August 15, 2024 • 54 mins
Take a dive deep into women's metabolic health with experts Lara Briden and Kira Sutherland. Uncover cutting-edge strategies to combat insulin resistance, pre-diabetes, and cardiovascular risks in women.
This episode explores the intricate connections between gut microbiome, hormonal balance, and mitochondrial function in optimising metabolic wellness. Gain insights into personalised nutrition, exercise protocols, and evidence-based supplementation for enhancing metabolic flexibility and overall health outcomes.
Episode highlights:
- Insulin resistance and pre-diabetes: Identifying key biomarkers
- Gut-brain axis: Impact on metabolic endotoxemia and inflammation
- Mitochondrial biogenesis: Exercise strategies for optimal function
- Hormonal influences: PCOS, menopause, and metabolic health
- Circadian rhythm optimisation for metabolic homeostasis
- Nutraceutical interventions: Myo-inositol, glycine, and adaptogens
- Personalised nutrition: Fasted vs. fed exercise protocols
- Ultra-processed foods: Metabolic consequences and alternatives
Connect with Lara: Lara Briden - The Period Revolutionary
Purchase Lara's Book: Metabolism Repair for Women
Connect with Kira: Uberhealth® with Sports Nutritionist Kira Sutherland
Purchase Metabolic Health and Vitality for Women Over 40 course
Register for "Optimising Metabolic Health in Women Workshop with Lara and Kira: Workshop: Optimising Metabolic Health in Women - Kira Sutherland
Explore more practitioner education on the Designs for Health website.
Shownotes and references are available on the Designs for Health website
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DISCLAIMER: The Information provided in the Wellness by Designs podcast is for educational purposes only; the information presented is not intended to be used as medical advice; please seek the advice of a qualified healthcare professional if what you have heard here today raises questions or concerns relating to your health
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:00):
Music.
Welcome to Wellness by Designs.
(00:22):
I'm your host, andrewWhitfield-Cook, and today we
have a great treat for you.
We're joined by both LaraBryden and Kira Sutherland, and
today we're going to be talkingabout optimising metabolic
health for women.
Welcome to you both.
How are you?
Speaker 2 (00:36):
Hi, good morning.
Speaker 1 (00:38):
Guys, thank you so much for taking time out of your
busy lives to join us today.
I realise how busy you are, butI think first if I can ask you,
Lara, just how big a topic isthis in today's society?
Speaker 2 (00:54):
Well, really, when we say metabolic health, we're
referring to the problem ofmetabolic dysfunction, or
insulin resistance orpre-diabetes.
Conservative estimates are thatit affects at least 40% of
adults, so that is quite a bigproblem, and a lot of people, of
course, don't realize that theyhave insulin resistance.
(01:16):
Which is part of our workaround this is raising awareness
and helping people tounderstand the signs and
symptoms.
Speaker 1 (01:25):
So, kira, can I ask you then, if we talk about these
insidious signs and symptoms,what should we be first looking
for, even before people presentto clinic?
Speaker 3 (01:39):
Oh gosh, what a great question.
What should we be looking for?
There's just so many signs andsymptoms, I just think anybody
not feeling optimum, a sluggishweight gain we will go into
hormone balance as well but justanybody needing to be aware of
(02:02):
what's going on with our body.
I don't even know if I have a,I don't know.
Laura, set signs and symptomsyou want to.
Speaker 2 (02:08):
Yeah, I would say the classic sign of insulin
resistance is feeling hungry allthe time and being more prone
to episodes of hypogastemia orlow blood sugar, which is kind
of counterintuitive, I'verealized, because a lot of my
readers and patients think well,okay, insulin resistance, pre
diabetes, so that must mean highblood sugar.
(02:30):
But actually blood sugar can benormal in the early phases of
insulin resistance.
It can even be low at times andthat's from the metabolic
dysfunction itself, sort of notbeing able to have the steady
supply of energy you know,supplying the cells with energy.
So people get blood sugarcrashes and have to eat snacks
just to kind of keep theirenergy up.
That's a classic sign.
(02:51):
Other common signs and symptomsare elevated cholesterol.
You can get sort of changes inliver function tests, mild ones.
If a doctor has ever mentionedfatty liver, that is almost
always insulin resistance.
Not always, because of coursethere are other causes.
But again, I've talked to manypatients who have been told they
(03:12):
have fatty liver.
They're quite puzzled by that.
They don't understand thatthat's actually related to a
metabolic issue.
And then of course weight gain,but specifically the weight
gain around the middle, or thevisceral fat, that apple shaped
weight gain, and it's importantto say that it is possible to
have insulin resistance but havea fairly normal body size and,
(03:32):
conversely, it is also possibleto have maybe a higher BMI, such
as what happened with like astrong, um, what's called gyno
shape or hip bum, bum weightshape that women can get, women
can have that and and actuallybe relatively metabolically
healthy.
So it's not synonymous withweight gain.
But, um, yeah, you can tell I'mquite passionate about insulin
(03:52):
resistance.
I think, uh, it's yeah, wellthere's.
Speaker 1 (03:56):
So there's so many questions that stem from that,
so forgive me if I'm gonnaforget a few.
But firstly, um, one of thethings I wanted to just ask you
about and I'll ask you, kira, umwas women overtaking men with
cardiovascular disease.
This has been seen since the1980s, I think.
(04:17):
But you've also spoken aboutthe paucity of good research on
women.
So is this a case that womenweren't researched, or are we
really truly seeing a flip, anincrease in cardiovascular
disease in women over men?
Speaker 3 (04:41):
That's a great thought.
Look, I think it's both we have.
You know, women arecardiovascularly is that a word?
But our cardiovascular systemis quite protected until
perimenopause and then whenwe're starting to lose hormones,
we lose a lot of thatprotective buffer that the
hormones gave us.
So the cardiovascular riskgreatly increases once we're
(05:05):
hitting peri and menopause andbeyond.
There is risk before that, moregenetic and lifestyle, but our
risk, we're very bufferedbecause of hormones.
So the big risk then comes whenperi hits, and that is half of
women's lives.
They're now going to be atgreater risk.
(05:26):
So we don't have the same riskas men until we start losing
those hormones and then we havequite great risk.
And then the issue becomes wehaven't researched women,
especially in cardiovascularrisk, but we haven't researched
women nearly to the level of men, and so we also don't recognize
(05:48):
a lot of the early signs andsymptoms we don't recognize like
women presenting with a heartattack or myocardial infarction.
It can be a totally differentset of symptoms which get
dismissed even in emergency orwith ambulance or just by
general people.
(06:08):
They almost can have thesepre-dronal symptoms for a few
days while things aren't goingwell.
And so there is a lot ofeducation now around what the
extra different symptoms canpresent, extra different
symptoms can present.
But again it goes to the idea,or, you know, it goes to the
(06:37):
fact that women, through allstages of life, have a lot more
I don't really want to saymedical gaslighting, but a lot
more dismissive symptoms thatwe're told just to live with it
or that's normal, or your pain,just deal with your pain when,
when things are getting prettybad.
So I think it's a coupling ofeverything for them.
And then we have insulinresistance coming and then it
increases cardiovascular risk ontop of that what you said just
(07:01):
sparked anger in me, because Ihave actually seen this women
being told.
Speaker 1 (07:07):
It's all in your head with, we know, the
endometriosis story.
It's all in your head.
Actually, no other end of thebody mate, but but um, I've seen
, just so that you know.
I've seen women doctors dismisswomen for this and it's just
I'm befuddled.
But anyway, um, lar Lara, youhad something to add to that,
forgive me well, I was justinterested.
Speaker 2 (07:28):
So did you have some statistics suggesting that
overall um heart disease isincreasing in women?
Because one thing and I haven'tseen those numbers but one
factor is smoking right like menused to smoke a lot more than
women did, and so that thequitting smoking collectively as
a society has changed some ofthe numbers around um
(07:49):
cardiovascular disease right, um, so the the stuff that I'm
going off.
Speaker 1 (07:56):
I mean, I was looking at even things from cedar
cyanide.
I haven't looked at theaustralian institute of Welfare,
aihw, but I do remember readingsomething years ago that women
were overtaking men in certaintypes of heart disease.
Now whether that wascardiovascular disease I'm not
sure, but Cetus Sinai attributedit to the introduction of women
(08:23):
post the 1980s in equivalentamounts in the workforce, and I
think it goes much further thanthat.
But anyway, I think that'spretty much small.
Speaker 3 (08:38):
It's the late 80s and the early 90s when we started
actually allowing women intoclinical research in any number.
So the likely like I'm makingan assumption here, but the
likelihood is our stats wereprobably higher than we ever
knew.
But you know it's, life's toodangerous for women to be in
(08:59):
clinical research, or it was,and depending on what country
you're in.
There still are, or are not,laws around the inclusion of
women in research.
We are getting a lot better,but it's it's not.
Speaker 1 (09:12):
Some countries just have guidelines, not laws yeah,
um lara, if I can ask you, yeah,absolutely yeah, lar, can I ask
you?
You mentioned a few of thoseearly symptoms of glycemic
dysregulation and, whether it benormal, elevated or depressed,
(09:37):
with their glycemic measurements.
That smacks of what we see inHashimoto's, where, you know,
the gland that we're dealingwith is an efficient pump, if
you like, an efficient producerof the hormones, and so damage
doesn't really get to be 100%until a whole lot of the gland
(09:59):
is damaged and there's only acertain portion left.
Similarly, in the thyroid gland, it can sort of take the load,
if you like, during the damageof Hashimoto's, so you can go
have elevated thyroid hormones,depressed thyroid hormones, or
they can present as euthyroiduntil a certain point.
(10:20):
Is that what we're seeing?
Is it that?
The pancreas?
What are we talking?
Alpha cells, beta cells, arebeing damaged and we only see
the full metabolic dysregulationwhen a lot of those cells have
been damaged.
Speaker 2 (10:43):
Broadly.
I mean, I think the conceptyou're talking about is this
idea of metabolic reserve thatthere's some resiliency built
into the system at first and asit starts to fail, then you get
less ability to maintainhomeostasis for sure.
I think one difference with thatfrom thyroid, though, is a key
part of insulin resistance ormetabolic dysfunction is
(11:05):
actually what's happening in thecells and the mitochondria and
the you know the receipt.
The cells that are receiving theinsulin signal are supposed to
be receiving the insulin signaland, to be fair, that's a factor
in thyroid disease as well.
You can certainly get somedegree of resistance to thyroid
hormone, but it's not analogousin that.
Yeah, I don't really thinkabout the pancreas so much.
(11:28):
In fact, I don't even sort oftalk about the pancreas so much
in my latest book on metabolichealth.
I'm talking more about themitochondria that you know, the
cells themselves, a lot aboutthe liver and all the other
organs that are responding toinsulin and that are also
working together with thepancreas to try to control blood
sugar.
But yes, you're right in termsof what you described like the
(11:48):
dysregulation of blood sugar isend stage, like there are much
earlier problems with insulinresistance, including a lot of
inflammation, and just includingthe chronically elevated
insulin itself that's causingproblems really, years before
blood sugar goes out of rangeproblems really years before
blood sugar goes out of range.
Speaker 1 (12:10):
You mentioned inflammation there.
No-transcript.
Speaker 2 (12:14):
Yeah well, the state of being an insulin resistance
or being metabolicallyinflexible is a state of
inflammation.
It's bidirectional, sochronically elevated insulin
creates inflammation to someextent and also underlying other
causes of inflammation cancreate insulin resistance,
(12:36):
create insulin resistance.
I'll give an example that wouldbe interesting to, as
naturopaths because, of course,where everything always comes
back to the gut.
So there is quite a bit ofresearch.
Andrew, I'm sure you would havecome across the term metabolic
endotoxemia before.
I think that's a reallyimportant one.
This is about essentially theLPS, like the endotoxins coming
(12:58):
from the gut via intestinalpermeability, inducing insulin
resistance in the rest of thebody.
In part, by the way, itinflames the visceral fat
directly because it's in closeproximity, the intestines right
there, and then, of course, itaffects downstream from that, it
affects the liver and itaffects the body's ability to
(13:19):
respond properly to insulin, tometabolize energy properly.
And how many of us clinicians?
There's two patient stories inmy new book about metabolic
health where you fix the gut andthen their sugar cravings just
go away.
I mean, one of the patients issomeone who she knew she should
stop having sugar.
She was really craving sugar.
She was trying to mentally makethese changes and I was like,
(13:41):
well, let's just, let's justwait, because you do have SIBO
and intestinal permeability orin one case, you know you have
blastocystis going on, you knowparasites in the gut, so let's
focus on the gut and then seewhat happens.
And that is a good example ofhow dynamic metabolism is
metabolic health is.
It's not in a separatecompartment from the rest of
(14:03):
health, right, like it'saffected by gut health.
It's affected by hormone health.
It's affected by the nervoussystem in a big way.
It's probably ultimatelycontrolled by the nervous system
, actually I would say even moreso than, say, by the pancreas.
It's a very dynamic part of ourhealth and it goes very deep,
right to the level of themitochondria, which is why
there's so many you know just somany factors, so many
(14:27):
interconnections.
Speaker 1 (14:29):
Kira, can I ask you then?
You deal with a lot of athletesand exercise is an important
component in metabolic health.
Talk to us about how importantexercise in how.
How important exercise is, howdoes that tie into inflammation
(14:50):
or managing inflammation, likepeople who over exercise, for
instance, or try to keep up withsomebody who's who's at a
higher level of exercise, andthey just get inflamed.
And yet there's that conceptthat some stress is good, even
for our mitochondria.
Speaker 3 (15:10):
Yeah, oh my gosh, that was like five questions.
So, and Laura?
if you want to come in on theinflammation.
One Exercise is, I mean, weknow how important it is, but
especially in insulin resistanceor metabolic inflexibility, if
we're saying, you know, yes, weneed the body to be in this
(15:31):
healthy state, we need the rightnutrients, we need that gut
health and decrease theinflammation, support the
nervous system, all of thatholistically comes into play.
But unless you have or areworking on fitness, you are not
oh my gosh, so many things.
You're not stretching thecardiovascular system but you're
(15:51):
also not creating mitochondria.
We got to remember mitochondriaresiding in all of your muscle
cells.
You know there's millions ofthem.
But unless you're buildingmuscle or maintaining muscle,
especially as we age, we aredrastically losing mitochondria
and their ability to functioncan decrease as well.
(16:12):
So it's, you know, oh my gosh,there's so many things to be
done there, working onmitochondrial health, in
building muscle, actually doingyou know the big thing again,
this is, you know, women, oncethey hit Perry and beyond, but
really it's for everybody we'rerealizing how important doing
weights is over constant cardioor high thrashing cardio.
(16:36):
You know people doing HIITclasses all the time hoping
they're going to burn fat.
It's yes, hypothetically that'sworking, but only to a degree
and then overtraining, creatingtoo much stress on the body,
creating too much inflammation.
There's that, that fine linebetween how much exercise is
(16:56):
optimum versus too much, andit's different for each person
male, female, different bodyshapes can cope with different
volumes of stress as well, we'refinding.
So there's that whole I meanit's a whole spectrum of what's
working for your body might notbe working for somebody else,
but the more we're exercisingand creating, you know,
(17:20):
mitochondrial biogenesis, thebetter we are for maintaining
the right physique that we'relooking for, optimum physique,
because it's more engines toburn more fuel.
People, people often forget theonly place we're burning fat in
the body is inside themitochondria.
So we need healthy mitochondriaand able to allow, you know,
(17:44):
both fat, carb and proteinburning, which is a big thing.
And if we're unfit, if we'relow in muscle, if we're insulin
resistant, the problem is withinsulin resistance or the issue
is you at a lower level or lowerlevel of fitness, lower issues
with insulin, we will pop intocarb burning.
(18:07):
I'm being very unscientifichere, but you pop into more
predominant carb burning quickerthe less fit you are.
So it's also the slow processfor people, as they gain fitness
and mitochondria health, thatthey will.
Their engine will start to burnbetter, but we need to give it
(18:28):
time.
And if we're going too highintensity all the time, we're
not.
Yes, it's great for the body,but we're not assisting um,
we're not slowly getting themitochondria to do a better job
yeah, I hope that made sense.
Speaker 1 (18:43):
Um lara, have you got anything to add to that?
Speaker 2 (18:46):
I just want to ask a question about types of fat yeah
, yeah, well, I was just gonnado things so in and kira and my
upcoming webinar forpractitioners about metabolic
health for women.
We are going to talk aboutdifferent body types pretty much
what Kira just touched on there, like different body, not just
shapes, but I would saydifferent nervous system types,
(19:08):
different metabolic types.
Really, people do better withdifferent types of movement.
So some people love that kindof high, that high intensity,
rapid sort of movement.
Some people are going to dobetter with the slow strength
training or you know, thewalking, and it's a lot to do
with the nervous system.
So we're going to explore thatin some detail.
I'm really looking forward toour usual back and forth when we
(19:30):
do our duet style webinars.
We have fun together sharingour knowledge.
And then the other thing, justto touch on what kira was
talking about there, which isjust an important detail that I
sort of want everyone tounderstand in a healthy with a
healthy metabolism, with healthyinsulin sensitivity, healthy
metabolic flexibility, ourdefault when we're at rest or
(19:53):
engaged in light activity is fatburning.
Fat burning is our actuallywhere we're supposed to be and
in a healthy state we shouldreally only tip into more
predominantly carb burning whenwe're engaged in high intensity
exercise.
As a caveat, we're alwaysburning a mix of fuels.
I don't want anyone to go awaythinking we're only burning fat.
(20:15):
It's always a mix, but itshould be predominantly fat
burning when we're healthy atrest.
Yeah.
Speaker 1 (20:23):
You know, I think the point there is you get these
people that go I'm going to burnfat and they're like this tense
and they're not enjoying theexercise.
I have to go to the gym I hateit but I'm going to.
You know that sort of thingrather than going for a bushwalk
(20:43):
or going for a walk along thebeach and enjoying the walk and
moving the rest of their body,not just their legs.
And you know the thing, thepicture in my mind that that is
conjured is the, the blue zones.
And I picture this.
You know, grandmother fromCorsica climbing down the
mountain steps for her lovelanguage, which is cooking for
her family, and collecting theherbs and the vegetables out of
(21:05):
her garden that's a little bitdown the path and putting them
in a basket and walking up.
She's bent over, she's movedher hands and her upper body and
then she's doing the walkingand carrying extra weight and
then she goes.
And all of this is involvedwith a love you know, and and I
think if we could engender thatin our patients to love what
(21:26):
while they're exercising, toreally enjoy it, it's, it's a
major flip, going right back toinflammation there yeah, can I
just say too, exercise is not apunishment for anything we've
done or anything we've eaten.
Speaker 3 (21:41):
Exercise should be joyful and, again, part of what
we'll explore.
But the whole body type ornervous system type what types
of exercise suit you so thatthey don't put too much stress
on the body?
Because some body types can goreally hard early in the morning
and they can handle that high,high cortisol.
Other body types are going toreally struggle, you know
(22:05):
they're more sensitive to thatmorning high cortisol and we'd
be better off exercising in theafternoons and just finding the
exercise that you love,absolutely bushwalking, hiking,
gardening, my god, you know ifyou're talking blue zones.
Gardening is some pretty hardexercise.
My body hurts gardening.
But yeah, whatever's workingfor people it's not.
(22:28):
Yeah, and I find for a lot ofpeople too, and you know, it's
kind of getting away fromnaturopathic principles more
into exercise phys.
But also, you know, socializingwhile you exercise is a big
thing for some people and that'sincredible, especially for
women, for our nervous system.
You know we have all thisresearch around being with other
(22:50):
people being so great for ournervous system and calming us,
and I think we forget that andthen we suffer alone, thinking
we have to do all this exerciseby ourself.
Speaker 1 (23:01):
Yeah, get a dog and exercise with it, or get a cat
and watch it while you'reexercising.
Speaker 3 (23:10):
Something else I wanted to say about exercise.
But yeah, keep going.
Speaker 1 (23:16):
Can I just go back to when you were mentioning fat.
We've got different types offat brown versus white and
there's some research showingthat you can actually change
that.
Have we got any more researchon what we can do to effectively
change to having more brown fatand therefore more of a
thermogenic body type?
Speaker 3 (23:39):
Laura, you want that one, yeah.
Speaker 2 (23:41):
Laura sorry.
Speaker 3 (23:41):
Well, there are lots of theories.
Speaker 2 (23:43):
I mean the research around brown fat and beiging
white fat into brown fat is, Ithink, all pretty new.
I don't know.
I'd love to hear what Kirathinks.
I don't think there's much sortof evidence-based conclusive.
This is something you can dofor sure.
I mean, it's only been like 20years since we even discovered
that adult humans have brown fat.
Before that, before that, wethought only infants and
(24:05):
hibernating mammals had it.
So this is all quite newinformation.
I mean I think it is theresearch is clear that people
who do have more active brownfat do tend to have healthier
metabolism, like they tend to bemore insulin sensitive.
That's.
Some of that's going to begenetic, some of it's just luck.
I mean, I don't know, there'sdifferent factors.
(24:26):
I said what do you think here?
Is there anything?
Any tried and truerecommendations?
For that?
Exercise was one way,potentially exercise.
Speaker 3 (24:34):
It's definitely genetic, you know carrying fat
is.
So let's, let's be honest,carrying fat is so genetic, it's
you know.
And it's definitely genetic,you know, carrying fat is.
So let's, let's be honest,carrying fat is so genetic, it's
, you know.
And it's also, have you turnedon those genes that are, you
know your body's starting tostore more as well, so it's
genetic lottery.
And then how well, you keepsome of those genes turned off
or not with, but with brown fat,you.
(24:55):
The one thing that comes to mindis cold exposure, but I went
down a rabbit hole on this theother day.
How much research we have onfemales and cold exposure versus
males is also questionable.
And I like cold exposure, Ilike the idea of it.
(25:15):
But again, we take ideas andthen we go so hard with them and
we do it all the time.
And I would question for thefemale physiology, and there are
people pointing out too coldmight be too much for a female
body, or, you know, we might notneed to be as extreme as we
think, but I don't know how muchdeep research there is on that
(25:40):
yet.
I think that's kind of up andcoming, but I would, you know,
it's just like people talkingabout fasted training.
Fasted training, you know,exercising in the morning while
fasted, yes, you hypotheticallywill burn, we know you'll burn a
few more grams of fat.
But eating before trainingactually helps stabilize
(26:01):
cortisol.
You know, cortisol will not goas high during training if
you've eaten a little bit,especially carbohydrate, before
training.
But protein can work and thereare theories that you know,
especially for certain bodytypes who are more sensitive to
cortisol in the mornings, itmight be better eating before
training, just a little bit,something to attenuate that rise
(26:22):
in cortisol, so the body's notfreaking out all the time that
you know it's starving.
So, oh my gosh, it's a littlebit of everything works really
well, but as humans we're likemore is better and then we dig
ourselves a hole.
Speaker 1 (26:38):
I think is really where my opinion is coming to so
is this what you're going to becovering in your webinar?
You're going to be coveringdifferent body types, different
genetic types, obviously, andthen how there are commonalities
between that that we all shoulddo, and then are you going to
(26:59):
branch off into how that bodytype, for instance, a gynoid
body type, might be betterserved by a certain type of
exercise and perhaps eatingpatterns, and then an android
type body type might have adifferent set of specific
(27:20):
regimens to stick to.
Speaker 2 (27:23):
Laura.
Well, actually the body typeswe're going to touch on and it
will just be part of the webinaris actually the PH360 sort of
six body types which are morebased on kind of an expanded
version of the ectomorphmesomorph kind of endomorph
types, which are more based onkind of an expanded version of
the ectomorph mesomorph kind ofendomorph types, but from a
female perspective in our case,and so, but the webinar is a
(27:45):
half-day webinar.
We're going to it's sort of a,it's a look, a closer look at
insulin resistance and how toassess that and how to treat
that and recover.
And Kira is going to talk a bitmore about the metabolic
flexibility she's just beendescribing this sort of moving,
this what's called sort of acrossover point between burning
(28:07):
fat and burning carbs andbasically being able to stay in
fat burning for more of the time, or predominantly fat burning
for more of the time, which isbeneficial for metabolic health
and just for feeling better too.
So it's not just about, you know, it's definitely not just about
obtaining a certain bodycomposition or anything.
I mean, I really don't evenreally like the term body
composition.
I think it's about havingenergy and feeling good and
(28:29):
having a reduced inflammation,reduced risk of heart disease
and all the downstreamconsequences of insulin
resistance if it's not addressed.
And for everyone listening,insulin resistance or
pre-diabetes is 100% reversible,so it can be a little bit
different for every person interms of how long that takes and
(28:50):
what strategies they want toemploy.
There really isn't a cookiecutter one size fits all, which
is why we need a half a daywebinar to explore it, and, of
course, it's also the topic ofmy new book on metabolic health,
so I'll be drawing on some ofthe things I learned when I was
writing that book.
Speaker 3 (29:08):
Yeah, yeah and we're, can we go?
Speaker 1 (29:11):
into therapy.
Oh sorry, you go yeah, so it's.
Speaker 3 (29:15):
You know, body typing is only one little thing we're
going into because it's, youknow, it's a little lens that we
have to, you know, look atbetween each person, because
it's not one size fits all.
But you know, I'm the numbersgirl when it comes to our
lectures, of doing much morelike.
We're looking at macros, we'relooking at, we are going to look
(29:36):
at calories, because you can'tnot look at fueling a body, not
calorie counting per se, butwe're going to look a lot at how
the physiology of the body isoperating in insulin resistance
or when somebody is moving awayfrom it, and the things that are
going to, the things we need tobe doing to get there to a more
(29:57):
, you know, a better staterather than insulin resistance.
So it's very much, we're verymuch not teaching just the
science.
We're teaching or presentingvery much a how to, what to go
do with this.
Right, you need something to godo rather than just learning
the theory.
Speaker 1 (30:16):
You need something to go do rather than just learning
the theory, let's go into whatwe can use alongside our
exercise and our diet therapy.
What do you find most to havemerit?
Things like you know, forinstance, polycystic ovarian
syndrome, with, you know, usingmyo-inositol, for instance.
(30:39):
Now, professor Annabelle Tbasically dismissed myo-inositol
in her.
I've got to say it was afantastic podcast on polycystic
ovarian syndrome.
This was a medical one, and Isuspect, though, that one of the
reasons she dismissed it wasbecause many of the supplements
(31:01):
out there that have myo-inositolin them have a paucity of dose.
They have, you know, a few 20s,or you know, scores of
milligrams, or maybe a couple ofhundred milligrams, but I've
seen gram doses of myo-inositolbeing employed.
Where do we go here?
Speaker 2 (31:22):
Well, I could speak to Lara.
Yeah, go ahead.
Yeah, I mean, inositol is quitean important supplement for
metabolic health.
I'll just preface it though.
I'll just say just again, it'skind of a bit of a paradigm
shift around this.
But I guess my key messagearound metabolic health and I'll
explore this in my book andI'll explore this with Kira in
our webinar but it's it's notseparate from general health,
(31:46):
right, like it's really not.
It's not like we've got thethings we need for it to be, you
know, to feel good and haveenergy and have general health,
and then the things we need formetabolic health.
They're one and the same.
So this is where thetroubleshooting approach comes
through in my book.
I'll explore that a bit in thewebinar as well.
Like you really do, you know,fix your health and you'll fix
your metabolism.
This is like similar to theprinciple from my first book on
(32:08):
period health is fix your healthand you'll fix your period.
They're not separate.
So this is why I give examplesof fixing it for some people
fixing their digestion andthey'll, you know, fix their
metabolic health.
So there's there's differentways to access it, different
levers you can pull.
But in answer to your questionon inositol, it is a
particularly well-researchedsupplement for insulin
(32:31):
resistance and there's not apaucity of data.
Actually, there's a huge amountof data on inositol for the
insulin resistance of polycysticovary syndrome and
perimenopause.
I mean, I would say it's one ofthe most evidence-based
supplements out there.
So I'll have to circle back andlisten to the podcast, where
she maybe, I guess, didn't feellike it crossed some kind of
(32:55):
finish line to arrive attreatment, but it was included
in the international guidelinesfor PCOS, both in 2018 and in
the updated ones now.
So it's one of the fewsupplements that's actually come
pretty close to crossing thatfinish line to get there, and I
know a lot of doctors use it andit's well.
Just speaking anecdotally, it'sextremely popular in the PCOS
(33:16):
space and you're right, it'sgram dose.
Speaker 1 (33:20):
I think her opinion was based on the paucity of
doses that we have insupplements.
Speaker 2 (33:25):
Oh, the low doses?
Yeah, no, it's a gram dose.
It's probably four to six gramsa day to get there and it works
in each and every cell right.
So we need quite a lot of itbecause we have quite a few
cells.
So one of the things it's doingis it's doing different things,
but it improves the signalingof insulin directly, enhances
(33:46):
insulin sensitivity.
It also improves thyroidfunction and sleep.
Speaker 1 (33:54):
Now, I didn't know that about thyroid.
Speaker 2 (33:57):
Yeah, it amplifies Tsh inside the cell.
It's um an intracellularmessenger, so it kind of.
I forgot the.
I'm not a biochemist so I don'thave the exact sort of details
of what it's doing, but it'skind of relaying the message of
different hormones inside cellsand it's, yeah, it's, it's
pretty popular.
And what a couple just fun factsabout inositol.
(34:17):
Um, we can make some of it, sothe body does make some.
So there's that.
I mean we, we traditionallywould have had a lot more in our
diet because, um, the I thinkit's a type of phospholipid.
Phospholipid inositol is quitehigh, um, in high concentration
in organ meats.
So I do think in my, in my bookon metabolic health I do talk
(34:38):
about our disconnect from ourtraditional diets and how that
has in part set us up formetabolic dysfunction.
Chapter one is called.
You know, metabolic dysfunctionis not your fault.
Some of it is the drasticchange in our food supply and
also environmental toxins, whichwe haven't even really touched
on yet.
But that is having a epigeneticor an intergenerational effect.
(35:00):
So that now I mean thisintergenerational effect is
pretty important.
So we are now getting teenagerswith pre diabetes, in some
cases type two diabetes andfatty liver.
That was unheard of 50 years ago.
And it's not like 50 years agoour diets were perfect.
I don't know about you, kira,but like you know, I would eat a
whole row of Oreo cookies or,you know, chips, or, like you
(35:23):
know, I wasn't.
I mean, I had in many waysthere was a good diet in my
house, but not perfect.
But we back then in the 70s, wethere was not the 70s and 80s,
when I was a kid and a teenager,there was not the insulin
resistance and obesity thatwe're seeing now.
So this something has do youhear what I mean by amplifying
each generation?
This is epigenetics.
(35:43):
So kids are being set up likein utero and even before they're
born, actually with, you know,genes being switched on and off
to be extra vulnerable to ourmodern environment, including
our food environment.
Speaker 3 (35:58):
Yeah environment.
Speaker 1 (35:59):
Yeah, yeah, anything to add?
Speaker 3 (36:01):
yeah, well, we just have that old.
You know, ultra processed foodis the big word, you know,
everyone's now using it.
If we look around, it is.
It's not just the liquidcalories coming from sodas,
although there is um research Iread a little while ago saying
teenagers get somewhere between60 and 80 percent of their daily
calories by a liquid, which isjust a frightening statistic.
(36:24):
I think that was a US statistic, I'll just put that there.
Yeah well, you can buy biggulps over there.
You know, in Australia our sizeof drinks is actually smaller
than over there is actuallysmaller than over there.
But yeah, ultra-processed foodreally hit in the late well, I
(36:47):
think it was the late 50s, early60s, and then by the 70s we
have a lot more of it.
And yeah, what's happening withour genetics?
Is it getting turned on or not?
So I had this discussion theother day with some other
practitioners and they werecommenting that I am always lean
.
If people have not met me, I'mnot a super skinny person, but
I'm very fit and tall, and Lauraand I always joke about this
(37:10):
I'm built like a big Viking andLaura's built like this tiny
little.
We're very different body types,so we love lecturing all this
stuff because it's so differentfor each of us.
But you know, even if we'recoming from a genetic background
, that's not great.
I definitely own every obesitygene that you could inherit from
(37:30):
my genetics.
It's just about that diet andlifestyle, not turning it on or
keeping it quiet.
Keeping it.
Diet and lifestyle, not turningit on or keeping it quiet,
keeping it, you know, asleep.
That's going to come into playfor a lot of people as well, if
you don't feel like you've wonthe genetic lottery which I
definitely didn't, which is whyI studied nutrition.
Speaker 1 (37:52):
Let's go back to we're circling back a bit here.
Lara, you were talking abouthow important the gut is.
You know, and you fix the gut,everything else falls into place
.
Talking about supplements thatwe can employ here, ordinarily
we would think about employingbacteria probiotics and
obviously, to go with that,prebiotics to help them stay and
(38:13):
proliferate in the gut.
But what about other thingslike berberine, where it's got
this sort of other effects withhelping blood sugar control?
How do we employ it responsiblywhere it doesn't become an
quote-unquote anti-infective, iedecimating the good guys?
How do we employ it effectively?
(38:37):
What dose do we use?
How long should we use it?
What are the caveats to use?
Speaker 2 (38:43):
Well, there are lots of different opinions about this
, so I will just point out thatberberine obviously is a
superstar for metabolic health.
It's also very popular.
It's quite similar to metforminin some ways terms they both.
For example, they bothstimulate a something called am
ampk.
It's a kinase that's likethat's very involved in um, in
(39:06):
metabolic signaling.
But they also are both, as youpointed out, antimicrobial
antibiotic and that is possiblyhow, in part, how they work, by
reducing the metabolicendotoxemia that I talked about
earlier.
So especially if they'reknocking back a SIBO or a small
intestinal bacterial overgrowththat is driving intestinal
(39:26):
permeability and metabolicendotoxemia, that could be one
mechanism by which they'reworking.
In terms of your question, likehow to dose it, I can tell you
what I do with my patients andthen we can here, we can get
here from here, and then youknow, we can see what you think,
andrew, it's.
I mean, certainly there areproducts out there that are seem
to be recommended to dose them,ongoing daily.
(39:47):
That's not what I personally,isn't how I personally use
berberine.
I tend to use it and the way Italk about it in my book.
I think it's secondary to saymagnesium or inositol or choline
is another important nutrient,that part of these um key, five
key metabolic nutrients that Iidentify in the book.
And then berberine is like anaccessory one that would be
(40:07):
particularly helpful, I think,if there's SIBO.
So if there is, if there aregut problems, then I would
technically typically do like aeight week course of it.
I don't do it every day becausethere's some research that
berberine works better if youtake it maybe five days a week.
So I might say you know, takethis berberine product twice
daily, weekdays only.
(40:28):
You just take a little break onthe weekends, take it for one
bottle, then take a break, thendo another bottle.
And of course that's afterscreening for any
contraindications, becauseberberine can interfere with
certain medications.
It's not safe during pregnancyor breastfeeding, so I think
it's not suitable for people whoare taking metformin.
I think it has to be metforminor berberine, not both, although
(40:50):
metformin can be combined withinositol or magnesium or some of
the other ones.
So that's kind of my view.
I'm open to change on this,like I'm open to new information
and revising my opinion aboutberberine.
I know there's lots of debateabout how to use it, what.
What do you do, kira?
How often do you prescribe it?
Speaker 3 (41:10):
yeah, I tend to do kind of four to six weeks on and
then four to six weeks off.
I hadn't read that researchabout not every day, but I'm
always under the assumption myclients forget to take
supplements.
A few days a week.
Speaker 2 (41:23):
It's a safe assumption.
Speaker 3 (41:27):
I'm a huge fan of berberine over metformin.
I mean, if people are metforminand it's working for them,
that's great.
But from a physiologyperspective there is some
research saying metformininhibits muscle growth.
So I'm always keen again,legally I would never take
(41:47):
anybody off any drug, but I'mkeen for the more natural.
You know I'm keen for berberineover metformin if I can,
especially if we're trying togrow muscle which is growing
mitochondria.
So I just I struggle with thatone a bit because I'm working
with so many athletes, but Ihave a lot.
You know, stats came out thisweek that 40% of Olympic female
(42:09):
athletes potentially have PCOS.
Did anybody see that stat?
No, yeah.
Oh yeah Well, so Olympics is onthis week when we're filming
this and but it makes sensebecause they have higher
androgens and a little bithigher androgens makes you a
better athlete for a lot ofdifferent sports.
So big conversation and I thinkthat's beautiful to know for
(42:31):
the people with pcos is 40 ofthese elite athletes are dealing
with that.
Speaker 1 (42:38):
That's quite stunning .
I thought it was androgendysmorphology, but it could be
just androgens driving it.
Is that what you're saying?
We?
Speaker 3 (42:46):
don't know.
I would love to see everybody'slife.
Speaker 2 (42:50):
I suspect what's happening is that sort of the
higher androgen women are theones that succeed at sport.
For some sports it's going todepend on the sport and there's
a there's a sliding scale ofandrogen, like at what point do
you cross over to being androgenexcess, you know, sort of.
And also we're all higherandrogen when we're younger.
That's true for men and women.
Speaker 1 (43:11):
So, yeah, this is yeah but it tends to trash that
old.
It tends to trash that old um,concept of polycystic ovarian
syndrome.
Was that syndrome X, where theapple-shaped obesity and
da-da-da, it just trashes it,doesn't it?
Speaker 2 (43:28):
Oh well, I hear what you're saying to have androgens
but not insulin resistance.
Speaker 1 (43:33):
It's completely possible to have androgens?
Speaker 2 (43:36):
Yeah, of course.
They don't have insulinresistance?
No, of course.
Speaker 3 (43:38):
They're doing an awful lot of exercise.
Speaker 2 (43:42):
Pcos is not, I would say.
The research suggests that atleast it depends on the
individual.
But I think there's many caseswhere the androgens come first
and then, in women, androgenexcess promotes or causes
insulin resistance, and in theother direction as well.
So it could become a viciouscycle.
Speaker 1 (44:02):
Gotcha Okay.
So moving on.
We've spoken about stress quitea lot.
Let's talk about things that wewould ordinarily use magnesium.
There's certain beautiful herbsthe ashwagandhas, the ginseng,
the American ginseng just sayingI love American ginseng Are
there any particular herbs andnutrients that you employ for
(44:24):
stress?
And particularly I'm going toask this on a personal level
what about those women that runon stress?
Speaker 3 (44:37):
Laura, do you want to go first?
Speaker 2 (44:39):
Well, I mean of, of course, my combo is magnesium
plus taurine.
I talk about that in all threeof my books.
They both support gaba,although, to be fair, there are
some people who don't feel greaton taurine, but most, most of
us do.
And there's just a new product,a new supplement which I just
ordered for myself to try, whichis a particular version of a
magnesium taurine chelate.
(45:00):
I think it's like lipophilic orsomething, or like it's got
some extra absorbable so itapparently crosses the blood
brain barrier.
I should have researched thisbetter before mentioning it
today, but it's a magnesiumtaurine combo that is supposed
to be extremely calming.
So, yes, so that's a good combo.
I'm also a fan of adaptogens andsome of the anxiolytic herbal
(45:23):
medicines I'll mention.
I'll give a plug to glycine aswell.
Glycine is one of the other.
That's one of the five of myfive metabolic nutrients.
So glycine is also very calmingand is done well in terms of
treatment for metabolicdysfunction and insulin
resistance.
It works in a few ways, but oneof the ways is probably calming
the nervous system.
(45:44):
Promotes sleep.
Speaker 1 (45:46):
But what dose do we have to employ of glycine there?
Speaker 2 (45:50):
Gram dose.
Three grams, yeah, probably.
I mean you're getting some withthe magnesium glycinate, so you
get.
I just had a quick look like atyour standard dose of magnesium
glycinate.
That would deliver 300milligrams of magnesium.
Sorry, I think gives you aboutone point something.
Maybe 1.4 grams of glycine.
It'll depend on the product,but the therapeutic target range
(46:12):
for glycine is about threegrams, so people can top that up
if they want to.
I saw someone on Twitter theother day talking about glycine
saying this can't be right.
You know it tastes sweet, ittastes nice, it has no side
effects and it helps you sleep.
It's like where's the catch?
You know where's the downside.
Speaker 1 (46:31):
Kira anything to add?
Speaker 3 (46:34):
Well, I'm all about the magnesium taurine as well,
obviously.
And Well, I'm all about themagnesium taurine as well,
obviously.
And I'm all about the nervoussystem herbs.
Yes, adaptogens as well.
You know any, any and alladaptogens, but especially with
an ear, ashwagandha.
I'm huge on schisandra becauseit's also we're getting that
(46:55):
little bump for the liver.
I think it's an unforgotten,not forgotten, but we, yeah, I
just think it needs a biggerplug.
Yeah, schisandra, withania,especially, I use them in
combination in the mornings forpeople.
I love the ginsengs.
The ginsengs, I think, are kindof forgotten these days and I,
(47:16):
especially Siberian ginseng,love it.
I do love the American ginsengas well we don't talk about that
enough in Australia and nervoussystem herbs.
So I'm loving the magnesiumwith nervous system herbs at
night, just to help pulleverything down, better sleep.
(47:36):
One of the things we haven'ttouched on today and I'm not
meaning to take it away fromsupplements is circadian
alignment and the research oncircadian, and it's a big part
of our talk.
It's a big part of the bit thatI'm talking on is circadian
alignment and misalignment.
You know, one week of circadianmisalignment starts to show
(47:59):
insulin resistance signs.
So really getting back torhythm of when we should be
eating when we should be slatingthe rhythm even of our
digestive system, which oftenisn't talked about.
You know our insulin worksbetter at different times of the
day.
So that's you know.
I'm a huge back to supplementson great.
(48:22):
You know magnesium, herbalsupplements that help you sleep,
I think, are a big part of thispicture, as well as
mitochondrial supplements.
You know things that help.
You know we forget about ATPand actually energy creation in
the cell.
There's so many nutrients thatwe can easily be deficient in
(48:43):
and we then don't make as manyATP per glucose unit or per fuel
unit, and it comes down to howgood we feel, how much we can do
per day.
Speaker 1 (48:55):
Yep comes down to how good we feel, how much we can
do per day.
Yep, can I?
There was something I've beenmeaning to ask, and it goes
right to the beginning of ourchat.
When we were talking aboutmitochondria, we would
ordinarily think about, yes,coq10, that's, it's just the
automatic nutrient that we thinkof for mitochondria.
How do you use it, though?
When we're talking aboutbalancing it, if you like, with
(49:18):
inflammation or stressing themitochondria, do you use
magnesium always alongside it?
Can I get a comment from youplease, lara, just about if and
when you use CoQ10?
Speaker 2 (49:30):
I don't prescribe it that often, not that I think
it's not good, I mean I thinkit's certainly occasional.
I prescribe it for maybefertility or certain aspects,
but I think I mean my go-to.
We've been talking a lot aboutmagnesium.
The mitochondria love magnesium.
They seriously love it.
It's like it's, you know, it'sit's inside their, you know it's
part of their key electrolyteor mineral for functioning.
(49:54):
And also just mitochondria.
I'm starting to think of themquite differently.
Actually they are not.
They're way more than just likeone little cog in the machine,
like they.
They're super dynamic and therewas just some research which
unfortunately did not make itinto my book because it's that
new.
It just came out in the lastmonth or so that mitochondria
(50:16):
change just in response topositive versus negative
experiences, basically beingwith a person you love or you
know going camping.
Well, your mitochondria will belike hooray, you know they'll
multiply.
Yeah, it's pretty amazing, soobviously.
Kira mentioned.
Yeah, kira mentioned.
You know, moving the body,building muscles, stimulates
(50:39):
mitochondria.
Mitochondria respond to everyhormone, especially estrogen and
thyroid hormone Mitochondria.
Really, there's certain thingsthey don't like, obviously, just
any kind of overeating, anykind of energy excess in general
is quite stressful formitochondria, but sugar in
particular can be quitestressful for mitochondria,
alcohol for sure.
(50:59):
And also I'll just inject alittle maybe controversial point
about a food substance thatmight be toxic or not toxic, but
you know, harmful tomitochondria and high dose would
be linoleic acid or omega six.
This is the whole seed oilcontroversy.
We couldn't have a podcastabout metabolic health without
touching on the seed oilcontroversy.
(51:20):
But if seed oils are causing aproblem with metabolic health
and insulin sensitivity, it'svia what they're doing to
mitochondria, I think, as,amongst other things probably.
Speaker 1 (51:30):
Yeah kira anything to add there with regards to a.
Speaker 3 (51:35):
I want that research.
Laura, send it through.
Yes, I'll send it ready to dolectures.
Research kind of goes back andforth a lot.
Look um, for mitochondria, foratp production.
If we think about that, we'relooking at all the b vitamins.
You know b1, b2, b3.
Often you know they're not theheroes that everybody talks
about, like 9 and 12, 5, 6, six.
(51:57):
But we need all the B's, alphalipoic acid, we need zinc, we
need there are so many thingsneeded you know all those
micronutrients and if you don'thave you know the right
ingredients, you're not bakingthe right cake.
That's probably a bad analogy,but but yeah, you know, a lot of
(52:19):
the basics need to be there.
Speaker 2 (52:23):
So a quick question around mitochondria Do you know
why?
I'm sure you both know this,but do you know why brown fat is
brown?
Speaker 1 (52:32):
It's the amount of mitochondria really.
Speaker 2 (52:34):
It's packed with mitochondria, and some of that
brown is from the iron inmitochondria, so iron is another
important nutrient for them aswell.
Speaker 1 (52:41):
There's something I had on my list and we just
haven't got time to go throughiron dynamics today.
Will you be covering this inyour webinar though?
Iron dynamics, because it's a?
Speaker 2 (52:52):
huge issue.
Oh, I'll touch on iron.
I think we'll touch on ironjust because we're going to, but
we probably won't go into it inas much detail as some of your
other guests, so you might haveto wait.
I wish I had two hours topodcast with you guys.
Speaker 1 (53:07):
There's so much we could talk about, Guys.
Unfortunately we've run out oftime, but I'm glued Like.
I love listening to you guysand learning from you.
Every time there's always a newthing that I learn from both of
you.
Thank you so much for sharingyour time with us today.
I really look forward to thiswebinar.
Everybody, if you have anyinterest, you really need to be
(53:31):
attending this webinar.
You're going to be listeningand watching two experts, true
experts in this field, that canhelp guide you, and therefore
your patients, through thesedifficult quagmires of metabolic
health.
Lara Bryden, Keira Sutherland.
Thank you so much for joiningus today.
Speaker 2 (53:50):
Thanks.
Speaker 1 (53:50):
Andrew.
Speaker 2 (53:50):
Thanks for having us.
Speaker 1 (53:52):
And thank you everyone for joining us today.
Remember we'll have all of theshow notes for today's podcast
and the other podcasts on theDesigns for Health website.
Thank you so much for joiningus.
I'm Andrew Whitfield-Cook.
This is Wellness by Designs.
Music.
Welcome to Wellness by Designs.
(00:22):
I'm your host, andrewWhitfield-Cook, and today we
have a great treat for you.
We're joined by both LaraBryden and Kira Sutherland, and
today we're going to be talkingabout optimising metabolic
health for women.
Welcome to you both.
How are you?
Speaker 2 (00:36):
Hi, good morning.
Speaker 1 (00:38):
Guys, thank you so much for taking time out of your
busy lives to join us today.
I realise how busy you are, butI think first if I can ask you,
Lara, just how big a topic isthis in today's society?
Speaker 2 (00:54):
Well, really, when we say metabolic health, we're
referring to the problem ofmetabolic dysfunction, or
insulin resistance orpre-diabetes.
Conservative estimates are thatit affects at least 40% of
adults, so that is quite a bigproblem, and a lot of people, of
course, don't realize that theyhave insulin resistance.
(01:16):
Which is part of our workaround this is raising awareness
and helping people tounderstand the signs and
symptoms.
Speaker 1 (01:25):
So, kira, can I ask you then, if we talk about these
insidious signs and symptoms,what should we be first looking
for, even before people presentto clinic?
Speaker 3 (01:39):
Oh gosh, what a great question.
What should we be looking for?
There's just so many signs andsymptoms, I just think anybody
not feeling optimum, a sluggishweight gain we will go into
hormone balance as well but justanybody needing to be aware of
(02:02):
what's going on with our body.
I don't even know if I have a,I don't know.
Laura, set signs and symptomsyou want to.
Speaker 2 (02:08):
Yeah, I would say the classic sign of insulin
resistance is feeling hungry allthe time and being more prone
to episodes of hypogastemia orlow blood sugar, which is kind
of counterintuitive, I'verealized, because a lot of my
readers and patients think well,okay, insulin resistance, pre
diabetes, so that must mean highblood sugar.
(02:30):
But actually blood sugar can benormal in the early phases of
insulin resistance.
It can even be low at times andthat's from the metabolic
dysfunction itself, sort of notbeing able to have the steady
supply of energy you know,supplying the cells with energy.
So people get blood sugarcrashes and have to eat snacks
just to kind of keep theirenergy up.
That's a classic sign.
(02:51):
Other common signs and symptomsare elevated cholesterol.
You can get sort of changes inliver function tests, mild ones.
If a doctor has ever mentionedfatty liver, that is almost
always insulin resistance.
Not always, because of coursethere are other causes.
But again, I've talked to manypatients who have been told they
(03:12):
have fatty liver.
They're quite puzzled by that.
They don't understand thatthat's actually related to a
metabolic issue.
And then of course weight gain,but specifically the weight
gain around the middle, or thevisceral fat, that apple shaped
weight gain, and it's importantto say that it is possible to
have insulin resistance but havea fairly normal body size and,
(03:32):
conversely, it is also possibleto have maybe a higher BMI, such
as what happened with like astrong, um, what's called gyno
shape or hip bum, bum weightshape that women can get, women
can have that and and actuallybe relatively metabolically
healthy.
So it's not synonymous withweight gain.
But, um, yeah, you can tell I'mquite passionate about insulin
(03:52):
resistance.
I think, uh, it's yeah, wellthere's.
Speaker 1 (03:56):
So there's so many questions that stem from that,
so forgive me if I'm gonnaforget a few.
But firstly, um, one of thethings I wanted to just ask you
about and I'll ask you, kira, umwas women overtaking men with
cardiovascular disease.
This has been seen since the1980s, I think.
(04:17):
But you've also spoken aboutthe paucity of good research on
women.
So is this a case that womenweren't researched, or are we
really truly seeing a flip, anincrease in cardiovascular
disease in women over men?
Speaker 3 (04:41):
That's a great thought.
Look, I think it's both we have.
You know, women arecardiovascularly is that a word?
But our cardiovascular systemis quite protected until
perimenopause and then whenwe're starting to lose hormones,
we lose a lot of thatprotective buffer that the
hormones gave us.
So the cardiovascular riskgreatly increases once we're
(05:05):
hitting peri and menopause andbeyond.
There is risk before that, moregenetic and lifestyle, but our
risk, we're very bufferedbecause of hormones.
So the big risk then comes whenperi hits, and that is half of
women's lives.
They're now going to be atgreater risk.
(05:26):
So we don't have the same riskas men until we start losing
those hormones and then we havequite great risk.
And then the issue becomes wehaven't researched women,
especially in cardiovascularrisk, but we haven't researched
women nearly to the level of men, and so we also don't recognize
(05:48):
a lot of the early signs andsymptoms we don't recognize like
women presenting with a heartattack or myocardial infarction.
It can be a totally differentset of symptoms which get
dismissed even in emergency orwith ambulance or just by
general people.
(06:08):
They almost can have thesepre-dronal symptoms for a few
days while things aren't goingwell.
And so there is a lot ofeducation now around what the
extra different symptoms canpresent, extra different
symptoms can present.
But again it goes to the idea,or, you know, it goes to the
(06:37):
fact that women, through allstages of life, have a lot more
I don't really want to saymedical gaslighting, but a lot
more dismissive symptoms thatwe're told just to live with it
or that's normal, or your pain,just deal with your pain when,
when things are getting prettybad.
So I think it's a coupling ofeverything for them.
And then we have insulinresistance coming and then it
increases cardiovascular risk ontop of that what you said just
(07:01):
sparked anger in me, because Ihave actually seen this women
being told.
Speaker 1 (07:07):
It's all in your head with, we know, the
endometriosis story.
It's all in your head.
Actually, no other end of thebody mate, but but um, I've seen
, just so that you know.
I've seen women doctors dismisswomen for this and it's just
I'm befuddled.
But anyway, um, lar Lara, youhad something to add to that,
forgive me well, I was justinterested.
Speaker 2 (07:28):
So did you have some statistics suggesting that
overall um heart disease isincreasing in women?
Because one thing and I haven'tseen those numbers but one
factor is smoking right like menused to smoke a lot more than
women did, and so that thequitting smoking collectively as
a society has changed some ofthe numbers around um
(07:49):
cardiovascular disease right, um, so the the stuff that I'm
going off.
Speaker 1 (07:56):
I mean, I was looking at even things from cedar
cyanide.
I haven't looked at theaustralian institute of Welfare,
aihw, but I do remember readingsomething years ago that women
were overtaking men in certaintypes of heart disease.
Now whether that wascardiovascular disease I'm not
sure, but Cetus Sinai attributedit to the introduction of women
(08:23):
post the 1980s in equivalentamounts in the workforce, and I
think it goes much further thanthat.
But anyway, I think that'spretty much small.
Speaker 3 (08:38):
It's the late 80s and the early 90s when we started
actually allowing women intoclinical research in any number.
So the likely like I'm makingan assumption here, but the
likelihood is our stats wereprobably higher than we ever
knew.
But you know it's, life's toodangerous for women to be in
(08:59):
clinical research, or it was,and depending on what country
you're in.
There still are, or are not,laws around the inclusion of
women in research.
We are getting a lot better,but it's it's not.
Speaker 1 (09:12):
Some countries just have guidelines, not laws yeah,
um lara, if I can ask you, yeah,absolutely yeah, lar, can I ask
you?
You mentioned a few of thoseearly symptoms of glycemic
dysregulation and, whether it benormal, elevated or depressed,
(09:37):
with their glycemic measurements.
That smacks of what we see inHashimoto's, where, you know,
the gland that we're dealingwith is an efficient pump, if
you like, an efficient producerof the hormones, and so damage
doesn't really get to be 100%until a whole lot of the gland
(09:59):
is damaged and there's only acertain portion left.
Similarly, in the thyroid gland, it can sort of take the load,
if you like, during the damageof Hashimoto's, so you can go
have elevated thyroid hormones,depressed thyroid hormones, or
they can present as euthyroiduntil a certain point.
(10:20):
Is that what we're seeing?
Is it that?
The pancreas?
What are we talking?
Alpha cells, beta cells, arebeing damaged and we only see
the full metabolic dysregulationwhen a lot of those cells have
been damaged.
Speaker 2 (10:43):
Broadly.
I mean, I think the conceptyou're talking about is this
idea of metabolic reserve thatthere's some resiliency built
into the system at first and asit starts to fail, then you get
less ability to maintainhomeostasis for sure.
I think one difference with thatfrom thyroid, though, is a key
part of insulin resistance ormetabolic dysfunction is
(11:05):
actually what's happening in thecells and the mitochondria and
the you know the receipt.
The cells that are receiving theinsulin signal are supposed to
be receiving the insulin signaland, to be fair, that's a factor
in thyroid disease as well.
You can certainly get somedegree of resistance to thyroid
hormone, but it's not analogousin that.
Yeah, I don't really thinkabout the pancreas so much.
(11:28):
In fact, I don't even sort oftalk about the pancreas so much
in my latest book on metabolichealth.
I'm talking more about themitochondria that you know, the
cells themselves, a lot aboutthe liver and all the other
organs that are responding toinsulin and that are also
working together with thepancreas to try to control blood
sugar.
But yes, you're right in termsof what you described like the
(11:48):
dysregulation of blood sugar isend stage, like there are much
earlier problems with insulinresistance, including a lot of
inflammation, and just includingthe chronically elevated
insulin itself that's causingproblems really, years before
blood sugar goes out of rangeproblems really years before
blood sugar goes out of range.
Speaker 1 (12:10):
You mentioned inflammation there.
No-transcript.
Speaker 2 (12:14):
Yeah well, the state of being an insulin resistance
or being metabolicallyinflexible is a state of
inflammation.
It's bidirectional, sochronically elevated insulin
creates inflammation to someextent and also underlying other
causes of inflammation cancreate insulin resistance,
(12:36):
create insulin resistance.
I'll give an example that wouldbe interesting to, as
naturopaths because, of course,where everything always comes
back to the gut.
So there is quite a bit ofresearch.
Andrew, I'm sure you would havecome across the term metabolic
endotoxemia before.
I think that's a reallyimportant one.
This is about essentially theLPS, like the endotoxins coming
(12:58):
from the gut via intestinalpermeability, inducing insulin
resistance in the rest of thebody.
In part, by the way, itinflames the visceral fat
directly because it's in closeproximity, the intestines right
there, and then, of course, itaffects downstream from that, it
affects the liver and itaffects the body's ability to
(13:19):
respond properly to insulin, tometabolize energy properly.
And how many of us clinicians?
There's two patient stories inmy new book about metabolic
health where you fix the gut andthen their sugar cravings just
go away.
I mean, one of the patients issomeone who she knew she should
stop having sugar.
She was really craving sugar.
She was trying to mentally makethese changes and I was like,
(13:41):
well, let's just, let's justwait, because you do have SIBO
and intestinal permeability orin one case, you know you have
blastocystis going on, you knowparasites in the gut, so let's
focus on the gut and then seewhat happens.
And that is a good example ofhow dynamic metabolism is
metabolic health is.
It's not in a separatecompartment from the rest of
(14:03):
health, right, like it'saffected by gut health.
It's affected by hormone health.
It's affected by the nervoussystem in a big way.
It's probably ultimatelycontrolled by the nervous system
, actually I would say even moreso than, say, by the pancreas.
It's a very dynamic part of ourhealth and it goes very deep,
right to the level of themitochondria, which is why
there's so many you know just somany factors, so many
(14:27):
interconnections.
Speaker 1 (14:29):
Kira, can I ask you then?
You deal with a lot of athletesand exercise is an important
component in metabolic health.
Talk to us about how importantexercise in how.
How important exercise is, howdoes that tie into inflammation
(14:50):
or managing inflammation, likepeople who over exercise, for
instance, or try to keep up withsomebody who's who's at a
higher level of exercise, andthey just get inflamed.
And yet there's that conceptthat some stress is good, even
for our mitochondria.
Speaker 3 (15:10):
Yeah, oh my gosh, that was like five questions.
So, and Laura?
if you want to come in on theinflammation.
One Exercise is, I mean, weknow how important it is, but
especially in insulin resistanceor metabolic inflexibility, if
we're saying, you know, yes, weneed the body to be in this
(15:31):
healthy state, we need the rightnutrients, we need that gut
health and decrease theinflammation, support the
nervous system, all of thatholistically comes into play.
But unless you have or areworking on fitness, you are not
oh my gosh, so many things.
You're not stretching thecardiovascular system but you're
(15:51):
also not creating mitochondria.
We got to remember mitochondriaresiding in all of your muscle
cells.
You know there's millions ofthem.
But unless you're buildingmuscle or maintaining muscle,
especially as we age, we aredrastically losing mitochondria
and their ability to functioncan decrease as well.
(16:12):
So it's, you know, oh my gosh,there's so many things to be
done there, working onmitochondrial health, in
building muscle, actually doingyou know the big thing again,
this is, you know, women, oncethey hit Perry and beyond, but
really it's for everybody we'rerealizing how important doing
weights is over constant cardioor high thrashing cardio.
(16:36):
You know people doing HIITclasses all the time hoping
they're going to burn fat.
It's yes, hypothetically that'sworking, but only to a degree
and then overtraining, creatingtoo much stress on the body,
creating too much inflammation.
There's that, that fine linebetween how much exercise is
(16:56):
optimum versus too much, andit's different for each person
male, female, different bodyshapes can cope with different
volumes of stress as well, we'refinding.
So there's that whole I meanit's a whole spectrum of what's
working for your body might notbe working for somebody else,
but the more we're exercisingand creating, you know,
(17:20):
mitochondrial biogenesis, thebetter we are for maintaining
the right physique that we'relooking for, optimum physique,
because it's more engines toburn more fuel.
People, people often forget theonly place we're burning fat in
the body is inside themitochondria.
So we need healthy mitochondriaand able to allow, you know,
(17:44):
both fat, carb and proteinburning, which is a big thing.
And if we're unfit, if we'relow in muscle, if we're insulin
resistant, the problem is withinsulin resistance or the issue
is you at a lower level or lowerlevel of fitness, lower issues
with insulin, we will pop intocarb burning.
(18:07):
I'm being very unscientifichere, but you pop into more
predominant carb burning quickerthe less fit you are.
So it's also the slow processfor people, as they gain fitness
and mitochondria health, thatthey will.
Their engine will start to burnbetter, but we need to give it
(18:28):
time.
And if we're going too highintensity all the time, we're
not.
Yes, it's great for the body,but we're not assisting um,
we're not slowly getting themitochondria to do a better job
yeah, I hope that made sense.
Speaker 1 (18:43):
Um lara, have you got anything to add to that?
Speaker 2 (18:46):
I just want to ask a question about types of fat yeah
, yeah, well, I was just gonnado things so in and kira and my
upcoming webinar forpractitioners about metabolic
health for women.
We are going to talk aboutdifferent body types pretty much
what Kira just touched on there, like different body, not just
shapes, but I would saydifferent nervous system types,
(19:08):
different metabolic types.
Really, people do better withdifferent types of movement.
So some people love that kindof high, that high intensity,
rapid sort of movement.
Some people are going to dobetter with the slow strength
training or you know, thewalking, and it's a lot to do
with the nervous system.
So we're going to explore thatin some detail.
I'm really looking forward toour usual back and forth when we
(19:30):
do our duet style webinars.
We have fun together sharingour knowledge.
And then the other thing, justto touch on what kira was
talking about there, which isjust an important detail that I
sort of want everyone tounderstand in a healthy with a
healthy metabolism, with healthyinsulin sensitivity, healthy
metabolic flexibility, ourdefault when we're at rest or
(19:53):
engaged in light activity is fatburning.
Fat burning is our actuallywhere we're supposed to be and
in a healthy state we shouldreally only tip into more
predominantly carb burning whenwe're engaged in high intensity
exercise.
As a caveat, we're alwaysburning a mix of fuels.
I don't want anyone to go awaythinking we're only burning fat.
(20:15):
It's always a mix, but itshould be predominantly fat
burning when we're healthy atrest.
Yeah.
Speaker 1 (20:23):
You know, I think the point there is you get these
people that go I'm going to burnfat and they're like this tense
and they're not enjoying theexercise.
I have to go to the gym I hateit but I'm going to.
You know that sort of thingrather than going for a bushwalk
(20:43):
or going for a walk along thebeach and enjoying the walk and
moving the rest of their body,not just their legs.
And you know the thing, thepicture in my mind that that is
conjured is the, the blue zones.
And I picture this.
You know, grandmother fromCorsica climbing down the
mountain steps for her lovelanguage, which is cooking for
her family, and collecting theherbs and the vegetables out of
(21:05):
her garden that's a little bitdown the path and putting them
in a basket and walking up.
She's bent over, she's movedher hands and her upper body and
then she's doing the walkingand carrying extra weight and
then she goes.
And all of this is involvedwith a love you know, and and I
think if we could engender thatin our patients to love what
(21:26):
while they're exercising, toreally enjoy it, it's, it's a
major flip, going right back toinflammation there yeah, can I
just say too, exercise is not apunishment for anything we've
done or anything we've eaten.
Speaker 3 (21:41):
Exercise should be joyful and, again, part of what
we'll explore.
But the whole body type ornervous system type what types
of exercise suit you so thatthey don't put too much stress
on the body?
Because some body types can goreally hard early in the morning
and they can handle that high,high cortisol.
Other body types are going toreally struggle, you know
(22:05):
they're more sensitive to thatmorning high cortisol and we'd
be better off exercising in theafternoons and just finding the
exercise that you love,absolutely bushwalking, hiking,
gardening, my god, you know ifyou're talking blue zones.
Gardening is some pretty hardexercise.
My body hurts gardening.
But yeah, whatever's workingfor people it's not.
(22:28):
Yeah, and I find for a lot ofpeople too, and you know, it's
kind of getting away fromnaturopathic principles more
into exercise phys.
But also, you know, socializingwhile you exercise is a big
thing for some people and that'sincredible, especially for
women, for our nervous system.
You know we have all thisresearch around being with other
(22:50):
people being so great for ournervous system and calming us,
and I think we forget that andthen we suffer alone, thinking
we have to do all this exerciseby ourself.
Speaker 1 (23:01):
Yeah, get a dog and exercise with it, or get a cat
and watch it while you'reexercising.
Speaker 3 (23:10):
Something else I wanted to say about exercise.
But yeah, keep going.
Speaker 1 (23:16):
Can I just go back to when you were mentioning fat.
We've got different types offat brown versus white and
there's some research showingthat you can actually change
that.
Have we got any more researchon what we can do to effectively
change to having more brown fatand therefore more of a
thermogenic body type?
Speaker 3 (23:39):
Laura, you want that one, yeah.
Speaker 2 (23:41):
Laura sorry.
Speaker 3 (23:41):
Well, there are lots of theories.
Speaker 2 (23:43):
I mean the research around brown fat and beiging
white fat into brown fat is, Ithink, all pretty new.
I don't know.
I'd love to hear what Kirathinks.
I don't think there's much sortof evidence-based conclusive.
This is something you can dofor sure.
I mean, it's only been like 20years since we even discovered
that adult humans have brown fat.
Before that, before that, wethought only infants and
(24:05):
hibernating mammals had it.
So this is all quite newinformation.
I mean I think it is theresearch is clear that people
who do have more active brownfat do tend to have healthier
metabolism, like they tend to bemore insulin sensitive.
That's.
Some of that's going to begenetic, some of it's just luck.
I mean, I don't know, there'sdifferent factors.
(24:26):
I said what do you think here?
Is there anything?
Any tried and truerecommendations?
For that?
Exercise was one way,potentially exercise.
Speaker 3 (24:34):
It's definitely genetic, you know carrying fat
is.
So let's, let's be honest,carrying fat is so genetic, it's
you know.
And it's definitely genetic,you know, carrying fat is.
So let's, let's be honest,carrying fat is so genetic, it's
, you know.
And it's also, have you turnedon those genes that are, you
know your body's starting tostore more as well, so it's
genetic lottery.
And then how well, you keepsome of those genes turned off
or not with, but with brown fat,you.
(24:55):
The one thing that comes to mindis cold exposure, but I went
down a rabbit hole on this theother day.
How much research we have onfemales and cold exposure versus
males is also questionable.
And I like cold exposure, Ilike the idea of it.
(25:15):
But again, we take ideas andthen we go so hard with them and
we do it all the time.
And I would question for thefemale physiology, and there are
people pointing out too coldmight be too much for a female
body, or, you know, we might notneed to be as extreme as we
think, but I don't know how muchdeep research there is on that
(25:40):
yet.
I think that's kind of up andcoming, but I would, you know,
it's just like people talkingabout fasted training.
Fasted training, you know,exercising in the morning while
fasted, yes, you hypotheticallywill burn, we know you'll burn a
few more grams of fat.
But eating before trainingactually helps stabilize
(26:01):
cortisol.
You know, cortisol will not goas high during training if
you've eaten a little bit,especially carbohydrate, before
training.
But protein can work and thereare theories that you know,
especially for certain bodytypes who are more sensitive to
cortisol in the mornings, itmight be better eating before
training, just a little bit,something to attenuate that rise
(26:22):
in cortisol, so the body's notfreaking out all the time that
you know it's starving.
So, oh my gosh, it's a littlebit of everything works really
well, but as humans we're likemore is better and then we dig
ourselves a hole.
Speaker 1 (26:38):
I think is really where my opinion is coming to so
is this what you're going to becovering in your webinar?
You're going to be coveringdifferent body types, different
genetic types, obviously, andthen how there are commonalities
between that that we all shoulddo, and then are you going to
(26:59):
branch off into how that bodytype, for instance, a gynoid
body type, might be betterserved by a certain type of
exercise and perhaps eatingpatterns, and then an android
type body type might have adifferent set of specific
(27:20):
regimens to stick to.
Speaker 2 (27:23):
Laura.
Well, actually the body typeswe're going to touch on and it
will just be part of the webinaris actually the PH360 sort of
six body types which are morebased on kind of an expanded
version of the ectomorphmesomorph kind of endomorph
types, which are more based onkind of an expanded version of
the ectomorph mesomorph kind ofendomorph types, but from a
female perspective in our case,and so, but the webinar is a
(27:45):
half-day webinar.
We're going to it's sort of a,it's a look, a closer look at
insulin resistance and how toassess that and how to treat
that and recover.
And Kira is going to talk a bitmore about the metabolic
flexibility she's just beendescribing this sort of moving,
this what's called sort of acrossover point between burning
(28:07):
fat and burning carbs andbasically being able to stay in
fat burning for more of the time, or predominantly fat burning
for more of the time, which isbeneficial for metabolic health
and just for feeling better too.
So it's not just about, you know, it's definitely not just about
obtaining a certain bodycomposition or anything.
I mean, I really don't evenreally like the term body
composition.
I think it's about havingenergy and feeling good and
(28:29):
having a reduced inflammation,reduced risk of heart disease
and all the downstreamconsequences of insulin
resistance if it's not addressed.
And for everyone listening,insulin resistance or
pre-diabetes is 100% reversible,so it can be a little bit
different for every person interms of how long that takes and
(28:50):
what strategies they want toemploy.
There really isn't a cookiecutter one size fits all, which
is why we need a half a daywebinar to explore it, and, of
course, it's also the topic ofmy new book on metabolic health,
so I'll be drawing on some ofthe things I learned when I was
writing that book.
Speaker 3 (29:08):
Yeah, yeah and we're, can we go?
Speaker 1 (29:11):
into therapy.
Oh sorry, you go yeah, so it's.
Speaker 3 (29:15):
You know, body typing is only one little thing we're
going into because it's, youknow, it's a little lens that we
have to, you know, look atbetween each person, because
it's not one size fits all.
But you know, I'm the numbersgirl when it comes to our
lectures, of doing much morelike.
We're looking at macros, we'relooking at, we are going to look
(29:36):
at calories, because you can'tnot look at fueling a body, not
calorie counting per se, butwe're going to look a lot at how
the physiology of the body isoperating in insulin resistance
or when somebody is moving awayfrom it, and the things that are
going to, the things we need tobe doing to get there to a more
(29:57):
, you know, a better staterather than insulin resistance.
So it's very much, we're verymuch not teaching just the
science.
We're teaching or presentingvery much a how to, what to go
do with this.
Right, you need something to godo rather than just learning
the theory.
Speaker 1 (30:16):
You need something to go do rather than just learning
the theory, let's go into whatwe can use alongside our
exercise and our diet therapy.
What do you find most to havemerit?
Things like you know, forinstance, polycystic ovarian
syndrome, with, you know, usingmyo-inositol, for instance.
(30:39):
Now, professor Annabelle Tbasically dismissed myo-inositol
in her.
I've got to say it was afantastic podcast on polycystic
ovarian syndrome.
This was a medical one, and Isuspect, though, that one of the
reasons she dismissed it wasbecause many of the supplements
(31:01):
out there that have myo-inositolin them have a paucity of dose.
They have, you know, a few 20s,or you know, scores of
milligrams, or maybe a couple ofhundred milligrams, but I've
seen gram doses of myo-inositolbeing employed.
Where do we go here?
Speaker 2 (31:22):
Well, I could speak to Lara.
Yeah, go ahead.
Yeah, I mean, inositol is quitean important supplement for
metabolic health.
I'll just preface it though.
I'll just say just again, it'skind of a bit of a paradigm
shift around this.
But I guess my key messagearound metabolic health and I'll
explore this in my book andI'll explore this with Kira in
our webinar but it's it's notseparate from general health,
(31:46):
right, like it's really not.
It's not like we've got thethings we need for it to be, you
know, to feel good and haveenergy and have general health,
and then the things we need formetabolic health.
They're one and the same.
So this is where thetroubleshooting approach comes
through in my book.
I'll explore that a bit in thewebinar as well.
Like you really do, you know,fix your health and you'll fix
your metabolism.
This is like similar to theprinciple from my first book on
(32:08):
period health is fix your healthand you'll fix your period.
They're not separate.
So this is why I give examplesof fixing it for some people
fixing their digestion andthey'll, you know, fix their
metabolic health.
So there's there's differentways to access it, different
levers you can pull.
But in answer to your questionon inositol, it is a
particularly well-researchedsupplement for insulin
(32:31):
resistance and there's not apaucity of data.
Actually, there's a huge amountof data on inositol for the
insulin resistance of polycysticovary syndrome and
perimenopause.
I mean, I would say it's one ofthe most evidence-based
supplements out there.
So I'll have to circle back andlisten to the podcast, where
she maybe, I guess, didn't feellike it crossed some kind of
(32:55):
finish line to arrive attreatment, but it was included
in the international guidelinesfor PCOS, both in 2018 and in
the updated ones now.
So it's one of the fewsupplements that's actually come
pretty close to crossing thatfinish line to get there, and I
know a lot of doctors use it andit's well.
Just speaking anecdotally, it'sextremely popular in the PCOS
(33:16):
space and you're right, it'sgram dose.
Speaker 1 (33:20):
I think her opinion was based on the paucity of
doses that we have insupplements.
Speaker 2 (33:25):
Oh, the low doses?
Yeah, no, it's a gram dose.
It's probably four to six gramsa day to get there and it works
in each and every cell right.
So we need quite a lot of itbecause we have quite a few
cells.
So one of the things it's doingis it's doing different things,
but it improves the signalingof insulin directly, enhances
(33:46):
insulin sensitivity.
It also improves thyroidfunction and sleep.
Speaker 1 (33:54):
Now, I didn't know that about thyroid.
Speaker 2 (33:57):
Yeah, it amplifies Tsh inside the cell.
It's um an intracellularmessenger, so it kind of.
I forgot the.
I'm not a biochemist so I don'thave the exact sort of details
of what it's doing, but it'skind of relaying the message of
different hormones inside cellsand it's, yeah, it's, it's
pretty popular.
And what a couple just fun factsabout inositol.
(34:17):
Um, we can make some of it, sothe body does make some.
So there's that.
I mean we, we traditionallywould have had a lot more in our
diet because, um, the I thinkit's a type of phospholipid.
Phospholipid inositol is quitehigh, um, in high concentration
in organ meats.
So I do think in my, in my bookon metabolic health I do talk
(34:38):
about our disconnect from ourtraditional diets and how that
has in part set us up formetabolic dysfunction.
Chapter one is called.
You know, metabolic dysfunctionis not your fault.
Some of it is the drasticchange in our food supply and
also environmental toxins, whichwe haven't even really touched
on yet.
But that is having a epigeneticor an intergenerational effect.
(35:00):
So that now I mean thisintergenerational effect is
pretty important.
So we are now getting teenagerswith pre diabetes, in some
cases type two diabetes andfatty liver.
That was unheard of 50 years ago.
And it's not like 50 years agoour diets were perfect.
I don't know about you, kira,but like you know, I would eat a
whole row of Oreo cookies or,you know, chips, or, like you
(35:23):
know, I wasn't.
I mean, I had in many waysthere was a good diet in my
house, but not perfect.
But we back then in the 70s, wethere was not the 70s and 80s,
when I was a kid and a teenager,there was not the insulin
resistance and obesity thatwe're seeing now.
So this something has do youhear what I mean by amplifying
each generation?
This is epigenetics.
(35:43):
So kids are being set up likein utero and even before they're
born, actually with, you know,genes being switched on and off
to be extra vulnerable to ourmodern environment, including
our food environment.
Speaker 3 (35:58):
Yeah environment.
Speaker 1 (35:59):
Yeah, yeah, anything to add?
Speaker 3 (36:01):
yeah, well, we just have that old.
You know, ultra processed foodis the big word, you know,
everyone's now using it.
If we look around, it is.
It's not just the liquidcalories coming from sodas,
although there is um research Iread a little while ago saying
teenagers get somewhere between60 and 80 percent of their daily
calories by a liquid, which isjust a frightening statistic.
(36:24):
I think that was a US statistic, I'll just put that there.
Yeah well, you can buy biggulps over there.
You know, in Australia our sizeof drinks is actually smaller
than over there is actuallysmaller than over there.
But yeah, ultra-processed foodreally hit in the late well, I
(36:47):
think it was the late 50s, early60s, and then by the 70s we
have a lot more of it.
And yeah, what's happening withour genetics?
Is it getting turned on or not?
So I had this discussion theother day with some other
practitioners and they werecommenting that I am always lean
.
If people have not met me, I'mnot a super skinny person, but
I'm very fit and tall, and Lauraand I always joke about this
(37:10):
I'm built like a big Viking andLaura's built like this tiny
little.
We're very different body types,so we love lecturing all this
stuff because it's so differentfor each of us.
But you know, even if we'recoming from a genetic background
, that's not great.
I definitely own every obesitygene that you could inherit from
(37:30):
my genetics.
It's just about that diet andlifestyle, not turning it on or
keeping it quiet.
Keeping it.
Diet and lifestyle, not turningit on or keeping it quiet,
keeping it, you know, asleep.
That's going to come into playfor a lot of people as well, if
you don't feel like you've wonthe genetic lottery which I
definitely didn't, which is whyI studied nutrition.
Speaker 1 (37:52):
Let's go back to we're circling back a bit here.
Lara, you were talking abouthow important the gut is.
You know, and you fix the gut,everything else falls into place
.
Talking about supplements thatwe can employ here, ordinarily
we would think about employingbacteria probiotics and
obviously, to go with that,prebiotics to help them stay and
(38:13):
proliferate in the gut.
But what about other thingslike berberine, where it's got
this sort of other effects withhelping blood sugar control?
How do we employ it responsiblywhere it doesn't become an
quote-unquote anti-infective, iedecimating the good guys?
How do we employ it effectively?
(38:37):
What dose do we use?
How long should we use it?
What are the caveats to use?
Speaker 2 (38:43):
Well, there are lots of different opinions about this
, so I will just point out thatberberine obviously is a
superstar for metabolic health.
It's also very popular.
It's quite similar to metforminin some ways terms they both.
For example, they bothstimulate a something called am
ampk.
It's a kinase that's likethat's very involved in um, in
(39:06):
metabolic signaling.
But they also are both, as youpointed out, antimicrobial
antibiotic and that is possiblyhow, in part, how they work, by
reducing the metabolicendotoxemia that I talked about
earlier.
So especially if they'reknocking back a SIBO or a small
intestinal bacterial overgrowththat is driving intestinal
(39:26):
permeability and metabolicendotoxemia, that could be one
mechanism by which they'reworking.
In terms of your question, likehow to dose it, I can tell you
what I do with my patients andthen we can here, we can get
here from here, and then youknow, we can see what you think,
andrew, it's.
I mean, certainly there areproducts out there that are seem
to be recommended to dose them,ongoing daily.
(39:47):
That's not what I personally,isn't how I personally use
berberine.
I tend to use it and the way Italk about it in my book.
I think it's secondary to saymagnesium or inositol or choline
is another important nutrient,that part of these um key, five
key metabolic nutrients that Iidentify in the book.
And then berberine is like anaccessory one that would be
(40:07):
particularly helpful, I think,if there's SIBO.
So if there is, if there aregut problems, then I would
technically typically do like aeight week course of it.
I don't do it every day becausethere's some research that
berberine works better if youtake it maybe five days a week.
So I might say you know, takethis berberine product twice
daily, weekdays only.
(40:28):
You just take a little break onthe weekends, take it for one
bottle, then take a break, thendo another bottle.
And of course that's afterscreening for any
contraindications, becauseberberine can interfere with
certain medications.
It's not safe during pregnancyor breastfeeding, so I think
it's not suitable for people whoare taking metformin.
I think it has to be metforminor berberine, not both, although
(40:50):
metformin can be combined withinositol or magnesium or some of
the other ones.
So that's kind of my view.
I'm open to change on this,like I'm open to new information
and revising my opinion aboutberberine.
I know there's lots of debateabout how to use it, what.
What do you do, kira?
How often do you prescribe it?
Speaker 3 (41:10):
yeah, I tend to do kind of four to six weeks on and
then four to six weeks off.
I hadn't read that researchabout not every day, but I'm
always under the assumption myclients forget to take
supplements.
A few days a week.
Speaker 2 (41:23):
It's a safe assumption.
Speaker 3 (41:27):
I'm a huge fan of berberine over metformin.
I mean, if people are metforminand it's working for them,
that's great.
But from a physiologyperspective there is some
research saying metformininhibits muscle growth.
So I'm always keen again,legally I would never take
(41:47):
anybody off any drug, but I'mkeen for the more natural.
You know I'm keen for berberineover metformin if I can,
especially if we're trying togrow muscle which is growing
mitochondria.
So I just I struggle with thatone a bit because I'm working
with so many athletes, but Ihave a lot.
You know, stats came out thisweek that 40% of Olympic female
(42:09):
athletes potentially have PCOS.
Did anybody see that stat?
No, yeah.
Oh yeah Well, so Olympics is onthis week when we're filming
this and but it makes sensebecause they have higher
androgens and a little bithigher androgens makes you a
better athlete for a lot ofdifferent sports.
So big conversation and I thinkthat's beautiful to know for
(42:31):
the people with pcos is 40 ofthese elite athletes are dealing
with that.
Speaker 1 (42:38):
That's quite stunning .
I thought it was androgendysmorphology, but it could be
just androgens driving it.
Is that what you're saying?
We?
Speaker 3 (42:46):
don't know.
I would love to see everybody'slife.
Speaker 2 (42:50):
I suspect what's happening is that sort of the
higher androgen women are theones that succeed at sport.
For some sports it's going todepend on the sport and there's
a there's a sliding scale ofandrogen, like at what point do
you cross over to being androgenexcess, you know, sort of.
And also we're all higherandrogen when we're younger.
That's true for men and women.
Speaker 1 (43:11):
So, yeah, this is yeah but it tends to trash that
old.
It tends to trash that old um,concept of polycystic ovarian
syndrome.
Was that syndrome X, where theapple-shaped obesity and
da-da-da, it just trashes it,doesn't it?
Speaker 2 (43:28):
Oh well, I hear what you're saying to have androgens
but not insulin resistance.
Speaker 1 (43:33):
It's completely possible to have androgens?
Speaker 2 (43:36):
Yeah, of course.
They don't have insulinresistance?
No, of course.
Speaker 3 (43:38):
They're doing an awful lot of exercise.
Speaker 2 (43:42):
Pcos is not, I would say.
The research suggests that atleast it depends on the
individual.
But I think there's many caseswhere the androgens come first
and then, in women, androgenexcess promotes or causes
insulin resistance, and in theother direction as well.
So it could become a viciouscycle.
Speaker 1 (44:02):
Gotcha Okay.
So moving on.
We've spoken about stress quitea lot.
Let's talk about things that wewould ordinarily use magnesium.
There's certain beautiful herbsthe ashwagandhas, the ginseng,
the American ginseng just sayingI love American ginseng Are
there any particular herbs andnutrients that you employ for
(44:24):
stress?
And particularly I'm going toask this on a personal level
what about those women that runon stress?
Speaker 3 (44:37):
Laura, do you want to go first?
Speaker 2 (44:39):
Well, I mean of, of course, my combo is magnesium
plus taurine.
I talk about that in all threeof my books.
They both support gaba,although, to be fair, there are
some people who don't feel greaton taurine, but most, most of
us do.
And there's just a new product,a new supplement which I just
ordered for myself to try, whichis a particular version of a
magnesium taurine chelate.
(45:00):
I think it's like lipophilic orsomething, or like it's got
some extra absorbable so itapparently crosses the blood
brain barrier.
I should have researched thisbetter before mentioning it
today, but it's a magnesiumtaurine combo that is supposed
to be extremely calming.
So, yes, so that's a good combo.
I'm also a fan of adaptogens andsome of the anxiolytic herbal
(45:23):
medicines I'll mention.
I'll give a plug to glycine aswell.
Glycine is one of the other.
That's one of the five of myfive metabolic nutrients.
So glycine is also very calmingand is done well in terms of
treatment for metabolicdysfunction and insulin
resistance.
It works in a few ways, but oneof the ways is probably calming
the nervous system.
(45:44):
Promotes sleep.
Speaker 1 (45:46):
But what dose do we have to employ of glycine there?
Speaker 2 (45:50):
Gram dose.
Three grams, yeah, probably.
I mean you're getting some withthe magnesium glycinate, so you
get.
I just had a quick look like atyour standard dose of magnesium
glycinate.
That would deliver 300milligrams of magnesium.
Sorry, I think gives you aboutone point something.
Maybe 1.4 grams of glycine.
It'll depend on the product,but the therapeutic target range
(46:12):
for glycine is about threegrams, so people can top that up
if they want to.
I saw someone on Twitter theother day talking about glycine
saying this can't be right.
You know it tastes sweet, ittastes nice, it has no side
effects and it helps you sleep.
It's like where's the catch?
You know where's the downside.
Speaker 1 (46:31):
Kira anything to add?
Speaker 3 (46:34):
Well, I'm all about the magnesium taurine as well,
obviously.
And Well, I'm all about themagnesium taurine as well,
obviously.
And I'm all about the nervoussystem herbs.
Yes, adaptogens as well.
You know any, any and alladaptogens, but especially with
an ear, ashwagandha.
I'm huge on schisandra becauseit's also we're getting that
(46:55):
little bump for the liver.
I think it's an unforgotten,not forgotten, but we, yeah, I
just think it needs a biggerplug.
Yeah, schisandra, withania,especially, I use them in
combination in the mornings forpeople.
I love the ginsengs.
The ginsengs, I think, are kindof forgotten these days and I,
(47:16):
especially Siberian ginseng,love it.
I do love the American ginsengas well we don't talk about that
enough in Australia and nervoussystem herbs.
So I'm loving the magnesiumwith nervous system herbs at
night, just to help pulleverything down, better sleep.
(47:36):
One of the things we haven'ttouched on today and I'm not
meaning to take it away fromsupplements is circadian
alignment and the research oncircadian, and it's a big part
of our talk.
It's a big part of the bit thatI'm talking on is circadian
alignment and misalignment.
You know, one week of circadianmisalignment starts to show
(47:59):
insulin resistance signs.
So really getting back torhythm of when we should be
eating when we should be slatingthe rhythm even of our
digestive system, which oftenisn't talked about.
You know our insulin worksbetter at different times of the
day.
So that's you know.
I'm a huge back to supplementson great.
(48:22):
You know magnesium, herbalsupplements that help you sleep,
I think, are a big part of thispicture, as well as
mitochondrial supplements.
You know things that help.
You know we forget about ATPand actually energy creation in
the cell.
There's so many nutrients thatwe can easily be deficient in
(48:43):
and we then don't make as manyATP per glucose unit or per fuel
unit, and it comes down to howgood we feel, how much we can do
per day.
Speaker 1 (48:55):
Yep comes down to how good we feel, how much we can
do per day.
Yep, can I?
There was something I've beenmeaning to ask, and it goes
right to the beginning of ourchat.
When we were talking aboutmitochondria, we would
ordinarily think about, yes,coq10, that's, it's just the
automatic nutrient that we thinkof for mitochondria.
How do you use it, though?
When we're talking aboutbalancing it, if you like, with
(49:18):
inflammation or stressing themitochondria, do you use
magnesium always alongside it?
Can I get a comment from youplease, lara, just about if and
when you use CoQ10?
Speaker 2 (49:30):
I don't prescribe it that often, not that I think
it's not good, I mean I thinkit's certainly occasional.
I prescribe it for maybefertility or certain aspects,
but I think I mean my go-to.
We've been talking a lot aboutmagnesium.
The mitochondria love magnesium.
They seriously love it.
It's like it's, you know, it'sit's inside their, you know it's
part of their key electrolyteor mineral for functioning.
(49:54):
And also just mitochondria.
I'm starting to think of themquite differently.
Actually they are not.
They're way more than just likeone little cog in the machine,
like they.
They're super dynamic and therewas just some research which
unfortunately did not make itinto my book because it's that
new.
It just came out in the lastmonth or so that mitochondria
(50:16):
change just in response topositive versus negative
experiences, basically beingwith a person you love or you
know going camping.
Well, your mitochondria will belike hooray, you know they'll
multiply.
Yeah, it's pretty amazing, soobviously.
Kira mentioned.
Yeah, kira mentioned.
You know, moving the body,building muscles, stimulates
(50:39):
mitochondria.
Mitochondria respond to everyhormone, especially estrogen and
thyroid hormone Mitochondria.
Really, there's certain thingsthey don't like, obviously, just
any kind of overeating, anykind of energy excess in general
is quite stressful formitochondria, but sugar in
particular can be quitestressful for mitochondria,
alcohol for sure.
(50:59):
And also I'll just inject alittle maybe controversial point
about a food substance thatmight be toxic or not toxic, but
you know, harmful tomitochondria and high dose would
be linoleic acid or omega six.
This is the whole seed oilcontroversy.
We couldn't have a podcastabout metabolic health without
touching on the seed oilcontroversy.
(51:20):
But if seed oils are causing aproblem with metabolic health
and insulin sensitivity, it'svia what they're doing to
mitochondria, I think, as,amongst other things probably.
Speaker 1 (51:30):
Yeah kira anything to add there with regards to a.
Speaker 3 (51:35):
I want that research.
Laura, send it through.
Yes, I'll send it ready to dolectures.
Research kind of goes back andforth a lot.
Look um, for mitochondria, foratp production.
If we think about that, we'relooking at all the b vitamins.
You know b1, b2, b3.
Often you know they're not theheroes that everybody talks
about, like 9 and 12, 5, 6, six.
(51:57):
But we need all the B's, alphalipoic acid, we need zinc, we
need there are so many thingsneeded you know all those
micronutrients and if you don'thave you know the right
ingredients, you're not bakingthe right cake.
That's probably a bad analogy,but but yeah, you know, a lot of
(52:19):
the basics need to be there.
Speaker 2 (52:23):
So a quick question around mitochondria Do you know
why?
I'm sure you both know this,but do you know why brown fat is
brown?
Speaker 1 (52:32):
It's the amount of mitochondria really.
Speaker 2 (52:34):
It's packed with mitochondria, and some of that
brown is from the iron inmitochondria, so iron is another
important nutrient for them aswell.
Speaker 1 (52:41):
There's something I had on my list and we just
haven't got time to go throughiron dynamics today.
Will you be covering this inyour webinar though?
Iron dynamics, because it's a?
Speaker 2 (52:52):
huge issue.
Oh, I'll touch on iron.
I think we'll touch on ironjust because we're going to, but
we probably won't go into it inas much detail as some of your
other guests, so you might haveto wait.
I wish I had two hours topodcast with you guys.
Speaker 1 (53:07):
There's so much we could talk about, Guys.
Unfortunately we've run out oftime, but I'm glued Like.
I love listening to you guysand learning from you.
Every time there's always a newthing that I learn from both of
you.
Thank you so much for sharingyour time with us today.
I really look forward to thiswebinar.
Everybody, if you have anyinterest, you really need to be
(53:31):
attending this webinar.
You're going to be listeningand watching two experts, true
experts in this field, that canhelp guide you, and therefore
your patients, through thesedifficult quagmires of metabolic
health.
Lara Bryden, Keira Sutherland.
Thank you so much for joiningus today.
Speaker 2 (53:50):
Thanks.
Speaker 1 (53:50):
Andrew.
Speaker 2 (53:50):
Thanks for having us.
Speaker 1 (53:52):
And thank you everyone for joining us today.
Remember we'll have all of theshow notes for today's podcast
and the other podcasts on theDesigns for Health website.
Thank you so much for joiningus.
I'm Andrew Whitfield-Cook.
This is Wellness by Designs.
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