Dynamic Dialogue with Danny Matranga - 331: The 7 Pillars of Health w. Dr. Kyle Gillett

Episode Date: October 24, 2023

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a 30 day money back guarantee and save 125 bucks on your Ice Barrel using the promo code Danny. So again, icebarrel.com slash Danny and check out using the promo code Danny to save 125 bucks. Welcome in everybody to another episode of the Dynamic Dialogue podcast. I'm your host, Danny Matranga. And in today's episode, we are joined by my good friend and now multi-time guest on the show, Dr. Kyle Gillette. Dr. Gillette is a medical doctor who specializes in what I would describe as a holistic, well-rounded approach to medicine. He's not anti-pharmaceutical. He's not overly pro-pharmaceutical. He's somebody that I would describe as being very much in the middle, somebody who champions both supplemental,

somebody that I would describe as being very much in the middle, somebody who champions both supplemental, lifestyle, exercise, and nutritional interventions. And today we talk specifically about a huge component of his practice, which is leading with the seven pillars of health, diet, exercise, sleep, stress, sunlight, spiritual, and social health. All of these things are integral to the health of the human being and the well-being of the human being across the lifespan. We want a long health span as well as a long lifespan, and you need to do something to hit on each of these things to really thrive as a human. Dr. Gillette and I discuss each and every one of these in detail. And for those of you who are hoping to help friends, family, loved ones live healthier lives, especially through the holidays, this is a must listen.

For coaches out there who are looking to make their clients' lives better through not just diet and exercise, but other health-promoting behaviors, this is a must-listen, perhaps my favorite interview to date. So sit back, relax, and enjoy the episode with Dr. Gillette. Dr. Gillette, how are you doing, man? I'm doing great. Thanks for having me back. Absolutely. For those of you who aren't aware, Dr. Gillette and I recorded an episode

specifically about hormonal health, female hormonal health, female physiology about six months ago. And it's one of the most downloaded episodes that we have done on the podcast because so many of you are invested specifically in how your physiology can impact your performance and your body composition. But after listening to a couple of guest spots, Dr. Gillette's done on other podcasts and listening to his podcast, which I believe is new. We'll talk about that a little bit too. I'd love to hear about that. I loved the way he framed and kind of wrapped the idea that there are seven essential pillars to human health. And I think that going specific and going into the nitty gritty is really, really valuable. But things that are very

general and apply broadly like this are so, so important for somebody like myself, who's very much on a mission to help as many people as possible live healthier. And so I can't wait to talk to you about this, man. And congratulations on the new clinic and the new pod. Thank you. I really appreciate it. And I love talking about these topics because I truly believe that food is medicine and exercise is medicine. And these lifestyle interventions are more powerful than any medication or supplement. Yeah. And so like, and you're practiced as a medical doctor, right? Like, and this is a big thing, you know, is qualifying expertise. And, you know, in the social media space, things can get a little hairy and it's hard to identify who really is and who

really isn't a reputable source of health information. And I can't think of too many people who are better positioned than somebody who works in medicine with people each and every day to improve their health. And I've got to assume, and I have seven pillars down here, that these seven pillars of health kind of became more and more clear to you as you started practicing medicine, but maybe even before you started practicing, maybe when you were in med school, how did each of these sunlight, diet, exercise, stress, sleep, spiritual and social health, how did these come to you and stand out to you as, you know, I'm a physician, I need to help people live a healthier life, but I cannot do that with traditional medical interventions and traditional Western pharmaceutical interventions alone? Yeah. A lot of the, I guess, wisdom that I've gleaned along the way is from seeing what the common denominator is with people that have very good health. Because there's this paradox of

people that go to the doctor all the time are on dozens of medications and they're some of the least healthy people and they have the shortest health spans, even if their lifespan is decent. And then a lot of people don't go to the doctor at all and they are particularly healthy. Now we can, of course, dive into that more later, but you look for the common denominators and exercise and diet are certainly two that stand out that a lot of people are aware of, but there's other interventions that people need to think about as well. And so like, I would say as a fitness coach and fitness professional, it's very clear to me how important diet and exercise are, both as interventions for improving long-term health, improving body composition, improving mental health. I see it all the time. But when we talk about benchmarks for diet and exercise for general population

health as a physician, let's start with exercise. What kind of recommendations are you making for patients who maybe aren't particularly interested or don't particularly enjoy something like resistance training or going on a run. I feel that I'm fortunate having grown up and having played a lot of sports. I have a proclivity for challenging and enjoying challenging myself physically. And we're moving further away from that as a population. Many people are more sedentary. Children spend more time with technology. They play less. So developing a love and cultivating a love for exercise is challenging. And for people who aren't particularly in love with it, how do you as a physician not only encourage it, but also get some traction there?

Yeah. The natural human condition is to be moving or standing most of the time. I am standing at a standing desk as I talk to you here. Heck yeah. And I know a lot of people have treadmill desks or even like a Peloton desk as well. So humans are innovating and figuring out how to get back to a more natural condition. And that being said, I am inside currently, so I'm not outside. But a lot of the different interventions that I recommend, I just write as a prescription like anything else. So I have prescription pads for nutrition, for diet, one for general lifestyle in general. And I am in the process of digitizing these prescription pads. But just like you would recommend, say, a medication or a supplement, I write down and circle some of the interventions. And it's not just calories in and calories out and micronutrients, macronutrients, of course. So there's actionable tips. For example,

if someone's attempting to optimize their body composition or lose body fat, then I might choose the first section has like six different options where number of meals per day is one of them. Calories is another one of them. Amount of protein per day is another one of them. Another carbs per day is another one of them. Eating speed is another one of them. So there's a lot of different, um, depending on the individual, just like you might choose a different medication for someone, which might work better depending on someone's genetics and habits, you can choose a different intervention. I like that.

You hit on something interesting, which is eating speed. And I think most people are aware that if you want to lose body fat, you know, I guess you probably eat less overall calories and I should probably optimize for more food. That's protein rich and satiating. But to what degree does eating speed influence the amount that people eat? Because this is something that psychologically I work with a lot, particularly with clients who compete or need to get very, very lean for a competition and you need to pull out all the stops. But eating speed does have a pretty substantial influence on how much we eat, huh?

Yeah, I think it's particularly clear in the case of, say, a new mom or a new dad or a pediatric patient. And they feel like they have less time, so they need to eat particularly fast. And when that's the case, you can certainly tend to overconsume calorically dense, but not necessarily nutrient dense foods. It's no secret that doctors are people too. And I struggle with all the same issues. For example, after my first child, I certainly gained too much body fat, probably 30, maybe even 40 pounds of excess body fat.

Wow. And that was one of the interventions that I felt particularly helpful, along with eliminating all liquid calories. Yeah, that's a big one. One thing for me. That's a big one. I actually just made a post about that this morning, that if I could recommend one behavior for body fat reduction for the average American based on how people typically eat,

it wouldn't be the elimination of a particular macronutrient or a particular food classification. It would be the elimination of liquid calories. I'm sure you see a lot in your practice, people over-consuming liquid calories. And when we talk about changes people can make for their health, there's two types of, or really three types of calorically laden beverages that people have a tendency to overconsume, all of which I think can be independently harmful in excess. The first is overly sugary sodas or beverages, overly caffeinated, oftentimes overly sugared coffee or energy drinks, and then, of course, alcohol. And did you eliminate all three? Do you have patients eliminate any of these three? Are there secondary health markers when you remove these calorically laden beverages

besides body fat reduction? Because I think alcohol, caffeine, and sugar at high amounts can all be pretty deleterious to your health. I eliminated all three with the exception of one to two standard alcoholic beverages. So not a 500 milliliter glass of wine, but an actual standard drink. Okay. In general is one shot of 80 proof or 40% liquor, one glass of, um, a wine. I think it's normally like 7%. So obviously wines are anywhere from like six to 15%. Yeah. Which, um, uh, that's a whole nother story, but that's not really like a, a 15% proof wine is not necessarily like really natural in the context, historical context of making wine.

But anyway, as far as like what, what I recommend to patients is usually something similar. If that individual drinks alcohol. Oh, and the other caveat to that is only in settings where it is potentially socially helpful. So how can I stop really helpful for like health purposes? Um, you can, you can make the argument that it helps with aromatase, but there's other things that do that better. Yeah, sure. And then it's, um, seven kilocalories per gram, of course, more along the lines of the nine that fat has compared to the four that protein and carbs have. Yeah. And I think we see a lot of justification for, you know, chronic alcohol consumption. The French paradox is often cited as like, hey, you know, there's look at the French,

they drink a ton of red wine and, you know, they're so healthy. And of course, there's ambivalence around the secondary health factors that the French and other European countries engage with that allow them to stay so healthy, even with elevated alcohol consumption. But when it comes to nutrition and when it comes to alcohol consumption, I'm hearing one to two standard drinks per week in a social setting is probably where you're going to set the guardrail for not just yourself, but hopefully for patients. You know, as somebody who works with clients who want to optimize

lifestyle performance and body composition, it's really hard to do that with chronic alcohol consumption. There's an interesting correlation, and it's a fairly strong correlation between endurance athletes, both cyclists and runners, and alcohol consumption. they are slightly more likely to be able to get away with it because they burn so many calories as a habit that they essentially have room for those empty calories. Sure. And then secondary to that, they also have less aromatization. Now, in your work, how frequently do you see primary and even secondary health issues arising from chronic alcohol consumption that many people would say is like, I have a glass of wine a night or two glasses of wine a night. I don't think I'm an alcoholic. I don't think I have a drinking problem. At what level of intake as a physician

do you start to see problems from alcohol consumption? It's very common, but it's usually not only related to alcohol consumption. So two things that I see all the time is difficulty with weight loss just due to the calories of alcohol. Both the calories from alcohol as a macronutrient and often the other carbohydrates that are with it. The second thing I see all the time is people that start GLP-1s like semaglutide, which is certainly in vogue right now. Yes. Alcohol will slow gut peristalsis and GLP-1s do the same thing. So it's very common to see vomiting and severe nausea after starting a GLP-1 just because between the two of those things, your gut is essentially paralyzed or having reverse peride, one of which is remote, one of which is in person,

both of which found out about the drug and said, hey, what do you think about this? They said, hey, why not? You've struggled with nutritional and dietary adherence. Your physician signed off on it. I don't have a dog in this fight per se, and I'm limited in how much I can help you outside of giving you directives. And both of them cited not only that it affects your appetite, but neither one of them wanted to continue drinking. It seemed to kind of nuke any desire they had to drink. Now, I'm not sure if you've seen this, but I figure it's a decent segue,

but there's some literature emerging around maybe them using some of these GLP-1s to treat alcohol addiction. I don't know if you have an opinion on that or if you have an opinion writ large about GLP-1s, but like you said, they're very in vogue. They seem to be beneficial for weight loss and for treating diabetes, probably through weight loss. And now they might even be used to treat addiction. Do you think that this is a classification of drugs that potentially could, you know, 20, 30 years from now, we'll be watching TV and we'll see the law firm ads. If you or someone you love use semaglutide, you know, do you think that these could be dangerous in some way? Or are you pretty liberal in your prescription of them if you

prescribe them at all? I am relatively liberal with GLP-1s for individuals that need it, especially individuals that are just about to develop diabetes that would essentially have diabetes otherwise, or for individuals that would develop some other severe pathology. In that case, again, going back to the scale, the balance of risk to benefit. The benefit just outweighs the risk. There's a lot of information and videos that consider GLP-1's appetite suppressants. And yes, they work on the hypothalamus, that orexigenic. Think of your orexigenic center as your hangry center or your anorexigenic center. That's, you know, same word as anorexia. So that's, you're not hungry, not angry. And yes, they do work on the hypothalamus and the hypothalamus has a lot to do

with like addiction and alcohol use. That's why a lot of times we use things like naltrexone. That's also active in the hypothalamus on opioid receptors or Welbutrin, which is also active in the hypothalamus. It's dopaminergic, but not to segue too much. It's there's a lot more, there's other mechanisms of action. So it also has what's called a gustatory response, which when your body produces its own GLP-1 after eating, that's where you get some of the satiety. And it also works on the pancreas. It's called an incretin. And that's where you get some of the satiety. And it also works on the pancreas. It's called an incretin. And that's where it basically helps you utilize your insulin better and secrete it at better times.

Gotcha. Kind of like potentiates the effect of insulin or helps you secrete insulin. And then it's also active in the periphery on receptors, working in both the liver and also throughout your body to uptake glucose. So there's a lot of different actions. So there's a couple of different black box warnings for it. I've seen a lot of people make videos that say it increases your risk of thyroid cancer. However, I think that is actually the least concerning side effect of GLP-1s like semaglutide because it's specifically medullary thyroid carcinoma, which is exceedingly rare and really only happens

often in specific types of multiple endocrine neoplasia. So I think that's very unlikely to be a class action lawsuit at some day. However, it can cause pancreatitis. And if you have really high triglycerides, for example, over 500, you could be at risk of pancreatitis. And if you have really high triglycerides, for example, over 500, you could be at risk of pancreatitis. And that's one issue. The most common issue is biliary pathologies. So an example of this would be you start semaglutide, let's say you're a 40-year-old female and your BMI is 40. A month or two after starting some agglutide, it not only paralyzes your gut, but it paralyzes little tubes that secrete enzymes. It's not uncommon to see someone need their gallbladder removed or to have another problem with the gallbladder or liver after

starting. So I think that is a dark horse for being like an unknown side effect in the future. a dark horse for being like a, an unknown side effect in the future. Gotcha. So with, um, just kind of to circle the wagons on nutrition and what people can do from a nutritional standpoint to improve their health. Um, when patients come to you, what are the big rock quick hitters items that you tell them to focus on with their eating behavior? Because energy density, overall energy intake in the form of calories, a lot of times that's over people's head. They're not even ready for a calorie total. They're not even ready for grams of protein total. Sometimes they are. But what are those big rock habits and behaviors that you see to be most effective at helping people live healthier with regards to nutrition? As you mentioned, I do like helping explain or helping raise the food intelligence.

Maybe food intelligence isn't a perfect term, but it's traditional literacy, perhaps. Yeah. You know, it's something that people understand understand raising the knowledge that each patient has about foods, at least to the level to understand caloric density versus nutrient density. Yeah. That's really smart. I love that. That's a baseline that almost all patients, except very young pediatric patients would be able to understand. And in the case of pediatric patients, of course you would have the whole family involved anyway. Um, so that would be the number one thing. The number two thing would be, uh, for most people learning how to skew calories toward earlier in the day. I'm certainly not against intermittent fasting,

but if there is a difficult case where, uh, it's been hard for the patient to lose body fat, often you see them eating a large amount of calories between, say, 7 p.m. and midnight. So basically finding a strategy, which often encompasses social health with that, too, to where they can consume the majority portion of their calories earlier on in the day. Yeah, and that honestly just sets you up for better sleep, which can help with willpower. We'll, we'll talk more about sleep in a second, but, um, and a simple prescription that you might make for exercise for somebody who's just trying to get their footing and being like, you know, doc, I know I need to exercise, but I just don't like it. You know, what, what can we do for patients and clients and friends and family who we are trying to encourage to exercise?

Because this is something that a lot of well-intentioned fitness fanatics who are, you know, I would call them missionary in that they really want other people to experience the benefit of exercise, but they have a hard time getting traction there. What do you have the most luck with? I like to say a movement past time to last a lifetime. So if you're moving, presumably your heart rate at some point would go over a hundred. Not that everybody needs to rigorously track that,

but everybody can find a movement past time that they really like. Occasionally you can, and this is kind of to play devil's advocate. Yes, you can kind of teach yourself habits to like something. Yes. Formula One. So I tried to make myself like Formula One by watching the Netflix documentary. And now I kind of like Formula One, but you can't always just force yourself to like something like that. So I hate cycling. My wife has a Peloton and she loves it. And she's really tried to get me into it, but I just can't do it. What I can do is brisk walks at lunch time and stand at a standing desk. So I do what I can. Um, and everybody can kind of find that for some people that might be tennis for some people that might

be walking a Frisbee golf course, there's an infinite number of permutations. Yeah. I'm obviously impartial and biased towards resistance training just because of the obvious benefits it has for, you know for increasing muscularity and how that can positively affect your blood sugar regulation, how that can help stave off osteopenia and sarcopenia. And as somebody who's quite zealous in my desire to share that with people, I've had to kind of find ways to say, hey, it does not have to be CrossFit. It does not have to be bodybuilding. It does not have to be powerlifting. There are so many ways to engage with resistance-based exercise. Let's just find something that you don't hate. And I have found over the years that it's not impossible to find something

in that particular modality that people will tolerate. Oftentimes, it's low on the quote unquote ladder, so to speak, in terms of intensity and depth. But even if it's just going to the gym and plugging into a machine for the lower body and a machine for the upper body and doing three sets of 10 and then walking while you watch your favorite show on Netflix on your phone for 20 minutes, the payoff relative to or compared to doing nothing is just, it makes you see just how important it is to meet people where they're at because a little bit can go such a long way. And I knew that we would spend a lot of time on diet and exercise, but it's really the other pillars of health here that I don't talk so much about with my clients that I do, but it's limited because of course, my specialty is in

nutrition and exercise. But when it comes to sunlight, stress, sleep, spiritual and social health, let's start with sunlight. What are the primary, let's start with perhaps downsides or what are the primary complications you see working with a population that, let's be honest, does not get outside probably as much as they should, does not get sun exposure, even just exposure to nature. How does this negatively affect our health? It does in multiple ways. One of the main ways that people are fairly familiar with is called the circadian rhythm. So that your body has a circadian rhythm for many hormones, not just melatonin, which is the sleep hormone.

But if you get outside, especially early in the morning, it helps shut off that secretion of melatonin from a gland called the pineal gland, which is along the optic nerve. That's why it gets the light signals. Fun fact, the ancient Egyptians actually thought the pineal gland was magical and regulated everything. I did recall learning this because they had quite a fascination with removing the brain post-mortem. And I remember they believed it was like a third eye of sorts or an entryway to different realities. They really chalked the pineal gland up to being quite special. And they weren't too far off. It clearly regulates a lot.

Yeah, it is certainly important, much more important than just for secreting melatonin or not secreting melatonin. But other hormones like cortisol, an adrenal hormone that regulates stress and also inflammation, actually, that also has a circadian rhythm kind of opposite of melatonin. And then testosterone and growth hormone are also part of the circadian rhythm. So regulating that is particularly helpful with the use of sunlight. And of course, helpful with the use of sunlight. And of course, as we mentioned earlier, humans are not, we have not had selection to have optimal health outcomes being indoors all the time. So it's very natural to have both the sunlight that encompasses heat exposure, cold exposure, basically being in the elements. Gotcha. So basically what I'm hearing is,

you know, our circadian rhythm is integral for hormonal health, for feeling good, feeling energized. And sun exposure is probably the best way for us to quickly and routinely get our circadian rhythm where we want it. And so you're saying morning sunlight is particularly important. I know Andrew Huberman's big on retinal light exposure. So is that something you also recommend getting outside and not looking directly into the sun, but letting the sun hit your face, maybe even walking in the morning to get that sun exposure? Definitely so. A good rule of thumb, 10 minutes on a normal day. If it's really cloudy, maybe a few extra minutes. In addition to that, there can be some benefit of red light exposure

to the mitochondria in your retina. I think it's 670 nanometers. Okay. And this would be like red light therapy, like the Juve and a lot of retail models. Yep. Okay. Theoretically, I would think a $3, 670 nanometer flashlight would do just as good. Really? Yep. Yeah. I think it's 30 to 60 seconds. But it has to be red optically. Like you have to see the light as red, correct? There's something special about the 670 nanometer frequency that helps improve mitochondrial function. Fascinating. And so with sun exposure, there's two things that we talk about a lot in the health and fitness space, one of which is vitamin D, vitamin D deficiency, which is quite common.

We actually discussed lab metrics and lab markers the last time we spoke and the commonality of vitamin D deficiency. How much sun exposure does somebody need to enhance the bioavailable level of vitamin D? Is that something that they can do with just sun exposure alone? And then also, uh, from a safety perspective, what is the safest way to get exposure to the sun and get the right amount of sun exposure without increasing the risk of, uh, you know, skin damage or even skin-specific forms of cancer.

Yeah. So if you're outside for a full day in relatively strong sunlight, you can get 40,000 or 50,000 units of vitamin D. Okay. So that's like 5 to 10x what you'll find in the average supplement capsule. Yeah. So that is a ton of vitamin D. However, even if your dermatotype is a light or pale skin dermatotype, which theoretically would absorb vitamin D better than some people just don't absorb vitamin D well. because they're not able to get adequate amounts of vitamin D due to high amounts of melanin, which repels sunlight for evolutionary reasons, and two, low sun exposure. So, they're almost chronically deficient. Yeah, that's a good way to look at it. The interesting

correlation between melanin and melanocyte-stim stimulating hormone, which is stimulated during sun exposure. And there's peptides there. There's actually four different peptides. I call them melanotan one, two, three, and four, but three is used for hypoactive sexual disorder in females. And it's also used for obesity. And it's also used for what's called lipodystrophy, which is abnormal body fat distribution in the abdomen. So it's interesting that this hormone that's naturally stimulated by sun exposure treats all those different things. And then if you have a deficiency in one of the melanocyte-stimulating hormone receptors, 100% of those individuals have severe morbid obesity, which you treat with a different melanocyte-stimulating hormone. As far as the question earlier about getting it safely, you obviously don't want to have sunburns.

melanomas, which are in general, the most concerning skin cancer for metastasis are related mostly to genetics and very, very severe burns. So you definitely want to prevent any severe sunburns. Basal cell and squamous cell, which are the two kind of more normal or common, and they usually invade locally and can be very disfiguring, but they usually don't metastasize. Those are related to cumulative sun exposure, especially for areas like your nose, which has cartilage or your ears. I definitely recommend sunscreen and also trying to avoid sun exposure to the face in general, because if you think about it, if we have to, if your doctor has to cut out a hunk of your skin or your tissue, you certainly don't want that to be in this area. your skin or your tissue, you certainly don't want that to be in this area.

Yeah. And to hit on sunscreens, I go back and forth. Like so many people, I'm very much prone to sensationalism at times. And there's been such a huge push from the naturalistic community that's very anti-sunscreen because of some of the parabens and polymers and ingredients in sunscreens. And I even remember growing up, my dad had to be very careful with the sunscreens he selected because he would get rashes if they contained certain chemicals. Do you have a preferred sunscreen? I know you're a parent, so you're applying sunscreen, not just to yourself, but probably to your kids. So is there a brand? Is there something you look for in a sunscreen?

Or do you think a lot of that is maybe perhaps overblown and not worth concerning oneself with? And that avoid sunscreen use in the name of avoiding exposure to chemicals is a stepping over dollars to pick up nickels kind of thing. Yeah. I actually do use a different sunscreen for my children. It's zinc oxide based.

Okay. It's called a barrier sunscreen. Okay. It also happens to be reef safe. I'm a little bit of kind of like a tree hugger. I'm with you there, man. I'm with you there all day. Yeah. So if you're at the beach, then I certainly use those because I figure why not.

And zinc oxide is not significantly more expensive. And I don't mind looking kind of silly with a barrier sunscreen. You don't want it to rub in 100% of the way. You can rub it in a little bit, but you want a little bit of it to kind of like the film to be visible. But that is what I like to use for my kids to be safe, to avoid all those confounding variables and potential endocrine disruptors. Gotcha. Perfect. So let's move from sunlight now into stress. Everything that's left starts with an S. Stress, sleep, spiritual and social health. Stress as a pillar of health. I'm assuming when you say that you mean stress management. Obviously, exercise and hormetic things like sauna and cold exposure can be good forms of stress that benefit the body. But I'm assuming we're talking about the management

of stress, right? Taking a break from this episode to tell you a little bit about my coaching company, Core Coaching Method. More specifically, our app-based training. We partnered with Train Heroic to bring app-based training to you using the best technology and best user interface possible. You can join either my Home Heroes team, or you can train from home with bands and dumbbells, or Elite Physique, which is a female bodybuilding-focused program where you can train from home with bands and dumbbells, or Elite Physique, which is a female bodybuilding-focused program where you can train at the gym with equipments designed specifically to help you develop strength, as well as the glutes, hamstrings, quads, and back. I have more teams coming planned for a variety of different fitness levels. But what's cool about this is when you join these programs, you get programming that's updated every single week,

the sets to do, the reps to do, exercise tutorials filmed by me with me and my team. So you'll get my exact coaching expertise as to how to perform the movement, whether you're training at home or you're training in the gym. And again, these teams are somewhat specific. So you'll find other members of those communities looking to pursue similar goals at similar fitness levels. You can chat, ask questions, upload form for form review, ask for substitutions. It's a really cool training community and you can try it completely free for seven days. Just click the link in the podcast description below. Can't wait to see you in the core coaching collective, my app-based training community. Back to the show.

Correct. And you can think about stress in kind of two different ways. One, you think about stress where all stress is bad, almost like pain is all pain bad. Or you can think about stress as in, these are the opportunities life gives us that require a lot of effort. require a lot of effort and how do we make that effort feel good? And to me, that's, uh, part of the like therapeutic, um, uh, you know, part of it could be related to being a parent. That's a good example. Um, there's going to be a lot of stress that comes up and there's going to be a lot of, um, shortcomings or periods of time where you feel like you fail. And that can be very stressful. Or you can kind of make that effort feel good, almost like you can make the pain of lifting weights feel good. Gotcha. So learning how to interpret stress as it comes to you

from a perspective and a subjective standpoint is valuable for a patient is what I'm hearing. And there's a lot of literature to support this that I'm aware of. I specifically remember, I don't remember what pop psychology book I got this from. But, you know, it was the notion that if you see stress as being exclusively negative, it has a substantially worse impact on your health than if you see stress as being potentially positive, in which case it doesn't have such a negative impact on actually measurable elements of health. Do you tend to see that as the case? Yeah, I would definitely agree. Being able to get that dopaminergic or that dopamine response, it almost creates a positive feedback loop

where it motivates you when the next scenario of equal or greater stress will come up. Gotcha. And so from a lifestyle and stress management standpoint, outside of like, okay, I'm going to do a good job of trying to frame my stress as positive. How do you work with patients to manage stress? Because sometimes stress is corrosive. It's overwhelming. It's debilitating. And it's a lot of times beyond what we can control, even when we're operating from this space of like, no, I'm going to frame this positively. I'm a resilient and adaptive human being. This is not going to get me down. Even the best of us have periods and elements of our life where stress is beyond what we can really handle with just changing our state of mind. How do you work with clients, patients who suffer from chronically elevated stress and how does chronically elevated stress negatively impact our physiology? There's two things to really consider significantly when stress has reached

to a point where it's pathologic. So perhaps there's some doctors might put a diagnosis to it, adjustment disorder, even bereavement if you lost a loved one, anxiety disorder, depression, cyclothymia. There's an infinite number of diagnoses that you can choose. But the two things to keep in mind is find out which loved ones or which family and close friends you have that might be able to go through this with you. So you're not isolated. Humans are social creatures, not to segue too earlier into the social pillar of health. And then the second thing is it's totally okay to feel better. And it's also okay to take a supplement or a medication, which by the way, I see supplements

and medications as the exact same. One's prescribed, one's not. They both have pharmacodynamic and pharmacokinetic effects. Sure. So I see them as the same. So it's perfectly okay to take a supplement or a medication, hopefully temporarily, just in order to feel better because it will improve your health. Sure.

Just talk to your doctor about the risks and the benefits of those. So let's assume that somebody is, and I find this to be pretty common in the proactive health community, probably very common amongst people that are listening to this podcast. I don't want a pharmaceutical intervention. I prefer to start with a lifestyle intervention and a supplementation form of an intervention. And I totally agree with you. There's supplements you can buy over the counter that are substantially more deleterious or have a higher risk profile than many pharmaceuticals. But we're living through a time where there's probably never been a greater distrust of

pharmaceutical companies for potentially good and for potentially misinformed reasons. So a lot of people would rather start with lifestyle and start with supplements. What's the number one lifestyle intervention for stress that's at least somewhat tolerable, going kind of back to how we talked about exercise, like, I don't want to do that, but I'll try this versus, or, and what would you say is the number one supplement? Number one lifestyle intervention. Some people might call it a mindfulness practice. Some people might call it meditation. Some people might call it a dopamine detox or dopamine reset. Okay. For me, kind of all three of those things are encompassed in, um, I'm not a religious person, but they're encompassed in my spirituality, which again, another pillar for that, but just praying. So, um, praying, including with my

friends and family has a pretty profound effect on stress. And, uh, regardless of how much of that is like, um, you know, clinically helpful or placebo that has also been studied and can be helpful as well. So just finding, um, like which of those interventions work for you. That is great lifestyle change for stress. As far as a supplement or a medication, if I had to pick one, I would pick L-theanine. It has relatively few side effects. It helps improve the alpha waves in your brain, which are the calm, cool, collected waves. We know monks and monasteries have a lot of these. They don't make you tired. So you can also take it in the morning and the evening. There's a decent amount of L-theanine, probably 10 to 20

milligrams in teas, like green teas and black teas. And of course you can take a much higher dose, like 100 or 200 milligrams in a supplement. Gotcha. And so this is not a, I'm not trying to question you too deeply, but I'm a non-religious secular type. And I think you said you're not religious, but you're spiritual. And so what does praying look like for somebody who is, to put it bluntly, if I'm not praying to God, what does praying look like? What does that behavior look like? Because I think that that's a really, it's a generally beautiful notion that one might be capable of engaging in a spiritual practice without, in a spiritual practice without, you know, giving it up to a deity, so to speak. Yeah, definitely. I would think it would be very similar to a mindfulness meditation.

There's a couple of different ones. Some people do like a raisin meditation where they'll just taste raisin, um, like think about the taste of it. You think about the, um, texture of it, et cetera, et cetera. Or you do a body scan where you sit down, you're in a very comfortable spot. You think about like the toenail of your big toe, and then you go from there. So again, a lot of those improve the alpha waves in your brain, the calm, cool, collected waves. Um, I would think that it would have a very similar like neurologic or physiologic output. However, all that being said, um, just discussing the spiritual pillar of health in general, all it is, is Maslow's hierarchy of needs. So for thousands of years, um, for better, for worse, probably for worse, a lot of

humans have thought about their physical needs or their mental needs, for example, their housing or their food. But then you get to the top of the pyramid and there's this area called self-actualization. And basically that's your metaphysical need. And that explains the why behind how people in developed countries have more stress, depression, and anxiety than ever. Now, yes, these things have been prevalent throughout all of history, but you'd think with less physical needs that we'd have less, but there's actually more because it's very difficult to answer the top of that box. Yeah, it's almost like if you don't have the bottom of the pyramid foundationally set, that tends to be what you remain focused on. In non-developing countries, we see this.

But when every other component of the pyramid is fairly stable due to convenience, due to lifestyle, due to where you live and what you have access to, you're then faced with that top portion of the pyramid, which might be the most challenging to attain in a society that's so pleasure-driven, dopamine-driven, and a lot of what we're seeking externally doesn't validate us metaphysically. So I like that. And that crosses off both stress and spiritual. So let's talk about sleep. And I see this a lot with clients who struggle with their sleep. They do not perform well. They have a substantially harder time with their nutritional adherence, dietary adherence. And they also tend to be what I would describe as more irritable, less receptive to coaching.

less receptive to coaching. Oftentimes, they struggle not just with alertness and wakefulness, but being chronically lethargic, all stuff that people know. What are you seeing in your practice with one, clients that are underslept? And then I guess, how many of the people that you work with are not getting adequate amounts of sleep? With sleep, I consider sleep disorders, including sleep apnea, which is the most common sleep disorder. That would be the number two thing behind metabolic syndrome for what's causing so much hormone imbalance. Wow. Wow. Whether it's estrogen dominance or low testosterone, which matters for both females and males, of course, um, I would put sleep disturbances, including sleep apnea as number two. So it's very common. Um, if somebody has a sleep, uh, if, if somebody has daytime

somnolence, which is being sleepy during the day or feeling like they have to nap or just loud snoring at night, I have a very, very low threshold for ordering a sleep study, which can be done at home pretty easily now. One interesting study that I saw was on young individuals with normal BMI, so they were not overweight, with PTSD, and they had an extremely high incidence of sleep apnea. In fact, obstructive sleep apnea. And we don't know exactly why that was. This study, I believe, was mostly in individuals who had been in the military. So perhaps that was part of it. Perhaps that was their sleep architecture as well. But if you're feeling tired or fatigued or whatnot, then at least thinking about getting some sort of objective or maybe even subjective data about what is happening during your sleep is very important.

There's a couple other things that sleep does. During REM sleep, which is your rapid eye movement sleep when you dream, that's particularly helpful for your mitochondria. And that's your best anti-aging. So everybody's always talking about anti-aging interventions. My two strongest interventions were REM sleep and then zone two cardio. Gotcha. So, so two things that I think a lot of people engage with, uh, specifically in this, we might touch on this when we get to the social element that can affect sleep are alcohol and cannabis. And I don't drink, but I do use cannabis and I've been, uh, essentially not using cannabis for about the last two weeks. Um, and I'd been using it at a pretty chronic clip

of I'm being completely transparent. And I think some of that was just compulsive. Some of that was just to detach and disconnect and some of it, who knows, but I have noticed more deep and more, let's call them vivid dreams, which I do think are often associated with REM sleep. And I've heard you touch on cannabis consumption and sleep. So can we talk a little bit about how cannabis affects sleep and how alcohol affects sleep? Because I do think that those two things are probably the most common, let's call them their drugs. There's the most commonly used drugs, particularly in the evening. And I think many people use them to go to sleep or help them sleep. But do these things actually do that?

Alcohol, I suppose, can help you fall asleep. it can help with like the the latency of sleep but it causes very poor quality sleep both deep and REM so um that alcohol never worth it as a sleep supplement in general you want to have alcohol mostly out of the system before you sleep which socially can be difficult given the times of day that people tend to drink. So that's kind of unfortunate. Cannabis has a couple interesting interactions with sleep. The endocannabinoid system can of course help with sleep. And if you look at what, um, naturally, I guess, activates the endocannabinoid system. Um, sometimes things like exercise can actually help. So some people feel really, really tired after exercising, but a lot of people know that if you exercise too late in the evening, that can also affect sleep. Not that that's the only effect that exercise has. Of course, it will shift your sympathetic and parasympathetic nervous systems and all sorts of other things as well, and your metabolism. things as well, and your metabolism. But one other effect that high doses of cannabis can have, particularly smoked cannabis, is that it can increase your prolactin, which can kind of

decrease your dopaminergic tone. Dopamine and acetylcholine are related to good REM sleep. So occasionally people take supplements or even medications to help with REM sleep. take supplements or even medications to help with REM sleep. A complete deficiency of dopamine first leads to a REM sleep disorder. For example, really, really restless legs or just horrible REM sleep. And then it leads to Parkinson's. My dad actually has Parkinson's disease. And previous to developing Parkinson's disease, which he developed at a very early age, developing Parkinson's disease, which he developed at a very early age. I would say I was about 12 years old when my dad developed Parkinson's. So he was in his late, I would say early fifties, early fifties, which is pretty young diagnosis. But for much of my life as a youth, I recall my dad being up very early, not sleeping all that much,

and maybe not tapping too much into REM sleep. So that's actually a connection I've never made until just now. Yeah. And unfortunately in hindsight, often, uh, you do see that is that there's pretty significant REM sleep disorders, even like kicking and screaming, kind of like borderline, the opposite of sleep paralysis is what it is. Sleep paralysis is like when you're kind of awake, but you can't move. So it's kind of the opposite of that. And then the area of the basal ganglia called the substantia nigra helps synthesize the dopamine. And I don't believe you actually develop Parkinson's until there's like less than 10% or less than 5% of function.

So a very, very low function before a diagnosable Lewy body dementia or Parkinson's disease. But certainly, that's part of the importance of dopamine for quality of sleep. However, that being said, if there's an individual that has a very, very low prolactin, then theoretically that can affect the latency of sleep. A couple of things that people know increase prolactin acutely is a seizure. So during that postictal state, when people are kind of confused or sleepy after the seizure, they have very high prolactins. That's also partly just due to the tonic clonic nature of the seizure. So not all seizures do that. But another thing is orgasm and ejaculation. So after an orgasm, people are kind of familiar with that tired feeling. A refractory period.

Correct. So prolactin is also high during that time. And that can certainly help aid with people going to sleep. And perhaps that is one of the effects that cannabis might have. We could get into like THC to CBD ratios and all sorts of things, but that's a good rule of thumb. Yeah. And with regards to alcohol, I've had it described to me as it's more of a sedative in that it has a sedative effect that even though you might drink so much alcohol that you black out for hours or you drink a large amount of alcohol and become quite sleepy, that the quality of sleep after even modest amounts of alcohol consumption is impacted pretty directly. Is that relatively on track? Yes. And I would actually consider that true for almost all GABA agonists, including benzos like Xanax or Klonopin or even non-benzos like Ambien or Lunesta.

Okay. And so for folks who want to get high quality sleep, because this is something that I'm very focused on, I want to make sure that I get enough sleep and I want to get high quality sleep, because this is something that I'm very focused on. I want to make sure that I get enough sleep and I want to get sleep of the highest quality. And we talked a little bit about Parkinson's, but one of the most emerging and concerning, you know, let's call it medical or neurophysiological findings we're seeing right now is low sleep correlated with development of cognitive specific decline, whether that be dementia, Parkinson's, Alzheimer's, you know, there's a cleansing effect of the, if, if you will, when you sleep, we knock a lot of the adenosine out of the brain,

we kind of clean it up. So, you know, you're taking good care of your brain while you're sleeping. And for people who are listening, like you think about how you take care of your body with exercise, you take care of your body and organs with good food choices. You really do a good job of taking care of your brain with all three, the right food, the right exercise, but probably none more so than the right amount of sleep. And so just like I asked you with stress, a lifestyle intervention and a supplementation based intervention for people who are like, I am committed to getting more sleep. What's something I can either add or remove from my

lifestyle? What's something I can start supplementing with that might help? Yeah. For the lifestyle intervention, I will go with, and hopefully this doesn't out me as like too naturalist or whatnot, but I'll go with the 10- 3, 2, 1, 0 rule that I actually got from Ben Greenfield. Okay. I've never heard of this. My fellow homeschooled Ben Greenfield, but just like me. But anyway, it's within 10 hours, no caffeine. Okay.

That depends on how fast you metabolize caffeine. I love that. 10 hours, caffeine, three hours and two hours, no exercise or eating big meals. One hour, no white or blue light. So if you wear blue blocking glasses, just the last hour of night. But even then, it's probably not worth it compared to everything else. And then zero snooze in the morning. That's one we're going to have to carve out and use it as a short form piece of content. The reason that I do all of those in some capacity without knowing that rule, specifically the caffeine one, that's one that I've been doing for years once I learned just how long caffeine stays in your system. But I like tying things to either acronym or a numerical cadence like that just tends to make it stick.

So 10 hours before bed, cut the caffeine. Three hours before bed, three to two hours before bed, limit rigorous exercise. And did you say food? Large meals. Large meals. And then one hour before, cut the screens. And then from a supplementation standpoint, and we don't have to select one here because I know there are several, and I will sometimes dabble with several if I feel like I need to use a supplemental sleep enhancer. Thankfully, I don't, but a lot of people would love to have something in their corner to help them sleep better. What are the most evidence-based supplements for those looking to improve their sleep? My go-to is what I also now call the Huberman protocol. Okay. He recommends this trifecta

relatively frequently and it's L-theanine, which we actually mentioned earlier. Yes. For alpha waves collected. Also a magnesium form that crosses the blood brain barrier. Those are like magnesium glycinate or threonate. Okay. In addition, apigenin. That's one that I'm more familiar with now, but I'm not actually familiar with it, uh, deeply enough to even tell you what it is. I know the supplement name. What's apigenin?

Apigenin does a couple of different things. It's considered an adaptogen. However, um, my favorite forms of apigenin are apigenin apigenin does a couple different things it's considered an adaptogen however um my favorite forms of apigenin are apigenin i think it's apigenin 7 glycoside apigenin 6 glycoside okay they're also known as vitexin or isovitexin and two of the brands are cognitavine and dopamide and these affect an enzyme called monoamine oxidase in the brain. They also help with, um, uh, potentially as like an antioxidant, but on this monoamine oxidase enzyme, it's a precursor for dopamine and actually also serotonin. So it will help with, uh, dopamine synthesis and

dopamine during REM sleep. Some people actually also use it for nicotine cessation or food addiction, for example, being hungry at night. Gotcha. And so that leaves just one pillar left, and this might be the most esoteric of them all, which is social. And I think with social health, so much of our social health or social behaviors are actually unhealthy. A lot of what people do socially isn't social at all. Think about social media and how negatively that can impact our health mentally, our stress. A lot of our social events are almost married to over-consuming food, over-consuming alcohol, not getting adequate sleep.

So much of what we do socially kind of works to, I don't want to say undermine these other pillars, but there are a lot of behaviors that exist within our social health that are unhealthy. But there's also a lot of components of our social health that are extremely important and really tie everything together. And going back to the top of that pyramid, good luck getting that thing filled if you are not getting the social connection that you need. And so focusing just on the good components of social health, you know, what are you really looking for with patients? If somebody comes to you who's struggling with either, you know, depression, elevated stress, even more, let's call it primary physiological issues like

insulin resistance, metabolic syndrome, obesity, you know, what are the best social interventions, social behaviors, things people can do to live not just fulfilled lives, but also healthy lives. When a large change is made, let's call it like a new habit is formed through, there's certain strategies that work best to form habits. And one of those is going through it with your family or your friends or your roommate or whatnot, people that are particularly close to you and that are around you on, if not a daily basis, multiple times per week, um, hopefully in person. So as we talk to each other through a screen, um, it is convenient and it allows interactions that would not be possible otherwise, but, uh, it is not ideal, especially if that's

almost all of your social interaction. Sure. So my wife sometimes jokes that the least healthy, um, one in the relationship always like wins. So if there's two different people and you're kind of like going back and forth between a choice that might be slightly more healthy or slightly less healthy, then a lot of times you go with a slightly less healthy one. Doesn't mean that you should never make that choice. Sure. The law of diminishing returns applies. So if you're looking for the 80-20 rule or the Pareto principle, 80% of the time or maybe 90% of the time, make the choice that is healthier if you make that more frequently. And then 10% to 20% of the time, make the other choice. I love it, man.

So to kind of succinctly put things together from a diet and nutrition standpoint, we're looking at optimizing for nutrient dense foods, not necessarily energy dense foods. We want to be mindful of protein intake, probably focus on eating a lot of plants, minimally processed foods, exercise. We're looking for something that's, I believe you said, and I don't want to butcher this, but it is a movement practice or a movement pastime that can last a lifetime. So just find something you like and do that. And I've found as a trainer, a lot of times what you start with evolves and pillars like sleep, getting that face-to-face human connection, how we perceive things subjectively is really big. Sleep, I'm sure we're looking for seven to nine hours. We want the deepest, most restful sleep that we can get. And then that last pillar, which is that spiritual pillar and working on the metaphysical and kind of the top of that hierarchy. So, you know, having circled the

wagons there, is there anything else that really stands out to you as health promoting, longevity promoting? What would you leave the audience with before I let you lose to get back to your patients? A couple other takeaways, and hopefully this is seen as glass quarter full. I always say some people are glass half full, some people are glass half empty, but I'm glass quarter full is even if you don't feel like you would like a gym in most decent sized cities, almost everybody can find a gym where there's something that they like doing. So like that movement pastime or whatnot, usually you can incorporate the social pillar into that somewhere where you fit in. There's a place for, I think

there's a place for a hundred percent of people. Yeah. I love it. It doesn't necessarily have to be at home. Um, as far as the dietary recommendations and such, yes. Count calories. Um, probably not their whole entire rest of your life. That would be a lot of wasted time. But yes, during optimization, count calories, but also incorporate other interventions as well. Don't worry about the argument about whether calories in, calories out is true or not. Just chat with your doctor and your healthcare team about the multiple different variations that can help for you. And then lastly, partly just because I'm a medical doctor, remember that medications and supplements are just tools. And lifestyle interventions is like when you get caught in

quicksand, you're trying to dig out. That's the actual doing lifestyle interventions. The medications and supplements are just a shovel to help you do so if you need one. interventions. The medications and supplements are just a shovel to help you do so if you need one. I love that, man. Well, Doc, where can they find your content? I'm a big fan of your podcast. I know that now you've got a phenomenally, a brand new clinic. I'm looking at the recording studio inside the clinic. So this is a clinic slash content creation space. So lots of ways for them to keep up with you. Tell them where they can find you. My main hub is on Instagram, Kyle Gillette MD.

And we are Gillette Health on all other platforms. And I believe it's the Gillette Health Podcast, Spotify, Apple Podcast, YouTube, et cetera. Awesome, man. Well, Doc, thanks so much for your time. And hopefully we can do a third one in six to 12 months as we continue to help people live healthier lives. I wish you all the best. Thank you. My pleasure.