Live Like a Girl with Dr. Mindy Pelz - The Effects of Insulin Resistance on Our Health - With Dr. Morgan Nolte

Episode Date: May 9, 2022

For full show notes, resources mentioned, and transcripts go to: www.drmindypelz.com/ep120/ To enroll in Dr. Mindy's Fasting membership go to: resetacademy.drmindypelz.com This episode is all about signs of insulin resistance, the importance of exercise, and what to know about estrogen in menopausal women.  Dr. Morgan Nolte is a board-certified clinical specialist in geriatric physical therapy.  Frustrated by a lack of preventative care that focused on reversing risk factors instead of just treating symptoms, Dr. Nolte founded Zivli — an online course and coaching program that helps adults reverse insulin resistance for long-term weight loss and disease prevention.  Zivli serves as a bridge between busy physicians and their patients by offering detailed education and ongoing behavioral support needed to change health habits for good.  Please see our medical disclaimer.

It is so expensive to be sick. And it is such a better use of our resources to do what we're doing and try to advocate that people take control of their health as soon as possible. It's never too early and it is never too late. Resetters, Dr. Mindy here. And I am on a mission to teach you just how powerful your body was built to be. This podcast is about giving you the power back and helping you believe in yourself again. Let's jump in. On this episode of the Resetter podcast, I bring you Morgan Nolte.

Now let's talk a little bit about Morgan's background. And then I really want to highlight for you some key points we had in this discussion because this one is a gem of a conversation that I feel like so many people need to hear. So here's Morgan's background. She is a board certified geriatric clinical specialist, which is really interesting because you'll hear we talk a lot about insulin resistance as we age, and she offers a really unique perspective. She is the founder of Zivoli, LLC, which is, we'll leave her notes in the links in the notes, so you can find that. She's graduated from the University of Nebraska Medical Center in 2014 and completed the Creighton University Hillcrest Health Systems Geriatric Physical Therapy Residency Program.

Outside of work, she loves cheering on the Nebraska Cornhuskers. You'll hear it in this discussion. And she loves spending time with her husband Justin and playing with her two kids. And I love this. She has this in her bio. She loves devouring audiobooks and being active. She lays down some amazing book titles in here that I 100% agree with. So if you are an avid reader or avid audio book listener,

There are some great books that she talks about in here. What you're going to hear in this discussion and why I brought her on is I really wanted her to walk through insulin resistance with us. Many of you know that I've talked a lot on this podcast about the poor metabolic health of our world. It's not just in America. And yet we don't really have clear markers that are showing us when we are moving towards insulin resistance. We only have the diagnosis once the doctor gives it to us. So I wanted to talk

about what some of those markers were. How would you know you are insulin resistant? So she went through symptoms. She went through blood markers. So those of you who like lab work, you're going to love this. And then I wanted her to talk about, okay, give us some key foundational ideas that we can implement so that we don't become insulin resistant as we age once we've identified those markers. So she went through some really simple hacks. Of course, we talked about fasting. She talked about some food choices. We dove into exercise and what exercise regimes were best for insulin resistance, which I think

you all will find very interesting. And then we ended up talking about menopausal women, estrogen and insulin connection and Alzheimer's and what we know about insulin resistance and memory loss and Alzheimer's. There is definitely when you look at certain health conditions, we have the official diagnosis of things like dementia and cancer and Alzheimer's. And we have the functional place where you are building these diseases, but you don't realize it. And this discussion is really centered around how do we recognize it? How do we stop it so it doesn't become a disease? So again, another great discussion. So excited to share it with you. As always, if you love this, please send it out into the

world. This is one of those topics that I am on a mission to help the world understand. Once we handle insulin resistance, everything will change. All the chronic diseases will change. Our exposure and how we handle new viruses will change. This is that important of a discussion. So enjoy. And again, I so appreciate your reviews and I appreciate you, all of you that share this out into the world together. We are more powerful together. We can rise above this moment in time. And I'm so grateful to share discussions like this with you. So we're just going to, we're going to dive right in. And I can't remember if we talked about this when I came on to your podcast, but I got, I have to say that that statistic that came out of the University of North Carolina saying that only 12% of Americans are metabolically fit.

It shook me. Yeah. And I really had to stop and make sure it wasn't a clickbait statistic. I know. And then it made me realize that most people don't understand what it looks like to be pre-insulin resistant, to be unmetabolically fit. because the only marker we have is blood work or a diagnosis from your doctor. So I want to start this conversation off with how would somebody symptomatically know

if they're moving in an insulin resistant direction? Yeah. So symptomatically with insulin resistance, it's almost sneaky. I heard this analogy really recently. I don't even know if it's true because I don't boil frogs. But if you put a frog in a pot and you start to boil it, it will just stay in there because that's all it knows. That's what it's used to.

Versus if you throw a frog into a pot of boiling water, it's going to want to jump right back out because it knows it's in danger. And so I think we have that statistic that you said about only 12% of adults are metabolically healthy. And so what that means is we have a lot of hidden metabolic disease in this country and people think it's normal. They think it's normal to be fatigued all the time. They think it's normal to not sleep well. They think it's normal to have depression and anxiety, even though sometimes, as we know, that can really be triggered by what we're eating, our environment. They think it's

normal to gain weight as we age. They think it's normal to have more joint pain as we age. They think it's normal, you know, to decline. And you hear that, oh, I'm just getting older. Um, my doctor said this is just how it's going to be, you know, they think it's normal to not feel good. And that's the bottom line. It's like we all want to feel good. We all want to feel like we have the physical and the mental capacity to do whatever we want, whenever we want for as long as we want. Being sick should not be normal, but unfortunately it is. So those are all, like all of those would be some symptoms. So just to kind of reiterate brain fog, fatigue, joint, joint pain, muscle. like frequent carb or sugar cravings is a really big one. If you bloat easily or if you feel like you have a lot of bloating, especially after eating a lot of carbohydrates, or even just some, polycystic ovarian syndrome for women or erectile dysfunction for men. And then you don't even need to get a fasting insulin test to understand this.

You've had Dr. Bickman on your podcast. He's been on mine. He's such an expert in this realm. And what we, what we have really. failed to recognize in medicine. And I'm a geriatric physical therapist. And so I've seen this firsthand is that we are, we work in silos, you know, oh, you have diabetes, go see your endocrinologist. Oh, you have heart disease. Now you need to go to your cardiologist. Oh, I don't deal with that medication. So we have physicians who are treating patients in silo and they're not communicating.

And I kid you not, I've had people who are on 33 different medications. And it is unreal that we don't recognize high blood pressure, altered blood lipids, including, for example, low HDL, high triglycerides, altered LDL, so too much of the small, dense, oxidized LDL, too little of the large point healthy LDL, things like, I think I said high blood pressure already, excess abdominal fat, all of those are symptoms of insulin resistance. And I think it's wild that heart disease is labeled as the number one killer in America because what causes heart disease along with diabetes and many forms of dementia and some cancers is insulin resistance. Right. And so until we really start talking about this and educating people that, hey, these are all symptoms of an underlying condition

that's completely reversible through lifestyle changes. We're not going to be making any headway in these big goals that we have to reduce medical expenses, to reduce falls, to reduce hospitalizations. It is so expensive to be sick. And it is such a better use of our resources to do what we're doing and try to advocate that people take control of their health as soon as possible. It's never too early and it is never too late. But once you understand and kind of see through, oh, I have high blood pressure. I have high blood sugar. I'm gaining a little bit of weight.

I'm kind of tired and my joints hurt and my brain is foggy. It's like you have insulin resistance probably. And there's a very simple fix. So that's, you know, from a clinical standpoint, that's kind of what people can experience early on. You know, and I see end stage. I see end stage diabetes amputations, peripheral neuropathy up to their knees. They can't feel where their feet are.

they're falling in a recliner chair most of the day. You know, it's depressing, really. And so that's kind of what spurred me to start this whole movement online to reach as many people as possible because it needs to happen. A hundred percent agree. And I guess my next question is, when is it normal? When is it normal to not lose weight as quickly? When is it normal to have the brain slow down, to have a little bit of fatigue?

Is there an age that that's actually supposed to happen? Gosh, I don't know. What do you think? I think that you hear stories of people just thriving into their 90s, into their 100th. I mean, it's just you hear stories. And so to me, in my opinion, I think that we have been conditioned to believe. that getting older means that we have to get weaker and we have to get more tired and we have to get sicker. Now physiologically speaking, yes, your hormones do decline. You know,

um, our estrogen will decline after menopause and that will change how we, uh, distribute our body fat and how we hold on to our body fat. Um, because as you know, you know, when our ovaries, um, no longer produce that estrogen, um, our fat cells and our adrenals can kind of pick up some of the slack. And so your fat becomes more valuable in many different capacities because estrogen is an essential hormone for women. And so if you're experiencing more more weight gain, especially around the midsection after menopause, it's, you know, it's a little bit normal, but it's fixable. And I think that that's the thing. It's like you can optimize no matter what age you're at. What's your opinion on that? Because I'm guessing you've done some.

Yeah, I mean, it's a great question. Yeah, it's a great question. And here's what I know is that the human body was made to live to 120. So when we see statistics like at 65, most 65 year olds are on six medications or more, that's not okay. So that's, that means that halfway through what your body was supposed to live to, you're now needing medications to, you're now needing medications to, function normally, or I'm going to put that in air quotes. So now, having said that, I will tell you at 52, like I have a goal, I want to go well into my hundreds without any medications. I have not put a medication in my body in decades. And having said that, I have moments where I catch my brain going, oh, I'm a little stiff this morning. Oh, my brain's not quite totally working the way I want.

I must be, is this age? Is it not age? So I'm still trying to figure out what that marker of decline is. What is that age? And each time I have a symptom like that appear, if I course correct with my lifestyle, if I course correct with foods, fasting, supplements, detox, biohacks, boom, all of a sudden I'm back feeling younger again. And I would say for the most part, I feel like I'm in my 20s with the lifestyle that I've created. And so I can only use myself as an example. I just don't think at 65 were meant to be in this rapid decline. No, and I've seen that.

You know, I've seen 60-year-olds that act like 80-year-olds. Yeah. Or higher, or they're already honestly dead because they didn't take care of themselves. Yeah. And I think it's important to not dismiss your body's symptoms. So we have a really good family friend and he was having aches and pains. for about a year and he just kept dismissing them. Oh, I'm just getting older.

I'm getting older. Turns out he had stage four prostate cancer that had metastasitis metastasized to the bones. And so as we, you know, as we're talking about this, if you have a symptom, definitely speak to your physician about it. Don't dismiss it as you're getting older, but really dive deep. It's a simple blood test that can catch that PSA. You know, he just hadn't hit that age where they do it routinely yet. Yeah.

So unfortunately, I just wanted to throw that out there too. for anyone who's. And I'm going to, I'm going to just get a little opinionated on how we handle our symptoms in our health care system right now. So I 100% agree with something like cancer. I think everybody should get a blood, blood work every year and know your numbers. Having said that, I feel like if you walk into your doctor's office and you're like, I'm fatigued. I'm not managing stress well, I can't lose weight. They're going to do their standard CBC. They're going to do your blood pressure. And nine out of ten times, they're going to come back and say you're pre-diabetic, your LDL, your total cholesterol and your LDL are really high. And your blood

pressure is high. You need to go on medication. And to me, that is the moment in which you cannot accept that diagnosis because it's you're not those numbers are not going out of balance from a lack of medication. They're going out of balance because of something in your lifestyle. They're not even going out of balance because of genetics. So I, this is why conversations like this are so important is I do not think we should normalize weight gain, high cholesterol, all high hemoglobin A1C. Like they're not, it's not normal. Yeah.

And I think this is a beautiful analogy for that. So if people are listening to those, oh, they're talking about me. I just got my blood work done. And that I would consider a pebble. You know, when life is trying to teach you a lesson, it will often start with a pebble. And you can choose to ignore it or you can choose to fix it. And if you choose to ignore it, life is then going to give you a rock. So for example,

had high blood pressure. I'm just going to ignore that for now. Take a medication. Not really going to change my lifestyle. You're probably going to get a rock later in life, like a mild heart attack or some other form of cardiovascular disease. And then you're going to be like, ooh,

now I really need to be hit tension. But then you've had probably years or decades of more unhealthy choices piled up. So it gets harder to change that behavior because it's more ingrained in your brain. And your body is physiologically used to that crutch of the medication. And if you still don't listen after the rock, you're going to get a boulder. You're going to get a massive heart attack or a massive stroke or you're going to have end stage CHF, um, heart failure and you're going to be short of breath and on oxygen. And I've seen it time and time again where people are tied to their oxygen tubing and they

cannot go out of the house without an oxygen tank. And it's like I think I have such unique perspective and drive and passion because I have seen this over and over again, right? Like some people might have a parent or a grandparent who had diabetes or had dementia or had heart failure. I'm like, I've had hundreds of patients. It is heartbreaking every time. And then I was like, just like you, I'm like, wait a second. Their caretakers, their children who are 20, 30 years younger are following in their footsteps.

They have the pebbles. They have the rocks. And if they don't pay attention, if they don't advocate for themselves, they're going to get this bolder that their parent has and that they're helping their parent deal with. It's just so powerful, you know. So I think it's a very important conversation to have. Yeah, we have, my practice has been a family practice for 25 years. And we have a saying in our clinic that why are you leaving your kids home to develop the same conditions and symptoms that you're trying to fix now? That health is really about starting young and creating, good patterns early on so those boulders or pebbles and boulders don't appear. And I think I love your point on that. And a pebble is so important because I don't think people see a diagnosis of,

or a statement by their medical doctor saying you're pre-diabetic, or you need to bring your glucose down a little bit, or your cholesterol is a little high, you need to go on a statin. They do not see that as a pebble. They see that as this is what happens to humans. and the standard of care is medication. So what can we do for the listener if those pebbles have already occurred? How? And let's just take the person who has already been given that diagnosis by their doctor, and they're wanting to do it differently.

They're wanting to address the pebble. Maybe they stay on the medication and they want to address the pebble. What are some of the practical steps that that person can take? I think it really depends on where they're at, but I'm going to answer this question as if you, like you just asked it, so maybe someone in their 40s or their 50s. So someone who still has most of their cognitive and physical capacity

to still make their own meals, right? Because it's a whole other conversation when someone's no longer mobile enough to cook for themselves and they have these conditions. So let's say you go in, your doctor might not even tell you. You might just get,

you know, an E through the portal. And there's a little note from your doctor, hey, you need to lower your blood sugar. Oh, crime any. Okay, let's, let's view that as a pebble and recognize it for what it is. It has decades of unhealthy choices. We know that fasting insulin can predict type 2 diabetes up to two decades before fasting glucose. I really believe that checking fasting insulin will become the standard of medicine in the next decade.

I hope it's before then. How often should you check it? I recommend getting that checked at least once a year. And there is, I'm really working hard to partner with a medical practitioner to be able to offer a fasting insulin test from home with a blood spot. So right now, the tricky thing about this is it's a harder molecule to test than glucose. We have continuous glucose monitors. You can get a finger prick test at home. But you can't do that with insulin yet.

So the technology is just not quite as advanced yet. but it's going to get there. So for now, there's companies like so well health. They have a complete metabolic panel with Dr. Alexander Soa, who founded that one. And so you can get that done at home, but that includes a few other things besides fasting glucose.

So go ahead. Yeah, just so if people have their blood work at home, again, I want to make this podcast as applicable to people as possible. What should their fasting glucose be? Yeah. So let's go over.

some cutoffs here. So from a glucose standpoint, quote unquote normal is anywhere between 70 to 100. And then if they're at 101 to 125, that's in the pre-diabetic range. Two separate readings of 126 or higher would be considered type 2 diabetic. And then a couple other numbers to look at would be blood pressure. And I'm talking about cutoffs maybe for a symptom of insulin resistance. So anything higher than 130 over 85. So if the top number is higher than 130 or the bottom numbers higher than 85, um, if your triglycerides are over 150, if you're a man and your HDL is less than 40, or if you're a woman and your HDL is less than 50, um, excess abdominal fat. So a waist circumference of greater than 40 inches for men or greater than 35 for women.

And then here's something a little bit tricky to would be skin tags. So your skin is an organ, you know, so that can show signs of illness too. And if you're having like little tags on your skin or dark patches of skin, that can be a sign of insulin resistance. So if you're noticing those, the first thing that I would say is just doing this as an opportunity to make a change. So instead of getting down. on yourself about, oh, I should have done something sooner or overwhelmed because you can go

to Dr. Google and get really overwhelmed with different opinions very quickly. The first thing that I really recommend people do is read the obesity code book or the diabetes code book by Dr. Jason Fung. I think that that is an excellent resource. And then the second book that I most often recommend for insulin resistance is why we get sick by Dr. Ben Bickman. beautiful that'll give you some motivation because because that will give you insight into the boulder and that will make you value the pebble of high blood sugar because then you're going to understand oh my gosh if i don't get this under control i'm putting myself at risk for all of these other conditions because again we're so used to silos in medicine and it's not it's like it can just

filter down and that's why i love talking about insulin resistance is because it's linked to diabetes. It's directly linked to Alzheimer's dementia and vascular dementia, several kinds of cancer, including breast and prostate cancer. It's linked to osteoarthritis. It's linked to Parkinson's disease. It's linked to so many different things. And that's what Dr. Ben Bickman's book really dives into cardiovascular disease is the physiology behind that in a way that, you know, someone who's not too science you can appreciate. So that's the first thing. If you get that high blood sugar diagnosis, don't freak out, but get educated. Educate yourself by reading or listening to the obesity code and or why we get sick. That's a great starting point to understand and have further

context to the next few recommendations. So the next thing that I would recommend is to lower the carbohydrate and not necessarily lower, but like, let's really focus on quality carbohydrates, you know, because I think a lot of people are so used to crash diets. I work with so many people who have literally tried everything. And, um, they often come into my Zivli program with fear because they have misconceptions from previous diet experiences. Um, and they're afraid that, you know, they're going to have to starve themselves to

lose weight because that's all. that worked in the past. I literally got done with a lifestyle audit this morning before this recording. And I went through an example meal meal plan that was, you know, healthy protein, healthy fat, fiber. And I said, what is what's different about this than maybe what you were expecting? And she says, well, I'm not afraid you're going to starve me. It's like, no.

That's how I feel about fasting when people are like, what? You want me to do what? I'm like, no, no, no, hold on. I'm going to show you how to do this in a way that your body wants it and craves it so that you, it just becomes effortless. I think that is a huge, the diet culture has really warped our perception of what changing food looks like. And so much when I went to go write my Fast Like a Girl book that will come out at the end of

this year, the very first chapter, I go. through five dieting myths that we need to let go of. And tell me what they are. Give me a little preview. You're going to have to read the bike. Well, the first one is stop counting calories. Yeah. And it's that one is really like it's so freeing.

But if you're a control freak who has been counting calories and it's kept your weight where you want it, it's hard to let go of counting calories. So that's a biggie. one of the other biggies is toxins. People don't realize that just because something is a diet food, if it's packed with toxins, it's going to make you insulin resistant. So I talk about like how we need to look at toxins. But to your point, I love what you're saying where I feel like, wow, like women, I know

we have both men and women listening to this podcast, but if you got eaten up by the diet culture, like I want to liberate you and just say hug yourself, love on yourself because, you know, you can eat, you can food that is such good quality, you can compress it into an eating window, and you can flip and thrive. Yeah. It's not hard. It's not. And I think that's the thing.

It's like we tell ourselves this story based on our previous experiences with weight loss. And I talk about weight loss a lot because that's what people are looking for. I did an Instagram post once that was like, I don't know, 240,000 people search for how to lose weight a month. Oh, yeah. And maybe there was like 2,000 people searching for how to lower insulin. And my point was we're asking the wrong question because you can lose weight in a lot of different ways and still not get healthy and still not address the mental weight, you know,

because how often are we focusing on cleaning up our diet, but we're not cleaning up our thoughts that, you know, drive us to those choices. Yeah. So I think that that's a really important thing when someone gets that pebble to not freak out and want to just do the next crash diet that their cousin Betty is doing. Right. Yes. Because it's just, it's silly.

And so make the commitment to learn how to live a low insulin lifestyle. That's kind of what I coined it as. It's like it really accompanies optimizing your nutrition. optimizing your intermittent fasting. And as both of us really advocate, I've learned a lot from you. If you have not gone through menopause yet, you're really going to want to do that in conjunction with your cycle

so that you feel great and you support your hormones. You want to reduce those toxins. I'm sure you're going to cover those in your book. Movement is so important. As I was researching for this episode, I read a stat in the XX brain by Dr. Lisa Moscone that said that there's evidence of brain shrinkage. So like your brain literally getting smaller from a sedentary lifestyle as early as

your 30s. Yep. So it's very important that we're focusing on healthy movement, specifically resistance strength training. Ideally two to three times a week, all major muscle groups at a moderate to high intensity. So we got to end the chronic cardio. I don't know if that's like one of your miss, but when we're talking about calories, that's a big one. Because oh, I burned 400 calories today on the elliptical or on the treadmill. It's like, whoop-de-do because your body doesn't have a calorie receptor. So it literally does not understand what just happened. It's actually triggering you to eat more. So there's that. You know, the cardio is, we got to get over that. It's great for stress management. I think that it's fun. You know,

some people really enjoy their cardio. And they like going for a good run or going for a walk. But we got to focus on that too, strength training. Yeah, with exercise, I will tell you one of my approaches to exercise has dramatically changed from what my 40s to my 50s. So tell me about that. Yeah. So I was a chronic cardio person. My background, I was a competitive tennis player. So we would run, jump rope.

Like we did, you know, you wanted your endurance and cardio up. And I, and I'm a running, um, uh, an addict maybe because it makes me mentally feel so good. But as I moved into my 40s, it stopped doing what I wanted. to do for my weight. It actually, the more I ran, the harder I found it to drop like belly fat. And I used to call it my wine bar. Like every time I would have a glass of wine, I would see that. And this is before I knew how to drink clean wine. But I would, I would just exercise my way out of any small little weight gain. And that had to dramatically change. And I had to take cardio and put it in the category of mental health, not physical health. So when I go and do a long run, I'm literally doing it

for the endorphins, doing it for my brain, but I'm not doing it for the body. So I switch to more weightlifting. And if you could talk a little bit about this, because I think this is a really important one, that if the more muscle you have, the more insulin sensitive you are. So explain why I think a lot of women my age are scared of weightlifting. And it's probably the most important thing. The other thing I've thrown in is yoga that we can possibly do as we age. Yeah. And before I do that, I just want to tack on a couple other lifestyle factors, stress management

and sleep. So I will talk about that strength training. But before I do, I just wanted to wrap up that conversation about like calories. because when you're used to the dieting mentality, you have two levers. You can eat less or you can exercise more. But when you focus on living that low insulin lifestyle, you have so many different things to optimize. Again, nutrition, fasting, environment, toxins, your light, stress, sleep, movement.

So so many different things. And that's why it truly is a lifestyle change. And you have got to get over that perfectionistic all or nothing mindset. It's not serving you as you work to change your life. lifestyle. So talking about exercise and strength training in particular, we know that, you know, as you age, our levels of the hormones like the human growth hormone, testosterone that helps support muscle mass as we're younger, those do decline. And so it becomes doubly important that as we age, we really focus on high, moderate to high intensity strength training

and adequate protein to support our muscle growth. And the reason is because that does two things. Number one is it helps keep fat out of your muscle tissue. Marbling is good in our steak, not in our muscle. So I think that's a really, it's really important. I thought of that one night when I was not falling asleep. I'm like, oh, that's a good one. So marbling is good in our steak, but not in our muscle.

We want our muscle to be muscle tissue because the more marbling or the more fat that infiltrates our muscle tissue, the less strong we are, right? And the less sensitive to insulin we are. And so the more muscle we have, the more insulin receptors we can have. And that's essentially like having more, I'm going to say it's a door, but it's not really, but having more doors open to let like the crowd come in. So if you think about like a big football stadium, right? And there's, I'm a huge Husker football fan. We got it. It's so funny because on us on Saturdays, the Husker football stadium itself is the second largest city in Nebraska. Oh my gosh.

It's so funny. And so it's kind of like you have all those people out and then they let what they open one door, right? But then what if they and it takes a long time for that glucose to come in, hangs out in the bloodstream. It's not good for you. It's inflammatory. So all those people are the insulin.

Okay. All, you know, or the blood sugar. Let's call the people the blood sugar. And then all of the. doors, you know, the insulin is kind of the guard at the door. I was going to say the insulin's probably the security guard that's like letting everybody in and out of the door. I love this analogy.

And then the door itself is called a glute for transporter. Okay. So that's kind of what comes to the cell membrane and allows glucose. It's like a tunnel, a tube slide is like the metaphor. The glucose is going to slide down into the cell once insulin opens up that door. Okay. So having more muscle tissue is like having more guards. And people can move, the glucose can move into the cell, the people can move into the stadium faster and more efficiently.

And you're just, it's going to be better because then you don't have so much insulin in your blood and insulin than going to your brain and raising your body set weight and contributing to central insulin resistance, which we can talk about. But like that's, you know, Alzheimer's disease is now being called type three diabetes. So there's a very strong link there. So muscle tissue, strength. It doesn't take long. It's like 20 minutes, 30 minutes, two to three times a week. It'll be the best investment of your time for your health, for your fitness, for your joint pain. So we know that strong muscles really support healthy joints too and healthy bones from osteopenia or low bone mass and osteoporosis prevention. We really want to aim for three times a week, especially for women focusing on hip exercises like the gluteal exercises.

to prevent that for moral neck fracture. If you don't know what you're doing there, go to a personal trainer who does or a physical therapist. Do chiropractors do like personalized fitness programs for people? Everyone's different. So absolutely there are some. I know in our office, we're building out a whole functional movement rehab piece to all of our biohacking tools because of the lack of mobility that humans,

are partaking in, and the pandemic really put it into a whole other level of, and so we've really had to adapt. You know, I always say that if you look at what the modern world is done to the human body, it's, you have to really make a clear effort to not become sick in this world because so many things, just walking into your supermarket, if you are not clear. and intentional about what you're buying. The food industry doesn't care about what happens to your health. They care about what happens to your taste buds.

The same thing when we look at the pandemic, I really feel like the human body suffered structurally. And I know we suffered mentally as well. But even moving to Zoom, everybody's on Zoom sitting so much and that's sedentary. We now need tools on how to help that. I also wonder what your opinion is on estrogen's decline and its effect on insulin. Because I see a lot of women over 40 tell me that I'm doing all those same things. I'm doing everything I used to do, but I'm gaining weight or I'm not getting the same result.

Do you see that too as women go through menopause? Yeah. So there's a couple different things regarding the estrogen. So as your estrogen declines, number one, your insulin resistance can go up. So estrogen is protective against insulin resistance, especially protective against belly fat. And so as the estrogen goes down, you will need to tighten up your lifestyle, whether that's in the nutrition, fasting, movement, sleep. A lot of times than women in their 40s, it's stress management to get the results that you

want. So you're going to have to tighten things up. The other thing is from a gut health standpoint, your estrogen actually has a big impact on your esterbolome, I believe is what it's called. And so what I can tolerate right now in my 30s, I understand that I might not tolerate certain foods as I continue to age and as the as the lining and the makeup of my gut microbiome changes as my estrogen declines. And so I think that's another important thing is that your gut health can and does change as you age because of that decline in estrogen. and you may not tolerate like dairy or gluten or alcohol or caffeine, caffeine especially as you age.

And again, we kind of touched on the adrenals a little bit and how those can kind of help produce some estrogen along with your adipose tissue as your ovaries kind of retire. And so have you covered the Pregnitalone steel or what's, have you thought it touched on that? Yeah, I did in the menopause reset. I wrote that out. You know, I think a really good question that I've noodleed on.

That's what I always say it. Like, in my own mind is estrogen is declining, making us more insulin resistant. Is the goal to do everything you can to become insulin sensitive through food and fasting? Or is the goal to maximize the little bit of estrogen you're being giving. or do you need to work on both of those things? So I think, yeah, go ahead. No, no, no. I'm curious your opinion because it's like which side of the coin are you going?

And in this conversation for the women over 40, I want you to understand that if you've gained weight, it's not your fault. I think it's, I think over 40, it's like it slaps us across the face. And it's like all of a sudden you're like, what? I just ran into a friend the other day. I was outside running. And she was like, I'm really struggling with menopause. I can't lose this weight. And I think that's why this conversation around estrogen is so important to understand

that estrogen's wild ride is going to make you more insulin resistant. Yeah. And I think there's two things that I'll touch on. I know that we could go deeper, especially practitioners that specialize in hormone and hormone replacement therapy could go even deeper. But in my opinion, that pregnant alone steel made a little bit. lot of sense to me because your progesterone and your estrogen and your cortisol or your stress hormone all come from that same precursor. And if you're not dialing in your stress and

all forms of stress, metabolic stress from like those processed and refined seed oils and added sugar and too much caffeine and alcohol, like that is a stress on your body. Emotional stress, work stress, relational, all of that is stressing your body out and it's forcing your body to produce more cortisol and it's not supporting the estrogen, the progesterone. And so if we can really reduce the stress and allow those adrenals to kind of function at a little bit of a higher capacity, I think that will help with that insulin resistance part. But then the second thing there is that we know that cortisol directly increases insulin. So from a stress standpoint, you know, the fight or flee response is wonderful because it, the purpose of that elevated, uh,

cortisol is to raise our blood sugar so that we have energy for our muscles to use. But now our stressor is an email from the boss saying, hey, we need to talk. Um, or like my kids, I have two young kids are going to be four and two. And I say, like staying home with them is like getting 20 or like 200 emails a day with a subject line that says emergency someone is dying. I love that. That's so well said. It's just like all of these. Yeah. But actually what is happening is they just can't get the lid off the marker. But they think the world is ending. Yeah. And so but it raises your stress. But when we're sitting here, as you kind of alluded to on these Zoom calls and meeting and sedentary stress, your body still raises glucose.

Your body's physiological response to stress is the same. It expects you to fight or flee. But when you sit, what happens is you don't transport those glute four transporters that we talked about earlier. So insulin can transport those to the cell for that glucose to move in or movement and exercise. And so that is really where the, the, the exercise and movement comes into play as more insulin receptors and then more glute for

transporters to get that glucose into the cell. So, you know, not only if we're not focusing on our stress management, are we kind of robbing our estrogen and progesterone, but we're, we're kind of contributing to insulin resistance from elevated cortisol. Um, because if we're just sitting there with all this stress and our blood sugar is going up, we have to release more insulin to get that blood sugar to go into the cell. And that is why exercise is so good for your mental health. It's a stress reliever. Your body wants to move.

It wants to kind of work that stress out. So that's a nice little tip there. Is it like a walk instead of going to the fridge, like go outside, go for a walk? So that that was kind of the main point there on the estrogen and why it's important that we dial on our stress for both of those reasons to reduce cortisol. So we can increase production of our sex hormones. and to reduce cortisol, simply to reduce cortisol and reduce insulin. Yeah, I have a line in Fast Like a Girl that says cortisol is the enemy of insulin. And I really think they, you know, cortisol goes up, managing insulin glucose, very, very difficult.

And I also agree that if you, like, the worst thing you can do is have an argument or a stressful event and sit down. Yeah. That's like the worst because now cortisol is just going to saturate the tissues. But cortisol is actually meant to make us move. So it's what drives us to run from the tiger. So to your point, if you get up and you move, you actually use that cortisol, not letting it damage you.

So that was such a brilliant point. I'm so happy you said that. Talk a little bit about the mental part of insulin resistance. Like we can, I think people are starting to hear that Alzheimer's is type three diabetes. If you haven't, I just want you to sit and really take that in. But I am also seeing anxiety, depression, brain fog, memory loss. These, again, the pebbles to your point that are causing, that are, the root cause is insulin resistance.

So start with that. Oh, and this is a doozy. I'm going to kind of keep it superficial. level here. Again, Ben Bickman in his book, Why We Get Sick, Talks about this more. And then I really enjoyed the XX brain by Dr. Lisa Moscone as well. I thought she had some interesting points about brain health. So yeah, if you didn't hear us, Alzheimer's is now being called type 3 diabetes. There is such a strong link. I cannot tell you how many patients I have with diabetes who also have dementia, you know, and like that's really how I got into this. I just kept noticing the pattern.

Why do all of my patients have all the same things? There must be a single cause. It's like Occam's razor, you know, usually the simplest explanation is correct. And I can tell you that I want my health span to match my lifespan. And even more than that, I want my cognitive span to match my lifespan. Yep. I want to recognize my children, my grandchildren, my great-grandchildren. I want to talk. That seems like a, that seems like a pretty legit request. Yeah. I want to remember things, you know, because dementia is so sad because you lose someone

before you lose someone. You lose their memories and you lose the shared experiences and you, you lose that connection before they actually pass away. And so I think that you shout out, if you are taking care of someone with Alzheimer's, If you're in the medical profession and you take care of people with dementia, it's a hard. It's a hard thing to do that. And I've been, I've treated so many people with dementia. And so I'm really passionate about this topic because if it robs you and it not only robs you, but a lot, it really robs your loved ones.

So insulin resistance has really directly been linked to not just Alzheimer's dementia, which is the most commonly diet. but also vascular, which is the second most commonly diagnosed form of dementia. And so traditionally, the research really focuses on these amy amyloid beta plaques and tangles in the brain that kind of like mess up the wiring and don't allow those neurons to fire properly. And insulin actually has been linked to both of those. So elevated levels of insulin does increase those plaques. And then these tau proteins, so TAU proteins in the brain are really what help keep our neurons structured properly.

And elevated levels of insulin in the brain, um, cause these proteins to kind of go haywire and increase the likelihood that your neurons will, will, will, will tangle. And so that you're going to get these tangles and you're going to get these plaques. But here's the scary thing is that they, have found these plaques and tangles and people who had no dementia. And so we've been thinking all along that, oh, it's these plaques and these tangles and they're interfering with the firing of the brain signals. But now it's kind of like we're questioning that because there's research coming out that people have those, but they never experienced dementia. And these are all,

um, after someone dies, they're doing brain autopsies to kind of see this stuff. Yeah. And so now there's this of new paradigm of brain research focusing on metabolic health of the brain. And lo and behold, you know, your brain is several times more metabolically active than your muscle. Uh, your brain uses a lot of energy. And so it's very sensitive to a lack of energy. And how many people eat is a high carbohydrate, high processed food diet eating many times a day. And essentially what you're doing is you're loading your body with glucose, all of the the time. You're raising your insulin all of the time. And the cells in your brain become resistant to that insulin. And so the glucose has a harder time getting into the brain cells.

And even though there's not a lack of nutrients, it's having a hard time. It's like the guards are like, I'm going on break. You know, if we're going back to that like sports arena analogy, maybe you used to have 20 guards on duty. And now because you're more insulin resistant, you don't. So instead of having 20 doors open, you have 10. And your brain is having a harder time getting the glucose into those neurons to fire. And that's kind of the symptoms of brain fog, the fatigue. And so it's so important to recognize that that your brain can become insulin resistant,

just like your liver, just like your muscles, just like your fat. And so that's kind of the progression of it is there's less insulin sensitivity. So there's less glucose uptake and your brain senses a lack of nutrients. You get the symptoms of the brain fog, the fatigue and some memory issues there. So there's kind of there's a paradigm there regarding how we used to look at Alzheimer's research and then more of the metabolic standpoint. So I think, what was that? What do you think ketones play? How do you think ketones play a part?

Because if we, I had an Instagram conversation, Instagram live I did with Dr. Gundry. And, you know, he's got a new book out really talking about the, the, a new look at ketones. And we talked about how the brain needs 50% glucose, 50% ketones. So if, if you're never giving the brain ketones, you don't get that healing effect. So do you think ketones can help this scenario? you? Yeah. And I think that there has been research on, so people with epilepsy, for example, research with the ketogenic diet and epilepsy or these neurological things. There's been research that has shown a ketogenic diet improves their cognitive function. And so I'll be interested

to listen to that and to do more research. But that's kind of the point there is if you're always giving your brain glucose, it's just going to become insulin resistance. Whereas insulin resistant. Whereas if you also kind of restrict the carbohydrates a little bit more, force it to use ketones. It's a cleaner fuel for your brain. It doesn't require that rise in insulin. And so it's going to, I'm guessing you've maybe done quite a bit of research into this. It makes you perform better. You have more. Oh, yeah. Oh, yeah. Focus. You have more energy. Like, I know that when I have to get something done, I fast. And I, And it makes me so much more productive because my brain fires so much faster.

What's your opinion on that? Yeah. Yeah. I find I always call it limitless. It's like the Bradley Cooper movie where he takes the pill. And now he can like learn nine languages and predict the stock market. That legit is how I feel on ketones. And I would say part of not feeling my age right now is really because of I dip into those ketones.

I was at a conference this weekend and there was a neuroscan that was showing the age of your brain. And I was so proud because my brain, they registered at the age of 30. And I'm like, yes, thank you. That's awesome. But I say that to say it's the lifestyle. It is not me. And I don't say it to like, oh, look at what I can do. I want to say it to look at what everybody can do when you get those lifestyle tools in place.

and the brain is one of them. And to your point, I feel like people are just waking up to this type 3 diabetes is Alzheimer's. But anytime you have a condition in the world that's happening to everybody, we have to stop and say, what else is in the world that's happening to everybody? We could have done the same thing with COVID. We could have said, why is everybody falling prey to this? which eventually people said, figure that out and said, oh, they're insulin resistant. That was a major piece of people who fell prey to COVID.

So Alzheimer's to me is the same thing. One out of three seniors are going to die with Alzheimer's. Okay. Do we just accept that? Or do we say what is in our environment that is making everybody have this, this condition and get this diagnosis? Right. Yeah.

And I think it's so important that women recognize. Dr. Mascone talks about this in her book. She has seen, she dissected so many brains and she saw evidence of Alzheimer's in 40s and 50s. And that risk accelerates after menopause. So we know that estrogen is even good for our brain. And as that drops, like your risk of memory issues and dementia goes up. And so if you have not already dialed in your lifestyle by the age of 40, 50, now is the time. Yep.

Because you can still do so much right now. to prevent the diabetes, dementia, heart disease that we've been talking about this whole time. It is not about weight loss. And I think that is like the biggest message that we've got to get out there is like get off those dang yo-yo diets that don't focus on health. You will lose weight as you get healthy. So I think if someone kind of listened to this podcast, oh, how can I lose weight? It's like I hope that they have a much broader understanding now like it's not about the weight loss. And as long as it's about that for you, that's probably not going to, you're not going to find the most effective answers there because there's a lot of ways to lose weight.

There's one way to lose weight and keep it off. And that's to change your lifestyle for the better. And so I think that's a really important message. Ah, so powerful. And you know what? I would say that weight loss can be your motivating door in. And we've seen that in our reset academy. me, like, this is what people come to a fasting lifestyle for. And I applaud that. But if that's your

only motivation, there will be a door out that will take you back to, you know, poor health. So let it be the motivator, but then discover a whole other world of health that your brain and body can hit. And you will, you'll be blown away. I mean, you'll literally be blown away. And I just want to tell you, it is never too early to start. I am 10 pounds lighter with a better body. body composition now than I was in high school. And I've had two children, you know, and so if you think, oh, I've had kids, I can't get my body back. Yes, you can. And you can get a better body than even before kids. So it really is never too young. And the sooner you make these changes, the greater the ripple effect you'll have on your family. So my kids will now be, will now be

healthier. My husband is healthier. And so as women, especially if you're a woman listening, recognize like you make the majority of health care decisions for your family. And so the healthier you can be mentally and physically, the better you can care for everyone else in your life. Oh my gosh. Mic drop. That was good. That was so good. I love it. So I could talk insulin resistance with you all day long. Like there's so many things to discuss on this topic that will hopefully elevate somebody's vision of why they want to stay insulin sensitive. But I do, I do want to honor your time. So let's, let's do this. The third season of the Resetter podcast, which we're in, is about gratitude. And so I've been asking everybody what gratitude practices they have. And it's been so interesting. Everybody has

something totally different. So talk about your gratitude practices and then talk about what's something that you're grateful for in this moment in 2022. let's stop my feeling is let's stop looking at all the things that are wrong and start looking at all the things that are right. So what is it in 2022 you're grateful for? I love this so much. So, okay, I'll start with my gratitude practice and we'll end on one and grateful for. I'm super big on mindset. I'm a big believer that in order to master our physical health, we have to master our mental and emotional health. I, uh, Benazotti says we have to intersize before we exercise. Oh, well said. I take that so seriously.

and every morning I really do try to get up and I write out specific things that I was grateful for within the last 24 hours. I don't have a set number. I just kind of go. And what that does is it cues me in to think about more of those throughout the day. So a couple examples are lingering hugs, you know, and my husband doesn't want to let me go and he just wants to keep hugging or the wind chime outside of my kids. I really like wind chimes or seeing a cardinal out the window or hearing the. bird's chirp or feeling the warmth of the sun on my face. So any of those really specific things that we can dial in and like if you can write it

down, that's great because it helps you focus there. And then I also write down like daily affirmations. And so a couple of my favorite are I choose to prioritize my emotional and physical health every day. And I choose to think and do things that feel good to me. It's pretty hard to mess up your day. like when that's what you're prioritizing. So my gratitude practice is really centered around like that daily journaling and specific

reflections of like, you know, like how my daughter smiled when we were in the shower together and the water hurt her face, you know, or how my son laughs when I shoot him with my hairdriar. So different things like that that are fun. And then what I'm most grateful for in 2022.

There's a lot. Like obviously like I, I'm really big on gratitude because it really focuses your attention. towards your desires and what you like. And it keeps them off of the, off of the negativity and just completely nonproductive. I'm big on like, I'm going to use my brain for productive energy, productive thoughts. I'm not going to worry about anything unproductive. Oh, there's so many things.

I know. I love that. No, I mean, and it's funny because when we started this season, we were talking about what was it that we felt like the world really. needed to hear. And this was back in November of 2021. And at that time, gratitude really was, I felt like, the main focus. And now I feel like we're getting more people that are like starting to appreciate the little things in life. And it's really, you know, there's energy. The more collectively we come together and think thoughts of gratitude, the more we rise to a level of love. We change the whole energy of, like to your point, not just our family, not just the people

around us, but the world. And the goal to me right now is not for us to get down in the fear and the anger and the pointing fingers. The goal is a human race is to elevate ourselves into love and joy and acceptance of all people, all conditions. and when we do that, we will shift the energy of the world right now. So all of your points were very, very valid. I love them.

And you can never have too many things to be grateful for. I'll pin it down, though. So for people, well, she didn't answer that question. Here's one I'm most grateful for in like Q1 of 2022. The book Asking It is Given by Esther and Jerry Hicks. The book, Think and Grow Rich by Neopolitan Hill or something. Napoleon. Yeah. Those are really good mindset books. I don't care if you want to make money, but if you want to get rich in your health, rich in your relationships, really good. And then if that asking it is given as to woo-woo for you, I am enough by Marissa Pierre is so good. So in our Zivli community, we're focusing a lot on mindset recently. And so I am enough and then asking it is given are the two books I recommend most on that. And I'm really grateful because I've learned more about it and I've learned how to control my thoughts. And I've learned how to have wonderful.

days like almost every day. And it just feels good to feel good. And so I'm really grateful for that and how it's impacted, um, you know, my relationship with my husband, my relationship with my kids, like my business. It's just been really cool. So I'm grateful that you're having me on here to talk. Oh, oh, grateful for you, Morgan. This has been great. Where can people find you? Yeah. So, oh goodness, I'm, I try to be all over the place. Instagram at Dr. Morgan Nolte, trying some TikTok. If anyone cares about it takes more. It's a whole different world ever. Oh, gosh.

I really like YouTube. I've done a lot of in-depth trainings on YouTube, but Dr. Morgan Nulte. My podcast, which your episode's going to air pretty soon, reshape your health. And then our website where people can learn more is zivoli.com, zivl-I dot com.

And that kind of stands for a live, which is live in Croatian in case anyone cares. And then low insulin lifestyle. So that's what we're all about. Thank you. Thank you so much for joining me in today's episode. I love bringing thoughtful discussions about all things health to you. If you enjoyed it, we'd love to know about it. So please leave us a review, share it with your friends, and let me know what your biggest takeaway is.