Dr. Ted Naiman

Ted Naiman is a board-certified Family Medicine physician in the department of Primary Care at a leading major medical center in Seattle. His research and medical practice are focused on the practical implementation of diet and exercise for health optimization. He has an undergraduate degree in mechanical engineering and utilizes engineering principles when dealing with complex systems such as human health and nutrition.

William Shewfelt

William Shewfelt is the host of the Will To Win Podcast and the 21daycarnivoreshred.com coaching community. By combining carnivore-style eating, a strategic blend of cardio and explosive strength workouts, and highly disciplined goal setting, he has been celebrated for achieving a 4% body fat physique, and for guiding many others to breakthrough success. As a novice actor in college, William beat out 10,000 candidates to star as Brody the red Power Ranger in the hit TV series. 

LEARN MORE AT:

instagram.com/williamshewfelt     instagram.com/tednaiman
https://podcasts.apple.com/us/podcast/will-to-win-with-william-shewfelt/id1460605151

https://www.thepediet.com/

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SHOWNOTES

The PE Diet: Leverage your biology to achieve optimal health

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08:15 - Paleo OMAD Biohackers: Real Foods + Intermittent Fasting + Life: Join Melanie's Facebook Group To Discuss And Learn About All Things Biohacking! All Conversations Welcome!

10:00 - William Shewfelt's Diet And health History 

14:00 - Dr. Ted Naiman's Diet And Health History 

16:20 -  How Is Solar Energy Stored In Plants Versus animals? 

18:30 - Nitrogen And The Circle Of Life

19:45 - The Energy Potential Of Carbon And Nitrogen In Plants Vs. Animals

22:15 - Minerals in Plants Vs. Animals (calcium, Zinc, Magnesium, etc.)

23:50 - Are Animal Products "Processed" ?

26:30 - Protein And Obesity: The Protein Leverage Hypothesis 

28:40 - How Much protein does one need per day? 

30:00 - How Do The Different Macronutrients Affect Satiety? 

33:40 - Are Carbohydrates Protein Sparing? 

35:00 - Is Gluconeogensis Stressful For The Liver?

38:30 - Carbs And Water Weight 

40:50 - JOOVV: Red Light And NIR Therapy For Fat Burning, Muscle Recovery, Mood, Sleep, And More! Use The Link Joovv.com/Melanieavalon With The Code MelanieAvalon For A Free Gift From Joovv, And Also Forward Your Proof Of Purchase To Podcast@MelanieAvalon.com, To Receive A Signed Copy Of What When Wine: Lose Weight And Feel Great With Paleo-Style Meals, Intermittent Fasting, And Wine!

43:25 - Low Carb Vs. Low Fat Vs Calories 

48:50 - The Implications Of Combining Fats And Carbs On Metabolic Health and Mitochondria 

52:00 - Excess Energy On Low Carb, And MCT Oil Supplementation 

54:30 - Can You Do Low Fat?

57:40 - How Long To Adapt To Lower Carb?

59:40 -  Metabolically Flexibility And Metabolic Memory

1:02:45 - The Danger Of Cheating On A Ketogenic Diet

1:03:15 - Athletic Performance On A Ketogenic Diet 

1:04:00 - What Is The PE Ratio?

​Protein to Energy Ratio Calculator

1:05:30 - Glycogen Storage Potential In Muscles Vs. Liver

1:09:45 - Carbs From Fruit Vs Starch 

1:13:45 - Low Protein For Longevity 

1:15:45 - Specific Adaptation To Imposed Demand: The Role Of Adaptation In  Exercise 

1:17:45  - Getting  Exercise From Life

1:18:30 - The Importance Of Max Intensity 

1:19:05 - How Much Time At The Gym?

1:22:00 - The Mental Aspects 

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TRANSCRIPT

Melanie Avalon:
Hi friends, welcome back to this show. I am here with William Shewfelt and Dr. Ted Naiman. They have crafted an amazing book, called The P:E Diet Leverage Your Biology to Achieve Optimal Health. Listeners, there are a lot of diets out there. There are a lot of theories about what supports the optimal health, what supports body composition. Oftentimes, it involves different macronutrients and things like that. But this book, The P:E Diet actually focuses in on something that really, really resonates with me, at least with all of the research that I've done on how diet affects health, longevity, and so many things, and that is really the role of protein in the diet. We'll go obviously into more detail, other things as well, minerals, the role of carbs and fats, so many things, but I really, really love this approach.

Melanie Avalon:
The book, it's an easy read, but very sciency, it's very nuanced, very approachable, so I really cannot recommend enough that listeners check it out. Thank you both, William and Dr. Naiman for being here.

Dr. Ted Naiman:
Oh, wow, thank you so much for having us.

William Shewfelt:
Thank you for having us on. 

Melanie Avalon:
I've been really looking forward to this for a really long time. For listeners who aren't familiar, to start things off, I'd love to get listeners a little bit familiar with you, your personal histories and what brought you to where you are today and what brought you to collaborate together on this book. So William, I don't know if you'd like to start. William has a really fascinating career trajectory, so I'm really excited for listeners to hear about that. Would you like to tell listeners a little bit about that, William?

William Shewfelt:
I would love to know what that career trajectory looks like! Basically, I guess how this all started off was: I've had quite a long just health and fitness journey that started when I was 13, really getting into the bodybuilding scene and getting into weights and from about 15 to 18 dealing with some severe acne which led me to a whole foods plant-based approach, which was effective for a period of time, until about three and a half years into that I was dealing with some severe hunger, lack of satiety, low mental and physical energy and a lot of gut issues with that.

William Shewfelt:
That kind of led to discovering keto, and about halfway into shooting this Power Rangers show that I had done, I basically stumbled upon Ted's work just through Twitter, and I asked Ted a few quick questions about how to implement some of this. I was just studying the stuff that I was learning from him. Once I implemented some of the protein to energy ratio concepts into the keto diet that I was doing at the time, that's when I really finally achieved the results that checked off all of the boxes for me, in regards to my health and fitness goals. 

William Shewfelt:
So from that point on, I would see people occasionally comment on Ted's Twitter, "Do you have a book coming out? Can you release a book?" Basically, this project kind of came from my own desire to read Ted's book. I basically wanted to see all of this compiled into one thing, so that's kind of what we worked together on to make happen, and now we're kind of looking to maybe getting this out to even more platforms and in different mediums. 

Melanie Avalon:
Yeah, it is so incredible. Listeners, if your ears perked up a little bit with the Power Ranger drop in there, William is well known as the red Power Ranger and the current Nickelodeon series for Power Rangers, right? Admittedly, I am not good with my Power Ranger knowledge.

William Shewfelt:
I don't blame you, I wouldn't expect you to watch it. It's now actually the season before last. They just recently filmed a new series with a whole new squad, so I'm basically old and washed up, but I'm right before the most recent season, yes.

Melanie Avalon:
Okay, wait, can I ask a really quick question? It's just super random. The Power Rangers, is it kind of like with all the other superheroes, where they're like Spider-Man or something, where there's always just like a new Spider-Man, even though it's still the same Spider-Man? The Power Rangers, are they the same Power Rangers, or are they supposed to be a new Power Ranger?

William Shewfelt:
It's basically a new team. The show is based off of a Japanese series, and what the American show does is it takes the themes from the Japanese series. The Japanese show every two seasons, so pretty much every two years, they will have a completely new theme. It might be based around ninjas or samurais or dragons or dinosaurs or whatever it happens to be. And they'll create a completely new storyline, new theme, new team, all that kind of stuff. The season that I had done, it was Ninja Steel, so it was kind of a ninja based season.

Melanie Avalon:
So the red Power Ranger, is it a new Power Ranger? Not like Spider-Man, where it's the same Spider-Man, but played by a new person. 

William Shewfelt:
It's a completely new character. Each of the different colors, though, they always tend to represent similar roles. But yes, it's a completely new character each two seasons. 

Melanie Avalon:
Okay, I just learned so much, and I learned it straight from the source, so this is a good moment! All right. Speaking back to what you're talking about, it's so wonderful that you had this interest and you found this diet that worked for you, and then that you were following the work of Dr. Naiman and that you got to collaborate. I mean, way to make things manifest, that's amazing. Dr. Naiman, would you like to tell listeners a little bit about your history and what brought you to where you are today? 

Dr. Ted Naiman:
Oh, sure, yeah. I'm a primary care doctor, and as of this year, I've been in practice for 20 years, which makes me super old, basically just as old as hell. I've been interested in diet and exercise for a really long time. I kind of started it out actually plant-based and vegetarian, I was raised vegetarian. I went to Loma Linda University, which is this famous vegetarian mecca. But after interacting with patients and seeing the sorts of dietary changes that could improve health, I experimented with a lot of other types of diets, and I did a ton of research, and ended up realizing that making it all about plants or animals is a really false dichotomy. It's just kind of a smokescreen, and really just muddies the waters for everyone. Everyone ends up wondering what the heck they're supposed to eat.

Dr. Ted Naiman:
So I've spent a lot of time trying to figure out what is it exactly that drives health when it comes to diet. And what I tried to do with this book is just codify sort of a universal theory of diet and why all of these diets can be beneficial, paleo and low carb and low fat and plant-based and all of this sort of stuff.

Melanie Avalon:
That's actually very appropriate. I did not know that, Dr. Naiman, about your history at Loma Linda and your experience with a plant-based diet. That's actually probably really fortunate for you now with this whole positing this theory of the role of protein and nutrition, since oftentimes the plant-based idea and especially the works of the vegetarian findings of longevity at Loma Linda; there's this idea of minimizing protein for health and wellness. I don't want to put words in your mouth, but it's probably nice that you do have that background, so people can't say that you haven't seen both sides of the coin.

Dr. Ted Naiman:
This is true. I'm kind of a double threat to the plant-based world, honestly, because of my extensive experience in study and personal and professional experience with plant-based diets.

Melanie Avalon:
That's probably the worst. They're like, "Oh, no, he's been there! Oh, no!" I just love it so much you're talking about it's not plant versus animal. I just lit up when you said that, because I think we get into these dietary dogma wars that do a disservice to nobody, because they think the answer is either no animal products, all animal products, no plant products, all plant products, when really it might be more complicated than that and have to do with a lot of things in the actual animal plant products themselves, how the body is reacting to them. So I thought, to start things off, something that you talk about when you start off your book, is: you talk about how solar energy actually is stored in plants and animals and the implications of that and how that ultimately translates to our bodies when we eat those. So would you guys like to talk a little bit about that, what that actually looks like on a scientific level? 

Dr. Ted Naiman:
Oh, I would love to talk about that. The reality is every single bit of dietary energy we ever consume comes directly from the sun, and plants store every bit of this solar energy as dietary chemical energy. They do that using air and water, they're using carbon dioxide and water, and these, the carbons and hydrogens and oxygens from carbon dioxide in the air and water to store solar energy as chemical energy. They do that with little chloroplast doohickeys in their cells, which are kind of like the mitochondrion that humans have in their cells. In fact, the chloroplast and plants and the mitochondria and humans are very analogous.

Dr. Ted Naiman:
So the plant is taking solar energy, air and water and converting it to chemical energy, which is basically carbs or fats, carbohydrates or hydrocarbons. And then animals eat the hydrocarbons or carbohydrates, and we strip off the hydrogens in our mitochondria using oxygen and convert it to carbon dioxide and water, which we exhale. So it's this really cool circle of energy going from the sun to plants to animals and using carbon dioxide and water, super fascinating, very cool. I am constantly amazed at how the system works.

Melanie Avalon:
Yeah, I love that. And then you also talked about in the book, even beyond that the energy. And we again die, there's this decomposition and return to the soil. So it really is this whole circle of life with energy. It's really, really fascinating.

Dr. Ted Naiman:
Right, right. All of this nitrogen is basically drawn up from topsoil by plants and incorporated into their bodies. And then, animals eat the plants and use the nitrogen. And then, when the animals die or anything dies is decomposed by bacteria back into the topsoil. So you have this nitrogen cycle. And then, you have the carbon cycle, where animals breathe out carbon dioxide, plants breathe in the carbon dioxide and give off oxygen. So the carbon is cycling back and forth between plants and animals, and the nitrogen is also. It's just a really, really cool circle of life. But plants and animals are intimately interdependent on each other, and it's plants that end up making all of our food.

Melanie Avalon:
So ultimately, maybe instead of thinking about things and plants and animals, we should be thinking about carbon and nitrogen?

Dr. Ted Naiman:
Exactly. Thank you.

Melanie Avalon:
Wow. I do have a question while we are talking about the plant versus animal debate, as it were. So the energy potential of this carbon and nitrogen, when it's found in the form of plants, compared to when it moves up the food chain into animals, what are the implications of that for us eating them? The energy that we extract from this carbon, when we get it from plants, compared to when we get it from animals, is there a difference, or how does that affect things?

Dr. Ted Naiman:
There's a couple major differences. Number one, plants tend to store most of their extra energy as carbohydrates. Plants can make carbohydrates or fats, obviously, because you have avocados and nuts and all these foods that have a bunch of fat in them. But plants tend to store the majority of their extra energy as carbs. And animals tend to overwhelmingly store the majority of their extra energy as fat. We have very little carbohydrate stories in our bodies. So you kind of get this automatic skew, where the plant-based people think eating carbs is good and eating fats are bad, because plants overwhelmingly store their energy as carbs and not as fat. And then, the animal-based people overwhelmingly prefer eating fat and not carbohydrate, because animal foods are going to have mostly fat and very little carbohydrates in them. But kind of once again, that's a little bit of a false dichotomy. 

Dr. Ted Naiman:
The other major difference between plants and animals is that when you look at things that are coming up from the soil, like nitrogen, which is absorbed in mineral form and other minerals, they are dramatically more concentrated in animals than they are in plants. A plant sucks up nitrogen and minerals from the soil, but it's limited as to how far its roots can reach. But an animal, like your cow, comes along and eats you know, 100,000 blades of grass, and it's going to bioaccumulate the protein in nitrogen and minerals, so it's going to have a much higher density of nitrogen and minerals, these micronutrients than plants do, which is why animal foods always have more protein, higher quality protein, more complete protein, more bioavailable protein and minerals. Then, plant foods, they're at a higher trophic level, they're one rung up on the food ladder, and they're just biomagnifying or concentrating all of these micronutrients.

Melanie Avalon:
Speaking to that, I think people are pretty open to the idea that we can get more protein potentially from animals than plants. But I think people's ears might perk up when they hear that minerals are actually higher up in animals, because I think when people think minerals they think plants, at least I do! So what are examples of these minerals, and how are they found in animals as well?

Dr. Ted Naiman:
Really good examples are calcium, which is always going to be higher and animal food than plant food, or zinc, which is an extremely common deficiency in people on a plant-based diet, that you'll always see much higher concentrations of zinc in an animal food than a plant food. There's about a dozen minerals that you have to get in your diet that are much higher in animal foods than in plant foods. Now, there are some minerals in plant foods. In fact, plants have a fair amount of magnesium in them, because the chlorophyll molecule is centered around magnesium, just like the hemoglobin molecule in animals is centered around iron. So you'll get more iron in animal foods, and you'll get a fair amount of magnesium in plant foods. 

Dr. Ted Naiman:
But other than that, all of your minerals are really going to be higher in your animal foods than they are going to be in your plant food. It's kind of like mercury in ocean fish: as you go up the food chain, you get higher and higher amounts of mercury. Now, in this case, mercury is kind of bad, but you see this same biomagnification or accumulation automatically happening, as you go up the food chain in the plants versus animal, as well.

Melanie Avalon:
This is a super random question, but I've often heard the argument, and I'm not trying to create dietary wars or anything, but I have heard plant power-based people make the argument that in a way animal products are more processed. There's this ongoing debate about getting energy directly from plants or getting it from animals and that animals are somehow processing the plants. So it's like having a processed form of energy. Do either of you have any thoughts on that, or have you heard this before?

Dr. Ted Naiman:
I think that makes sense, and that's totally true. A really good example of that is an adult male gorilla, who has just as much muscle as a human, but literally spends 16 hours a day chewing plant matter and eats 60 pounds of food. The plant-based people are like, "You can be just a strong, look at a rhino, look at a gorilla." And it's true, the gorilla has 300 pounds of muscle, and it absolutely does not need to get protein from any other source. But it's literally eating 60 pounds of vegetation a day, and it's literally chewing 16 hours out of its day, compared with my pit bull, eats twice a day, and she eats for about 30 seconds each time. It's like a can of solid meat twice a day, and she eats it in 30 seconds. She spends probably less than one minute of the day eating, and that's all she has to eat. It's incredibly efficient. I'm sure you could call that outsourcing the processing to animals. I'm going to submit that maybe that's better, I certainly would prefer that. 

William Shewfelt:
Yeah, I think processing has a negative connotation to it. And I think in this case, with the animal foods, it's actually a positive thing that's happening. You are getting a much higher nutrient density with, let's say, a pound of steak. The amount of food that I would be eating when I was plant-based, just the sheer volume of food, it would take so much time out of the day, and there was a lot of, I think, digestive work that went into that, I could definitely feel that. Yeah, I could definitely agree with what Ted's saying there, eating takes a lot less time for me now that a lot of those nutrients are more concentrated and processed through the animals.

Melanie Avalon:
I think we have this whole really negative idea with processing, thanks to the conventional process food, but I'm not so sure that that argument extends to the form, the natural processed form of food that we might get in an animal product. So going back to protein, again, this is one reason that I loved reading the science, and this book is ... For me, personally, I have always been a proponent of, well, I say, "Always," always ever since I started understanding the implications of diet and how it affects your health, high protein has really resonated with me. It's always worked for me. When I go lower protein, I just don't feel right. I'll read these books, because there's so much out there now about trying to posit low protein diets for longevity. So on the occasion that I try going a little bit lower protein, I'm just like, "I need my protein."

Melanie Avalon:
So protein: you guys talk about in The P:E Diet that a lot of the health problems that we have today, even the obesity epidemic might actually involve a lack of protein. So would you like to talk a little bit about that? What role is protein playing, and why is it so necessary, and why are we potentially not getting enough of it today?

Dr. Ted Naiman:
A lot of my research and work for this book was based on the protein leverage hypothesis. We have a lot of studies that showed that most animals will eat until they get a certain amount of protein. And we have studies in humans that suggest that the amount of non-protein energy you eat goes up in an inversely proportional way to the percentage of protein in your food. In other words, let's say you need 150 grams of protein a day for satiety, but you're eating French fries, which are 6% protein, potatoes and oil, you have to massively overeat carbs and fats from French fries to get enough protein to not be hungry. And that's protein leverage. So the theory is that we've diluted the protein in our diets with all the carbs and fats that are cheap and ubiquitous, and then people have to overeat non-protein energy in order to get enough protein to not be hungry.

Melanie Avalon:
All right, so there's this idea that we might have this hunger that we can't fill until we get enough protein from our food. What are your thoughts on the amount of protein a person does need per day? I know there's the conventional ranges put out there by the government, but I don't know if you guys subscribe to that. Do you think it's actually more than that? What do you think is the amount of protein somebody should be shooting for per day?

Dr. Ted Naiman:
The RDA is established as a very, very, very bare minimum that you have to just squeak over in order to not have a frank full blown deficiency. So a lot of adults will have an RDA of maybe 60 grams of protein. But again, that's just the minimum you have to eat to not get sick. And in my opinion, optimum is much higher than the RDA. In fact, if you're worried about satiety, and if you're trying to avoid ingesting too much energy, you really want to leverage protein for satiety. And yes, you're eating more protein than you absolutely need to survive, but I do think that's optimal from a satiety standpoint, especially since 90% of Americans are metabolically unhealthy from overeating energy. So I think one of the best ways to avoid that is to just crank up the protein percentage of your diet.

Melanie Avalon:
Yeah, and then speaking to satiety, this is something else I really want to jump into, so I'm glad you touched on that. Going back a little bit, you were talking about, for example, the difference between low carb diets, low fat diets and all of the debate surrounding that, when really protein might be a common factor here. How do these different diets potentially affect society both in the long term, the short term? Because something that I found fascinating, especially things like carbs, for example, because on the one hand, people go on low carb diets, and their hunger goes away. It's like they finally feel free from food. And then, there are people who never quite feel full unless they have carbs in their meals. It seems that with some people having carbs makes them want to eat carbs constantly, whereas others, it's just about finding the right amount of carbs to feel full. So how do the various macronutrients affect satiety in the short term and long term, protein, carbs and fat?

Dr. Ted Naiman:
I think there's a couple different phenomena going on there. First of all, I think that most people legitimately are eating until they get enough protein to not be hungry. And then, if you reduce either the carbs or the fats in your diet, you're going to be significantly increasing the protein percentage, so you literally just don't have to eat as much to get the same quantity protein. If I go very low carb or very low fat, my protein percentage just jumped up quite a bit, so I'm going to have to eat less to get protein satiety.

Dr. Ted Naiman:
I think that, in the case of carbohydrate, there's one other little feature there, and that's that when you eat carbohydrate, your blood sugar goes up and then falls back down again gradually. Some people feel this glucose excursion, they feel their blood sugar falling, and it makes them hungry again, way sooner than they would have been otherwise. So it's like you eat just your dry toast and juice for breakfast, and then three or four hours later, you just feel this low blood sugar and you're eating again. And you might be just as hungry as if you hadn't eaten any breakfast at all. So there's this falling glucose aspect to carbohydrate that I also think makes people eat more frequently. And your average American's eating eight times a day in a 16-hour window and 300 grams of carbs. We're literally eating carbs every few hours.

Dr. Ted Naiman:
I think that when people radically reduce the carbohydrate amount in their diet or carbohydrate frequency, they start getting more immune to this falling blood sugar phenomenon that makes that many people hungry all the time. So that's kind of like a separate facet of all of this, you've got your protein leverage where you're eating to get enough protein and minerals, and then you've also got this falling glucose thing that makes some people carbohydrate dependent. And if you just go low carb for a period of time and get "fat adapted," you're sort of immune to that and you're not subjected to that, so you don't have to eat quite as often, which I think is kind of separate and also helpful, if you know what I mean.

Melanie Avalon:
I'm so excited, because I do have some follow up questions, because I've had some questions that have been haunting me about all of this, especially the role of protein and satiety health, so super excited to get your opinion. Okay, so with the protein, I have heard it posited that carbohydrates are actually protein sparing or that when you add in carbohydrates you actually need less protein. Do you have thoughts on that?

Dr. Ted Naiman:
It's absolutely true that carbohydrates are protein sparing, in that if you're on a very low carbohydrate diet, you're going to be utilizing more protein for gluconeogenesis to make glucose. So you're constantly making glucose. Let's say I'm doing a bunch of high-intensity exercise that requires a lot of glucose. If I eat no carbs at all, I will use more protein to make more glucose. And if I was eating carbs, I would spare that protein. You will see bodybuilders, for example, getting by with lower protein intakes, if they're eating carbohydrate. Those two can almost be interchangeable, in terms of manufacturing the glucose that you need, either just to be alive and running your metabolism or to do high intensity exercise. So it's absolutely true that carbohydrate is protein sparing. And that's really why you better be eating either protein or carbs if you don't want to break down your lean mass.

Melanie Avalon:
Okay, now you just brought up my obsession that I have questions about, which is gluconeogenesis. I have ... it's mostly a love relationship, but it's slightly love/hate, because I have some uncertainties about it, because I personally have struggled with gut issues in the past and currently, microbiome issues, bloating, things like that. And I found that having a high protein diet with less fermentable fruit and produce really allows me to keep that managed. I do think I'm relying on that gluconeogenic pathway to create carbs from protein.

Melanie Avalon:
Do you think, kind of like ketosis, there's this idea that gluconeogenesis is not the natural state that our body is meant to be in ... There's this idea that it's a stressful state or it's only activated in emergencies, so in this case it would be not enough carbs. So we're having to turn to protein, kind of like there's the idea that ketosis is an emergency state, because there's, well, same - the carbs. But what are your thoughts on that? Gluconeogenesis, is it stressful for the body for the liver to undergo that process and create carbs from protein, or is it totally fine and it's just another pathway that most people aren't using as much?

Dr. Ted Naiman:
I think what a lot of people don't realize, what almost no one realizes is that your liver is constantly manufacturing enough glucose to keep you alive at all times, no matter what you eat. In the background, there's this low amount of gluconeogenesis that's constantly occurring. Your liver is constantly manufacturing all the glucose that you need, and it has to do this, because the liver is responsible for making sure your glucose level is perfect at all times. Your liver doesn't know if you're going to stop eating for the next two months. If you're not going to get food for weeks, it has no idea what's going to happen. So it's just steadily making glucose. When you eat carbohydrates and have exogenous glucose coming in, that just raises your blood sugar on top of the level that the liver's already making and stores glycogen in the liver on top of what you're already making. 

Dr. Ted Naiman:
So no, the gluconeogenesis process is not stressful. The time where it might start to be stressful is if you're doing huge volumes of highly glycolytic high intensity exercise. If you're doing exercise higher than 80% of your maximum output, you're burning a ton of glucose. And if you never eat any carbohydrates, yes, you will spend more time manufacturing more glucose in your liver to try to replenish that glycogen. In fact, if you're doing more than about two hours of extremely high intensity activity a day and eating no carbohydrates at all, that's probably going to be additional stress, trying to manufacture the glucose to make up for that. That will probably reduce your performance and make you more "overtrained." If you're not doing high intensity exercise in large volumes, no, it's not stressful at all to completely rely on gluconeogenesis for all of your glucose. If you're running a competitive marathon every day, okay, it's starting to be an issue. 

William Shewfelt:
Just something I want to pitch in about that: In periods of time where I've been in more intense states of training, let's say I'm training daily or twice a day, one thing I've noticed really, really helpful is with the inclusion of, let's say, a cup of white rice or potatoes at night, I would actually drop water weight, so I would notice in my face or in my abs, my muscles would actually fill out, so my muscle glycogen stores would fill out a bit. 

William Shewfelt:
But I think something about including that bit of carbohydrates to support the training would actually ... I don't know if it would decrease my cortisol or what, but I would lose a lot of water weight, sort of just that level of water right on top of the muscles, and I would have fuller muscles, which is kind of a trick that a lot of bodybuilders use. That's something that I've noticed is helpful when training stress goes up to not add that additional stressor of you've got fasting and then you've got no carbs coming in and you're training extremely hard. That's something that I've kind of played around with and found helpful.

Melanie Avalon:
That's absolutely fascinating, and I think there's something really there with the whole waterway. It's so interesting, because I think people, especially if they've been low carb for a while, they might anticipate that adding in carbs will create all of this water weight gain, but it's really interesting to know that you experienced the opposite; despite the muscle glycogen filling up, there just seems to be potentially this water weight drop. Dr. Naiman, do you think that would be something that would be involved with cortisol? I mean, that was my initial thought.

Dr. Ted Naiman:
Yes. Typically, if you're eating no carbohydrate and doing a lot of high intensity exercise, your resting heart rate will literally go up and your sympathetic nervous system tone will literally be higher; you might have higher cortisol, you might have higher epinephrine, norepinephrine, you will be literally more stressed out. We do see that eating some carbohydrate there will lower sympathetic nervous tone, so there's absolutely something to that. And there's definitely absolutely something to the fluid manipulation of eating carbs and glycogen, and that's why every bodybuilder in their peak week, the day before a show, they're going to eat you hundreds of grams of carbs and do this super compensation trick, where you fill your muscles with glycogen, and then if you don't drink a bunch of water you'll actually suck some water out from underneath your skin into your muscles with that glycogen storage, and that's how they get this sort of dry peeled bodybuilder look. So that's all totally valid, yep.

Melanie Avalon:
While we're still in the carbs and fat world, assuming that we have this paradigm that we're looking at, where we have protein as the central anchor, as a will to focus on, and then there's the potential, at least, for metabolic health, it seems to be either lower carb or lower fat. What are your thoughts on that? Why should one potentially gravitate to one or the other, compared to having carbs, fats and protein in a higher amount, like in a high carb, high fat?

Dr. Ted Naiman:
I think there's two big reasons. First of all, by either cutting down carbs or fats, your protein percentage is higher and you're just literally going to eat less, and that's definitely evidence based. We have studies that completely suggest that this happens in pretty much all animals. If you eat a higher protein percentage, you're not going to eat as much, so going lower and carbs or fats is going to be an instant win. 

Dr. Ted Naiman:
The other factor is that the combination of carbs and fats together is extremely rewarding, let's put it that way. If you ask people what foods are problematic for you, what are you addicted to, what do you overeat, what is it that you're craving, all of these foods are high energy density, carbs and fats together, your doughnuts, your pizza, your cupcakes, your candy bars, all of your addictive and overeating and hedonic and dopamine releasing foods are these high energy density carbs and fats together, and it's when you combine these carbs and fats that you're going to eat more. If we just give you plain boiled potatoes, you're gonna eat two of them and you're done eating for the rest of your life. But if we put a bunch of sour cream and butter on there and some bacon and some cheese, you're going to eat the hell out of that. 

Dr. Ted Naiman:
So when you're eating liberal amounts of carbs and fats together, you're definitely going to eat more, just from a hedonic point of view. So it's like there's this push and pull to eating too much. On one side, pushing, overeating, you've got dilution of protein and minerals in your food, so you have to overeat the French tries to get enough protein and minerals to not be hungry. But on the pull side, you've got the combination of higher energy density carbs and fats together, that's really tasty and hedonic and releases dopamine, and I'm going to say is basically addictive, so you're going to overeat the French fries, because you want to eat more. So it's like people are overeating, because either they need to eat more, protein dilution, or they want to eat more carbs and fats together. And both the sides of this coin have the same thing in common, and that's carbs and fats together.

Melanie Avalon:
Okay, here is a thought experiment, and I just am curious to know your thoughts: Say we could have a situation, like it was very controlled, it was enforced, so we didn't have to worry about the overeating aspect, eating a high carb, high fat meal, but perhaps calorie restricted or at maintenance level, compared to maybe eating more calories, but eating low carb or low fat. For metabolic health in a person, and I know there's like a very vague experiment, but for metabolic health do you think there's a difference there, as far as how people respond to those macronutrients?

Dr. Ted Naiman:
No, not at all. I think if you fix the calories, it's all going to be exactly the same. If you lock people up in a metabolic ward and give them higher protein, lower protein, higher fat, lower fat, higher carbs, lower carbs, they're going to all have the same response metabolically. And that's why you hear all these people saying it's all about calories, because it is absolutely all about calories. The problem is: fixing calories is the most artificial, stupid thing in the entire universe, because nobody ever does that. And the whole world is just one giant ad-lib diet experiment, where people eat as much as they want and nobody fixes any calories, and they're not going to and they never will. So it's absolutely ridiculous to artificially constrain calories.

Dr. Ted Naiman:
I mean, if I had one really high protein, low carb and low fat group with fixed calories in this metabolic ward of your thought experiment, if I gave you just basically a smoked salmon omelet and a salad, so the carbs and the fats were both pretty low, and then I gave somebody else just like eight Pop-Tarts or something, where the protein's very low and the carbs the fats are high, but the calories are the same, what we're not going to see is how hungry the low protein high carb and fat together people are three or four hours down the road, that's what we're not going to be capturing. Metabolically they're going to be exactly the same, and that's why we have so many people saying it's all about calories, calories are absolute. I totally agree with that. I think it is all about calories, if you artificially constrain that; I also think that's completely worthless in the real world.

Melanie Avalon:
Yeah, my only follow-up thought there is: I can see how you know high carb high fat, at least calorie restricted meal, that is controlled, and in our thought experiment of our metabolic ward might not create the metabolic problems, but I do wonder, especially for those who have markers of insulin resistance or just metabolic issues, if there's something about having the carbs and fat fuel together that creates ... is it just processed as easily by the body and so can create this excess fuel buildup, even at lower calorie states? It's just something that I think about a lot, the metabolic efficiency that you can get on a low carb or a low fat diet compared to when you have these substrates together. I mean, for some people, if they're great at processing all the things all the time, maybe it's fine, but then I feel like some people really just don't respond well to, even if it's calorie restricted, that combination.

Dr. Ted Naiman:
I do think you're right. We have this Randle cycle, where you're basically either burning carbs or burning fat. And if you try to overload yourself with both at the same time, with metabolic oversupply of both carbs and fats together, that's extremely bad, that will literally break your mitochondria. We see mitochondria that are presented with metabolic oversupply of carbs and fats together, they will undergo fission where they split up into tiny little mitochondria, and they're trying to be less efficient so they can waste more food energy, because there's too much. You can literally kill your mitochondria, or typically that leads to apoptosis, where your cell dies as well.

Dr. Ted Naiman:
But metabolic oversupply is a huge disaster for your mitochondria, and that's probably what's driving a lot of the horrible downstream complications of all cardio metabolic disease, like type two diabetes and Alzheimer's and atherosclerosis and all of this stuff. Everyone who's obese, everyone who's pre-diabetic, everyone who's diabetic, they all have one thing in common: they have smaller mitochondria, they have fewer mitochondria, they have lower mitochondrial function. Mitochondria is the only way fat is leaving your body. The only place that fat is burned is in your mitochondria. And you'll break those suckers if you chronically have metabolic oversupply, and that is typically resulting from too much carbs and fats, like you pointed out. So yes, I think there's probably an advantage going either very low carb or very low fat. And if you're smart, you do both and eat a bunch of protein.

Melanie Avalon:
Is there still that danger in the low carb or low fat state? I know, because you're just speaking about excess energy and then the potential to really mess up your mitochondria. For example, say you're on a low carb diet and you're hardcore, like high supplementing with something like MCT oil. Could there be the potential there for your mitochondria to break from just too much... and there be no carbs, but too much energy from the MCT?

Dr. Ted Naiman:
There really could. And actually, this is one of the reasons why I'm super down on on exogenous ketones. I apologize if your show's sponsored by exogenous ketones or something, I don't think it is, but honestly, if you have metabolic oversupply where there's too much carbs, you've got too much fat in your fat cells, you've got too much triglycerides in your bloodstream, all of your cells are refusing this energy, you've got too much intramuscular triglycerides and you've got too much energy everywhere, the exogenous ketones are basically trying to go to the front of the line. And you might be forced to oxidize those, your mitochondria, even though they've got way too much of everything else hanging around. 

Dr. Ted Naiman:
And the same thing might be true of MCTs. Some of these things can enter your mitochondria without the transport that a long chain fatty acid might need. I think that actually might make your problem worse. So I'm really down on giving exogenous ketones to anyone who's overweight, like if you're trying to treat their Alzheimer's or something like that. I think you might be giving them an alternate fuel that their brain can use transiently, but actually worsening their underlying disease and worsening the metabolic oversupply to their mitochondria, which is the fundamental problem that's broken. So yeah, I think that's actually bad. I'm not a big fan of MCT oil or exogenous ketones, because 90% of everybody in the country has some amount of metabolic syndrome from basically too much energy in their body.

Melanie Avalon:
Okay, that is so fascinating. The reason I've been thinking about that more is: I've been experimenting with a lower carb diet, especially for my gut issues and things like that. And I found that MCTs actually work well for my gut, and I could take in a lot of calories that way, but I started getting, and this is just completely N of 1, but I started getting so hot, and I was like, "Am I just killing my mitochondria?" I just had this intuitive feeling that I was just creating all of this excess energy. I mean, this is just me, but I'm like, I don't know how it's being processed, I don't know what it's doing. So I'm just really fascinated by the potential of what might be happening there.

Melanie Avalon:
Another question while we're still in the carbon/fat world: We're talking a lot about how low carb and low fat are both potential routes to go to support metabolic health. Why do people so easily gravitate towards the low carb? Does low fat work for some people, or is it just a matter of finding what works for you? I feel like there's just this whole world that is very hardcore low carb. But if you have high protein, low fat, do you think that's a way that you can go as well?

Dr. Ted Naiman:
In the metabolic ward studies, if protein is matched and calories are matched, you get identical response to either low carb or low fat: everyone loses weight, everyone lowers fasting insulin, everyone improves parameters. They're pretty much identical. What I think you're not capturing there is how hungry people are or how they feel or how often they feel like they need to eat. I think if you're starting out too fat, if there's too much fat in your body and all of this fat has to be burned in your mitochondria for it to leave, and you're eating carbs all the time, you basically never really rang your metabolism off the stored body fat or rarely or not as often as you should. And you're kind of tied to these carbs, and you feel all these excursions in your blood sugar, and you're hungrier more often.

Dr. Ted Naiman:
That's why I think anybody who's overweight is probably going to benefit from carbohydrate restriction, so they can get better at burning fat. That's a skill they need. They need to get better at running their whole metabolism without carbs and exogenous glucose. They need to get better at fat oxidation. That's why I highly recommend carb restriction frontline for anyone who's already overweight.

Dr. Ted Naiman:
Now, if you're starting out thin, let's face it, if you're thin in today's food environment, you don't suffer from carbohydrate issues, and you could go with a very high carb, low fat diet, I think that's totally fine. Anyone who's thin right now, effortlessly thin in our food environment is probably going to be fine with a low fat high carb diet. But if you're already overweight, you should really go the other way around. What you want to do is get better at fat oxidation. So you're going to want to restrict carbohydrates. And in both settings, I recommend that protein be the dominant macro nutrient, of course. Protein always has to be the highest, but you could go low carb or low fat and get results. 

William Shewfelt:
Yeah, Ted was just mentioning with the metabolic ward studies, during the three years when I was doing a plant-based diet, I honed in on doing a high protein low fat approach. And I was less satiated doing that, eating around 3000 calories a day, than I am now doing a high protein low carb approach, eating 2200 to 2400 calories a day. So I'm more satiated on fewer calories with that. So I think that's definitely one of the things that doesn't get factored into those studies, the way that people feel from the fuel source.

Melanie Avalon:
And how long did it take, William, for you to, when you did make that switch from more plant-based to the lower carb approach? I'm trying to remember when I interviewed you last time, your actual story surrounding that. How long did it take for you to see changes in your digestion, your energy levels, your fatigue? How was that adaptation process for you?

William Shewfelt:
In terms of energy levels and fatigue, my energy started increasing after about two to three weeks. I definitely felt some immediate benefits just from finally including salt, electrolytes, red meat, all the B vitamins, so I definitely felt some immediate benefits to it. But, in terms of getting greater satiety off of fewer calories, that really kicked in after about six months, because I had continuously been trying to force fasting into the routine or force different styles of training just to try to lose the extra last few percentage of body fat. So I was really trying to force the process. 

William Shewfelt:
But essentially, when I finally allowed my body to get accustomed to a higher protein, lower carb approach, and I really nailed in the protein to energy ratio with that, it honestly took me about a good six months. And then, I started getting down into pretty low levels of body fat and a very moderate training routine, and having great appetite on that, being able to fast effortlessly, when I would eat I would eat to satiety and I would be satiated at honestly pretty low calories. So that particular aspect of it did take a while. I think you can probably use P:E Diet principles to get lean in a short amount of time, but to really have your appetite stabilized and to have that satiety stabilize over time, it can take a good few months to really let your body reset, maybe its set body weight, set point and get that homeostasis back.

Melanie Avalon:
Yeah, you brought up so many good things there. One of the things I do wonder so much, I don't know if we know this, but I do wonder how long it takes for our actual cells to switch. We always use this word "Metabolically flexible," but how fast does that process actually occur from them processing different fuel substrates? And then, I wonder if there's some sort of metabolic memory in the mitochondria? If you've been low carb in the past and then you bring back carbs, will it be easier the second time around to start processing, to switch back to low carb? I don't know if we know this, I don't know if it has to do with genetics or even epigenetics within the mitochondria. I don't know if you guys have thoughts on that.

Dr. Ted Naiman:
Oh no, that's definitely true. There's an inertia to your metabolism. There is a sort of a hysteresis in the mitochondria, where you'll up-regulate the oxidation pathway for either beta oxidation of long chain fatty acids or burning carbs. So you basically up-regulate the pathway it takes to burn one thing or the other, and you get better at it. And then, it takes a little bit of time to switch over, and that's usually like a week or two. 

Dr. Ted Naiman:
But I think when you're trying to do something athletic at really high intensities, using one path over the other, that might take months to optimize, just because there are so many different layers to fat adaptation with exercise, you've got lipolysis, and you've got to break down the fats, mobilize the fats, shuttle the fats into your mitochondria, and there's so many things that you have to up-regulate there. That could take, like William said, six months to get to the point where you can do the same athletic endeavors in maybe a low carb state. But yeah, there's absolutely this inertia to your metabolism. It's like if you had a factory that just makes cars, and you tune it all up for making cars, but now you switch to making trucks; it's going to take you some time to switch over and change all your equipment, and once you have it all switched over and changed, then you get really good at making trucks. You know what I mean? There's this little bit of inertia to it.

William Shewfelt:
Yes. In terms of an example of what Ted was saying, I've trained with Robert Sikes, who's a ketogenic bodybuilder, who has been doing the diet now, it might be three or four years, hasn't cheated a day on it. I mean, he's about as strict as you can get. And he's able to train very intensely for about two hours per session at a very, very high level about five to six days a week on a completely fat based metabolism. Training with him and seeing him doing that, it's very, very impressive. But one of the things that he told me was that took a lot of time for him to develop that ability, and it really does kind of take not cheating on the diet. I think the more you cheat on it, you might shortcut some of the adaptation process that's occurring. So to achieve that sort of a level of fat adaptation, it probably does take a level of commitment that people really have to stick to.

Melanie Avalon:
I am so glad you brought that up. Okay. In the short term, I think that's huge for a lot of people. I don't know, I shudder, because I think what a lot of people will do, especially with ketogenic diets, is they'll decide to try it, they'll go super high fat, low carb, super high fat, they won't stick it out long enough to really adapt, and then they'll crave carbs, so then they'll throw in some carbs while they're in this state that they've been in of really high fat, and I'm like, "Oh, then that's just like slamming your body in a way," without ever experiencing the potential benefits. I think that's quite possibly a potential issue for a lot of people. And then, I'm so glad both of you guys brought up that maybe it does take longer on the athletic side of things to make those adaptions, because there are a lot of studies showing the benefits of low carb diet.

Melanie Avalon:
And then, oftentimes, there will be studies showing, or seeming to show, that athletic performance isn't quite capable, the height, the same intensity. But I often wonder if it's just because the studies aren't long enough to let people actually ... their bodies just haven't reached that adaptation period yet, because it seems that anecdotally there are a lot of people, you guys both spoke of examples, where if you stick it out long enough, you can get back that high performance physical activity even on a lower carb diet. William, you're talking about, and both of you guys in this book, what is the protein energy, the P:E, what does that look like in foods? I mean, obviously listeners, get the book, because it's all there, but just like a brief preview of what that looks like.

Dr. Ted Naiman:
The P:E ratio is basically looking at grams of protein in the food versus grams of non-protein energy, which would be net carbs and fats. If people want a really good visual of what that looks like, I would go to the website, ptoer.com, like the letter P, TO, T-O, E-R, dot com. We have a little graphic there and a little slider calculator doohickey gizmo thing that just gives you this really great visual snapshot of what this looks like. Food that would be pure protein would be egg whites or whey powder, food that would be pure non-protein energy would be refined carb or refined fat, like sugar, flour and oil. And then you've got kind of this scale of higher protein foods, like lean meat and green vegetables, and then you've got lower protein foods like basically all of your grains, sugars and starches, your high fat foods and stuff like that.

Melanie Avalon:
Awesome. So for listeners, I will definitely put links to that in the show notes. And then again, it's all beautifully laid out, very easy to follow with great pictures in the actual book, so I definitely recommend checking that out. I have one more question sort of related to this before maybe we can tackle some exercise questions. Glycogen stores in the body, this is something I've been wondering because, I've been lower carb now for quite a while, but I actually intuitively kind of want to try getting back to a high protein lower fat approach. Does the glycogen storage potential in your body change when you've been low carb for a while? I know this is actually discussed a lot in the Ray Peat world. I don't know if you're familiar with his work, but there's this idea that-

Dr. Ted Naiman:
Yes.

Melanie Avalon:
Okay, I guess you are. This idea that you need to maximize your glycogen usage, your glycogen stores and that you actually have to work to build up those stores. Does our glycogen storage potential change when we change our diet? If I've been low carb for quite a while, is it going to be hard for me to bring back the carbs?

Dr. Ted Naiman:
In terms of glycogen storage, you can store about 100 grams in your liver, you can store average of maybe 300 grams in your muscle; that's pretty much it. If you don't eat carbs for about 24 hours, your liver glycogen just dwindles down to basically effectively zero or as low as it ever gets, and just stays there indefinitely until you eat carbs again. And the liver likes to stay empty of glycogen, because its job is to suck incoming glucose out of your bloodstream and then buffer it out slowly over a period of hours. It kind of protects you from high glucose.

Dr. Ted Naiman:
Muscles are different. Their job is to stay reasonably full of glycogen or at least have some glycogen in them for emergency use, because any time you're sprinting for your life or expanding 100% of your intensity in action, you have to burn 100% pure glucose from glycogen in the muscles themselves. So your liver likes to stay empty, your muscles like to stay fullish. If you just stop eating carbs, about 24 hours later, your liver glycogen is pretty much zero or as low as it ever gets, and you're making ketones as a result. But your muscle glycogen will stay wherever it was for a pretty long time, and it will never go all the way down to zero. You always keep some glycogen in your muscles.

Dr. Ted Naiman:
But then, if you go very, very low carb and then also do a bunch of high intensity exercise and deplete all the glycogen in your muscles, and you do this just total glycogen depletion with days of no carbs, tons of high intensity exercise, and then you eat a whole bunch of carbs, you get this super compensation, where you might shove 600 grams of glycogen into your muscles, so it will be the highest it ever, ever gets, because your body is like, "Wow, we don't get carbs very often, we want to hold on to it." And that's basically what every single competitive bodybuilder is doing the day before they get on stage. They'll do a glycogen depletion phase, where they eat no carbs and do a ton of high intensity exercise to suck every bit of glycogen out of their body. And then, they'll eat maybe 800 grams of carbs and try to just shove it all into their muscles, so they look really full the next day. 

Dr. Ted Naiman:
So you'll see this glycogen kind of going up or down, depending on the environment. If you just exist for weeks with no carbs at all, and you just sort of live in a low carb state, your muscle glycogen will hover at around about 30% of what it would be with this super maximum, super compensation mega carb load trick. You know what I'm saying? So you'll sort of stay at like 200 grams of glycogen in your muscles or something and you won't really go below that. Now, if you do high intensity exercise, in about an hour of high intensity exercise, you'll burn every single bit of that glycogen, and then you'll just slowly build it back up over the next 24 hours. But if you don't eat carbs, you'll stay at this kind of lower muscle glycogen state, maybe a third of what you your absolute maximum would be. So it's kind of weird, it's kind of complicated, depends on what's going on. But that's kind of the basic way the glycogen functions.

Melanie Avalon:
And does it matter, the source of those carbs? For example, more starchy glucose based, would that more likely refill the muscles, versus something like fruit, would that more likely refill liver glycogen?

Dr. Ted Naiman:
Yeah. Fructose has to be processed in your liver, and you're a little more likely to turn fructose into ... you have to store it as fat, and you have to convert it into uric acid, and metabolically it's just not as great, versus glucose, which every cell in your body can utilize. So glucose is probably better than fructose. But if you're a competitive athlete, you want to replenish your liver glycogen too, so you can dole out some more liver glycogen to your muscles as well with high intensity exercise, which happens. And that's why something like Gatorade is going to have some fructose and some glucose in it.

Melanie Avalon:
Yeah, where I'm coming from is: out of all the different dietary approaches I've fiddled with, the one that I think at least worked really well for me at the time was kind of bringing together a lot of these different ideas, but it was doing intermittent fasting, eating in the evening, high protein, lower fat, but actually high fruit, rather than other types of carbs. And what I found from that, and this is why I'm always researching this, because I just really want to know if this is what was happening, but intuitively what I felt was that I was mostly just filling up my liver each night rather than my muscles. And then, during the day, my liver was keeping my blood sugar level with the stores that it had, and then I was kind of filling up again at night. And while I was doing that, it seemed to work really well. I don't know if that's actually what was happening, but that's what I'm always trying to figure out: what was actually happening then? So I'm just really fascinated by all of it.

Dr. Ted Naiman:
It's tricky, because if you just did a ton of high intensity exercise and your muscle glycogen is really low, all the carbs you eat will literally just fall into your muscles down this concentration gradient, your muscles basically just suck up all the glucose in your bloodstream, even without much of an insulin spike. You're just so insulin sensitive and your muscles are so good at disposing of this glucose, if they're empty on glycogen, that it's almost like a free for all if you eat carbs right after an hour of super high intensity exercise. And muscle glycogen is a very high priority task for your body. So when you eat post workout carbs or you do the sort of carb backloading thing you're describing, a lot of that will go into muscle. But then, once the muscles are sort of full, not like completely full, but fullish, like medium, then the rest of your liver will absorb, and you'll have this liver glycogen that slowly drifts down over the next 16 hours or so.

Dr. Ted Naiman:
But I think that this glycogen flux is really good for health and metabolic sensitivity. So I love it when people are doing high intensity exercise for glycogen depletion, and then eating some carbohydrate and cycling this glycogen. I think that's a totally reasonable thing. So your approach of just eating carbs maybe once a day and backloading them is probably great.

Melanie Avalon:
Yeah, well, I'm so glad to hear you say that. It's like I'm sighing relief. I keep trying to get back to it, though my problem is I think, because I've been low carb for so long, every time I try to bring back the carbs, I get the massive sugar cravings, and I'm like, "No!" I think what I need to probably do is just stick it out, commit to that sort of pattern where I'm doing lower fat, higher carb in a backloading type pattern and just stick it out through those days of cravings. I imagine they might go away, but I think a good takeaway for people is that there are obviously a lot of different approaches that can work and feeling free to experiment. But at least my personal opinion, and I believe Dr. Naiman's and William's opinion is that protein is definitely something you probably should not fiddle too much with. How do you guys feel about the occasional low protein day for longevity or something like that? Do you think that might be viable?

Dr. Ted Naiman:
Personally, I think that everyone's worried about signaling mTOR and what this is going to mean for cancer or longevity. So insulin stimulates mTOR a lot and the very worst scenario is just being overfat all day long, all day, every day, you know what I mean? So if you're fatter than you should be, your insulin is just constantly elevated, your fasting insulin is high, your postprandial insulin is really high. You're just basically stimulating the hell out of mTOR, and your IGF-1 levels are high. All of this sort of decreased longevity and increased cancer risk is, in my opinion, mostly happening from this metabolic oversupply. So if you're super, super lean, and you're not eating constantly, and you don't have any metabolic oversupply, I don't think that going a day or two of not eating protein, I don't know that that's going to give you any additional health benefits.

Dr. Ted Naiman:
I think that your number one strategy should be as lean as possible for maximum insulin sensitivity and minimum metabolic oversupply. And I don't know that if you've already arrived there that, "Okay, I'm not going to eat protein for three days," and for some sort of magic autophagy or lower cancer risk, I don't have any evidence to suggest that that's really going to work.

Melanie Avalon:
Gotcha. I'm glad you brought up the role of lean. Focusing in on lean, the role of muscle, I think is something you discussed in your book, obviously so important, and which also can bring us into the topic of exercise and such. William, I'd love to hear your thoughts on some of this. So for exercise and training, something you guys talked about in the book is the role of adaptation and the need to basically keeping your body guessing when it comes to exercise. So why is that, and what does that look like practically?

William Shewfelt:
Yeah, what we're really targeting with that is basically ratcheting up the intensity in the shortest duration of time. So the SAID principle, where it's Specific Adaptation to Impose Demand is: your body is going to adapt to whatever demand you're imposing upon it. So if you're walking all day, you'll become a much better walker, but you're not necessarily going to have the sort of muscular adaptation that would allow you to fill up more glycogen that would help you dump glycogen during high intensity exercise. So what we kind of promote is: what is the best investment or what's the best return on your investment of time.

William Shewfelt:
And what we found that to be is basically following a higher intensity training protocol that you can do one set to failure, a full body workout daily, this can take 10 to 15 minutes, where you basically go from your head to your toes, so you're doing a pushing movement, a pulling movement, something for your core, so a hinging movement, as well as something for your back and a leg movement. And then, as far as cardio goes, rather than perhaps a 45 to 60 minute session on the elliptical, doing an all-out burst for maybe 30 seconds, whether it's jump roping or sprinting or jump squats, and then you could rest for another 30 seconds, and then hit another interval of that. So you're basically getting a much better bang for your buck, and the adaptation response that that's going to elicit is going to be so much greater than spending an hour and a half on a lot lower intensity exercise.

Melanie Avalon:
Okay, that was something I really loved about the exercise section of your book, because I know for me personally, and listeners probably know this about me, I'm not a big gym person, I tend to try to embrace my "exercise from life." So I'm just constantly like ... I actually wear weights around when I'm grocery shopping, and I'm always lifting things, and I like to do quick bursts of things when I can. But that said, the mentality of the exercise section of the book, even though I don't go to the gym, the concept really, really I feel applied to my life, and I think it applied to so many people, whether you're in the gym or not even in the gym, just this idea of keep doing these intense exercises briefly so that your body is not adapting, like I said.

Melanie Avalon:
I love how you talked about it. You talked about basically: when we hit our max intensity that our body consciously doesn't know what's happening. So it's like, "I have to adapt to this because this cannot happen again," it's like crisis mode for the body. And you can get stronger from that. I just really, really love that concept. And then, I will say, this book, actually was probably one of the first times that there was a gym exercise section in the book, and I was like, "I think I'm actually going to use this." So thank you, you got me sold.

Melanie Avalon:
So listeners, definitely check it out if you would like to maximize your exercise and maximum return on investment. That was something I loved: what does the time commitment look like? Is it spending hours and hours at the gym, or what does that look like? 

William Shewfelt:
I think Ted's got it down. With a busy schedule as a practitioner, I mean he keeps the super, super simple. I personally, just because I like the gym, what I do isn't efficient at all; I like to spend more time there. But Ted, how much time does it take you on a daily basis just getting a workout in?

Dr. Ted Naiman:
I basically never work out more than 15 minutes, and it's really just doing a set of a pushing move, like push-ups to failure, and then a couple rest-pause sets, pulling move, like pull-ups to failure, and then some sort of leg move like squats. And then, I also try to do a burst of cardio and that might be just jump squats or jumping rope or something like that. And yeah, it's definitely 15 minutes start to finish, and it's with ... I don't go to the gym, the only equipment I usually ever need is something to pull on, like a pull-up bar or a set of rings or a suspension trainer or something. I have to have something to pull on, but that could can be like a frigging tree branch or something.

Dr. Ted Naiman:
Not only is it just 15 minutes a day that I spend working out, but I will frequently break it up, and it will be interstitial to the rest of my day. I might spend three minutes in the playground doing pull-ups on the monkey bars or something. And then later, I'll spend three minutes doing this a couple sets to failure of a pushing exercise, like a push-up or a handstand push-up. So I could actually have these four little micro workouts of three minutes each scattered throughout my day. They could pretty much take place anywhere I'm at. So I've just really fragmented it up, and I've been experimenting with the minimum effective dose of exercise for a really long time. I'm trying to figure out what's the very smallest amount of exercise you need to get it done and the very least time and equipment and money.

Dr. Ted Naiman:
I'm just trying to be as minimalistic as possible, mostly because I want to convince my patients, "Hey, you don't need a bunch of crap to get an exercise. You don't need a gym membership and a trainer, bunch of crazy equipment and all this time and money and stuff. You could, wherever you're at right now, just drop to the floor and do a set of push-ups all the way to failure and beyond, as hard as you possibly can. The next day, you'll literally be stronger in a push direction and a push movement with your pushing chain muscles." People just don't understand how little it actually takes if the intensity is as high as you can possibly generate, and that's what this book is all about.

Melanie Avalon:
I love that so much. I think that's so wonderful. And then, I'm glad as well, William, that you brought up for you, you love going to the gym. So for you, there's the mental aspect to it, so it's something you enjoy, it's something that you love. You're not there because you're ... I mean, I don't know why you're there, but I didn't get the sense that you're there because you're dreading it and you're feeling like you have to commit to this certain amount of time. For you, it sounds like you really enjoy it. 

Melanie Avalon:
And I think I just would love for everybody to, because I think physical movement is just so important, supporting our muscles, so important, finding that movement that works in your life that you enjoy. And I think that's possible for literally every single person, because I think our bodies intuitively want to move, I think we just get stuck. Because of our modern society, the foods we're eating, our lifestyles, we get stuck in the state of being sedentary, and it's hard to start moving when you're not moving. But then once you're moving, it can feel good.

William Shewfelt:
I like what you were saying, Melanie, about simply exercising through life. Almost what we're describing is for the person that does not want to do any sort of physical activity throughout the day, or perhaps they're as sedentary as possible, like this is the minimum investment that you need to make to keep your body progressing and to keep yourself mobile, limber, healthy, getting stronger over time. Let's say it's somebody like you who has a very active lifestyle in general, you're getting that movement in throughout the day, you're not living a sedentary lifestyle. And for me, I'm not really sure why I'm at the gym that long either! To me, it's mainly a mental time, it's a great time to listen to music, it's a great time to focus on the body part that I'm working. Some guys work on cars, some guys have different hobbies. For me, it's always been like a fun passion project of building my body as a whole. And it's also just a great mental time, fun way to anchor my day in the morning.

Melanie Avalon:
Yeah, that is so wonderful. And it reminds me of, I'm paraphrasing, but it's one of the last things that you guys said in the book, and I was actually talking about this on the intermittent fasting podcast, I quoted you guys, because you said something about how for long term sustainability with diet lifestyle, that it'll only be sustainable if you enjoy the process that got you there. And I just thought that was so profound. I was like, "That is so true," because really, if you do enjoy the process that gets you there, there's very few reasons you would ever have to worry about stopping or rebounding or falling off the wagon. So I really, really love that so much. 

Melanie Avalon:
To wrap this all up, and it kind of fits really well, there is one question that I always have as the last question for every guest on this podcast, and it's just because I've realized how incredibly important mindset is when it comes to health and wellness. I just think it's so huge. So for both of you, what is something that you're grateful for?

Dr. Ted Naiman:
Oh, wow. The thing I'm most grateful for is my health. And honestly, having the job that I have, and seeing people who lose their health all day long, I've realized that health should be everyone's number one concern. And if you don't have your health, nothing else matters. I mean, your family, your possessions, everything else goes out the window if you lose your health, so your health should be everyone's number one concern, and it is definitely the single thing that I am the very most grateful for without question.

Melanie Avalon:
For you, William? It doesn't have to be the most, or it can be, it could be whatever you like.

William Shewfelt:
Ted's response is way more applicable to the podcast. But I would honestly say, this just came to my head, I tell them this every day: I'm very grateful for my parents, I think in terms of mindset. At the end of the book, we talk about how you have one trip through this life and you really want to make the most of it. And health is perhaps the primary domino. It's maybe the major pillar of allowing you to make the most of this one trip through life. But yeah, just having a good start in life has such a huge impact on your ability to continue moving forward.

William Shewfelt:
I think so many people are exposed to information about health and wellness and self-improvement and ways to improve their life, but perhaps because of limiting mindsets that they were given or adopted somehow through their adolescence and childhood, it stops them from ever implementing anything, maybe because they simply don't have the self-esteem or they don't believe in themselves. So I thank God and I think my parents every single day that they raised me the way they did and they were encouraging, supportive people. So I'd say that's what I'm very grateful for.

Melanie Avalon:
I love that so much. And I could talk about all this for another hour, so I will stop there. But thank you guys both so much. Thank you for the work that you're doing. Your book is just such a wonderful resource, and I think you really are bringing to light something that is so important, as far as protein, diet, health, exercise. And then, we just ended on the sustainability of it all and how to really implement it and really make changes. So I cannot thank you enough. 

Melanie Avalon:
For listeners, if you go to the show notes again, the show notes will be at melanieavalon.com/protein. There will be links there to the book, and we also have, thank you guys for this: you are offering our listeners 10% off of all primal body carnivore plans. Those are available at primalbody.co, so thank you so much for that. I'll put links to that in the show notes as well. But thank you, this has been absolutely wonderful, and I'm just really excited to follow the rest of your works, see where this all goes and hopefully, maybe, we can bring you guys back in the future for another episode.

Dr. Ted Naiman:
Oh, well, thanks so much for having us.

Melanie Avalon:
All right. Thank you. Bye.

William Shewfelt:
Thank you, Melanie. Bye.

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