 Hey, this is Dr. Mike Teenelson here, and I'm doing a presentation of a screencast here of one I did at the Ancestral Health Symposium in 2013. Fortunately they had a few issues with recording it, hence the screencast and not a live performance, but I wanted to thank them very much for inviting me to come down there and give this presentation, and I wanted to be able to share it with all of you. So I'm talking about metabolic flexibility, and my overall argument here is carbs as a hormetic stressor, survival advantage, or a completely horrible idea. So thank you very much to AHS and letting them present some science to you. If you ever had the chance to go to their conference, I would highly recommend it. I had an absolute blaster this past year, and I will definitely be back again. So very good times. So my goal in about 20 minutes or so here is two things. One, hopefully to make you think differently, explain a little bit about what metabolic flexibility is also. The role of carbohydrates and possibly the role as a hormetic stressor, and if you don't know what that means, we'll get into this. And do they offer a survival advantage? Usually in 20 minutes, probably shouldn't present two goals, but a little bit of an overachiever here, and I'm sure you guys will be able to catch on as we go through this. So when I gave this, I was actually a PhD candidate in exercise. Since then, I've actually graduated. So I'm officially a PhD research on this in about 2006. I'm also presented this concept to some advanced military agencies who are very interested in this, especially in relation to performance for soldiers. Peer reviewer, published research. My background, I also did a master's in mechanical engineering. The reason I tell you that is because that will become a little bit more important here explaining the thought process behind this, Bachelor of Arts in Natural Science. So here's a question. So we talked about, I want people to think differently. So is it good to be a turkey? So I know it's kind of an odd question. So here's our little turkey friend here. So we think about what goes on in the life of a turkey. So let's say you're this turkey guy and you're hanging out with all your other little turkey buddies. You're having a good time. A farmer comes in and gives you food each day. You've got, let's say you're raising one of those nice paleo farms. You've got room to run. You can hang out with all your other buddies. Farmer comes back the next day and gives you more food. This goes on for a couple of years. And if you were to look at the turkey at that point, you would say, hey, this turkey's got a pretty good life. So you've got two and a half years or so of the turkey life. But what happens then? So can you think of a day that is probably not good to be a turkey, at least in the U.S.? Let's figure out what it is yet. Of course, Thanksgiving. So what happens on Thanksgiving, at least in the U.S. here, you're probably going to end up on a plate. So if you're a turkey and you've been around for about that time, I'd say it's probably not a very good time to be a turkey. Probably going to end up on somebody's dinner plate. The point of this is where you look matters. So if we looked at two and a half years of the turkey life, up until the day before you end up on somebody's dinner plate, you'd say, that's a pretty good life. If you look at it the day that you end up on somebody's dinner plate, probably not a very good life, right? So how you look at data and where you look, especially over time, matters. And so Rengle here, a fancy word is anti-fragile. And this can also apply to your metabolism. That'll make more sense here. So I thought this is a very good way of looking at it, especially if you're looking at the body through an ancestral health-based way of looking or evolutionary medicine, however you want to phrase it. Your body is very much survival-based. We are designed and programmed to survive pretty much all costs. So what is surviving better? I would argue you can increase your health, increase your performance, and it's also good for fat loss. So what exactly does this mean in English? So the fancy term is metabolic flexibility. I'll explain what that means. To me, it's the ability to survive under a wide variety of conditions. So if you can increase your metabolic flexibility, I would argue that you're increasing your body's ability to survive. So whenever you say survivor, there's all sorts of these cool survivor shows out now. And one of the things that people think of is, well, do you have to be like this guy down here and snack on bugs? Not really, as though I have eaten bugs before and they're actually not too bad. If you put enough oil on crickets and fry them up, they're actually quite tasty. But bug-eating in terms of a survival advantage is optional. So what exactly are we talking about with metabolic flexibility? At a simplest level, you want to use the right fuel at the right time. This will decrease your risk of disease, especially looking at diseases like type 2 diabetes. And I would also argue, helps you survive, right? So you said physiology in essence is very much survival-based. So a fancy definition for this is the capacity for skeletal muscle to acutely shift its reliance between lipids and glucose during fasting or in response to insulin, such as post-prandial conditions. So you're probably wondering, well, what the heck does that mean in English? So we're primarily looking at skeletal muscle here, because that's the main thing that's using fuel in the body. Of course, there's fuel being used by your other organs and everything. And we're looking at its ability to shift its reliance between lipids, which is just a fancy word for fats, and also glucose, right? We can also substitute glucose with carbohydrates if we want. And the two conditions we're looking at are primarily during fasting, right? So fasting, meaning no food or no calories coming in. So if you've been sleeping overnight, unless you've been on Ambien getting up, rating the fridge in the middle of the night, that would be a fasting condition. Or in response to insulin, such as post-prandial conditions. So post-prandial is just a fancy word for after you ate. So we're looking at the ability of one of the main tissues in the body that uses fuel, skeletal muscle, and how it changes using fats and using glucose at two different times. So a decrease of loss of this is hypothesized to play a role in various disease processes. One of the main ones is actually impaired fat oxidation, or fat burning. And of course, if your goal is to get leaner, this is not going to be a good thing, right? We want the opposite of this. We want to increase the use of fats as a fuel source. And one of the ways we can alter this a little bit is with insulin. So insulin I consider a leverage point, metabolic leverage point. And what that means is if you exert a small amount of force on this, you can hopefully get a pretty big change on the other end, right? Kind of sort of like the, you've seen the little teeter totters, right? So press down on this end, you get some effect over here on this end, right? And if we make this teeter totter even longer, right? We've increased our lever, therefore we've increased our leverage. So insulin has a high amount of leverage. It's also needed for survival, right? So if you have an issue where your body does not produce any insulin and you're not on exogenous insulin drugs, you will not survive very long, right? Remember we went back and said that we're looking at this from a survival base. So I would say if you remove something, does that impair their ability to survive? If it does, that's something that we probably want to look at because it's going to have a pretty high effect. We can think of insulin as a fuel selector switch. I believe I got that from Dr. Jeff Volick. So high amounts of insulin is primarily going to push the body to use carbohydrates. So if you're reading our paleo cupcake over here, non-gluten of course, your body is going to take in carbohydrates and in a healthy person, your insulin is going to increase, right? And that makes complete sense because your body needs to get these carbohydrates out of the bloodstream and to be either stored in tissue or possibly used. Excuse me. The main way it does that is by increasing insulin. Lower levels of insulin push the body to primarily use fat. So one of the main conditions you would see here is fasting. Remember the previous slide we talked about fasting? So if you are fasted, it's my horrible writing here, you are using primarily fat and your insulin levels in general are going to be relatively low. We ideally want to function under both conditions. Just keep in mind that high blood glucose levels is actually toxic. Your body is going to do everything possible to get glucose the heck out of the bloodstream because if we allow high levels of it to accumulate there, it is very, very bad. And in healthy people, it's almost impossible for that to happen. I would say it probably is impossible. If you have an impaired health such as diabetes and it is not being controlled with medication or anything, you can have issues where your glucose gets so high that it is incredibly toxic. So here's our little paleo guide in a nutshell, right? Avoid fatty meats, eat your veggies, get your daily exercise. So this guy is running for his life. So he's getting some pretty good exercise. Again, survival here is the key. So what the heck does this have to do with our paleo friend guy here, right? It's kind of an angry-looking paleo guy. So one of the conditions we'll see is if we look at, let's say, paleo life here, one of the main ones is probably no food, right? Ability to find food at times can be very scarce. So if there's no food, right? In essence, this is a fasted condition. And our insulin levels, well, that looks really bad. Anyway, insulin levels are going to be very low, right? No food coming in, low insulin. We want to primarily be able to function under this low insulin state, right? If you can't function under a low insulin state, and you argue a fasted condition, your ability to find food is going to be severely compromised. And consequently, your ability to survive also going to be compromised, right? So we still need to function because we have to go out and find some food. Or if we're lucky, have someone bring food to us, but that's not very good for survival. The flip side is we go from periods of no food to potentially lots of food. So if you're out and you get to kill the big saber-toothed tiger or whatever you're eating, or you're walking along, find a whole bunch of honey, you are probably going to eat as much as you possibly can, right? But you still need to function under this higher insulin condition. Because if you go out and you find some honey, you eat as much as you can, and you pass out in an insulin-induced coma, you actually can become food then, right? That's going to be very poor for your ability to survive. So the goal here, no food, lower insulin. You still want to be able to function. Lots of food, higher levels of insulin, the ability to not become food. So just a little side tangent, because I get some wonderful hate mail about this too. Yes, honey has been around for a long time. I actually found a stingless honey bee in Amber, 96 to 74 million years ago, right? So honey, in essence, is glucose. So argument here, there is times where you're going to see higher levels of insulin. You still want to build ability to function. Is this going to happen every single day at every single meal? Nope, of course not. That's probably one of the issues with modern society is people who are not very tolerant to glucose, eating a lot of glucose all the time, right? Carbohydrates. It doesn't mean carbohydrates are bad. It just means that they are potentially bad for people at that time. So again, here's our little condition here. We got our woolly mammoth. So let's say we catch one of these guys, going to provide a lot, a lot of food, right? In essence, you're probably going to have a higher level of insulin and you want the ability to still function. So I always wonder, what ever happened to the woolly mammoths anyway, right? You know, where did they go? Did they just kind of disappear or whatever? And so one theory is expanding forests in Europe. Parts of Asia robbed grass-eating mammoths with a preferred habitat. And unfortunately, gradually starved them to death. If we had a metabolically flexible mammoth, would it still be around? If it could potentially go for long periods of time or possibly switch to a different food source? Maybe. So to surprise whoever the researchers found that genetic diversity remains stable and even increased a little bit right up until the bitter end. So here's our woolly mammoth. We actually found one here. You can see he's hiding out near nice big waves here. Somehow he started his own surfboard company, the woolly mammoth surfboard brand. And it looks like he's drinking a tasty adult-style beverage here. So possibly woolly mammoths are still around on the beaches of California somewhere. And this is exclusive footage here just for you. And in case you're wondering, this is a faked photo, right? Does this really look like a woolly mammoth to you? I doubt it. The minimum of our flexibility? The ability to survive. So one of my favorite bands, ESEP ROCK, really great stuff. Adapt to your circumstance or play your final hand. Fortunately, the woolly mammoth kind of played its final hand. So what about a hormetic stressor? So first off, what the heck is hormesis? Hormesis, generally favorable biologic response to low exposure to toxins and other stressors. So if we want to simplify this, you could say some is good, more is bad. And I know that's a dramatic oversimplification. Do you guys recognize this scene here? Hopefully you do. This is a very classic movie. This will make sense in a bit. So here's a fancy word for it. Mithranthasism. I probably slaughtered how I pronounced that. So practice of protecting one's self against a poison by gradually self-administering non-lethal amounts. So do you figure out where this is from? So it's the princess bride. The story of how you've been taking in small amounts of Iocane powder to build up his immunity. So even though he's been switching the glasses back and forth here, it wouldn't really matter, because in essence he's become more immune to that substance by having small amounts over a long period of time. So can this happen with carbohydrates? Do they serve a role as a hormonic stressor? Inconceivable. I'm not going to bore you with all the infinite amount of details. This is a lecture I gave when I was teaching this in class about anaerobic and aerobic pathways, which fuels are used, and all that kind of stuff. But a simple concept that people tend to forget is a crossover effect. This goes back to Brooks and Mercer around 1994. It's actually been described even well before that. But as we increase our power, which here is just measured by aerobic power, the fuel usage changes. So if we're over here at this end at rest, we're primarily using, in a healthy individual, very little carbohydrates. So down here, single-digit percentages. And in this healthy person, we're using a large amount of fat. So rest primarily using fat. If we increase our training, let's say we're down here at near 100%, we're doing some high output, weightlifting, low reps, that type of thing, moderate reps. We really want the ability to use carbohydrates. So our carbohydrate use is going to be very, very high. Our use of fat, very, very low. So this crossover effect shows that based on our activity, we were actually switching the fuel sources that we're using. So at rest, primarily fat. High intense activity, primarily carbohydrates. So metabolic flexibility is the ability to switch back and forth between these two fuel sources. And I've seen some data, unfortunately, the data I saw was primarily in aerobic. Athletes who had been training for a long time, taking in high amounts of carbohydrates, and what you saw is that their crossover point actually disappeared. Two lines kind of came close together, but literally never crossed over. So they had a problem switching fuel sources. So how do we get here? Yes, of course, calories matter. So if you take in an energy excess, it's a little graph of showing what can happen. So on one side, we get hypertrophic adipocytes. Your fat cells get bigger. We have a decrease in adiponectin. This is actually a good hormone. And what happens is we've got problems here with insulin use and fatty acids. Flip side, we've got a decrease in insulin suppression of free fatty acids. And again, we end up with the same problem down here again. And there's also some thought that this is also modulated by other factors, especially related to the immune system. We used to think that fat cells just sat in their collective fat butts all day. They did absolutely nothing. Now we know that fat cells are probably one of the most metabolically active organ systems in the body. So create all sorts of different hormones and do actually have a large effect. So again, glucose, toxic and high amounts. So what do we do? So insulin is a leverage point. One of the main reasons is lots of things oppose insulin in the body. And it's also under very good dietary control, right? We know if you eat more, for example, carbohydrates, insulin goes up. So the recommendation then, if you're doing high intense exercise, you're doing CrossFit, you're doing some weight training, working hard, you want to use carbohydrates as effectively as possible, right? If you look at a disease process such as McCartle's disease, those people due to a lack of an enzyme have a really hard time using carbohydrates. What you see is that their ability to do highly intense exercise is unfortunately pretty horrible, right? So we know we need to use carbohydrates. At that point, it's probably to your benefit to have a little bit higher insulin release, right? Remember we said higher insulin is going to push the body to primarily use more carbohydrates. So I'm a big fan of this is Vitargo. You can use any type of high insulin releasing carbohydrate. I'm a big fan of using that around the time of intense exercise. Lower intensity work, you want to do the direct opposite. You primarily want to use fat. And I would argue that you probably want to do this under a lower insulin condition, right? So you see all these people lining up to get on the treadmill, convinced that they need to drink four quarts of Gatorade to get through their low intensity training session while watching Oprah. Yeah, I'd say that's not the best idea. So for athletes I train, if they do any type of low intensity work, my goal is to get them to use a higher percentage of fat and how we do this is a lot of times that training will be done more fasted. They're higher intense exercise sessions. We'll primarily have carbohydrates, especially before and a little bit after you want to get a higher insulin level condition, we want the ability to use carbohydrates, right? And remember long term, a lot metabolic flexibility, I want the ability to switch back and forth between both conditions. So use carbs during high intensity exercise, right? If you're using carbohydrates all the time and sort of like burning nitrous going to Walmart, right? It's like trying to put a spoiler on a Ugo. You can put a spoiler on it, but it's still a freaking Ugo, right? It's not going to make it go any faster. The metabolic flexibility, use the right fuel at the right time. Fat for fuel, primarily most of the time, right? So if your day is spent doing mostly walking around, low activity, desk work, that type of thing, your goal is to use fat primarily for those activities, right? Low intensity, want to use fat. Carbohydrates, you want to use that during high intense exercise. You want the ability to use carbs allows you a much higher level of performance. So low to no carbs equals a low tolerance for intense exercise. So if you're doing high output glycolytic type work, three to four, sometimes athletes have worked with five times a week and you're trying to do this on a very low carbohydrate diet, in my experience, you will do okay for about three to four weeks and then the wheels come off and your performance just tanks. Why? You're not providing the fuel that your body needs for that type of exercise. And it's pretty amazing. We tell those athletes to use more carbohydrates. The performance goes up and oddly enough, all of a sudden they start losing fat again, right? If you're doing things to limit your performance in the gym, you're literally limiting the amount of overload you can apply to your muscles and to your system. So long term you're actually limiting your gains. I also talked about McCartle's disease where they have an impairment of the use of carbohydrates and their ability to do high intense exercise is pretty horrible. So what do we do, right? So my goal of this lecture, number one, is hopefully to think a little bit differently. Do you want to be a turkey? Possibly. Depends on when you look, right? So you want to think about survival based. You want to think about function, right? And we can think about these things in terms of ancestral health, evolutionary approach. I definitely agree that that's a very good way of looking at these. We want to operate under lower and higher levels of insulin, right? Now you don't want to be whacking your insulin levels super high all the time every day. That's not going to be good. But on occasion, you want to be able to function at high levels of insulin. That's going to be primarily using carbohydrates. You also want to be able to function under lower levels of insulin, which is primarily going to be used fat. So it's not really one or the other that's better. It's actually both, right? You want to switch back and forth between both. So you're probably going to need carbs for your woolly mammoth running. So if you're trying to taste down that woolly mammoth, you're going to run like hell and you're going to hope you have a fair amount of carbohydrates. So this is just showing you, we're thinking differently. So if we do high intensity training, right? So when corrected for energy cost of training, decrease the sum of six subcutaneous skin folds induced by high intensity interval training program, nine-fold greater than standard endurance training program. So again, most of you guys probably know this. High intensity training even for pure body composition reasons is going to be better. So again, talking about insulin. And the second part, carbs are a hormonal stressor. You want to use the right fuel at the right time. Fat for fuel most of the time. Carbs for fuel during high intense exercise. If you're slow, you're going to become sabertooth tiger food. If you pass out in an insulin induced coma, you're also going to be sabertooth tiger food. So again, it's not one or the other. It's actually both. So what does it look like, right? Most of your meals, protein and veggies, right? And you're some steak that I cooked up with some mushrooms, very, very tasty, some fish. Going to go out and do some high intensity exercise. I can do push-ups, right? You don't necessarily need barbells. Go play with some stones, right? As an atlas stone, I'm strapped into the seat of my car to get it home. Low intensity work, right? Drinking on your way back from the bar. Celebrating. But you also want the ability to have carbohydrates at times and still be okay, right? And then I want to be the man of the world, have a nice big breakfast, some pancakes once in a while, and still do okay. I also want the ability to do nothing for a while, right? The ability to do fasting and still be able to perform okay. And you don't want to look like this, right? If you have this reaction after having a bunch of carbs, I would say you probably have some stuff to work on. So Monday, what do you do? In general, right, this is probably going to be nothing new to most of you guys. Your carbohydrate approach is generally going to be, you know, a little bit on the lower end. Carbohydrates in general are going to be before and after your high intense training days. That's going to be a high insulin condition. And you still want the ability to function, right? Most people actually do better in the gym, especially with weight training. Still want the ability to do some intermittent fasting, right? So fasting, no calories coming in, low level of insulin, still be able to function, right? So your body's going to be primarily burning a bunch of fat at that point. And so my last thing here is, the question I always get is, what do you think of the world optimal, right? Everybody wants to find, is this really the optimal approach? I would argue that's like leprechauns, pots of gold, little jackalope guys who I actually thought were real up until a couple of years ago. This doesn't exist, right? What you really want is to slowly move and do things that are better. So for some, that may be adding carbs before and after their high intensity training. For others, that may be adding longer periods of fasting. Every once in a while. So if you need more information about me, feel free to drop me a line, go to my website, www.MikeTNelson.com I've got a six part fat loss training video section there. It's free. And thank you very much for your time. Hopefully this was useful. Thank you very, very much to AHS for having me come out and do this presentation. It's an amazing event. I really did actually enjoy it. I had tons of fun. I'll be there again next year. So if you see me there, please come up and say hi. Thank you very much.