The Chris Cuomo Project - Dr. Will Cole

Episode Date: April 25, 2023

In this week’s episode of The Chris Cuomo Project, functional medicine expert Dr. Will Cole (author, “Gut Feelings: Healing the Shame-Fueled Relationship Between What You Eat and How You Feel”) joins Chris to discuss America’s lifestyle-driven chronic health problems, the bidirectional relationship between physiological and psychological health, the allure of taking Ozempic for weight loss, whether certain processing agents in foods sold in the U.S. should be made illegal, why wellness shouldn’t be about shaming or obsessing your way into health, best practices for a healthy gut, and much more. Follow and subscribe to The Chris Cuomo Project on Apple Podcasts, Spotify, and YouTube for new episodes every Tuesday and Thursday. Learn more about your ad choices. Visit megaphone.fm/adchoices

wellness, oh, it's all new agey. No, it's the key to a better you. Who says? Well, I'm Chris Cuomo, but what do I know? I'm just asking the questions. Today on the Chris Cuomo Project, though, what a treat, Dr. Will Cole. Yup, yup, the same one.

The guy is a guru in the making, although that's not how he describes himself. He's a clinician. He's a researcher, and he is about functional medicine, what that means, and how we have to start trusting our gut feelings. A great book that really gets into the heart of how we start to heal and how we can get to a better self and what that means. I am so into it because I am broken and damaged and trying very much to get to a better self and what that means. I am so into it because I am broken and damaged

and trying very much to get to a better place. And this man is a resource and a really fun interview. Here he is, Dr. Will Cole. Thank you for subscribing and following. I'll see you after. Support for the Chris Cuomo Project comes from PrizePix. I got to tell you, there's a reason prize picks is America's number one fantasy sports app. Three million members. Why? Easy. Plenty of action if you're into DFS. And it's just you against the numbers. You pick more than or less than on two to six player stat projections.

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Check it out. So let's talk about this through a different lens than they're used to. And I am coming to you as a wellness skeptic, okay? And because I think most people fall in that bucket if they're not already adapters. You're either all in or you think it's hooey. So to extend how we can help, let's deal with the hooey because that's who we're talking to, right? Everybody else is already in. Why preach to the converted? You don't need a pat on the back. You're killing it already. So the first obstacle to entry is this. Wellness is not real. Medicine is real. And everything else is speculation.

And this week it's ashwagandha, and next week it's matcha, and then it's red wine, and then it's take this tincture. And you guys are always changing your minds because this is all guesswork. What do we know? There's so much nuance and context around these topics.

And I think there is a lot of noise, a lot of hyperbole and fluff within quote unquote wellness that I wouldn't advocate for. I can't speak for everybody within the wellness world, if there even is one sort of monolithic sphere. There's just so many different voices that are talking about things that they are trained in or learning and are passionate about. But I think coming from a functional medicine perspective, my perspective is it doesn't have to be either or. It should be both and. Is that the mainstream reputable institutions like the Cleveland Clinic has a functional medicine center. And we're all trained through what's called the Institute for Functional Medicine,

where you're really bringing in the best of both worlds in, where we have amazing advancements in diagnostic and acute emergency care, and we need that. But we also have an epidemic rise of chronic health problems, where we spend more on health care in the United States than the next 10 top spending countries combined. Yet we have the most chronic disease, the shortest lifespan of all industrialized nations. So I think the best of both worlds, how we really can serve this nation is coming together instead of being this toxic tribalism, us versus them, which certainly, as you know, happens in the political sphere, but it's also happening within healthcare, where it's quacks and woo-woo, and we're just throwing these bombs on people versus saying,

how can we come together to really solve this problem of chronic health problems? And by that, I mean type 2 diabetes, lifestyle problems, metabolic issues, weight loss resistance, many autoimmune issues, even mental health issues. These are the most health problems that the average doctor is seeing, the average GP or PCP is seeing, is largely lifestyle driven.

So we have to have these conversations. And I'm not saying there's one size for everybody. There's a lot of bio-individuality. But I think exploration and experimentation, asking these questions, these big complex questions of what do we do to solve these chronic health problems is really what we should be asking and not saying, well, it's all or nothing and us versus them. My oldest sister, who is a Western-trained doctor, but has a lot of the same inclinations you have. She put it to me in a way that really helped me get over an initial obstacle of suspicion, which is

I don't get taught about food in medical school. I do not get taught about diet. It's not a real thing for us. And yet everywhere all over the world, we see that what you put into your body is absolutely dispositive in what you get out of it and what manifests itself for good and bad. So those two things can't go together and give you a sense that Western medicine has it down. And that was really helpful to me because it's just basic and obvious.

So then I get to the next level of skepticism, which is in America, uniquely so in America, okay? And here's the anecdote that really knocked it home for me. In Italy, they have a culture that is now deteriorating where they had a portion of every day called pranzo. And pranzo is kind of a mid-afternoon nap, okay? What in Spanish that they would call like a siesta time was, we're done with lunch, we got to chill out a little bit, refocus, come back to work. Now that's evaporating because of the 24-hour market cycles. And what that really did for me was help me understand, oh, so stress is real and what is going on

emotionally, psychologically must impact. And then I started seeing it everywhere. I see the integration. I see it in myself. I see it in my gray hair. I see it in my hairline. I see it in my face. Like what I've gone through, and I am the first one to admit it. It's not that I went through such bad things compared to what I've seen people deal with in life. I just lost a job and got the shit kicked out of me by the media for a few months. But personally, I didn't handle it that well. And so I understand this integration of how you feel in one regard. But that is rejected in America.

I don't want to hear about your sadness, doctor. I don't want to hear, oh, you're depressed. Suck it up. And yet I see it as a root of all of our maladies, and least of all, gun violence. But how do we get people to understand it's not diabetes okay, depression is magical thinking and not a real thing. How do we get past that? Because it seems to be if we can do that, then we're on the right road. Yeah, I agree with you.

I think that this is a major disconnect that we have in our society where burnout is this badge of honor. It's deified in many ways. And the reality is that I'm so happy that we are normalizing mental health care conversations. And we have a long way to go. But I think we've made some good strides in the past 10 years of starting to destigmatize conversations around mental health care and things like burnout and anxiety. But in coming from a functional medicine perspective, I think in many ways, it's an incomplete conversation that somehow, as you said, it's relegated. Mental health issues are relegated as this abstract thing,

but the reality is mental health is not separate from physical health. Mental health is physical health. And our brain is a part of our body just as much as anything else. So something that I'm really talking about with patients, conversations that I'm having and gut feelings, my latest book, it's really talking about this bi-directional relationship between physiological and psychological and how they both influence each other, right? I mean, there's underlying components to brain health issues. There's a whole field of research in the scientific literature known as the cytokine model of cognitive function. Cytokines are pro-inflammatory cells. So it's researchers exploring what are these inflammatory components

to things like anxiety, depression, brain fog, fatigue. But then conversely, researchers are also looking at things like chronic stress and unresolved trauma and these mental, emotional, even spiritual components and how that influences our biochemistry just as much as a food that doesn't love you back. So I think that these are the things that people, we need to catch up. We really need to catch up. And you mentioned like in Italy, they have these practices or in Spanish cultures, they have these practices. Our ancestors knew a lot of stuff that we have this massive hubris today that somehow we know better because we have randomized controlled trials. But now we have science really catching up with antiquity that, wow, our ancestors knew some things.

They got some things wrong, but they knew a lot of stuff that just intuitively led to a more fulfilling, enjoyable, less burnt out life. You're 100% spot on, but what a challenge to get people on this page in America. I mean, we're so far from this. We have pockets of it. But for every Dr. Cole, you got like five Joe bag of donuts that believe that steak and potatoes work good for that, it'll work good for me. And I'm not even

sure that tobacco is really bad just because the thing's on fire when I put it in my mouth. Maybe it's not, maybe we're overthinking it. But why did they create Zen Buddhism? I mean, it is a way of keeping your expectations to the present moment so that you don't stress yourself out about what has happened in the past that you can't fix and what's going to happen in the future that is unknown. There was always a recognition of this. Here is the magic. Now, Christina says the reason that your book, Gut Feelings, is so important, obviously, this is an entendre play here. The gut is like the kind of new window into our world of homeostasis within our bodies. world of homeostasis within our bodies. And it is so resonant with, we know this because gut feeling is, everybody knows it. Why do you feel something in your stomach?

Because there is a connection of mind, body, and spirit where people do this. The Italians, again, you know, they have a, someone's nervous. Someone's unsure about something. What happens? You start getting a nervous stomach. You shit your pants. You start getting all these different digestive issues. The Italians called it the gagarelle, which is cacarelli, which is just, you know, problems with going to the bathroom.

We know this. We know that when you are nervous, I just recently did a VO2 max test because I'm a beast. And I was tracking, I'm doing something with somebody about aging athletes and how you got to start respecting the change in what you can put out and how you maximize yourself with different capacities. And if I am stressed out, which is very easy for me because for all I know and all I read,

I joke with this with my team all the time. If life were a written exam, I'd kill it. The practical exam kicks my ass. I make the same mistakes. I don't live a life of balance the way I try to. I worry, I worry, I worry. I see it in my metrics. My VO2 max, my calorie burn rate, my power output are all

directly related to sleep, which is related to stress and where I am coming out to that testing session. Here's what we need in terms of secret sauce from a big brain like you. We can't keep saying mental health. It is inherently reductive. I can't come up with a better way. I'm hoping that wellness catches on. It's got a little bit of a new agey feel for people, but we have to stop delineating. And I think it will help in terms of just getting us

on the page of, well, of course your fever's not going down as fast as his is. You're so worried about it. But have you come across this obstacle? What do you do to get away from saying the words mental health and not feeding into the problem of separating mental health from health to begin with? Yeah. Well, I think that another way of saying it is brain health. How's my brain health? And we know that it's more nuanced than that. I mean, the way that the brain's communicating with the endocrine system, so getting really technical. Oftentimes when you're talking about mental health on a physiological level, you're talking about the neuroendocrine system. How's the nervous system regulated? Are there inflammatory components? And because of

this dysregulation in the nervous system, how is it then impacting things like the hypothalamic pituitary adrenal axis or the hypothalamic pituitary thyroid axis, the brain's communication with our hormone system, our endocrine system? So I think part of this, so much of this is language and words and semantics and how we convey to the person, the lay person out there that's reading the articles, listening to the podcast, listening to the news to empower people because there is a disconnect. You're right. I think that a lot of conversations within wellness sound normal to people within wellness, but then we're in this weird bubble where it is conversations around Ashwagandha are pretty normal, but not to the average person out there.

People don't like change. People like easy. And it does always seem like there's one more thing. One week, it's we're all watching Game game changers and I'm never going to look at a piece of protein the same way again. The next week it's stay away from vegetables unless they're cooked and you really get the minerals through the animals and the phytonutrients that you need through them. So go back to the meat. And now I got my blueberries and walnuts in the morning, but I got a, there's a better anti-inflammatory legume for me to be trying.

It's always changing and people want easy and are afraid of change. So how are we supposed to adjust? There is so much confusion out there. I lovingly call it Dr. Google because you can really substantiate any agenda you have at the click of a button and pull some study and use it at a context or to prove a point or elicit your worst fears at a click of a button. And I love freedom of speech and the democratization of information, the decentralization in many ways of information. When you talk about podcasts and long form conversations like this, there used to be these gatekeepers amongst information, health information specifically, but now people are being empowered going on PubMed themselves and learning

about these things. I think that's wonderful to be empowered as a consumer to know and make decisions for yourself, talk with your doctor about, but be an empowered consumer, I think is a great thing. But it's this endless vortex as well of conflicting information. So I think it's a matter of being informed, but also going to a trusted source, going to someone that you can learn from and evolve from. It's anathema to American culture, though, because we are drawn to the easy and the quick fix. That's why the diet industry is so huge. And, you know, we see in our social media feed, Dr. Gundy. And what is it that I, what is it one thing? And who is this gorgeous guy with no shirt on hanging from the pull-up bar telling me that if I just change this one thing

in my diet, that's why he looks like that. And even though most of your cognitive self is telling you that's got to be bullshit, there's that one part of you that's like, but if it's easy, I'd love to try it. It's so at odds with what people like you are trying to help us understand all the time, which is, man, there's so much going on and you've got to balance it and you've got to adjust and you've got to be practical. No, I want it easy, man. I want you to come out with a Kohl's capsule and I take this and all of a sudden my hair comes back, man. That's what I want. I know.

We want the quick fix. I get it. I hear you. There's no, and that's the nature of this, of the culture we live in, right? I read a study recently of what determines the virality of a post or story on social media. It's typically anger and anxiety. And you know this. I mean, this is how it typically works. And that's the stuff within wellness that oftentimes gets shared. It's the polarizing extreme. And there can be truth within the polarizing extreme, but context matters, which is as sexy. Is that, okay, maybe there are plant compounds that don't

work for some people. That doesn't mean that everybody should be afraid of lectins and phytic acid and plant foods. I think the average American could benefit from bringing more plants, foods into their life. And the flip side, I think there's a place for these more carnivore-ish protocols for people who need it, right? There's a place for people to have reactions, food sensitivities, they can be used. So I just know seeing people for a living at the telehealth center, if I hung my hat on one way for everybody, people for a living at the telehealth center, if I hung my hat on one way for everybody, I'd be proven wrong all day long based on labs and health history and what their personal preference is. Going back to stress, if they hate what they're doing with their foods or whatever

they're doing with their wellness, that stress and anxiety and obsession around whatever that thing is, even if it makes sense on paper, is going to produce a completely different result. So that's the mind-body connection in that way. So I don't know if that answers your question, but it's just important for people to realize that normally things are not black and white. It exists on a spectrum and context matters. And it's not one fits all. And it's not one move away from everything changing.

And look, we know that. We know that there's not one thing that makes a relationship fundamentally different. It's about a complement of different behaviors and features. Fitness is about variety. Anybody who's into fitness knows that. We don't fake the funk here. And here's the real talk. Over 40 years of age, 52% of us experience some kind of ED between the ages of 40 and 70. I know it's taboo, it's embarrassing, but it shouldn't be. Thankfully, we now have HIMS, and it's changing the vibe by providing affordable access to ED treatment, and it's all online. HIMS is changing men's health care. Why?

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if appropriate. Restrictions apply. You see the website, you'll get details and important safety information. You're going to need a subscription. It's required. Plus, the price is going to vary based on product and subscription plan. The Chris Cuomo Project is supported by Cozy Earth. Why? Because I like their sheets. That's why. A lot of people don't get a good night's sleep for a lot of reasons.

One of the ones that you can control is bedding. One out of three of us report being sleep deprived. Okay, well, what is it? Well, it stresses all kinds of things, but the wrong sheets can make you hot, can make you cold. I'm telling you, I don't even believe it either, but Cozy Earth sheets breathe. And here's what I love about them. Cozy Earth's best-selling sheet is a bamboo set, okay? Temperature regulating. Gets softer with every wash. I'm not kidding you, all right? Now, so if you go to CozyEarth.com and you enter the code, enter the code CHRIS, and you can get up to 35% off your first order. CozyEarth.com, and the code is Chris. Let me ask you about some trends

and I want your take on them. First is a layup. I'm sure you're hearing this if people are bold enough. Well, no, they probably are because nobody's seen the downside. This, I'm a shot away from shutting down my appetite and losing 9 million pounds. I am seeing it everywhere. from shutting down my appetite and losing 9 million pounds.

I am seeing it everywhere. Ozempic, I haven't seen anything spread as fast as Ozempic, even though it requires the boogeyman, which is an injection. Usually like that's the big obstacle to entry. But whether it's Wegovy or Ozempic, whatever that class of drugs is, I haven't seen anything like this since Dexatrim.

You're too young. But that I'm going to take this pill, which is just speed, and it's going to retard my appetite. And people are losing a ton of weight. But how can it be so easy? I think that people, kind of repeating what we just said, but people want the quick fix. This is the latest example of that. And it seems to be at these lower doses that aren't given, the higher doses that diabetics would be taking, very little side effects. It can make people feel nauseous and sick. But as far as the cost reward benefit for the average American that's looking for a little leg up when it comes to weight loss, I think it's alluring. But my concern would be long-term, what's the long-term impact of this? But beyond that, just on a practical level, what's the long-term sustainability of that

weight loss? Will you gain it all back? And then some still. Can a tool that has low side effects, if this indeed has low side effects long term, and it's an effective tool, and you back it with some sustainable habits in your life, I'm not against it. I think that could be an example of the best, if it's working on the mechanism of action, if it's working on leptin levels, for example, many people within the United States have insulin resistance. That's the leading cause of weight loss resistance in the United States. And part of that is high leptin, which is a hormone that our fat cells produce. So if this medication could modulate that and support that in some way, it could be a tool within the toolbox, but it's not going to be the only tool when you're talking about sustainable weight loss.

It could be a quick fix, but people don't want that. So I hope conversations around these medications, but I don't think it's happening much, is, okay, this, but what are the other things you're going to do to keep it off? And I think that's the confluence of factors that we need to be having and not this magic shot that's going to cure all your weight loss resistance problems. What do you think of making illegal processing agents in food that they should be recognized, let's say like high fructose corn syrup,

that it should be recognized as a poison and banned, and that that is the difference between the American diet and the European diet. They don't allow a lot of the things that we do here. And if we made them illegal, people would be healthier. Do you agree? I think that there's, within reason, there are probably, there are examples where the EU has done some amazing things from a consumer protection standpoint. And my Europatian clients tend to have less to worry about when you're talking about food quality, reading labels, because things that we have to decipher on the back of a box, they don't really have to take into consideration. And on top of that, potentially the soil that the food is grown in, there's a lot of things to consider with that, the hybridization, the genetic modification of certain crops. Yes, from a consumer protection, there are things that we allow in this country when it comes to food that it's just go a bit too far of the state saying, we know what's best

for you and we are not going to allow anything. And that's up to whose interpretation. So I think what we need here is an informed consumers and informed consent. And if that means labeling things appropriately on the box, then people can make the decision for themselves. The problem is the ingredients are oftentimes hidden on the labels. It looks healthy on the front because of flashy marketing and people are empowered and informed on how to read the label. So much of this is just being informed and being empowered and making the decision for what's right for you. Okay. I have two more, and then I'm going to use myself as a guinea pig for why I believe everyone who cares about themselves or someone who's got any type of issue needs to buy gut feeling. First, big increase in, assuming you have the money, hormone replacement therapy. Aging athletes are male, even female, taking testosterone because their testosterone, like, I got, and a lot of times, the new me is I talk about a lot more stuff in my life now that I don't really give a shit if people know anyway.

Because, you know, when people lie about you on a regular basis, the truth is not as scary anymore. So I go for a checkup and my testosterone level is low, normal low. And the guys like the endocrinologist is like, you know, you're under so much stress right now. You're so freaked out that, you know, because he's an integrative medicine guy, functional medicine guy. So he is like, I'm not surprised your testosterone dipped. You know, he's like, you've been karmically, you know, had your ass kicked. You know, we're going to have to track this over time and see. And he's like, you know, and now they have a gel that can give you more testosterone, but I'm like, you know, I'm too OCD. I'm not, I didn't want like gel.

It's like too messy. And he's like, you know, we have these like simple shots and I'm like, but I'm going to faint every time. I can't give myself a needle. And he's like, no, it's different. He said, but we're not there yet. And I said, okay. And he was relieved.

He's like, you know, I didn't really want to have this conversation with you because so many bigger guys that I have who are, you know, clanging or, you know, clanging, bang, weightlifting guys like I have who are clanging or clanging bang, weightlifting guys like I am, are coming to me for testosterone and they're coming to me for human growth hormone.

And what do you make of that? Are we seeing something that, yes, this is progress, this is how we stay younger longer, or are we setting ourselves up? I think it should be lifestyle first. When you're looking at the statistics of why most men have low testosterone and why we have epidemic levels of hormonal imbalances across the board, no matter who you are, even low testosterone in women, we see it quite a bit. And it is contributing to their low sex drives, their fatigue, their brain

fog, that they're not able to build muscle, lots of things. And just because something's common doesn't necessarily make it normal. And just because something's someone's everyday doesn't mean they should settle for it. But the mechanism of why most people are struggling with low testosterone is insulin resistance. This is the vast majority of the mechanism. So again, the quick fix American way is to say, let's just inject or rub some gel on to get our T levels up. But why is it low in the first place? And for some people, after they've dealt with the insulin resistance, they've started picking up heavy things because weight training is a great way to support testosterone levels.

They cleaned up their diet. And all of that is they're better off than they would be if they weren't doing all those things. But their levels are still not where they should be. I think judicious hormone replacement, or I even call it hormone replenishment, where it's just low doses of these things, can really be a tool within the toolbox to make them feel better, increase their energy levels, help them move past that health plateau. I think there's a time and place for it. It should be based on labs. It should not be done flippantly. And I

would say it shouldn't just be done on symptoms alone, meaning that just take this and see how you feel. I think it should be based on data because you could overdo these things that can come with potential problems. So I think judicious use of it based on labs, it can be a great tool for some people. Yeah. I'm worried that you start making everything in your body grow faster. It makes everything in your body grow faster. And I don't know, well, I just know what I read, right? But the idea of, well, what makes cancer grow? What makes things that, you know, I read, right? But the idea of, well, what makes cancer grow? What makes things, you know, I mean, if you're feeding a growth cycle, it feeds anything that wants that. Next one, cholesterol. Eggs bad, eggs good. Now the latest reckoning is correlation, yes. Causation, maybe not.

And what's the practical thing? All right, we'll use Cuomo as a guinea pig. I have high cholesterol. I think I have it genetically. It definitely has been getting higher as I've been getting older. Do I have a great diet? No. Is my diet better than most people's? Yes. Um, so my doctor, my father died of heart disease. He had this weird heart disease, um, called amyloidosis, uh, protein getting dumped into his heart. Doc knows all this, but for you at home, um, it was really weird. There was no treatment. It was really sad and it became oxygen deprivation for all the different systems in his body. And he eventually died, not genetic, but they wanted me to get checked out after I became 50.

So they look at my heart. I'm a beast. And they say, you know, you're over 50. So there's a little bit of soft plaque and some of those things, but it's not hardened plaque yet. You got the high cholesterol. Your calcium score is zero, which is where they're looking for the hard stuff. And so I'm good on that. But soft becomes hard, right? And they said, so it's time for a statin. We've been giving you all this rope for years about the, let me come back in six months and let's see how it is. And your cholesterol never really comes down.

It doesn't matter how much red yeast rice you eat. Take the statin. I say, no. Why? One, I'm a self loather. So I'm not so interested in longevity. Two, I don't know that the high cholesterol, if I'm such a beast and everything is so good and I just have a little bit of soft plaque, maybe this research that I'm reading about cholesterol, maybe it's not the boogeyman that we thought it was. And my heart doctor, who is really respected, and the endocrinologist, who's really respected, and they're really open-minded, they're like, you are wrong. You need to take this Lipitor,

and the statin will bring it down. It will keep the plaque from getting hard. And this is what we know. But then why is there all this research that the correlation versus causation, which is a meaningful difference, which is, obviously, Doc knows this, but for you, does high cholesterol cause heart disease? Or do we see with people who have heart disease that there is often, if not always, high cholesterol? But that's a distinction with a difference between cause and that is just a factor. What's your head on it? This is such a controversial topic, right? Because you're not always going to get the same, you're going to get a million different

opinions within this, within even the wellness world. My take on this is total cholesterol by itself is an incomplete perspective on cholesterol metabolism. It's about half, about half of people, depending on the study that you look at, but half of people who have heart attacks and strokes have normal to low cholesterol. A lot of the studies, as you inferred, that have to do with the diet heart hypothesis, you've been kind of looking at cholesterol as its villain. It's really more to do with correlation, less of causation. So it's just an incomplete perspective. It could be problematic. And we're talking about within reason. But if it's total cholesterol above

200, it's not necessarily a bad thing. We have a bit of a more flexible view within functional medicine, as long as things like the calcium score is good. And we run labs like what are called the nuclear magnetic resonance or NMR test, which is a very conventional test, but it's looking at what they call the sub-fractionation of the particles that carry cholesterol. So it's looking at things like the small, dense LDL particles, which are protein carriers of cholesterol. Someone could have very low to normal cholesterol, total cholesterol, but very high levels of these small dense LDL particles, which are oxidized, inflamed, that have the increased cardiovascular

events. It could potentially tear through arterial walls. They're problematic. So the analogy that's typically used within the functional medicine space, when you talk about high cholesterol and why that is, we have to look at the context of it on an individual basis. Genetics can play a part of it for some people. But the body's producing, the liver is producing cholesterol typically to repair something. So in states of inflammation, the body can produce more cholesterol to repair things on a cellular level. Our cells of our body are made of a phospholipid cholesterol layer. So the analogy is blaming the fireman for the fire. Well, the body's producing the fireman, these repair molecules of cholesterol to repair the damage

that inflammation brings. It's not cholesterol that's the problem. It's the inflammation of the particles that carry cholesterol that could be the problem. So we look at an NMR panel. We look at basically the quality, not just the quantity of the cholesterol and what pattern you are, as well as inflammation levels. The American Heart Association, the CDC, we measure things like high sensitivity C-reactive protein. We want it under one, which so does the AHA and the CDC. Something like homocysteine, which is another inflammatory marker in functional medicine. We want it under seven for most people. And then going back to insulin resistance, looking at A1C, looking at glucose, looking at triglycerides. So all of that context matters. So it's not enough to say,

well, cholesterol above 200, give them a statin drug. There's more to the story than just that. With that said, there's some evidence to show middle-aged men have had a heart attack that maybe have a family history of it. Low doses of a statin drug can be a tool within their toolbox. But what's the mechanism of action? Some researchers are postulating it may be the fact that statin drugs can have a mild anti-inflammatory benefit. So could it be the fact that any benefit that they're getting from that low dose of statin is the fact that it's lowering inflammation levels a little bit? I would just say, well, if that's the case,

they're probably a lot more effective without the potential side effects to lower inflammation levels that statin drugs can bring. So time and place, I think some people can get some benefit from them. But I do feel as a culture, you have esteemed doctors that care for you, that know what they're talking about. I hear a lot of people that their doctors aren't really looking at these additional scores. They're only looking at total cholesterol and they're just giving it out like candy, which I think that that's probably done a little bit too flippantly. So that takes us to why I was so dogged in my determination to have this particular doctor on.

All of the best reckonings that matches antiquity with the advancement of our understanding brings us back to the gut. reckonings that matches antiquity with the advancement of our understanding. Brings us back to the gut. A lot of your oxygenated blood comes from the gut. Inflammation is a real thing. It drives autoimmune. It drives all these digestive things and all this stuff. It's very real. It's something I deal with as an ethnic Italian blood thing. We have high inflammation and it affects everything in the body. Your book is such a, there's enough clinical understanding in it without overwhelming to give a sense of competency

that adds to the cogency that if you can get this right and you even tie it in with the title, that is so true, man. You feel it in your gut. You feel things about people. You feel things about situations. Your digestive system is such a great indicator of your overall thing. There's nothing more debilitating. you know, like I'll, I have horrible allergies. I'll take allergy attacks any day over any type of digestive issue. It saps energy out of you like nothing else. So the reason I want people to get the book is because it really does center on, if you're going to, if you're going to take a step in the direction of figuring things out, starting

with the gut and this interaction for everything and what works and what doesn't is absolutely the best first step to take. And you really nailed it in the book. And that's why I'm glad it's such a success. And what do you want people to take away from it if they are not already cold devotees and wellness obsessed? Thank you for the opportunity. It means a lot. I think that we don't have to be wellness aficionados. We don't have to. I think sometimes people can feel overwhelmed with where do I even start? And I just, the body's amazingly resilient. And if you start just being consistent with the simple stuff, the body can really move and achieve amazing things. Something on the back cover of that book that I think is a good place to maybe wrap this up for the book is that I say you can't heal a body you hate. You

cannot shame your way into wellness or obsess your way into health. And I think a lot of these things within wellness could be abused and people can get into restrictive dieting. That's the antithesis of sustainable wellness. This is really about nourishing your body, feeling good. And ultimately, it's based on labs and data. And the labs aren't lying. And that's ultimately what it is. If you are dealing with insulin resistance

or type 2 diabetes or an autoimmune issue, lean into these principles of supporting your health and watch what the labs say. And I think that will speak for itself. When people get into gut health, the first thing they think about is probiotics. And once again, we immediately take the flight to convenience and we want to take a pill. So you'll see that the one that has any clinical, you know, data attached to it, FloraStore is like three times the price of everything else because it's got that nod. So people think they take the pill and that's all they have to worry about.

Then you have the opposite end of the spectrum, which is where people are dumping tons of fermented foods into their system all the time because we're told it's good. What do you want people to know about what are the best practices for gut health? Well, first, I think it should be focusing on what you are feeding your body, not about what you're not having. We can talk about that too, like the most offenders to the gut health. But it starts with food. You really can't supplement your way out of a nutrient deficient diet. So if you're not taking supplements, just start with your breakfast, lunch, and dinner. Fermented foods do have their place. They're potent things. They can be quite cleansing, to say the least, if you've never had sauerkraut or kombucha and they have copious amounts of it.

So start off low and slow, but they are providing your body probiotics, bacteria from the fermentation of the foods, but they're also providing some fiber, some prebiotic foods, which all vegetables and fruits will provide you. fruits will provide you. So I think first and foremost, if you want to talk about gut health, you have to talk about prebiotics, which is fiber, which the bacteria in our gut, which is collectively known as the microbiome, depending on the study that you look at, we have upwards of a hundred trillion bacteria in our gut. And to put that in perspective, we have about 30 trillion human cells around there. So we are vastly more bacteria than human. And these things co-evolve with us. We have a symbiotic relationship with it and it influences our brain. I mean, 95% of serotonin is made in the gut. 50% of dopamine is made in the gut. It works upon what's called the vagus nerve, which is how it impacts our mood because it's regulating our parasympathetic, our resting,

digesting aspect of our nervous system. And fiber plays a major role in GI motility, which is what influences not only digestive health positively, but also our vagus nerve and our mood. And the fact that 75% of our immune system's in the gut, we keep talking about inflammation throughout this conversation. Inflammation's a product of the immune system's in the gut. We keep talking about inflammation throughout this conversation. Inflammation's a product of the immune system. So if you want to be supporting healthy inflammation levels, you want to look at where the predominance of the immune system resides, which is in the gastrointestinal system.

So it's very basic, but fruits and vegetables are a good place to start. And then decrease the things that are the bigger, or sultures to the microbiome, which would be, look at the grams of added sugar, processed sugar you're consuming. And then number two, I would say alcohol, which I lose friends every time I say both of those things, but it's true. It's true. Why alcohol? Well, it can have sugar. So that's part of it too. But alcohol is a neurotoxin, right? There's

no way around it. I'm not being a puritanical teetotaler. I'm not saying you can't have any. But some people, especially people that are interested in wellness and their lifestyle, they'll still keep the drinks in the evening or on the weekends. And they're stuck at this plateau. They still have the bloating. They still can't lose weight, still have issues. Well, I have seen countless times people just stop the alcohol for 30 days and move past

that plateau. It's a neurotoxin. It impacts your brain health. It can impact your gut health. And in addition, talk about labeling. You go to Europe and the purity of the wine that's there versus the purity of the wine that's here, there can have coloring and agents that aren't even on the label in the wine here that they would never get over in Europe. So that's a good example of transparency and informed consent

when it comes to the things we're consuming. So there you have it. Dr. Cole says drink tequila. That's really the takeaway from that. If they've learned nothing else to this conversation, it's that. I remember how heartbroken I was when I was living by the fiction that, well, tequila is different because it's a plant, you know, and it's not like other alcohols. It's not a depressant. And it's all bullshit. But alcohol is alcohol.

It doesn't matter what the fermentation process is. The idea of why we care about these things, again, I'll use Cuomo as the guinea pig. And I don't really understand this. Maybe you'll give me a road to understand this. I eat a lot of carbs, okay? So, and I do a lot of unhealthy in terms of balance practices.

Like I'll do gain periods where I like double my calories and I start lifting heavy weights and I do one type of self-defense training that is much more gross movements and stuff like that. And I'll do that for like three months. Then I'll do what I'm starting now, which is a cut, which is where I now change my diet. I cut my calories. I start doing a lot more HIIT training and stuff that's not bulk necessarily resistance training. When I cut carbs out of my diet, okay, bread, rice, pasta, potatoes, I wind up having digestive issues immediately, no matter how well I substitute fiber, cooked vegetables,

added fiber, water, which I have a problem with. I'm like always dehydrated. I think people tend to be dehydrated, but I'm like really dehydrated. And I don't understand it because I thought that those foods were supposed to be a problem for digestion and yet when I remove them, like I'll have things, like I'll be completely constipated even though I'm drinking water, I'm eating the vegetables, my calories are lower.

So at first I thought, well, maybe I'm just not going as much because I don't have as much in me. But then if I just eat some bread or I eat some potato chips, then I go to the bathroom. It's like so weird and I don't have as much in me. But then if I just eat some bread or I eat some potato chips, then I go to the bathroom. It's like so weird. And I don't understand it. And when I research it, it doesn't seem to be that common. So assuming it's not just like unique to me that like, you know, I have some weird thing that I got to figure it out. When people go to a healthier diet, what

is it important to remember in terms of what you have to do for your gut to keep the trains on time? Yeah. So, and that's a good indicator. It's a check engine light, as we call it. Because many people, they are going every two or three days or it's always loose or always constipated. And I get it. It's their every day. So, they normalize it because that's all they know.

What's normal from a Bristol chart standpoint, which is like the continuum of bowel movements, it's one to three snakes a day is what we say in functional medicine. So the formation is like a snake. The frequency is one to three times a day. So people can check the next time they go to the bathroom what that is. So if they're going less than that or more than that, the consistency is off from that, that's a sign that your body's telling you something, that you need to check into it. Typically, if someone's more constipated, it could be any number of reasons, but fiber intake is a part of it. But what it sounds, it's interesting the way you're saying it, like you're keeping your fiber intake up in the form of vegetables, but you've decreased,

you said rice, potatoes, you said potato chips too. So, but what, which ones are you not having whenever you notice that things backing up? If I take carbs out of my diet, the, the, the bad one, you know, like the, I, you know, I take sugar out of the diet, which I think it may also have something to do with it. But, you know, the classic potato rice pasta and bread, I just cut them out. I think potato rice and like a whole grain bread, like a rice flour bread, can be great for some people. And with the amount of activity that you're doing, most Americans aren't working out the way and training the way that you are.

So your body is burning off more than the average person. It may just be because of your activity level. You just need those higher levels of complex carbohydrates. Most people are more sedentary and they would benefit from getting their carbs mainly from fruits and vegetables. And some gluten-free grains would be fine for them. But that's bio-individuality. That is ultimately saying we cannot make overly reductive statements on something like rice and potato and rice bread, because I have many patients that they notice the same thing. They're more regular. They feel better digestively when they have these things. And another phenomenon that I see is a lot of people within the wellness world, they'll go, quote unquote, grain free, which many Americans have

problems with refrying grains. I'm not saying that's an issue, but what they'll invariably do is go over to a lot of nut flours, like almond flour, there's almond flour, there's that. And they're having copious amounts of almonds. If you think of how many almonds you need to make like an almond bread or almond crackers, it's a crap ton of almonds.

And it's causing some digestive problems. So it's not black and white to say, well, okay, that grain-free is automatically great. Follow your gut and see how you feel. Be your own end of one experiment. And there's nothing wrong with some whole grain rice, some potatoes, some rice bread, something like that. So I think you're fine. No shame about it. What do you want to leave people with, Dr. Cole? Wellness can be very divisive. I think people are very skeptical about wellness. What do you want to leave people with, Dr. Cole? Wellness can be very divisive. I think people are very skeptical about wellness. People can have their guard up. They see clips on social

media. But ultimately, the things that I'm talking about and have talked about for the plus 10 plus years I've been in functional medicine, 12 years at this point, it's ultimately about getting people healthy. This is the most uncontroversial thing out there is seeing people that have insulin resistance, being able to reverse it. People that have chronic fatigue have energy levels. People's doctors are able to reduce and eliminate medications as they're regaining health. Who could be against that? I don't know. But I think there's still so much us versus them and tribalism within functional medicine and conventional medicine. To me, I hope that through this conversation, people can maybe say, oh, wow,

people in wellness aren't that weird, maybe a little bit weird. But we really should come together and say, what are we going to do on a macro level to improve the health of our country, but on an individual level is what you're doing working for you. And if not, you have to do something different to see something different. And this is one potential path for you. What is the best change that you've made in recent memory that has benefited you?

Uninstalled TikTok. That would be that for me. Because of the Chinese? No, no, no, no, no. No, it was purely just just it's like was intoxicating of just the algorithm knows me so well it was like showing me whale videos and like all these random things that just suck my time up so it had nothing to do with the chinese but it was just uh people on my team have tiktok we're on t TikTok. But for me, healthy boundaries with technology is my point here, is that I don't need more apps to spend my time on.

I want to get out in nature, spend time with my family. And I still use technology. We're using it right now. But TikTok was this endless vortex for me that I needed some space. Well, I got to tell you, Dr. Cole, you are a celebrity in my household especially. And this is one of the great blessings of doing the Chris Cuomo Project is I get to talk to people that matter to me personally and specifically. I love the work you're doing. I wish you very good luck with it.

And thank you in advance for saving my marriage. Yeah, this made my day. I mean, I'm your biggest fan. My wife is your biggest fan. So it's both ways. This is a dream come true. I knew at some point I would meet someone who watches my show. I love it.

And I watch clips on social media still for you. I mean, I just, I can't get enough of Chris Cuomo. So thank you. All right, brother, be well. And thank you for taking this opportunity and doing me the favor. I'm gonna call away if there's ever anything I can do. What a smart man, what a reasonable man,

and what a gift his work is to those who are trying to figure out how to get healthier on all levels that matter. How we think, how we feel, how we behave, how we eat, all of it is so important and there's so much to be learned. So our gratitude to the good doctor. Gut Feelings is a great read. Gratitude to the good doctor. Gut Feelings is a great read. Thank you for being with me, subscribing, following, wearing your independence by getting free agent gear and a little let's get after it merch.

I will see you on News Nation, 8 and 11 p.m. Eastern, five days a week. It's always good to have you here for the project. Thank you, thank you, thank you.