Show dictated using AI transcription, typos may occur, please contact Mikki for clarification

00:03
Welcome, hi, I'm Mikki and this is Mikkipedia, where I sit down and chat to doctors, professors, athletes, practitioners, and experts in their fields related to health, nutrition, fitness, and wellbeing. And I'm delighted that you're here.

00:27
Hey everyone, Mikki here, you're listening to Mikkipedia, and this week on the podcast I speak to returning guest Mark Cucuzzella, all about the importance of zone 2 training for health and performance. We talk about what zone 2 training is, and why it's not just the domain of the athlete, and how it works to increase fatty acid uptake and improve metabolic flexibility.

00:54
saving someone from an energy crisis that can occur when they are unable to burn fat. And of course we talk through the reasons why this is so important in terms of metabolic health and is under recognized with that regard. We also have a good discussion in and around what we see with former athletes and their start stop approach to getting back into their training sport and how

01:21
Their approach isn't necessarily the best way to do it, going balls to the wall, and where walking could actually really help them. Anyway, we also discussed the benefits from an athlete perspective, and how a current athlete can determine if they need more zone 2 training. We touched on the athlete heart, and the latest updates around what is known with regards to cardiovascular disease risk. Now as I said Mark has been on the show before, he was on episode 23

01:51
and we will put a link in the show notes to that podcast so you get more of an idea of Mark and the work that he does on a day-to-day basis. But Mark Cucuzzella is a professor at West Virginia University School of Medicine. As a US Air Force reservist, he designs programs to promote healthier and better running with the US Air Force Efficient Running Project. Mark has presented running workshops on over 50 military bases.

02:19
and has been a national level Masters runner, having competed for over 35 years with more than 100 marathon and ultra marathon finishes under his belt. Mark is a two-time winner of the Air Force Marathon and has a marathon PR of 224. As well as being the race director for Freedom's Run Race Series in West Virginia, Mark is a director of the Natural Running Center, an education portal designed to teach healthier running.

02:48
He is also the owner of Two Rivers Trents, a centre for natural running and walking in his hometown of Shepherdstown, West Virginia. Mark's innovative work and story has been featured in the New York Times, NPR, Outside Magazine, Running Times, Runners World, Air Force Times, The Washington Post, Jammer and other medical and media outlets. And he was one of the speakers at Low Carb Denver where I

03:17
just attended and it was a brilliant talk which made me want to jump on the call and chat to Mark all about that presentation. So you can contact Mark over at DrMarksDesk.com and we've got links to articles and presentations. So Mark has provided a drop box that has a range of different papers and presentations that are on this topic that we're discussing today.

03:46
links to a couple of the other papers that Mark and I discuss in the interview. I think you're really going to love this one. So just a reminder, the best way to support this podcast is to hit the subscribe button on your favourite podcast listening platform. That increases the visibility of the podcast out there and amongst literally thousands of other podcasts so more people can get the opportunity to learn from the guests that I have on the show like Mark. All right team.

04:14
Please enjoy this interview I have with Mark Cucuzzella.

04:23
you're running right now, Mark? Is it? I'm kind of like, it's just mental therapy. Okay. I haven't done any. I've signed up for a fall marathon, so maybe I'll try to get some leg speed back. Yeah, yeah, yeah. It's been a very busy few years just maintaining health. See, this is good. And this is why- This thing's actually very interesting too. I kind of like have it use it as a step stool. It's called a sand dune runner.

04:51
Okay. Have you seen this? You can actually run inside on it. It's like a, look up Sandoon Runner. This thing will crush you. Not in a bad way, but if the weather's horrible, you can just step on the Sandoon Runner while you're on a call. Oh, sure. Is it like a steep machine? Like those old school steep machines? Yeah, but it's like your feet totally work and it's not like a machine. It's just this little pad and you saw it. I mean, this is what it is, right?

05:20
Yeah, oh that is crazy. I have a little ball for feet. I have all the widgets. Got kettlebells back here. You know, I mean nothing, nothing, nothing crazy but just stuff that like if you're standing like, you know, kind of what we talked about at the conference, right? Yeah. What I want to buy is a walking pad to go underneath my standing desk. Well, that's what that kind of is. Like you could stand.

05:45
You could just, you know, you're just restless, right? You would just kind of march in place on it. Yeah. And it'd be like quicksand. Yeah. Yeah. Sand dunes stepper. I don't know if they... Stand dunes stepper. I wonder if we'll get, I'll Google that later. Cause I wonder if we've actually got that available. Interesting. They're, I think they're made in the States, but they probably, I don't know if they distribute in Australia. They probably would send you one as a podcaster. They would send you one. Especially if we talk, we'll talk about it here. Say, Mark, what do you have around your desk?

06:15
Yeah, you'll be like, oh, I've got this, I've got this. So Mark, it was great to see you at Low Carb Denver. And I wanted to get you to come back onto the show to sort of talk specifically about zone two training and not necessarily just for athletes, but I absolutely want to cover the applicability of it, obviously to the athletic population, but also

06:43
Genpop because I during that Sunday session, there was just a really good discussion as to how important that aerobic based training is for people who wouldn't even ever use the word training. So I felt like that was like a really, you know, a good thing that we could dive into and of, and of course we've talked about your introduction to low carb.

07:07
on the podcast before when you came on. And for those listening, I will link to our previous episode, which you were one of the first people actually that I interviewed. So that was a real treat. However, can you give us a brief 101 as to your introduction to low carb? Because I always enjoy hearing people's sort of origin stories and you've got a particularly sort of interesting one, given your background as a physician and things like that. So

07:35
How did you change your metabolism basically is sort of the question. Yeah, well, it was so wonderful to meet you in Denver, Mickey, when I saw you, I was like, oh, wow. You know, I think I heard your voice. I know that voice because I've listened to your show so many times and been on your show, but I'd never seen you. And I was like, oh my gosh, you made that trip. That was a long trip, but it was a wonderful weekend just listening to so many people and just interacting outside of the conference.

08:05
Yeah, it was so fun. You know, you go to learn and you know, I take away a lot from these conferences and relationships. But yeah, my you know, gosh, I think I think I spoke at maybe not the first one, the second low carb. It was Breckenridge or Veil. I forget what it was, you know, so going way back. But but my adoption into low carb, probably like everybody, there's like some sideways story. You know, I was a like, like, you know, as a runner, right? So distance runner my whole life, and we all eat tons of carbohydrates.

08:34
And that's kind of how we rolled. And I was in the military service, and my labs came up like really close to fully diabetic. And that was kind of odd because I was lean and running and didn't look like a type two diabetic at the time. And I was a physician, and we were mandated to get lab work. I don't think I ever would have had lab work unless I was mandated because that's our requirement. You go every year, you've got to get your basic labs just to make sure you're.

09:04
deployable. I think it was like my A1C was 6'3". For probably the two or three years before that, and I just thought it was normal, I was waking up at like two in the morning every morning needing to eat. I was eating right before bed and just constantly eating and was losing weight. I was actually like, I was probably eating, maybe ate that. I don't know, hard to imagine how many calories I was eating. I thought it was just because I was running.

09:33
GP looked at me and said, this is kind of odd that this lean guy is diabetic and sent me over to the endocrine clinic. And I was a family doc, fully trained, and I never had ordered a C-Peptide on a patient. I had to go look up what that was, because I knew it had something to do with insulin. You know, here I'm a full doctor and telling people to eat less and exercise more to lose weight and all this stuff that we know now is from your show.

10:01
is there's way more to the story, but my C-peptide came up at like 0.3, which is making just a little marginal amount of insulin to not be on insulin. But I was so massively insulin sensitive that that little bit of insulin and what was called a second phase insulin response would kick in and crash my sugar. So they put a CGM on me for a few days and then you could actually see what was happening. So I would eat a standard meal for me, which would be like...

10:30
pasta, and it would go up to like 250. But then like two hours later, it would crash hard like that, like, but that's when I was like hangry all the time. And, but kind of paradoxically, at the time, I was doing a project for the Air Force on the fitness test and trying to figure out like, why are these people not passing the fitness test and, you know, got into a lot of like, we didn't call it zone two training, then it was just called like Lidia aerobic base, you know, so, so it was, yeah, it was just like, okay, it's not

10:58
lack of speed, it's a lack of endurance. We didn't have all these technical mitochondrial functioning terms at that point. Yeah, so I realized pretty quick in that project that the reason people were not passing the fitness test wasn't because they were not exercising. They all exercised. It was because of obesity. The weight was up, Mickey. Their odds of passing the test went down. Probably multiple things to that. Yeah, carrying more mass, but if your mitochondria

11:28
There's probably isn't good either. And I'd come across Gary Taubes' work. So it just pretty turned everything upside down, you know, and I was like, Hmm, this is curious. So I was at that, that year that I was, I was diagnosed as a, as a moaty, we would call it maturity onset, diabetes of youth or Lata, you know, latent type one, you know, I had already kind of done the leg work that low.

11:52
hard diets are safe and effective. Because I was traveling to all these military bases, giving seminars on how to pass the fitness test. And I'd be in a base gym with like a hundred airmen and none of them wanted to be there because they were all the folks having difficulty with the fitness test. And I was asking this question, you know, has anyone, you know, here lost 50 pounds and kept it off for a year? You know, maybe one person was reluctantly raised their hand.

12:21
I'd say, you know, Airman Smith, what did you do? And no matter what base I was going to and speaking to, it was always some version of low carb. They'd say, well, you know, I'm doing paleo, or I gave up all the sugar, I gave up all the bread, or maybe a more courageous one, because I was a doctor would actually say, under doing the Atkins, you know, but they thought I was going to yell at them. But...

12:46
Yeah, so I knew the science of low carbohydrate and what that was was actually safe and effective. So in two days, I turned the food pyramid upside down and I was like, wow, the most immediate thing was I felt good. I didn't need to wake up at two in the morning to eat a bowl of cereal. I was eating bowls of cereal at two in the morning. I mean, waking up and eating right before bed, eating before my runs.

13:16
the doctor in the lounge hoarding bagels, because it was kind of like you needed them because you were having these hypos. So like just immediate, just stability, and I could eat three meals a day. Like, wow, like, you know, like eat three meals a day and not like snack at night, wake up in the, like, it was just, wow, like my life changed. And, you know, I started checking my sugars and, you know, it all kind of came back, not perfect, but.

13:46
you know, in a range to keep me eligible for military service. Yeah, and Mike, do you think as an athlete, and I wonder about this when I talk to athletes, whether sometimes almost like the number of miles that you log is a bit of a badge of honour. So this is where people get into that kind of like junk miles, like, oh yeah, I did 120 miles last week because I'm awesome. I often wonder whether the amount that someone needs to eat is also a badge of honour, like the amount that they can eat without gaining weight is quite a...

14:15
It's unusual. You know, it's like, you know, I'm so good that I have to eat all of the time and look at me, I'm not gaining any weight. Like, like I wonder how much of how many people might have the experience that you've just described, but they don't look at it as a as an issue per se. But it's more like, wow, I must be training so hard that I'm just burning through all this energy. Yeah, we did actually in college, we did. I ran in college at University of Virginia. We had a dining hall for.

14:44
folks that were on athletic teams and you know, you'd football players be there and they'd be three times the size of the cross-country runners. Literally, right? So like, you know, we would be, you know, a buck 30, 100, you know, 30, 140 pounds and the football guys were in kilos, you know, they were 150 kilos. We may have been, you know, 65 to 70 kilos maybe. So, but we, you know, we'd sit down and, you know, you'd share tables with these guys and we would eat like more than them and they'd look at us and they're like, where are you guys? But you would, it would be kind of like, like the...

15:13
know, maybe the humble brag thing where, you know, you'd sit there and eat all this food, you know, and you'd like out eat the football guy and, you know, who three times. So I think there was a little bit of that challenge eating work, but then we were like 18 to 20 at that time. So I think any 18 to 20 or all this mess, anyone who's doing sport.

15:34
You know, it's massively insulin sensitive. 100%. And it's interesting. So you, and that's the thing with you, it's not that you had lost your insulin sensitivity, but you just had some... I stopped making insulin. I had a little second phase response. So I would have these highs and then these crashes, but I was losing weight. So it was clearly insulin insufficient for, for what I needed to be, to maintain body mass and muscle. Mark, had you not sort of...

16:02
went gone low carb, what would have been the sort of medical outcome of that? Like what was your, what was the progression for that? Yeah, it's, you know, because I was a doctor, you could kind of self treat in a way, you know, you check your sugars and if it's all okay, you know, you don't need, but if I had not read anything, you know, or known anything, you know, which the Air Force project and dealing with the fitness test got me to really read, you know, I would have been biased that, oh gosh, you know, like,

16:32
like eating a high protein, high fat diet, low carb causes a heart attack. Yeah. I mean, my father had bypass at 35, so I immediately would have been, well, I probably need to be medicated. Yeah. You know, I'm not going to change my diet. You know, I'm eating a healthy diet because I'm eating all these whole grains, low fat, you know, skim milk and on the cereal, you know, so I'll cover it with insulin, you know, but that's clearly what I would have done. But I think it would have.

17:00
probably not ended up well because if you're massively insulin sensitive and even you throw some long acting insulin in, your risk of lows, I mean, you'd be chasing it all day. I mean, it was just, but yeah, so it was very liberating to take ownership. But fortunately, you know, the glucose meters and then maybe four or five years ago, CGMs became easy and accessible. So then started using CGMs and then you don't have to check your sugars three or four times a day.

17:29
So they were, and I think myself and my patients were very early adopters of CGMs for type twos and diabetes remission. That was one of my talks at Low Carb Breckenridge or whatever it was like five years ago, like the very beginnings of CGMs for patients. See, it's interesting, Mark, because like a little, and this is a slight tangent from zone two training, but that's fine because this is just a conversation.

17:56
I see a lot of backlash against CGMs online for people who are otherwise insulin sensitive. And I think, so I'll give you my perspective and I'd be keen to hear your thoughts is that the first time, if you don't know, then I think you've got a lot to learn just from slapping one on and seeing what happens regardless of body size, regardless of training regime and other health sort of lifestyle factors.

18:25
Whereas, and I know that there are people out there who would agree and say, yeah, actually, like despite the fact that you might seem healthy and be healthy, you can learn a lot from how your body responds to certain foods. Like, because you cannot rely on something like the glycemic index to tell you, you know, what type of food might be a better source of carbohydrate than others. However, I also see on the flip side, there are people who are absolutely against the idea of CGM for anyone who isn't

18:54
diagnosed. What's your take on it? Yeah, I mean, it's such a ridiculous sentiment to say, well, I'm against them. I mean, the world now, unfortunately, has kind of become I'm for it or I'm against it. Right? Like we've eliminated nuance and critical thinking. Okay. So are you against? Okay. Some people want to step on a scale every day, some don't. Some people want to check their blood pressure every day, some don't. Some people want to track their sleep.

19:23
know, with some type of device, some don't. But it's a human right to be able to see what your blood sugar is. How can you be against that? You know, and I think anyone who's using one of those probably needs to have someone, you know, a good quality health coach, you know, an RD, you know, someone like yourself who understands like, why are you using it? What information are you getting? So, so I can help you interpret that information. Okay, is this signal or is this noise? Is there something there?

19:52
You know, so it's called a straw man argument. So someone's saying, I don't think someone should use a CGM because I had one patient one time who put one on and developed an eating disorder. I mean, that's just a silly statement to say. I mean, people are developing eating disorders all the time with or without CGMs. You know, so you can't blame the C, maybe that person had an eating disorder and put on a CGM. So, I mean, it's just now, you know, you can go into any pharmacy. I mean, the...

20:21
more people are using glucometers now without diabetes just to understand blood sugar because they're self-empowered, right? They want to know what's going on. We did a small pilot study using CGM for new diabetes patients, right? And part of the title of the article was empowerment, empowering patients to understand. And so new diabetes patients, no medications, medication naive. We put a CGM on them.

20:50
And really no fancy coaching. We gave them a book that helped them just log a few things. Right. What's you figure out what the effect of sugar, food, you know, whatever exercise is on your blood sugar and sort it out. And two thirds of the patients met the criteria for diabetes remission without medication in four months. Wow. You're like, wow, what if we did that to the world? I mean, it's a pilot.

21:15
We didn't have health coaches. We didn't nothing, no fancy apps, no nothing. Just put a CGM on them, let them see, geez, I eat bread, my sugar goes up. I don't eat bread. I go for a walk, my sugar goes down. I mean, what is not like, and we wanna catch diabetes before they're fully diabetic, right? Because by the time people are told they have type two, you know, they probably have 70% beta cell failure. So if you can pick someone up,

21:43
You know, pre-diabetes is diabetes. So someone says, oh, it's just pre-diabetes. No, that's early diabetes. And then there's pre-pre-diabetes, if we actually measured insulin levels. No, I mean, I think, you know, why would you not agree that if you're someone who wants to know your blood sugar for a specific reason that seems reasonable, they should be over the counter. I mean, really, they should be. I don't see.

22:10
They're not doing harm. I mean, look at all the other stuff that's over the counter that put people into kidney failure. Right, they take ibuprofen, you know, and they, yeah, after running, and like there's so many things over the counter, literally Tylenol, right, aspirin, right? Like you can kill yourself with this stuff. But I'm sorry to kind of rant there, but it really is so misplaced to anyone who has that hardened opinion. I wouldn't want to see them as a physician because clearly they don't have an open mind.

22:39
And it's called shared decision making. So if you came to me, Mickey, and said, these are the reasons I want to use a CGM for two weeks, four weeks, you know, I'm just, I'm training for Ironman. I just want to see, I'm trying to get stable blood sugar. I'm trying to figure out, you know, how many carbs per hour? Like, sure. You know, what harm are you going to do by putting a little device on your arm that, you know, breaks the skin a little bit, but there's no, there's no risk in the, in the device at all.

23:04
And that's where I see utility for an athlete actually, is less about what's going on during training. Cause I feel like you don't really get that much information if you're out there on a ride. It's not going to tell you X number of grams of carbohydrate that you need to be sort of eating. So I see less of the application during training and more about that day to day, like how the energy is through the day. Because particularly if people are, listen to your story, Mark, and when...

23:30
Shit, that's me. You know, that's how I am. I'm hungry all of the time. Like using a CGM could be quite a good way to understand how to balance a day to day. Yeah, just a tool to help sort it out, right? There could be multiple things. Let's look at your CGM. Oh, well, you're hungry when you're crashing. So let's, okay, let's, to not get hypoglycemia, we want to avoid hyperglycemia, right? Because the hypo follows the hyper. But most people think, oh, I'm hypo, I need more sugar. No, the reason you're hypo is because you did eat sugar.

23:59
And this happens after gastric bypass a lot. You know, they get this reactive hyperglycemia because they become really insulin sensitive in the way their body is actually kind of disposing of the carbohydrates. They get these massive super low blood sugars where they just need to eat protein. The solution is not more sugar. It's actually like you need, you know, fat protein, almost no carbs, like carnivorous type diet, post-gastric bypass for reactive hypo.

24:28
Yeah, that's interesting because I see a lot of clients actually, and they are exactly that, like post-gastric bypass and their original diet prescribed is in fact a high protein sort of... It's never sold as a low carb diet, but it's always promoted as a high protein diet. Yeah, so it's always protein shakes with four grams of carbs, pre and post-gastric bypass. Yeah, interesting. Interesting. So Mark, let's talk then about zone two training.

24:58
So, you know, obviously changing your diet is one way to change your metabolism, but through aerobic training, we can essentially make some great inroads as well. And so can we start by even sort of, but well, first, what is zone? What are the zones? If you can sort of start there, and then why it might matter. And I know we've sort of briefly touched on it, but I'd love to sort of talk about it from an ethical perspective too. Gosh, so I think...

25:25
from a human and an athlete. And I think, you know, at the conference too, Mickey, is like almost every talk somehow started to touch on mitochondria, right? There's nothing new under the sun. So to be a healthy human, brain, heart, muscles, you want to have multiples of mitochondria. You want robust mitochondria. You want to build your mitochondria and you want your mitochondria to function. The more mitochondria you have, most likely the healthier you are and the longer you're gonna live. And these have to be functional mitochondria.

25:55
So the mitochondria are mostly in our, what are called the type one fibers, the slow twitch fibers, the red meat fibers. These are robust in mitochondria. Your heart's loaded with mitochondria. Your brain's loaded with mitochondria, but in the muscular system, they're gonna be your slow twitch fibers. And that is really the base of fitness because when we exercise in a conversational pace, you're stimulating more mitochondrial

26:24
growth, so generation of more mitochondria and generation of capillaries. So the capillaries are the roads per se and the mitochondria are the energy factories. So the more we go out and we just walk or we jog or we cycle or we row or we dance or cross-country ski, hike, whatever it is, you are growing mitochondria and you're growing these capillaries, you know, the little roads. We have 60,000 miles of capillaries that feed these mitochondria.

26:54
Zone two is, and the mitochondria love to burn fat, right? So that's at a baseline. So the mitochondria in the slow twitch fibers love to burn fat. That's the preferred fuel. So your heart loves to burn fat, right? You know, we had needs to beat. Say you haven't eaten for a week, your heart still needs to function. Your brain still needs to work. So mitochondria love fat. They like ketone bodies. They can burn carbs. They can burn fat, but they, they, they love fat.

27:23
And when we exercise at the slower pace, we are utilizing mostly fat oxidation. And as soon as you kind of cross a line, like, you know, you're going out for a run, right, you're, you're kind of starting now to get a bit more winded. You're kind of shifting out of zone two into what is called zone three, which is you're recruiting some of these more faster Twitch fibers, and these are more glucose burning fibers.

27:50
So if we need energy right away, you gotta get up the hill, pass a car, you know, if you're a car, it's like the gas and the electric, right? You've got this gas tank, but you got this big electric battery. That's when you're shifting into this next gear. So the bigger that first gear, which would be zone one, zone two, which is fat oxidation, conversational pace, the more you can actually go into that faster gear because that faster gear, we use more glucose and the

28:19
byproduct of glucose utilization is lactate, we would call it. So lactate is a form of fuel. Now, if you don't have a robust mitochondrial system, that lactate is associated with a hydrogen ion. So everyone probably has experienced where their muscles just kind of want to shut down, right? You sprint a quarter mile and we call it rig, rigor mortis basically, you get acidic.

28:45
So it's not lactic acid per se, you know, it's, it's, you get an acidic environment. So if you're starting to use a lot of glucose and you can't buffer that lactate, which is built with the glucose, you're going to, you're going to be limited. You're going to just basically shut down. But the bigger that mitochondrial machine is, the bigger those type one fibers are. So they call it the lactate shuttle. So it's like a little shuttle bus. So if you've built all of this endurance training, these

29:15
really robust slow twitch fibers, then when you need to inject the gas and you produce the lactate, it's actually shuttled back into the slow twitch fibers and can become fuel. But if you haven't built up those slow twitch fibers, it becomes acidic. This goes back to back in your country like Arthur Lidier. This all goes, Phil Mathiton, so this all goes back. Arthur Lidier didn't understand what George Brooks did.

29:44
Indigo Salman and all the, you know, CPT transporters and all this stuff. But, but he knew that without the endurance training, they couldn't do hard training. So they would do in the off season, just tons of endurance training. And when they felt flat, like when, when he sensed that the athletes were just kind of flat, like their fuse was kind of burnt, he would just send them out to do easier running for, you know, three days, five days a week. And when he said, when you feel like coming back to the track, come back to the track.

30:13
So they, if they somehow let that part of their training go, they couldn't do the hard training. And, you know, but we've learned about the physio, Frank Shorter, you know, talked about him in my talk, he understood the same thing. He was self-coached and he knew the more he did the hard training, the more he needed to do the recovery training, or else it wouldn't work. So you know, he ran, not that any, you know, human beings listening to this podcast are going to run 100 miles a week. He was an Olympic champion.

30:43
But so he ran 100 miles a week for like 17 years of his career. And every weekend he would do a 20-mile, just probably for him, he didn't know what the zones were, but it was a conversational run with other peers that he may have had or by himself. But he did that all year long. Yeah, go ahead. I'm sorry. Sorry. The way you're talking about Frank Shorten, it reminds me of this book. And I bloody hell, I can't remember what it's called, but it's amazing.

31:12
encyclopedia of runners and every chapter is devoted to a runner and how they used to train. Is it Zatopec? Is that the? Yes, he did. Yeah, Emil Zatopec won the 5-10 in marathon in 54. Okay, I knew you would know. No, it would have been 56 because his 60 was when Peter Snell, who was Lyddiard's runner, came out and...

31:39
won and several of the New Zealanders won in 1960. That's right. And so this guy, and I don't know if you've seen this, if you, I wish I could remember the name, you will know the book. And it has an entire chapter on his life and how he used to train and the races that he won. And they also, which always fascinated me was give you like a weekly schedule of his runs. And he would run like 20 times 800 meters.

32:06
It's not even 20, it was 40 times 800 meters in the morning. He did insane amounts of repeats and boots. Yeah, yeah. Morning and night. Morning and night. Like, I wonder where his zone two training was. It had to be in there somewhere, but you know, like, it's crazy the amount of running that all of those sort of runners used to do back in the day. I mean, people run, like, you know, there are people who do excellent, like, heaps of miles and stuff now, but it always used to amaze me at how resilient these runners were back then.

32:36
Yeah, there were some subsets of runners who could respond to really high intensity training, like year in, year out. There are a few in far between though that would actually be able to maintain that over multiple Olympiads. So Zadopek, for example, if he was going to go to, I mean, no kidding, 40 times a quarter mile. Yeah. So through his life, he had to have developed just a massive mitochondrial system. Yes. Because...

33:04
Or else he would have been done at like the fourth one. So he goes and does a pretty intense 400 meters builds up lactate. But, you know, this guy probably never drove a car when he was young. So probably his whole upbringing was work and labor. So he was able to buffer that lactate so he could take a one minute or two minute recovery. And his lactate level, like if you were measuring that, which they didn't back then, his lactate level would probably down close to a baseline.

33:34
Because he just disposed of his lactate so quick. That's why all these kind of fancy people now, especially the triathletes side, they stick their ear and they measure a lot of lactate because if their lactate hasn't gone down low enough, they're probably wasting their time trying to do another interval set because they're already toast before going into that set. So you can get more scientific, but he was most likely just intuitive plus probably as tough as nails.

34:01
You know, growing up, you know, post-war Czechoslovakia, you know, there's probably something. The brain is always, I don't think any of us can put ourselves into, you know, I've read a bit about Emile Zadepec, but, you know, these people had really hard lives, you know, hard labor. Yeah. Yes. And I wonder how much of that is genetic as well, you know, like how much of our ability to build it resilient in a ton of mitochondria, is there a genetic component? Do we know, Mark?

34:31
Well, I think so. There's David Epstein wrote a book called The Sports Gene, and he's a really good and brilliant writer. So let's just take two populations from Africa. You know, so you've got West Africans, you know, who migrated mostly to Jamaica, the best sprinters in the world or none. Right. And there's a cultural side of that too. You'd have to read Epstein's book. So if you're in Jamaica, you want to be Usain Bolt, right? So you want to be, he's the guy. So you're the...

35:01
youth track club. So there's a culture of sprinting, but there's more, you know, genetically a West African is more muscular build more type two fast twitch muscle fibers built for speed genetically. Then you go across Africa to East Africa up to the rift valley at 9,000 feet, you know, the Collegian. So in this one tribe, he talks about that in the book. So from this one small tribe in central Africa.

35:31
East Africa, Kenya, there were more sub-210 marathoners than in one year. There were like 200 that had been in the United States for the last two decades. We had three in the last two decades. And here in one year in this little village in East Africa, there were 200 runners that ran a marathon under 210. If you look at a Collegian's build versus a West African,

36:01
They're totally different body types, very lean and long Achilles tendons, and even looking at muscles like the gastroc and the soleus. The gastroc is more fast-twitch muscle fiber. If you look at a sprinter, their gastroc, that's the two heads in the back of the calf, very well developed. They look like bodybuilder types. Then the East African runners, it's like they don't even have any calves. They're like, where's their calf? Yeah, yeah, yeah.

36:31
The soleus, which is the deeper muscle, which is more part of the spring of the Achilles tendon, which is distance running, is a slow twitch muscle fiber. So they don't need a big gastroc, because they're not sprinting, they're just springing. But maybe that's a, you know, read Epstein's book. But of course there's genetics too, you know, but then epigenetics, you know, your environment and your culture. Everyone in East Africa now wants to be Elliot Kipchoge. So the culture.

37:00
in East Africa is I want to run, I want to win the Berlin Marathon or whatever that is. Yeah, for sure. And so, you know, mitochondria is a bit of a, as you said in the conference, it came up quite a bit. And I also now see it out there on sort of social media, and it's certainly in that public sphere as well. But I think that a lot of people who might be falling into the camp of

37:25
not necessarily athlete, but sort of that gen pop who would just unfit. I don't know how much they would think about the way that exercise can improve mitochondria, the way that they might be well familiar with the Michael Mosley's of the world who are like, take an ice bath, improve your mitochondria. Like that sort of hacking your mitochondria, these sort of short, sharp, not, it's not that they're not lifestyle, but they're almost like quick fixes. Whereas what we're talking about is,

37:54
pretty simple and actually possibly more, we know so much more about how effective it is too. Yeah, there's so many different nuances there. So I think the one paper that I've read and maybe some other folks have read this on your podcast is there's a paper by George Brooks, who 30 years ago really had this lactate shuttle model and Inigo Samalan who...

38:21
who trains a Tour de France rider. So he's an exercise phys professor at CU, but showing the difference in what happens in the mitochondria between a metabolic syndrome patient and an elite athlete. So when, so let's just take the muscle cell and the fat droplets in someone who has metabolic syndrome, obesity, diabetes. So there's all these fat droplets in the muscle cell.

38:49
Now these fat droplets in the sick patient are dysfunctional. So they're ectopic fat, it's inflammatory fat, the mitochondria don't use them. They release a lot of inflammatory markers. So they can't really be used as fuel because the mitochondria are dysfunctional and the fat droplets are also dysfunctional. It's probably not the word, just atypical. They're not physiologically optimal, normal fat cells.

39:15
So they're going to create a whole inflammatory cascade. So there's multiple arms, multiple levels of dysfunction and that need to be fixed to return to factory settings. So we want to compare factory settings would be, okay, what is the physiology of an elite athlete, right? They have the perfect mitochondria. They can eat carbohydrates, right? They can eat fat, they have perfect mitochondria. So the fat droplets in someone who's well and fit and athletic, these fat droplets, so we can use fat for fuel.

39:44
Now the most readily-utilizable source of fat is sitting right in our muscles. Then we have fat that's another part of our bodies that has to be transported through the serum with carried on albumin, little transporters and get to the muscles for fuel. But these, these local fat droplets in someone as well can actually be used right away for fuel access. And it's great. It's highly efficient, much more ATP, which is the currency of energy production. So.

40:11
You take a fat molecule, so say you've got a medium chain triglyceride, so you've got 16 to 18 carbons versus a glucose molecule of six carbons. So you get a lot more energy, you get a lot more currency from the fat. So right away, the fat is not healthy in a metabolic patient. And the other thing that happens right away in someone who has diabetes metabolic syndrome

40:38
is when they go exercise, so when lactate goes up, so when our mitochondria don't work, as we talked about before, Mickey, so when our mitochondria are dysfunctional, we're burning sugar and the mitochondria don't work, so we're producing lactate, which is associated with an acid, and that lactate level goes up, because we can't clear it, the shuttle's not there, the type one fibers aren't there, so we just build up lactate. So as soon as that lactate goes up, it shuts off fat oxidation.

41:08
So the sick patient gets off the couch and their lactate goes up right away. So it's like, it's a paradox. So like, how can, and then they're told by, you know, well, they just read an article in the New York Times that they should do seven minutes of high intensity and it's a way for them to get fit. But it's like, no, it would crush them. Maybe if you're already fit, you could do that. But if you're not fit, like you're just gonna, it's gonna be a miserable experience.

41:37
because as soon as the and you want to burn fat for fuel so healthy human whether you wanna lose weight or not needs to be able to use fat for fuel that's just a healthy way to live this is called metabolic flexibility so to train that at least in my opinion i guess you know twenty years maybe will know more you know you go out for a jog and it feels pretty good right like i'm happy my brain's happy you know you're getting positive hormones because your mitochondria work

42:06
diabetes patient to go run, jog. It sucks for them right out the door. 100%. 100%. Like this sucks, but you're like, well, you're just going slow. Just suck it up, buttercup, go a little more. But no, so I think we need to tell those people to slow way down. Yeah, yeah, for sure. Right? But fix the diet because the diet's going to help with their whole fat adaptation.

42:35
topic fat, so they need to fix the diet. But go walk, like just go for a walk or an easy swim, you know, like a gentle bike ride, right? Like not, you know, head down, right? Just get the cruiser bike, right? Yeah, just get off of your Strava or whatever the heck it is. Just go conversational pace. Yeah. Because as soon as they're breathing heavy, stop. Yeah, because then they're building up lactate. Yeah.

43:04
So Mike, when you were talking about this in your talk at Low Carb Denver, the people that I had in my head weren't necessarily the people who had always been inactive. In fact, the people I were thinking about were former athletes. And these are the people who I see and are mates with, you know, who have done Ironman once or used to be a runner and now they're not. When I say now they're not, what I mean is now they're

43:33
You know, either they've got a family now, they've got more job responsibilities, they want to train, but they don't do it on a regular basis. So what they do is they once or twice a fortnight, jump on Zwift and they do a Zwift race. And then they're so buggered from it and they aren't able to recover that they didn't do nothing for the next four or five days. And then the next thing they try and do is the Zwift race again. And

44:01
I see it and I think, my goodness, the problem is, is that you are constant, that you are identifying with the athlete you once were. And it's not that they're not an athlete, but they're just at, well, they're no longer that competing, regularly active individual that they used to be. And they're almost doing themselves a diff service because they haven't had that factory reset that you were talking about and they need it.

44:31
Yeah. Yeah. I don't know if you use the same terminology, Mickey and New Zealand, that would, they're type A type A people, right? Yes they are. Yeah. And I think if you're coaching a type A person, like the people that are, like you could take athletes and people are either horses or mules and it's fine. You could be one or the other. You just have to understand who you are. You know, the people that are like the Ironman triathletes, college athletes, they're horses, right? That's why they're.

44:59
doing that stuff and they will run until they break. And then the mule, as soon as they get a little uncomfortable, they slow down. So they're fine. You don't need to give them any advice at all. They're good to go. They're gonna live long. Their mitochondria are fine. They're not gonna win the Boston Marathon and they're not gonna finish an Ironman, but they could care less. They're just fine. They're healthy humans. So it's the people that really do have that data.

45:26
And I think all these, I'm not on Strava, I don't track anything, you know, because I think it just puts this, you know, you don't need that. But I think, you know, if you're advising them, you have to give them permission to slow down and convince them that that's important. You're going to have to do that. I mean, Phil Maffetone with Mark Allen, you know, back in the 80s, you know, he got us, you know, he was like Yoda, right? So goes and seeks his advice.

45:57
you know, Mark, you got to slow down. And, you know, he's like Yoda. So Mark didn't challenge him. He's like, he listened to the logic about it and said, okay, I'm going to go do that. Yeah, yeah. And it was great. It's like the hero's journey, right? Yeah, what you're doing and you go seek, you know, seek the wisdom and then you go back away and then you come back and you've just discovered something. Yeah. And you don't start, but that's what really those folks need to do.

46:24
And there's so many people, I think, that have done it. You know, they were broken and then whether they're, you know, age groupers or high level, right? They'll go kind of do a mathitone style block for six months. You know, slow down, eat better, eat clean, build those mitochondria, whether it's heart rate training, something to act as a governor to make them not go faster. The type A's need a governor. You know, they need something to beep and yell at them to slow down, you know.

46:53
or else they won't. I agree with you. But then in six months, they would be able to... But it takes time, you know, and it's priorities. You know, if people have three kids, a job, and they want to, you know, complete the Iron Man at an age group record, it's... You know, it's not going to fit. I mean, someone explained this to me one time. I heard it on a talk. Like, you've got, you know, you've got 10 cards. That's, you know, you got to play those 10 cards. No more, no less, right? So you've got to...

47:24
You know, you've got your family, you've got your job, you got to recover and you got to exercise. And maybe you've got some recreation or other things. So, so you can't make cards up. Well, I want to play five for exercise and three for recovery, but I got a job and I need to sleep and I want to spend some time with my family, like, no, no, you're just played 15 cards. So I think at, at each stage in life, you have to be a professional triathlete is, is playing like five in their training.

47:53
three in recovery, two for sleep, they have nothing else going on in their life. Totally, but it's their job as well. Totally, no job, no family, no nothing. That's not you or me or anyone listening to your show. Yeah, for sure. And you know, Mark, I feel like there's just almost a mental block for these people that we were describing in that they feel like they'll get more bang from their buck if because they do it less often, they should go harder. Whereas because of the state that they're in,

48:21
it's that they need to change the outcome goal, I think, a little bit, because that's what they're sort of attached to. Whereas sort of building up that mitochondrial resiliency, making those diet changes, changing the way that they move, ultimately will get them to their goal in a much healthier state, and they won't get a heart attack and die. Yeah, even Lyddiard, you know, back in the day, he called his, is your training GISA or PISA, right? So PISA is the leaning tower.

48:51
You know, so if you're doing a lot of high intent, so that at the top is the high intensity, you know, so ultimately you're going to break and it's, it's going to fall over. But Gisa is the pyramid, right? Not the food pyramid, but the pyramid, right? So that the base of the pyramid really is your health. If you're not healthy, you're going to break no matter what your training is, but it's all that zone one, zone two endurance training, you know, and then you've got maybe a little zone three. And if you choose, you know, if you're competitive, throw in.

49:17
some specificity. So timing and specificity is really important. Like your countryman, Nick Willis, I think he's run the sub-four for more consecutive years than anybody. So he'd be interesting. What does he do in the office? Because that's pretty phenomenal. I think he's had over 20 years of sub-four. I think so, yeah. Yeah. So again, he's been at the top of his game for a long, long time.

49:46
So whatever he's doing is smart. You know, like the people who, you know, at the top of their game, you know, or Bernard Legat was probably similar to Nick Willis. So he was, you know, you, you, Kenya, then US, but he was still running, you know, sub fours in like his mid forties. But, you know, when he was in his teen, he's running like sub fours, but he would take a month off, like completely off D train, you know, and a lot of just.

50:13
You know, he knew when his season was, you know, a lot of early endurance training, you know, he ran to school as a kid. Like, like he had that endurance training already dialed in even before they lined him up for a race. I think a lot of what's happening now, you know, in culture, which is going to be more difficult in America to develop these athletes as we don't live like we did. And, you know, maybe in New Zealand, 40 years ago, people walked around the school.

50:40
Kenya, they still do that here. There's zero physical activity, and then they want to join the high school team. But I think by that point, that critical development to become a world champion, maybe that ship has sailed already. Yeah, that's interesting, isn't it? Because it's no different here in New Zealand. It's seldom do kids walk to school. Of course, there are kids that will walk to school, but the prevailing thing is being driven to school because parents are busy. It's convenient, and I'm certainly not.

51:10
I'm not dismissing that, you know, I understand the realities of actual real life. But then of course, physio has taken out of the curriculum because there's no room for it because we need to do all of these other things. And it's just, I do worry about the youth of today. Yeah, I think we all do. You know, Lorraine Muller and Rod Dixon, I got to hang out with them in New Zealand and you know, both, you know, Olympic champions and they just described their childhood compared to now, you know, they didn't even wear shoes to school.

51:39
And they would be running all the time in school, you know, games and recess. You know, so it was just a different, different world. Yeah, for sure. Now. So if you're a parent listening to this, you know, just let, if your kid can, if it's, you know, we have that boogeyman thing, oh, we're afraid someone's going to kidnap her kid or something, but let your kid walk to school if possible. Yeah.

52:00
Totally, Mark. And so obviously with regards to, you know, I said, I want to talk to you about zone two. Essentially, we've talked about mitochondria and mitochondrial health. And so a bit of a tangent, but I did mention things like ice bath or sauna. Like what was your understanding of the utility of these to help build mitochondrial resiliency, Mark? I mean, it's okay if you're like, I actually haven't really looked at that, but I'm just keen to hear what you know.

52:27
Yeah, you know, I haven't dug into a little bit literature specific about what that does to mitochondria, but I don't, I think, I mean, I think just knowing how physiology works. Sure, if you go for a long jog, hike, bike ride, you know, you've added that stimulus and you like to soak in a hot tub or an ice bath after that just to relax, that's probably good. But I can't imagine how not exercising a muscle.

52:56
can lead to any mitochondrial growth. I think it'd be a very hard thing to really demonstrate. But if it helps you recover from your activity, right? So you can go out and get a little bit sore, whether it's a sauna or hot tub or ice bath, there's really like no specific best way. It's like, whatever you feel good, recovery is for you. What recovery?

53:23
is recovery. So you can go out and do something again. So stress plus rest equals growth. Stress without rest, then you just over train. Yeah, nice. And I know that in the... I have a little hot tub, it feels great. Yeah, for sure. I know. Yeah, I don't know what it's doing in my mitochondria. But it's really good for your recovery. Yeah, it's people that have the same thing with sauna as like up in the Scandinavian countries. Yes.

53:52
is by does something for your mind, which is powerful to just relax. You can't be on your cell phone if you're sitting in the hot tub. That's true. Or at least you shouldn't be. And I know, you know, in that cold water thermogenesis, they, you know, people talk about brown fat and that mitochondrial rich sort of fat and that you can generate more brown fat from being. Yeah, maybe so maybe there is a little bit with, with brown fat regeneration, but most people don't want to be like freezing cold.

54:21
I'm skinny so like no, you're happy without my heat down at night. That freaking cold bath. And you're in West Virginia. I mean, I feel like that would be quite cold actually in general. But I also wonder how, you know, despite the fact, yes, of course you can generate more brown fat, I do. I always wonder with things like this, what's the clinical, how meaningful is it clinically? Like yes, yes, in a study they may show a.

54:49
regeneration or a generation of brown fat, but what is the outcome of that in real life? Because there's that difference between what they find is significant statistically in a study versus what's actually meaningful. So I do wonder about that. Yeah, and I think genetically, so if you're northern tier Eskimo, you have a lot of brown fat genetically. And brown meaning loaded with mitochondria, it's like red meat versus white meat. So that's what we mean by brown fat. That is healthy fat.

55:16
So that is maintaining your metabolism, maintaining your heat. And the brown fat actually isn't kind of around our like wiggly jiggly stuff. It's kind of mostly like trunkle, kind of like upper, like upper neck. I'd have to look at a map like where this brown fat is, but a lot of that is, is genetically determined if you were born in an equatorial part of the world, you don't have as much brown fats, you know, would not be an evolutionary adaptation to help, help you live, but you know, there's, you know, you can read things and there's theories like you.

55:46
You know, you turn the heat down at night, like if you live in like any part of the world like I am, you know, probably, you know, you should not just be in this euthermic environment 12 months a year. And, you know, let's just set the, you know, what is 70 degrees in your terms, like, you know, 18 degrees or something, but just set that homeostasis all the time. You know, I think the body needs just like training.

56:13
The body just needs variability. You know, that just, we probably shouldn't need science for that, right? Like we had seasons, you know, go out and run in the warm weather a bit in the summer, right? You become more adapted to warm weather exercise. You know, we develop the ability to sweat more. We conserve the sodium in our sweat, right? So we have all of these magical adaptations by exercising in the heat that allow us to exercise in the heat. And then in the winter time, you know, I keep my house at 66, you know, it's not...

56:43
horribly freezing, but it's cold. But that helps me, like I sleep like the dead at 66, and then when I have to go out and run and it's 18 degrees Fahrenheit, which is negative something, then I'm fine. I'm not like going from this sauna at six in the morning out into freezing cold. The body makes the shift a little easier.

57:09
I was not overly disappointed that I wasn't able to run when I was over in Denver because it was so cold. It was cold those few days. I know. I did miss, you know, it would have been a great opportunity to have a run with you though, you know, go out and like I would have had I had had been running at the time, I certainly would have packed my running gear and anticipated it being super cold because we just don't really get temperatures like that here in New Zealand. Like I've never been in minus 10.

57:36
And you were 18 time zones away too, so it would have been, it's hard sometimes when you do like your kind of trip. Oh, I know. Like you're just trying to adjust to day and night and go out to exercise. I know and I've just actually. Because it's the middle of the night, like literally you're awake, your brain is like this is the middle of the night. It's funny actually. So I was in the gym at 4am Denver time, which was

58:00
12 a.m. New Zealand time. And then I looked and I saw Marty Kendall. Marty Kendall. Yeah, he was in there as well. Glenn Finkel and the South Africans. Yeah. And you're like, oh, these guys, you just can't sleep. Yeah. So Mark, in terms of the, because you know, you're knowledge-based for obviously running history, which I just bloody loved in your talk. So if anyone is interested in this topic, they should absolutely purchase those low-carb Denver.

58:26
sort of virtual streaming tickets, which are still available. People can still jump on, purchase them and see your talk in amongst a whole bunch of others, which are similar in terms of how they talk about mitochondria, but they just are looking at it from different health and wellbeing sort of perspectives. So, I really loved your talk. And like, is mitochondria and zoonotr is this something that you're super interested in? You always do a deep dive in the in the literature about or...

58:55
What other things are you sort of looking at and interested in right now? Yeah, so my career is a doctor, so I'm interested in diabetes remission and obesity, medical obesity, because that's such a massive problem around the world. So, you know, applying lifestyle measures to make these conditions go away, not just manage them with more pharma, because these are essentially dietary and lifestyle conditions.

59:23
There's a lot of talk, I go to the conferences on low carb. Low carb is a powerful hammer for metabolic syndrome, type 2 diabetes. But exercise, I think, is like the magic pill. So there's no downside, there's no controversy. So if we can become a little more exercise focused, and I had like two slides on it, you're trying to do a full day seminar in 30 minutes, literally. I know.

59:48
So when we exercise, there's this magic glucose transporter that comes to the surface of the cell. So it's called a Glut4 transporter. So when we eat some carbohydrate, a well person, can eat carbohydrates, their glucose goes up. So your pancreas secretes insulin, which connects to this insulin receptor, which brings this little transporter, and the glucose goes from your serum into the cell, and you've got energy. All works wonderful. But in the diabetic, that system's broken. They're insulin resistant.

01:00:17
But when you exercise, it's like the magic back door. So these Glut4 transporters come to the surface of the cell, and it's about a 50x increase. So like you go exercise, you can increase your glucose disposal. Yeah. Forget about the drugs or any of the other debates. And we showed this in our pilot study with the glucose monitors. We told our patients, go figure out.

01:00:44
What's the effect of exercise? Oh my gosh, I go for a walk and my sugar goes down. It's like, whoa, there's no downside to that. That's great. Go for a walk. You could shoot insulin, store it, or you could go for a walk. So that's like the CGMs, you know? These people didn't have CGMs. They wouldn't have had a clue. And they're like, oh my gosh, that's fascinating. I can dispose of glucose just, not a run, not a CrossFit workout, nothing high intense, just by going for a walk.

01:01:13
So go for a walk after your meals. And there's good research with that too as well. Oh gosh, yeah. Yeah. The physiology is there, the mechanisms are there and the research is there. Yeah. But it's, no one's making money off of this. So like, why is that not like on every MedPage Today headline? Wow. If you walk, your sugar goes down without insulin. Yeah. And I've got to say as well, like, I don't know how you feel about this, cause I can't recall talking to you about it, but you know, I, um,

01:01:42
over the last three years with the pandemic and shutting down the gyms and the donuts that got people encouraged to get vaccine and whatnot. And I'm just thinking that there was never a focus on metabolic health. And if anything, it was almost, well, not only was it ignored, it was almost like the opposite of the type of advice that we should be giving people because

01:02:10
I've heard people talk about it yet, we had a pandemic and people are saying we're still in the pandemic or whatever, but what about the obesity? At what point does that sort of the... I wrote a blog which we published on our WVU, West Virginia University, in April 2020. It was called, Is it Time to Quarantine Junk Food? And at that time, it was like a six page blog. I could probably find it, all the mechanisms, like this is the time to look at this, right?

01:02:40
And then Nina Teicheltz who you met also, she and I put together an article. It took nine months to get it published. Crazy. It was just like a two pager. Is it time to lock down sugar? Okay. Like the amount of pushback we got just to get that published. And that, so that, that got published in maybe October 2020, something like that. So really early in the pandemic. But like, why was, and there are like only a few articles out of the thousands of COVID articles that exist. Like how many?

01:03:10
were published with an action plan, right? Not just, oh, wow, all these people with these comorbidities get sicker. No, this was the action plan, right? The title is a time to quarantine junk food, is a time to lock down sugar. And I can send you the link to Neva and I's article and share it. But no, it was just indeed sad. I had patients in the hospital with COVID. They had the glucose monitors on their text to me. And they'd be like, doc, they're feeding me

01:03:39
pasta and stuff. My sugar's 400, they're putting me on steroids. You know, the cytokine storm, you know, and they're like locked in. No one can bring them food and they're literally feeding these patients stuff that's going to kill them, right? Like the only thing you can control is the food, right? You can't control the cytokine storm, but they were still feeding them. No, you have to have this. I mean, my patients were smarter, sad to say, than...

01:04:08
many of the doctors, because they had glucose monitors on. Yeah, interesting. And you're just like, it's insane. I had to call the hospital a couple of times to say, look, can you not give this person this? And you had to actually like getting people's, you know, getting their face a little bit. Say, look, he has a glucose monitor on and you're feeding him spaghetti. Why don't you just feed him eggs and salad like he wants? Yeah, yeah. And it's his human right. And were they responsive to that, Mark?

01:04:32
It was kind of weird. They kind of did, but like, why should I have to call and argue to give them something that's not going to kill them? It's like, yeah, yeah. You shouldn't. I mean, then there's millions of patients around the world that that's happening to, you know, who don't have someone calling, who don't have glucose monitors, they're just along for the ride. So we could have like another whole show on that. No, I totally, I totally appreciate that whole idea of factory reset. I feel is something that a lot of people will probably need even more so post.

01:05:01
the last few years. Yeah, yeah. Are you familiar? It's a slow reset. Yeah. So you can't force the reset to factory conditions like your computer. No. You can just turn it off, control off, delete, and it all goes back. It takes, for as long as it took you to get to where you are in the state of health, that's suboptimal. It's gonna take time to get back, but that's okay.

01:05:25
Zero urgency, right? This is what I say to people all of the time. Like you don't, like there's no time bound to this every day that you put into practice these behaviors. Get healthier. It's another day closer to where you want to be. Yeah. Amen. Yeah. Yeah. If you have a bad day, just get back on board. Exactly. The next day it's all good. Exactly. Mark, thank you so much for your time this evening because it's just gone nine at WV time and I imagine we'll be well past your bedtime. Can you just...

01:05:54
briefly remind us where people can find you. I don't think you're that active on Instagram, to be honest, because you didn't retweet any of my tweets. No, I'm not on Twitter or Instagram. Someone actually hacked me on, a friend of mine said, is this you? So someone actually hijacked my identity on Instagram and was selling nutrition supplements, which is actually terrifying. You know, that someone was trying to make money and so it's like, oh, this stuff's kind of, but.

01:06:21
Yeah. So, um, I have a little website called Dr. Mark's desk, which links to, I have a shoe store that sells minimal shoes and I direct running races. So if you're out here, you can come do our trail races. We were a lot of fun. Awesome. And blog a little bit on, on running, but actually have a Dropbox folder for all of this low carb athletic zone two stuff. So if you, and we could put in your show notes, tinyurl.com.

01:06:47
forward slash low carb athletics. Okay, I will find it. Yeah, I'll send it to you. We have like the long version of all my slides. They're all fine to share. And as well as like maybe 40 or 50 articles on all this stuff. So if you're a nerd about like exercise science, you know, the literature, the primary literature with articles going back to, you know, the 40s and 50s about all this stuff. So that's a good place to go.

01:07:17
That's amazing, Mark. Any other work by Phil Mathiton. So like I didn't make any of this stuff up, you know, I think people are discovering the science of what all these coaches and athletes knew. Arthur Lyddiard, you know, what he knew, there's nothing new under the sun. Like what he knew in 1960. Yeah. You know, as he was training cardiac patients, right? That's that's how he got to start was teaching cardiac patients to jog and jog slow. Walk first. Yeah. And then ultimately some of these heart patients.

01:07:46
ran marathons, you know, but they started with, you know, their first goal was can you jog in 20 weeks, you should be able to jog 30 minutes. That was the cardiac program, not in two weeks, it was 20, 24 weeks, something like that. That's like most people now don't have the patience. In 24 weeks, that's like, what the hell is that? That's like, I want to be better tomorrow, but no, no, that's what it takes. That's what he would say. It was walk around, walk around.

01:08:13
a little more jogging, and ultimately you're jogging the whole thing, but over the course of time. Yeah. Mark. Yeah, all old school stuff. Yeah, totally. And as is often the case, like practice will almost always come before research. I feel like sometimes the practice of it makes people curious and then they research it to sort of see what's going on. Yeah. What athletes have done, Steven Seiler, for the history of time, you know, for the history of time, 80-20.

01:08:38
90-10, right? 80 to 90 percent of people's training are in this technically zone one, zone two, whether no matter what sport they're in, in an endurance sport. Yep. Yep. So why, if that works, now we have to figure out scientifically why is that true? Yeah. Yeah. They all just do it, right? They know that this is what they need to do. And so that's our job is to, and then transfer that to the patients who are not elite athletes. Okay, how do we adjust these principles for the sick patient? Yeah.

01:09:07
And that's, I think, the next frontier is we're starting to understand a little more what's happening in the sick patient that's different. Yeah, yeah. That's awesome. Mark, you're so generous with your knowledge and your time. Your show is amazing. I love your show and you've interviewed so many awesome people, so it's a privilege to be on again. Amazing. Well, you are one of those awesome people. And everyone is so generous with wanting to share information. So thank you so much. All right. Well, have a great day, afternoon. Yeah.

01:09:37
Get a shower and get some rest. See you Matt. I got my sweaty exercise clothes on. Nice. Okay. Bye. Bye bye.

01:09:56
All righty, I think that you guys would have really enjoyed that conversation. And as I said, we've got links to all of the things that Mark and I discuss in the show notes, including a link to his previous podcast interview with me, if you missed it the first time around. Next week on the podcast, I'm excited to bring to you the discussion that I have with women's health advocate, Amber Shaw. It's a good one. She keeps it very real.

01:10:23
Until then though, you can catch me over on Facebook at Mickey Willardin Nutrition, over on Instagram and Twitter at Mickey Willardin, or head to my website mickeywillardin.com where you can sign up to the waitlist for Monday's matter that is happening in May, not too far away. Book a one-on-one call with me if that's what you require, or sign up to my recipe portal or one of my meal plans. All right team, you have a great week. See ya.