and their fat is going to be more likely to go up to. So that's That's kind of the whole picture of why weight loss gets harder after menopause.

It's definitely not impossible, but it is the time to optimize your lifestyle to lower the insulin, lower the cortisol, lower the inflammation, and then your body will feel like, okay, I can release this weight now, but just following a low calorie diet, not going to cut it anymore. So we have to have a more specific approach for this phase of life. I like to say there's four pillars to a low insulin lifestyle. There's nutrition, and that includes what you eat, which we've kind of already covered, and when you eat. So intermittent fasting, we'll get to that.

It includes physical activity. That's the second pillar. Stress and sleep. Those are the four primary pillars. And I include, if you're thinking about environmental toxins and other types of toxins, I include that in the stress. There's different kinds of stress, and that would be a form of, cellular stress. And then all of that is on the foundation of mindset. And I describe it as like a

healthy habits house. If you're trying to build a house of good nutrition and physical activity and good sleep and stress management and you build it on sand, that's not going to last. Those habits aren't going to last. But if you have a strong foundation of mindset, then those habits will last, whether you're going through a stressful season or you have a busy work project or it's over the holidays. Like, anytime somebody gets off track, quote unquote, it's a mindset issue. And so I think that's a huge component of my coaching and of our program is addressing habit change and mindset.

And so I think we can kind of wrap that up at the end. But just to kind of dig into some more of the science behind insulin and inflammation, if we're talking about intermittent fasting, I'm. Actually, can I say, before you go further, just because it's so valuable, what you're sharing about mindset and how related it is, even though I know my audience is going to be upset because I interrupted you while you're in your flow. A question that I have on behalf of my audience and for myself, if you had a list, what are one, two, three of the most sort of toxic things that you see people doing when it comes to mindset? That is the key single thing, you know, however many it might be, it might be one thing, might be two things, maybe three things. I think it's worth highlighting because if you're saying that mindset is so pivotal to sustained weight loss, it's worthwhile here while we have everybody's attention to sort of highlight.

So what are some of the most damaging things that you see over and over that interrupt people's goals when it comes to mindset? What a beautiful question. No one has asked me that question before. So I'm going to have to really think about it. The first thing that comes to my mind, and I'm so happy to unpack mindset, we could have another entire episode of mindset. I think the first thing is comparison.

And so if we're thinking about social media and we're thinking about scrolling through Instagram, scrolling through Facebook and you're seeing people losing weight, you have no idea how they're doing it. You have no idea if they're doing it in a way that's sustainable, but you compare yourself to them. Or maybe you see a picture of yourself from 20 years ago and you're comparing yourself to yourself 20 years ago and you're like, oh, gosh, like I have gained some weight. So anything that draws your attention from your progress to like the gap in the progress. I mean, I don't know

if you've heard of the book, The Gap and the Gain. Yeah. Okay. I think that's a really helpful analogy here. So a lot of people focus on the gap of where they are compared to where they want to be. And I think it's a lot more advantageous to focus on the wins and how far you've come. And our brains primitively want to look for the negative. We are wired to look for danger and for the negative things that could go wrong. But we have the power to choose our thoughts. We have the power to choose our thoughts, which means we have the power to choose how we feel. And so if we have that power, we need to use it.

And one way that we can use it productively is anytime you find yourself in a gap, like, oh, I've only lost half a pound this month. You're comparing where you are now to where you want to be. And we have to, but what else changed in this month? Are you being more consistent with your water? Are you being more consistent with your protein? Are you having a better emotional attitude? Are you sleeping better?

We have to rewire our brains to focus on our winds and not comparing ourselves and not focusing on where we want to be, but instead how far we've come. Right. Did you also get, did you gain muscle because you're now working out? And so you only lost a half a pound. And last month you lost more. But maybe you gain muscle because you're working out or you're doing some resistance training, which is why people are so much of a bigger proponent of like not just the scale,

but body composition, whether it's through an in-body scan or a dexas scan. There could be a lot of reasons that play into it. But kind of thinking about especially women and postmenopausal women, a lot of them come from the Weight Watchers generation where the end all be all is a scale. And that was the only measurement of progress. and they perhaps were shamed in a Weight Watchers meeting like, oh, you only lost a half-town. Are you sure you did everything that you could? And so that really plays into it.

A lot of like trauma from weight loss happens. And so we have to retrain our brain. Another really, really powerful thing that's overlooked is not practicing gratitude. So gratitude is one of the fastest ways to kind of raise your vibrations. and when I say vibrations, I mean your thought frequency. A lot of people are, I don't even know, I wish I knew the percentage of people that were on, like, anti-anxiety, medication or antidepressants. And I really wish that physicians knew more about mindset and the power of gratitude and, like, and the power of diet with mental health, my goodness, and started to prescribe this stuff either before or in conjunction with those medications. but when we focus on specific gratitudes, that will help elevate your vibrations.

And so I think a lack of that is important. I think, you know, the other thing that I want to add in is a lack of understanding. So you're like, what are they doing? And I don't necessarily think that they're doing something. I just think that they don't understand that they can choose their thoughts. And they don't understand that your thoughts create an emotional. emotional, like it's actually a vibration in your mind. And the emotion that you feel is a direct relationship to the thoughts that you were thinking. And then the emotions that you feel will drive your

actions. Oh, I'm stressed out. So I'm going to go eat. Well, why are you stressed? You're stressed because you had a thought that ignited the emotion of stress in your body, which drove you to eat. And then that eating, if you do it over and over, it becomes a habit. And so I think that a lot of people just aren't aware that they can choose their thoughts, therefore they can choose their emotions and behavior change becomes so much more enjoyable. You're not trying to like white knuckle your way there. So those would be kind of my top three things, like being in the gap instead of the game, not practicing gratitude and then just not being aware that you have so much power that is untapped if you're not paying attention to your thoughts. Those are beautiful. For not having thought of the answer,

you had a perfect answer. I'm sure it's going to be very helpful to our audience. Okay. So I interrupted you. You were about to go down the pathway of continuing on the conversation of insulin. I actually wasn't sure exactly where you were going to go, but I'll pass it back over to you now that we've had a chance to talk about mindset. And it is funny. Please don't anyone like leave him a negative comment for interrupting me.

I see those on YouTube a lot like not necessarily from you. But oh, I'm so glad that you did. I'm okay with it. Everybody can express their opinion at the end of the day. I'm here to make sure that your message gets out there, and I'm here to fight for my guest. And so I'll take some haterade. You know, I'll take some haterade here then.

I love that. Because I'm here to fight to make sure that your message gets across and that I ask and I represent the audience who I know, you know, would be interested in those topics. So, yeah, bring it on. I'm okay. I'm a big, I'm a grown boy, so I'm good to go. Okay, so I'm going to use that haterate in the future probably.

I wanted to talk about the pillars, right? So we talked about nutrition. You want to prioritize a high protein, healthy fat, fiber diet, keep starches and sugars to a minimum. When you do eat them, use the strategies to reduce their blood sugar impact that we talked about. Intermittent fasting is probably the most powerful tool that you can use to lower blood insulin levels. However, a lot of people are jumping into this tool too soon. So intermittent fasting is pretty much anything over 12 hours, in my opinion. The research will vary. There's not a great definition. It's also known as time restricted eating. You're just choosing to eat within a certain window. So I think 12 hours should be the baseline for pretty much everybody. 7 p.m. to 7 a.m.

That's a great baseline. 8 p.m. to 8 a.m. I prefer people to eat a little bit earlier before bed, like stop eating at least like three hours before bed, I think is great for sleep. Anywho. intermittent fasting will be so powerful, but if you're already stressed out, it's not going to be your best first step or your best strategy because it is kind of like another layer of stress on your body. So for people and for women in perimenopause, it might not be the best solution, especially if they're really stressed out. Men tend to tolerate intermittent fasting really well. Post-menopausal women tend to tolerate fasting very well. Women who are still cycling. like myself, we have to be a little bit more specific around when we're fasting.

So like anything longer than about 14 to 16 hours, I save for the week of my period and like the week, kind of like the week after. But I don't like to fast during ovulation and I don't like to fast the week before my period around that time. So the hormone production is just ramping up for women. We tend to need a little bit more food. We want more food. And so like honor your.

body and fast according to your cycle. But I tell you what, like if you can tolerate intermittent fasting, once you have those baseline health habits established, again, like mindset, weekly accountability means, sleep, water, protein, that's a really, really great strategy for you to move into. But I'm not a fan of using fasting as the end-all be-all. Because if you don't have good baseline health habits, your results from fasting will be short-lil. And so we want to use it as a tool and the lifestyle use it strategically. I think that a lot of people could benefit from like a 16-8 schedule during weight loss. I really like that.

And then one day a week doing like a little bit more of an extended fast. It's like a 20 to 22-hour fast doing one meal a day. And then one day a week doing like not really any fasting. So having like a, oh, 12 to 14-hour fast day, kind of like an exception day is what I call it. That seems to be a really nice rhythm for women, especially to lose weight. Like Monday through Friday, maybe you're eating 10 a.m. to 6 p.m. An eight-hour window. And then on Saturday, that could be your exception day.

Maybe you got to eat, have three meals a day. And then on Sunday, just have one meal a day. So it's okay to mix up the fasting schedule. And then I usually like longer fasts for weight loss plateaus and for severe blood sugar issues. So if people have really, really high blood sugars, like one of our members right now, doesn't want to take blood sugar medication, blood sugar lowering medication. And so his starting blood sugars were around 300, like baseline. And so he needed a little bit more of an aggressive fasting schedule to get those blood sugars down.

So he's doing like a 36 hour fast a couple days a week. And so for him, that's a good strategy because we really want to be bringing those blood sugars down. For women who have a weight loss plateau, if they can try like a 36, sour fast, that might be a really nice strategy. So I view it as a tool in the low insulin toolbox, but not the end-all be-all. And maybe not the thing that a lot of people should start off with if they are new to this world. It's better to focus in on the add-in components that are there because sure, fasting might help you lose weight quicker, but will you be able to keep it off afterwards if you don't have these tools as you were mentioning? Exactly. Yeah, but I love that I love

fasting. I think it's a great way to like recalibrate your relationship with food. For me personally, it really highlights a lot of my cravings are emotional. So is it physical hunger or is it emotional hunger? And a lot of times it's emotional hunger that we're experiencing. And so I think it's a great way to learn those true hunger cues versus emotional hunger cues. Can I ask you a question on that topic? You know, there's a mutual friend that's also been on your podcast as well, Cynthia Thurlow. And she shared that over the years, especially as an individual who doesn't have a lot of weight to lose, right?

She's not, you know, obese or, you know, being overweight and had not really prioritized protein and strength training and other things for herself personally. Again, this is somebody who, you know, has a TED talk on intermittent fasting and the benefits of it that are there. She said, for me personally as being, you know, in a lot of my. my demographic being similar to me. You know, they might have 10, 15, you know, pounds they want to lose to get into their optimal sort of space, not her, but she's saying my audience.

But they're also trying to work on the protein goals. They're trying to build lean muscle mass. They're also trying to do this. I've sort of changed my mind a little bit. This is her speaking. And it's that if I do some of these longer facets are there beyond like the 16 hours and 12 hours, I end up losing, or there's the fear of losing so much muscle mass that's there, and it just takes me so much effort and energy as I age to get it back.

So I've largely, now that I'm in a healthy place and I feel good and I'm very stable, and it's really about optimizing, I've stayed away from those fast because the tradeoff is not as needed for me and the risk of losing that muscle mass is very high. You know, do you generally agree with that thought process? I do. I think that there are some benefits for autophagy from longer fast, and she would agree with that. You know, autophagy is that cellular cleansing process. It starts at about 18 hours of a fast.

And the longer you fast, the deeper you get into autophagy. And so there's some really good evidence that longer fasts that stimulate autophagy may be efficacious for cancer prevention. And so for me, that's the trade-off is I want to do all I can to preserve lean muscle mass, but once in a while, I want to bias the autophagy benefit. And I don't have the weight to lose either. Like, I'm kind of in that maintenance phase. Fasting is harder for me. Like, I think I did a 40-hour fast once after a really heavy food vacation. And that was fine. And I think I've done a 40-ish-hour fast another time and that was okay. But it's hard, you know, and I think that there's companies like pro long. I don't know if you've had them on the show. And they're like a fasting mimicking diet where

you eat a little bit of food, but you stay kind of under the nutrient thresholds that prevent atopathy is kind of my understanding of it. It took me a long time to wrap my head around that. And I think that that might be a little bit more the route that I go if I want to focus on autophagy, boosting it just to make it a little bit easier for me. But yeah, I mean, in general, I agree. And it's interesting, like Dr. Peter Attia, I thought he was on some show, maybe, you know, like some Netflix documentary with maybe Chris Hemsworth, and he was having him do a four-day fast.

Do you know what I'm talking about? I know of the show, but I didn't watch it. But yeah, I saw the clip where they were talking together and they were revealing, I believe it was Chris Hemsworth risk of Alzheimer's or something like that. They were talking about the APOE genes or something like that. I could have gotten that wrong. But yes, I'm familiar with it. Right.

But then in his book, Outlive, which was very dense. Did you read Outlive yet? Let's call it skimmed. And I'm regularly going back to read sections that because it's quite dense. But yes, I'm generally familiar with the framework and the approach and the key messages that are in there. And I have seen how he sort of changed his mind on fasting. Exactly.

Yeah. And I really thought that was really interesting that he changed his mind on fasting. I used to prescribe like those longer extended fast and now I don't think the tradeoff is worth it. And I'm like, that really makes sense. So I kind of agree with like Dr. Rottia and what Cynthia is saying. And just from my own personal standpoint, like I feel better when I don't fast for an extended period of time. But I want to do it occasionally just for the autophagy.

but I probably won't make it that long, that long, like a four-day fast, a five-day fast. Like, it's just not probably in my, and I don't have it in me to do it. So I think that there's benefits, especially for people like that gentleman I was talking about for blood sugar management, there's benefits for those extended fast, but for just people at a healthy baseline, we got to prioritize the muscle mass, I think. Yeah, that's great. So this was all part of a conversation of the four pillars. that you were walking through and fasting was one of them.

What are some other pillars that you want to walk through when it comes to this approach that you have with clients? Yeah, let's talk about sleep next. A lot of people don't understand how important sleeping, you know, seven to nine hours a night is. I think eight's kind of the sweet spot. And I used to say I'll sleep when I'm dead. I used to get, you know, five to six hours of sleep regularly a night and didn't know.

Like I just think a lot of people don't know. how important sleep is. So the reason that sleep is really important is because of how it affects your appetite. If you are not sleeping well, you're going to have a higher level of stress, so cortisol. And those levels of cortisol actually make you want to eat more carbohydrates. So that's an important thing. After a bad night of sleep, like just pay more attention to your hunger and your satiety cues. You're going to be more likely to overeat. You're going to be less likely to feel full after you eat. It also just doesn't recharge that willpower battery, like that emotional reserve that we all

have before we get to the screw it line in the day. Screw it. I don't care. Like the better, the more sleep you have, the more reserve you have before you get to that screwed, I don't care line. So sleep is important. It's important for your hormones. It's important for muscle mass.

Like human growth hormone, for example, spikes at night when you're sleeping. That's when you repair. That's when your muscles build and get. stronger. So again, back to the muscle conversation, sleep is important for that. I think that, like I said earlier, everything is easier with sleep. But it ultimately comes to how does it impact our hormones. And it impacts your grayland. It impacts your satiety hormones. It impacts your cortisol. It impacts your human growth hormone. And so some practical tips for people to sleep seven to nine hours a night. Very important. Consistent sleep in wake time.

So if you're really struggling turning the TV off at night, you have to ask yourself, like, is it more important that I watch this one more episode or is it more important that I get a restful night of sleep to support my health? Like, obviously, that's more important. So you have to be on the same page with your partner about what time is bedtime. I want you to, if you need to set an alarm on your phone, if you need to, I wish that like TVs had like automatic shutoffs or something like that. But stop, you know, stop at the middle of the episode before they hook you.

in with another hook, stop between episodes, but you got to figure out of time to turn that TV off. The other thing is blue light blocking is critical. So blue light is emitted from all of our screens, cell phones, computers, TVs, tablets. And the amount of blue light that's emitted naturally as they make their products is about the same that you get from the sun at noon. And blue light goes into your eyes and it actually causes a slight elevation in cortisol. Again, the stress hormone, but it's not just like, oh, we need to fight or flee. It's also, let's stay alert. We need to stay alert here.

Cortisol and melatonin, which is your sleepy hormone or on a teeter-totter with each other. So if cortisol is up, your melatonin cannot come up naturally. And so when we block that blue light, we help lower the cortisol production so that melatonin can naturally come up. So if you're popping a melatonin gummy or you're taking a melatonin tablet and you're not already blocking your blue light, please do that. You need the orange or like the amber colored like the blue light walkers, not just the yellow, not just the light tinted. You need the ones that block nearly all blue light. Yes, your TV will look funny, but you will sleep deeper and you will

fall asleep faster because your melatonin is naturally increasing. So a couple things, and that's so obvious. It's like if you've had a stressful day, of course it's harder to fall asleep. Of course your sleep isn't that good. And that's again because your cortisol is up so your melatonin can't gum up. A couple other tips is to eat carbohydrates earlier in the day. So a higher carb meal around bedtime might impair sleep. Try to stop eating around three hours before bedtime. That's going to help obviously reducing alcohol intake. If you choose to drink, do it earlier in the day so that it has time to metabolize and it doesn't wake you up in the middle of the night from your blood sugar kind of spiking and then dropping again.

Early morning sunlight is going to be great for your circadian rhythm to help reset that internal clock. If you can get outside, it's so hard sometimes, but even like I'll just pause when I take the kids to school and I'll try to look towards the east and get some natural sun in my eyes, even if that's all I get. It's a pause within about 90 minutes of the sun coming up. So all of those are some really simple tips that people can do to improve their sleep. that cleaning up your diet will help too, like reducing the added sugar, reducing the blood sugar

spikes throughout the day. That's all going to be great for your sleep. Some simple things people might not think about as an eye mask and earplugs. So we want it to be dark. We want it to be quiet and we want it to be cool. We live in a farmhouse that'll be 100 years old in 2030. And so there's really, there's really poor insulation in the closets. And so we got an eight sleep, which is a mattress cover, that, have you heard of that one? Yeah, I use it at home. I love it. Yeah, I like it too. And it really helps because in the thick of the summer, our bedroom's like 80 degrees. And I'm like, oh, oh my gosh, do we need to get a window AC? What are we going to do here? But the eight sleep, it can cool off or it can heat up based on what you need. And so that's really helped me

sleep better in an environment that can get kind of cold or get kind of hot. And so I think all of those are basic sleep tips and people aren't doing them. They're so simple. They're so simple and I think it's a germ rome that said you know it's the simple things that lead to success the hard part is it's all like it's easy to do the simple things that lead to success but it's also easy not to do them so that's all these things that I'm talking about that we're talking about they're simple habit changes and they really have a cumulative effect and that's why when someone comes to me as someone came to me today during a coaching call I was like what do you think about this blood sugar supplement. And I'm like, I think we have bigger fish to fry. Like,

are you doing your mindset stuff? Are you sleeping? Are you drinking your water? Are you eating your protein? Are you eating your fiber? Like, once we have these in place, let's sprinkle in some supplements to augment your results or to break a plateau or whatever we need to do. But if we're, if we're ignoring these simple basic health habits, which so many people are, you can't, you're not going to get results. You can't out supplement an unhealthy lifestyle. So I think that's a really important point. And then the last phase of the pillars is stress. And I wanted to save this for last because it really works into mindset nicely.

So for stress, there's different types of stress. There's emotional stress. There's physical stress. There's metabolic stress. There's cellular stress. So emotional stress is like you're angry, you're scared, you were offended, you're hurt, you're stressed out. You just, you feel it, you know, viscerally in your body.

The physical stress would be things from like a high intensity interval training session, intermittent fasting perhaps, strength training. All of those would be good stressors on your body in moderation. Not in moderation. The next would be like a metabolic stress. So when you have those refined seed oils or when you have added sugar, that's a stress on your cells. And then the last would be like the cell.

toxin. And so if you're eating things out of plastic or if you're cooking on non, you know, a nonstick cookware, I live on a farm. We have pesticides around us. Like that's definitely a cellular stress, which concerns me a little bit. So, you know, heavy metals in your water. For example, we really tested the water when we moved into the farmhouse because I wanted to be sure that our old pipes weren't leaching metals into our waters. So all of those things are cellular stress. But predominantly the biggest problem is the stress caused by our own thoughts. And that's where the mindset comes in.

So so many people are causing inflammation by their negative thinking. And so when it comes to stress management, I mean, I'm never going to tell someone don't go to counseling. Like I think if you need professional help, please get professional help. there are also so many things that you can do to help your own mental health. Every single thing that we talked about today is going to help your mental health. Exercise can be very beneficial. From an insulin standpoint, I kind of skipped over this one, but we want to focus on strength

training, all major muscle groups at least twice a week at a moderate to high intensity. That means that you're getting to muscle fatigue, like where you can't do another one with good form, after about 10 to 50, no more than 15 repetitions is what I usually recommend. If you're doing more, you need to increase your weight. But then whatever reduces your stress, if that's gentle walking, if that's running, I used to teach jazzercise, if that's yoga. We want to do the stress reduction, physical activity exercises. Those are the two that we focus on at least at first.

So that can be great for stress management. You know, I really, really love how Dr. Nolte emphasizes how important it is to prioritize doing the simple things to live a low insulin lifestyle, not just to maintain a healthy body composition, but to also maintain a healthy body and mind. Making our body insulin sensitive so that it pumps out the right amount of insulin at the right times is so essential for supporting our overall health and our liver specifically. And the good news is that insulin resistance is not only preventable. It's reversible. I've seen them firsthand with my own family members. Really coming to the understanding about how important insulin sensitivity is was a game changer even for my own health.

I actually saw firsthand that, yes, a lot of carbohydrates and refined sugar is a big part of what drives insulin resistance. But when I specifically started to add lean muscle mass, I went on an intense journey of a year to get serious about it when I turned right. before I turned 40 and found out that I was skinny fat. I said, okay, I need to get my muscle health, my lean muscle mass in order. And so I went on that journey. And it took me about nine months, eight months, and I added almost about nine point something pounds, eight point nine pounds. There was different ways to measure, so they all showed up a little bit differently. But let's just

call it nine pounds. I added nine pounds of lean muscle mass to my body. And I even was eating a little bit more carbohydrates, a little bit more carbohydrates, which means I'm not fearing carbohydrates, the occasional white rice, the sweet potatoes, whatever it might be, the God forbid oatmeal. And I saw something pretty crazy happen when I added lean muscle mass and I started walking more. And I prioritized my muscle and exercise resistance training. I was able to eat more carbohydrates than previously. And guess what? My fasting insulin, which is one of the main markers that our guests today have talked about, improved. So this is the power of stepping into prioritizing muscle and understanding how to live a low insulin lifestyle.

I had it for me. I want that for you as well. Now, that's the end of today's episode. If you enjoyed it, do me a favor. Send this episode to a friend. You can text, message it to them. You can screenshot it to them. Send this episode to a friend

who might find this inspiring, especially when it comes to their 2025 goals. Until next time, this is Drew Prod signing off. Thanks for tuning in.