Hey everyone, it's Mikki here. You're listening to Mikkipedia. This week on the podcast, Cliff and I get together and have a wide-ranging conversation about wearables, running, carbohydrate fueling, alcohol, and how we interpret health risk.

Broadly, it's a conversation about looking at the totality of evidence, communicating risk accurately, and focusing on the behaviours that matter most for long-term health.

So, as per usual with these conversations, you really are a fly on the wall as you listen in on Cliff and I really just sort of chewing the fat on some of our favourite topics.

And in fact, even last week, we just jumped on a call about something entirely different, and it could have actually been a podcast.

And I don't doubt that you've listened to several of Cliff's episodes now because he's such a regular on the show.

So, I'm pretty sure that you're really going to enjoy this one.

So, for those of you unfamiliar with Cliff, which is a surprise to me, Cliff Harvey, PhD, is New Zealand's expert on the effects of a ketogenic diet in a healthy population.

But he is so much more than that.

He has been helping people to live healthier, happier lives and to perform better since starting clinical practice.

Back in the late 1990s.

Over this time, he has been privileged to work with many Olympic professional Commonwealth and other high-performing athletes.

He has also worked with many people to overcome the effects of chronic and debilitating health conditions.

Along the way, he has founded or co-founded many successful businesses in health, fitness, and wellness space, including the Holistic Performance Institute,

New Zealand's leading certification and diploma for health, nutrition, health coaching,

and performance that has many of the world's experts teaching on the course, such as Dr. Eric Helms and me.

So, students really are learning from the best.

And honestly, I get asked so often from people who are just hungry to learn more in this space.

And I'm always sending them over to Holistic Performance Institute, particularly if you are interested in clinical nutrition, which is an area that they really excel in.

Cliff has over 20 years of experience in health, fitness, and wellness.

So, I'm sure you've heard of him.

So, I'm sure you've heard of him.

So, I'm sure you've heard of him.

He has over 20 years of experience as a strength and nutrition coach.

And in addition to his PhD research, he's a registered clinical nutritionist, he's a qualified naturopath, and holds a diploma in fitness training and health coaching in patient care.

And you can find Cliff over on Instagram, at Cliff Doggy Dog.

Or you can find him over at cliffharvey.com, or also check out holisticperformanceinstitute.com.

Before we crack on into the show, though, I would like to remind you that the best way to support this podcast is by following me on Instagram.

And if you're not following this podcast, be sure to hit subscribe on your favorite podcast listening platform.

That increases the visibility of Mikkipedia, and amongst literally thousands of other podcasts out there.

So, more people get to hear from the guests that I have on the show, like Dr. Cliff Harvey.

All right, guys, you enjoy this conversation.

Okay, well, even if it was, okay, that's good.

We're recording, but tell me anyway.

I have an old Oura ring, and Kirsten had given it to me.

I have an old Oura ring, and Kirsten had given it to me.

because Will didn't like wearing it you know you got to wear it at night to get the best

data and stuff like that so I got a lot out of that because I was using it to monitor RHR and

HRV just for recovery and stuff like that I found it was really good if you started especially with

the kids you know you start to get sick but you're not sure yet but RHR spikes by like 10 beats per

minute and that tells you that maybe you're getting sick or whatever so I found it really

useful anyway but it started malfunctioning because it's pretty old now it's a gen 2 or

something so it's really old so I was looking into getting another one but now you have to

pay a subscription so I thought I don't like wearing anything at night anyway are there any

other options and I bought a Withings sleep analyzer oh what is this it's really dope it's

like a pad that you put under your mattress yeah and it tracks your sleep sleep apnea respiratory

rate HRV RHR all that stuff and it's really good so I bought a sleep analyzer and I bought a sleep

that kind of stuff so I don't need to wear anything now wow so just go to sleep wake up in

the morning cool yep everything looks good oh my god and is there good sort of data I mean as well

as much as any of these tracking devices can does it give you kind of solid data um comparing it to

another measure my understanding is yes because I think Withings they make a lot of medical grade

equipment so I think it's pretty good I think it's as good as any of the other

sort of well it's not a wearable but it's as good as the other wearables I think and it's

certainly good enough for what I use it for it's like a blanket almost as a wearable but like an

under bed blanket um how much it's quite small oh is it yeah oh okay I had it in my head that

you were like putting it like some sort of like undercover for the bed but is it just

and it literally goes underneath your mattress not the mattress protector so there's still

quite a bit of gap oh yeah crazy um and I think it was 230 bucks

that's really reasonable does Bella have one as well no we didn't get one because she doesn't

really we're on a bit of a budget at the moment she doesn't really care much for that vehicle

bio feedback type stuff um but we would have got one had you know we got a discount on a second

one unit or whatever and we're going to see how it goes with my one too and if she wants to get

one we can get one that makes sense and you really highlighted one of the reasons why I haven't gone

down that route of tracking my sleep or my HRV etc.

because I just don't I don't enjoy I've got a watch which by all accounts the data you get from

your watch isn't great anyway a lot of people swear by it but um I from what I understand it's

not the best uh second point the reason why you don't didn't want to get another aura is exactly

why I don't want to get an aura I don't want a subscription I mean that just sounds expensive to

me um and and also I don't know where I'd wear it because I've already got my you know my wedding

rings and then my mum's ring and then my mum's ring and then my mum's ring and then my mum's ring

so I'm like I've run out of fingers uh and then the third reason is that um well actually those

are the really the two big reasons but this sounds like something that I could buy into

because it's no effort you're not wearing it it's not that expensive equally um Hubster is

probably not that fast either he'd be a bit like Bella like well I mean maybe but you just go right

ahead yeah I hate wearing things at night so the aura ring was kind of a compromise

because it was if I wear a watch at night I'll wake up and without even realizing it I've taken

it off in the morning it just annoys me so and the ring was kind of the same sometimes like I

hate having something on my fingers especially with jiu-jitsu and stuff you know because

sometimes your fingers get swollen from all the grabbing and you know arthritic old joints and

stuff yes so yeah so it'll be interesting because I I'm not a big fan of tracking in one respect

either because I think it's kind of like food tracking it can drive a bit of stress

around you know being too overly committed to the data and you know worrying too much about it

trying to make all these changes and if it's not going to be something that's actionable what's

the point anyway and the only reason I shifted that over the last couple of years was I did

notice that it helped me to be aware of a few other things like if there was an impending

cold or flu it sort of gave me an early warning sign I did find that using RHR as sort of an acute

measure was quite good for adjusting

training loads HRV similarly you know it's a bit more of that sort of chronic measure and I know

that there's a lot of flaws with it because people will say well you know even when HRV is depressed

and RHR is high you know athletes can still go in and hit a PB it's like yeah sure they can and

that might be appropriate for an elite athlete in their early 20s but for me a sort of semi-retired

recreational something in their late 40s if it tells me that if the data is telling me maybe I

should back off sure I'm going to do it but I'm not going to do it because I'm not going to do it

I might hit a PB but maybe I'm better off not doing that anyway just you know have a bit of a

lighter day and just be aware of that kind of stuff it was also pretty interesting looking at

the sort of correlation just personally between if I inadvertently had a higher nickel day the

day before and how that was affecting those metrics so sometimes you know reversing that

it's like oh well RHR is a little bit up what did I eat yesterday oh yeah we went out to that

restaurant and maybe I didn't know what was in the

food and maybe I did spike my nickel a little bit so yeah it's all interesting stuff well I was

laughing Cliff as you were talking about potentially getting obsessive with data because

I mean I can go either way really and what I noticed for myself is about two or three weeks

ago I realized that I was on a Garmin step streak so I had managed to beat my step goal

like almost every day for about I think 40 days and I'm like oh okay yeah

okay and then I'm like wow I really want to keep this going and so up until this morning I was on

day 58 day 59 I was I was always meeting my step goal and I was so stoked equally though in my head

I thought at some point I'm going to need to break this and I'm going to have to deal with

the consequence of how I'm going to feel about that and I almost wanted something to sort of

do it for me so I didn't have to be the initiator of the breakup between me and my data so this

morning I had a couple of webinars I did yesterday it was a super busy day I then got to bed quite

late because it took a while to unwind but it also was up a bit early because it's just what I do

and then I left the house to go for my run drove to the gym got out the car went to turn my watch

on wasn't on my wrist so I forgot I forgot to pick my watch up and I'm like there goes that

there goes that step streak I didn't even care that I wasn't able to

track my run albeit I did track my run because um I had my phone and I am interested in my run

data and I'll I can explain more in a minute um and obviously my steps are still going to be my

steps regardless of whether my watch is on my wrist or not but now but now I it's the Garmin

step goal that I've broken not the actual step goal so yeah I was a bit bummed if I'm if I'm

honest well I think you know I think steps are really important and you know we I think we've

asked before that research where even where people are getting in that sort of higher intensity

exercise you know doing their weight training and they're not getting their steps they still

have poorer morbidity and mortality outcomes but I also think there's this idea which I don't agree

with and you know particularly the social media sphere where you have to be doing cardio and you

know weight training cannot function in any sort of cardiovascular sense and

neither can any of the higher intensity forms of activity and I just think that's garbage because

a lot of people say well and I've had this advice before you need to do more zone two

I'm like yeah but I walk the dog every day and it's only 20 minutes but I go to jiu-jitsu twice

a week 90 minute sessions sure maybe half an hour of that's really intense but 60 minutes is just

kind of rolling around on the floor and doing positional stuff I'm sure my heart rate's elevated

and even doing things like housework you know a lot of people say well that's not

cardio but hey if like when I was wearing the aura it read it as activity my heart rate was

moderately elevated like I think there's a lot of nuance there where

personally I don't think people need to do strict cardio if they're doing movement at

varying intensities through the week I just don't think it matters in any meaningful way right

interesting because I feel differently actually this is this might be the one thing that we

disagree on

actually I'm sure there are many things that we disagree on but um I I maybe it is the endurance

nature you know my you know I'm an endurance girl at heart I love cardio like I cannot tell you I

cannot put into words how much I love running it is you know that meaningful to me not that

everyone needs to run but um but I do think that in this era of social media particularly and maybe

it's the cohort that I see and in my little um

in my little box on social media or whatever when I hear a lot of macro coaches whoever they are

um say you don't need to do any cardio walking and strength training is all you need to do

and I'm like what what about how heart health you know it's just it's so dialed into just

fat loss and I know that's their gig that's the thing they talk about that's I mean I

love talking about that but it's not the only thing that is important it's overall health

which is which is important so I'm

so i absolutely champion um aerobic activity and and i can't speak to housework because i actually

don't do it but anyway well i don't disagree with you though and i'm certainly not saying

that housework is um like cardio per se it's low intensity it gets the heart rate up enough that a

wearable is going to track it for example what i was more meaning is that let's say i'm doing two

hours a week of low to moderate intensity jujitsu where my heart rate is elevated that entire time

i've got to consider that that that's kind of like it's kind of like cardio right just because

i'm not jogging yeah doesn't mean that that's not cardio but a lot of people would say well it's not

you need to do in addition to that x or y and then i think similar to my um aversion to the idea of

you know the the volume hunters and strength training so you've got to have more and more

volume right for hypertrophy same thing i've seen in the zone two space where people like

the more you can do the

the more you can do the

there's no limit it's like yeah i get it but we've got lives you know and am i going to get

a meaningful benefit in addition to my 20 minute walk a day 30 minutes of strength training every

day 90 minutes of jujitsu you know maybe the odd harder walk hike in the weekend or whatever

would adding some survival shuffle jogging through the week really do anything apart from

screw my knees up it's a good question it's a good question and in fact it reminds me of i

remember listening to a podcast where i was like oh my god i've got to do this i've got to do this

and i remember listening to um rob and Mikki talking about talk about it on the healthy

rebellion podcast i used to love that podcast they've they're no longer or at least they haven't

they've taken a long hiatus anyway um and they got in they were very much i believe in the same

space as what you're discussing then they got into doing some defasted um zone two work a few

mornings a week and just just to see how they felt and just to see whether it helped with some of the

things that they were trying to achieve and for all for whatever they were doing they were trying to

do it for they um noticed a change and so i guess the the real question really is cliff is that you

don't think it would make a difference give it a crack but unless you unless you run that i mean

if you care and if not no big deal but that would be it would be interesting right for 90 days

if you did i don't know or for three months you did three extra sessions of zone two for 30 minutes

a session i don't know i don't know what would you notice well maybe that's an experiment i need to

do

watch the space let's do that i totally um i tell you i'll update you on my running because i know

you are fascinated by it i'm fascinated by running it's my just my favorite thing yeah yeah and

particularly my running um so i've been feeling particularly slow and listeners of the podcast

would have heard me say snippets of this over the last however long but most but our events over the

last couple of years have been the long slow events it's been the multi-day stage race

where you run and you hike and you you shuffle and you jog and and the idea is to get get to the

end of each day recover and go again anyway um i've had my significant injury issues again i

won't bore i think i've already talked to you about it in person and bored the listeners with

it already but over the last month i've just um i i don't know if you do you know david roche have

you heard of him no he is a super high carb guy

he is in his um ultra running events he's a he's a coach first and foremost and his wife is a coach

as well uh and and he his if you say someone has a claim to fame his would be advocating for a super

high carb approach um and he was he consumes 150 grams of carbs an hour during his ultra runs which

is quite a feat in itself given that it's a hundred mile event right so and he won i'm

once maybe he won leadville twice i'm not sure maybe just once um on this method and outside of

that him and his wife are they've got excellent training programs and and they managed to weave

in a lot of you know strength training and um and other aerobic work in a way that sort of means that

you can just follow the plan and not have to do the mental arithmetic yourself as to where i'm

going to fit the strength and etc um but because i was feeling so rubbish cliff

and just really sluggish and slow i i did two things which i never thought that i would

necessarily do the first one is start stretching and so i did uh les mills online hip mobility

classes they've made such a difference such a 15 minutes such a difference sorry listener you've

heard me say this talk about this before um and then and then the next thing i the other thing

i've done is i've just like i haven't gone full noise on the carbs but man i've upped my carb game

has made a world of difference pre-running during running after running during the day

like i feel so good my recovery is excellent my appetite is also excellent um and all i care about

is how well i'm running like it is it is it is such a great feeling actually i love this because

i i was just watching a video by anthony chaffee on facebook where he was saying again

that you do not need one gram of dietary carbohydrate not one and i mean i i i just

will love to watch the comments on this because i'm sure there'll be some people jumping in saying

you know you don't need those carbs for exercise etc but uh karen and i co-wrote the chapter on

sports performance in the um ketogenic textbook and you know consistently we find and there's not

a huge amount of data right now but the studies that have been published have shown that the

consistently find that those people who are even habitually low carb thriving on a low carb diet

benefit basically to the same extent from the same dosage of carbohydrate during exercise

so that tells us like it's not so much about high carb versus low carb it's just about you know

follow the diet that fits your lifestyle your goals all that kind of stuff but recognize that

when you're putting your body under those more intense loads longer durations of exercise etc

you're just

going to benefit from that extra short-term fuel like it that's fine like and who cares

why become so dogmatic about something that you wouldn't just have a little bit of carb during

training hey interestingly talk about those really big carb loads during or carb doses during

exercise joe and i did some field research with the irel endurance team going back to probably

2002 i think yeah and at the time a lot of people were saying that they were not going to be able to

do it again because they were not going to be able to do it again and i think it was a lot of people

were still very much in that idea that i can't remember what the threshold was you'll probably

remember but there were thresholds you cannot take in more than x amount of carbohydrate per hour

it was yeah 60 it was often um 60 grams with just glucose but 90 grams with glucose fructose

but they were the the limits yeah right and and we found that when we were testing

glucose and lactate every circuit of the moon ride 24 hour mountain bike ride

we found that our

athletes needed significantly more than that to preserve performance lactate etc and and even to

keep blood glucose relatively stable because we knew that if this glucose in those relatively

short circuits was suddenly spiking that didn't necessarily mean that was coming from exogenous

carbs that wouldn't be possible it means that they're getting a bit of a liver dump right

yeah so we were trying to keep them as stable as possible and we found

for these top level athletes that they were having to take in a lot more than they previously

thought

and so i i think that that started getting out into endurance circles because people started

talking about it so maybe um joe and i had some role to play back in the day oh oh i don't doubt

it i don't doubt it like it's it's so interesting isn't it cliff like and david um roach came across

on my radar because he was so adamantly against low carb and initially you get defensive and

you're like come on mate like that's not what the research shows you don't you know you can't have

a hundred you can't say you can't do it you can't do it you can't do it you can't do it you can't do it

that 150 grams of carbs is what everyone needs and and then of course i just listened to him on

a podcast i'm like well he's not really saying everyone needs 150 grams of carb um and it just

sort of like and you know i've had there's been loads in this research space of what that sort of

uh that minimum requirement might be in order to boost performance you know rather than looking

you know and there's of course all of the studies that have been assessing whether 120 grams of

carbs produces better performance outcomes and we don't have the research to show that they do

at all actually and dan has done a great job of sort of distilling that um scientific um information

and did a great paper and i just released that podcast a couple of weeks ago but i did think

cliff i'm like you know i mean i've been low carb forever for as long as it's been since we've been

talking about low carb at aut which is 2011 but well before that as well because i was just

naturally a restrictive

person so so the um so i'm like you know what i just need to start listening to other information

than just my biased um little neck of the woods that always talks about how great low carb is i

actually just now need to start listening to other voices just to get a better balance of

what might work and i mean i tell you what it's been game changing man so good i just think some

of those voices in the low carb space are

ignoring the evidence they know and you know for people who are listening to this and don't know me

i've been prescribing ketogenic diets for nearly 30 years and i i you know like i say i wrote the

co-authored the textbook on ketogenic diets i've got a phd which you know Mikki helped supervise

part of my pathway towards that in ketosis ketogenesis ketogenesis so it's not that i'm

against keto at all i've probably used it more than most people on the planet and in practice

and you know through personal experience but we can't deny that there is robust research out

there showing that some people benefit way more from higher carb some people benefit more from

low carb some of that is physiological some of it's psychosocial and so you know from a personal

perspective it really comes down to horses for courses not just per individual but even

temporarily like i've really thrived on keto in the past but that was because i was

wanting to stay lean stay light for fighting or weight lifting i'd maybe forget to eat and keto

was better because i could just go through you know a couple of three-hour lectures when i was

lecturing at the college or university and not have to worry too much about my cognition so much

and whatnot whereas at other times if i'm trying to put on muscle or i'm maybe a little bit more

prone to hypomania and and you know not eating and whatnot it's probably a little bit better to

have higher calorie intake higher carbon

be a bit more structured with eating so you know it just it all depends right yeah oh that's super

interesting and i i completely agree um i think it's very easy to get stuck in a certain way of

doing things and you just you do become blind to to other information or other research like i mean

if you think about the path towards infestating low carb in the first place but at least for me

i'd only learned that higher carb was the way to go

and and i'd put my blinkers on to any other information until until it you know we started

talking about it at aut when when we were there equally you can then just go the opposite direction

and not think about that in fact not everyone needs to be low carb and i think actually that's

what i was going to say brandon has been a very you know his work's very insightful to me because

he works with a lot of women who are you know metabolically healthy who who

are on board like 400 grams of carbs a day and are completely fine and probably until i get see

cases like that i don't wouldn't have quite believed that that would be possible because

i'd probably been down so far down the rabbit hole in that space well i think there's there's way too

much but but but but right we see these people who thrive on a high carb vegan diet and then

the carnivore and keto crowd will say yeah but but but

all of those buts don't matter because the fact is they're eating a diet they're healthy they're

living these long lifespans therefore all your butts don't actually matter in the same way that

you know i talked about this with with trex we mentioned this at the last sni conference

we both sort of said the same thing in that if for example the plants are trying to kill you

argument was correct we would see it and we talked about this before as well we'd see it in the

research right we would see it in those

big cohort studies where there would be the smoking gun, just like there is with smoking,

like what we're going to talk about today, like there might be in some cases for alcohol. You'd

see it, but you don't. Therefore, if there's all these plausible reasons why something might be

bad, if there's all these plausible reasons why every gram of carbohydrate might be damaging you,

maybe you've got a plausible reason, but it doesn't matter functionally

because we see people thriving, right? Yeah.

And I can't stand the argument of, yeah, but what if they had gone carnivore,

they'd do even better. Like, you don't know that. You can't say that at all. It's a ridiculous

argument. To the same, and on that same note, it's like when Dan won the age group race in Kona

on very little carbohydrate. A lot of people like, imagine if he had carbohydrate. And it's like,

actually, you know what? I don't think, I don't know what kind of difference that would have made.

But what?

Was it low carbohydrate? Because all my conversations with Dan have always been that

he lives low and competes high. Oh, no, it was low. And I think he had one gel

through the entire run. So he was, he, he. Interesting.

Yeah. Yeah. But, but he, but it was, he did have carbohydrate, but it certainly wasn't

at the, at the heroic levels with which a lot of athletes are having. So, so yeah, no, I'm,

yeah. But to that point, it's not like he would have,

he would have gone better. Who knows? Who knows? But had he been chugging 120 grams carbs an hour?

Do you remember when Michael Phelps got like busted for smoking cannabis?

Oh, no.

And so much of the commentary was about, oh, what a shame. Imagine how much faster he would

have gone if he wasn't doing that. Or imagine how many more medals. It's like,

how fast do you want this guy to go? He's like the greatest swimmer in time.

How many, how many gold medals do you think he needs to get on top of that?

Do you really think smoking that joint that one time?

That is ridiculous. And quite, quite hilarious. So, so yeah, so that's, that's what's been going

on in my neck of the woods, really, Cliff. Have you been having the odd beer?

Always have the odd beer. So, and this is.

How dare you?

I know. I do know. Okay. So this is, I'm so pleased we're having this conversation

today about alcohol in part, because I know Cliff,

that you're, so when I see information about alcohol being, you know, killing you,

essentially shortening life, essentially, there's that part of my brain that probably

gets a bit defensive and goes, come on, that can't be true. Totally true. And then of course,

I see there, there was a research study a couple of months ago that showed that exercise was

protective from a health perspective in terms of the harmful effects of alcohol. So I'm like,

well, that's great. That absolutely plays into my bias. Because I do enjoy a beer.

Yeah. As do I.

Yes. But you are, you're not, I think I would probably enjoy a beer more than you enjoy a beer.

Yes. I would say, well, enjoy more maybe, but.

Maybe, maybe, maybe we enjoy it the same, but maybe the frequency is slightly different.

You enjoy it more frequently? I'd say so. One of the big reasons I don't

drink as frequently as I otherwise.

Would is purely because of that ApoE4 gene risk, right?

Oh, you've got that.

Yeah. So where there's that proclivity towards, well, interestingly, the research doesn't really

tell us there's much association between alcohol and Alzheimer's, right? But maybe in those people

who are genetically predisposed to those kinds of challenges, you just don't want to take the risk.

So I don't really have a lot of the other risk factors that would preclude alcohol at the normal

sort of health level. So I don't really have a lot of the other risk factors that would preclude

that healthy dose or normal healthy intake. But because of that, I tend to try and limit it

to sort of three drinks a month. The way I do that functionally is just to buy generally a dozen

beers for the month. Oh, nice.

And that's it. And if I drink them in the first couple of weeks, because maybe we go up north and

have lots of Barbies or whatever, then that's done. And if they last longer than the month,

that's fine too. But it's just an easy way to

sort of self-regulate that in the same way that I'll buy a block of chocolate every week and I

can eat that however I want. Just having those little sort of rules for yourself that are easy

to apply. Oh, yeah. I love guardrails. I find them really helpful in terms of me not having

to make decisions around anything. So with regards to alcohol, my guardrail is three times a week.

Um, I'm going to enjoy a drink. And in fact, the amount that I drink now is definitely less than

it was two years ago, actually. And I think just because unfortunately I don't feel great

the day after when I do. And it really does, and particularly red wine, unfortunately really does

impact my sleep, but ultimately I don't love waking up feeling sluggish. And I, I love the,

I love waking up feeling fresh. Um, but of course it's a trade-off and I,

enjoy that. My most favorite times to enjoy alcohol is just when Hubster and I are at home.

Like I don't like if we're out, um, you know, if I'm out at, uh, like a party or we're out to dinner

with friends or whatever, it doesn't really phase me whether or not I drink. In fact, a lot of the

times I prefer not to, cause it feels like a wasted opportunity. Cause I'd much rather just

enjoy it in the best possible way. Um, that's like me with the, with dessert. Oh yeah. I never,

I never want to order dessert out because I feel like I'm not enjoying it. I'm,

talking and stuff. And by the time you finish it, it's like gone. It's like,

oh, I didn't really enjoy that. Yeah, that's exactly, that's exactly the same thing with me.

So, um, but I will say that those guardrails are, um, sometimes they're a little bit, um,

they don't do their job because sometimes I can just like, for example, we've gotten back from,

uh, Melbourne, um, this week and, and I already, and I've said, well, I'm not drinking Friday night

cause I've got my long run on Saturday, but I, you know, if Barry came home this evening and said,

oh, well, we have a glass of red. I'd probably go. Yeah. All right. So, so I, so I do have my

phases as well. It's a work on, let's just say. Yeah. Hey, you brought up mortality just before.

And I think that's really important for people to initially, at least, at least focus in on,

because it tends to be that, I guess, similarly to some other areas, people forget that most

imperative of outcomes. Are you going to die early? I agree. And this isn't about, um, saturated

fat or anything like that, but, but this is the same sort of problem or issue with saturated fat,

right? We diet, we focus in on one outcome specific to a particular condition rather than

just the overall outcomes. Is that, am I right? Yeah. A hundred percent. Exactly. Yeah. And I

think, you know, as well, you'll know, I, I, I don't know how,

all other researchers work, but I think a lot of us in that sort of public health nutrition space,

we will default to that quite rightly. So as being the, the, the pointiest end point,

do you die earlier? And I think that's particularly important when it comes to discussing alcohol,

because I'm not advocating for people to drink. Like I think if people don't drink,

keep on not drinking. If you want to drink, then you can probably find a way to do that safely.

If you can't find a way to do that safely, don't drink, right? That's the, the pragmatic advice.

But I think a lot of people don't understand that according to the research we have at this point,

the bandwidth you have is actually quite wide. If we're just looking at overall mortality,

you know, 18 drinks a week for women, what is it? 30, is it 34 drinks a week for men?

Is that what, is that the, what the data says,

Claire? Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah.

If you look heavily, if you look at the mortality data,

is it that risk increases if a woman has more than 18 drinks in a week?

I believe that's what it does say. Yeah. Yeah. Go, go check and we can just edit out whatever.

The only group for which there was a significantly increased risk of all cause mortality were those

drinking more than 45 grams of alcohol per day. So in New Zealand and Australia, that's four and a

half standard drinks. A day. So,

are you saying that for men, for women, it's two and a half drinks per day? Wow. On average.

And that this is the meta-analysis that most people point to. The Zhao and colleagues meta-analysis

from 2023 published in the Journal of the American Medical Association. So a lot of people point to

this as being the main evidence that there is no safe dose of alcohol. Where I think the confusion

lies is that, you know, all the previous, well not all, but most of the previous meta-analyses and a

cohort studies showed that there was potentially benefits to low intakes of alcohol. So it was that

idea that there is a healthy dose of alcohol. And a lot of people reviled against that saying, yeah,

but is that because of these different confounding influences? Probably, you know,

and we can get into that a little bit, but the Zhao and colleagues meta-analysis

pretty much put the nail in the coffin of that idea and really showed as well as later,

studies have sort of supported this, that there is no healthy dose. But it didn't conclude that

there was no safe dose. Although a lot of the conclusions that the authors themselves make,

or that other people interpreting the studies make as to, well, the likely safest dose is zero,

doesn't mean there's no safe dose. Because if we don't see any significant increase in those

mortality risk outcomes, up to two and a half to four and a half drinks per day,

that's not a safe dose. So I think that's a good idea. I think that's a good idea.

I think that's a good idea. I think that's a good idea. I think that's a good idea.

Like that's quite a lot, right?

That is a lot. That is a surprising amount. Is it just that the data isn't there? Is the data

that we're relying on just a little bit flaky? Is it not reliable? Like what's your read on that?

I think if we're talking about there being, you know, power of numbers, I'd say we have

the data because how are you going to look at it? You know, we've talked about this before.

Are we going to?

Do long-term randomized controlled trials giving people high doses of alcohol? Probably not.

All we've got, like any of these potentially vice-related lifestyle factors, we rely on the

cohort evidence. So we rely on temporally strong, but yes, somewhat weak in terms of confounding

influences research. But the Zhao and colleagues meta-analysis had from memory 107 studies and

over 700 different studies. So we rely on the cohort evidence. So we rely on the cohort evidence.

So there's a lot, right? The population, I can't even remember that was included,

but it's massive. Looking at big cohorts, right? So we have a lot of data. But I think digging

into your point, the big variability we see is the different disease endpoints. And so this is

where people get sidetracked, I think, and start to go down the cancer route, which, you know,

we'll talk about. But for cardiovascular diseases, typically,

there's a safe dose, which is pretty high. And I think it was somewhere between, you know,

a lot of the research shows that are 7 to 12 drinks a day for men.

Wow. Wow.

I know, right? So you pretty much aren't increasing your risk if you're a pretty happy drinker.

Now, I don't think any of us who are in clinical practice would ever advise our clients that that's

okay.

Yeah. Yeah, absolutely.

But then that's brought down a lot by the cancer risk, which is, you know, far more grave.

And that's, I think, where a lot of people then default to. It's like, well,

sure, that's what the all-cause mortality data says, but what about cancer incidence? And that's

where things really shift. But, you know, to your earlier point, can we tell people that they just

should not ever have a social drink because of one disease incidence factor versus the larger topic

of, will this actually...

Cause you to die early. And that's a lot less clear. What does appear to be true is that there

is, you know, like I say, a fairly wide range there within which people could potentially

enjoy some low intake of alcohol and still be very healthy. Like the cancer thing, sure,

it's the elephant in the room. And I think it's really important to consider because

we don't want to be telling people that you can drink, you know, two to five drinks a day.

Because a lot of those people might have a familial risk or a genetic risk of cancer.

And so for that, I think the interesting take home is that there probably is a stronger case

to be made that specifically to cancer, there's no safe dose. But I still don't think that that is

as nuanced a conclusion as it needs to be.

What makes you think that, Cliff? Not just think that, but what is it about the data that you

look at that, and you're like, actually, that's something that we could say, but it's not

necessarily set in stone. Like what's the, what's the go? Because cancer is everywhere. People are,

myself included, we have the, it's one of the most frightening things to have,

to be diagnosed with, or to know someone who's been diagnosed with. And of course,

we want to avoid it at all costs. And it is one of the reasons why women are so understandably,

I am, I'm anxious about something like breast cancer, yet we've got a higher rate of death

or risk of death from cardiovascular disease, for example. But, you know, it's just really

set into our brains, understandably so. I think the main way, the main reason is the way

the data are typically presented is in the average daily intakes.

And they're typically fairly, is the right term, ordinal, in that you're looking at sort of a daily

intake of one. And that can increase one's risk of cancer, specifically the female predominant

cancers, and particularly, obviously, the cancer-related, sorry, alcohol-related cancers.

Not all studies show that, though. You know, that that finding is somewhat equivocal if you're

looking at individual studies. Obviously, we will default to meta-analyses, though,

and they typically tend to show, yes, there is a risk at sort of one

rate of death. But, you know, that's, that's, that's, that's, that's, that's, that's, that's,

standard drink per day. Other research has suggested that that risk might be sort of a

tipping point of around half a drink per day. And, you know, that small increase in risk,

we're talking about after full adjustment, probably about a 5% increase in overall risk.

So the first question to ask is, is that meaningful in terms of, you know, the actual

absolute numbers, absolute effect on, say, mortality outcomes, et cetera. But here,

particularly, we're talking about cancer.

So, I mean, that's still probably a risk that a lot of people wouldn't want to take. But even with

those fairly low thresholds, particularly when we're looking at the very common one of one drink

per day increasing cancer risk, what does that actually mean for people who have relatively low

intakes? Because if you have three drinks per week, you're under half a drink per day, right?

And so that's where I sort of think, well,

at those lower ends of intake, it's very washy, it's very inconclusive. And

the effect sizes are so minuscule, we can't really say anything.

Cliff, can you describe for the listener the difference between relative risk and, you know,

as you see it presented in the media, presented on, you know, other social channels

and journal articles, and how that,

differs from absolute risk? And do we know numbers of absolute risk around these things?

For what it's worth, I can quickly do a quick search for absolute risk as well. If you don't

have them on the top of your head, I will go look. Yeah, you'll have to pull it up.

Yeah, I will. I totally. So in terms of absolute risk, we're thinking about absolute numbers of

people who develop a condition, right? So if it's breast cancer, and there is like, say,

one in 10,000,

risk of developing breast cancer, if you have a drink a day, that might increase your risk by 20%.

But that then takes that absolute risk from one in 10,000 to 1.2 in 10,000. Is that how I would

describe relative versus absolute risk? It's a great way to describe it. I got stuck because

I used to explain this to my students, looking at the absolute versus relative risk from

the effects of certain drugs,

used in therapies. And when you sort of explain things that way, sometimes when there's a really

high risk of adverse events and things, people might re-evaluate whether they're prepared to

take something or maybe even a supplement or something like that. But I was getting caught

up in the weeds of how to apply that to alcohol. Oh, yeah, no worries. This comes from the 45 and

up study. Did you look at that study? No. Okay, cool. It's an Australian cohort study. So who

knows? But

Dazale and Stockhol, that's the one that you used, isn't it?

Yeah, yeah, yeah. Yep.

Yeah. Nice one. I'm seeing that there. Yeah.

Which is kind of the biggest one. And it's the one that most people talk about. Although

we saw another study referenced recently, which is that health effects associated with alcohol

consumption, a burden of proof study, which was published in Nature. So we're talking about

pretty big prestigious journals, right? JAMA and Nature.

Yeah. That interestingly didn't look at mortality, though.

Yes. Right? That was looking at

disease risk. And there was an increased risk for all cancers at any intake

from that study. And that's what a lot of people are now speaking to. Is it worth the risk? But

again, it wasn't all cancers. Well, across the board, it was. And in terms of total cancer

incidents, yes.

There was an increase. But some cancers did not see increases, right? Esophageal, liver,

prostate, stomach. There were obviously risks for all sort of alcohol-related cancers,

the female-specific cancers. But we're talking here about disease risk. And again, they categorized

it as low intakes being around one or two drinks per day. Now, I still think that most people who

would consider themselves to be...

Low or infrequent, low-dose drinkers would probably not be having a drink or two a day.

Agree.

And I think that's particularly true nowadays. Maybe back in the day. But nowadays, I think a

lot of people are more likely to have one or two drinks one or two nights of the week.

And interestingly, when we look at frequency data, the people who tend to, in at least a lot

of the research, have the best...

Long-term health and mortality outcomes are those drinking around three or four times a week.

More than that, negative effects. Less than that, negative effects. Now, why would those people

drinking less than that have negative effects? Well, my presumption would be that it's because

those people are episodic binge drinkers, which we also know to be quite negative.

So where people are having, let's say, one drink, two, three, four times a day,

a week, they're probably not predisposing themselves to any market risk. And I think

you mentioned earlier, there are a lot of mitigating factors there too, right?

And this is where... It's interesting, eh? Because

confounding happens in a lot of different ways, and it's not unidirectional.

One of the interesting things that happened in this area of research is that a lot of the suspected,

I guess, negative outcomes,

from abstaining, because abstainers often ended up looking worse than people who were having

a couple of drinks a week. But it was actually, I think it was Zhao and colleagues

previously to their 2023 meta-analysis had looked into this, and they had looked at abstainer bias.

And predominantly what they were looking at there is, why do people abstain?

There are people that are going to abstain because they have health-positive behaviors,

but they're also going to people who abstain because they are

alcoholics, former problematic drinkers. There's going to be people who abstain because they have

serious health conditions, right? And that provides quite a lot of bias. And when that's

accounted for, it pretty much washes out any of that effect. So then we do start to see that,

yeah, people who abstain are probably in the best position. But then maybe people who are having

one or two drinks a week, there's really no difference. Yeah, that's interesting. I'm

looking at information from the British Journal of Cancer,

which, to your point, are looking at all of the causes of cancer. And I think you mentioned this,

but what's interesting to me is the categories with which people are at risk and what they're

compared to. So to your point, a lot of the categorization appears to be women who drink

over 10 drinks a week versus women who drink sort of zero to one drink a week. There's

quite a variation in terms of, and that's actually just looking at greatest risk related to health

outcomes versus no risk or lowest risk related to health outcomes. And I think that I've got this

right, but to your point, a lot of the mouth and esophageal cancers, liver cancers, obviously

they're very high numbers in terms of their relative risk, like 2.58, 2.89, like significant,

albeit.

It's a significant amount of alcohol as well, like over 30 drinks a week versus less than three

drinks a week. So, you know, it's a significant amount. And the others are, you know, for every

10 weeks, 10 drinks per week, you get an increase of like 5% in terms of risk. If you look at all

cancers combined, actually was their major sort of finding. And that was Weber 2026. Super

interesting. Yeah. And I mean, I think, and I don't think any of us would deny that alcohol is a

toxin and it's, it's neurotoxic. It's systemically toxic. It's, it's not a health positive thing,

just in an absolute sense, but like anything that are the poisons in the dose. And one thing that

needs to be considered is also confounding influences there. Residual confounding, obviously

we try to adjust for in research, but adjustments never, it's never precise. And it really depends

on what is being adjusted for.

We would obviously assume given that there are linchpin behaviors and crossover of health

effects, you know, within people's diet and lifestyle, that those people who, who make an

effort to, and are able to drink very moderately are probably fairly moderate people. They probably

have other health behaviors, just like healthy abstainers are likely to have a whole bunch of

other health promoting behaviors. And so, you know, I think, you know, it's, it's, it's, it's

you know, the, the healthiest lifestyle overall. Now some, some will be, we all know athletes who

eat well, train hard and go out and get hammered two nights of the week.

They're going to be the sort of outliers in that category, but Hey, maybe they're also mitigating

some of the damage, not entirely. And I'm still not suggesting that anyone do that, but you know,

we, we have evidence.

that, for example, following a healthy Mediterranean diet, and interestingly, and I don't know

exactly what this means when they say this, but a Mediterranean, I think it's called an

alcohol consumption pattern or something like that, or alcohol drinking pattern.

Those people who follow a Mediterranean diet and adhere to it well and also follow that

sort of Mediterranean alcohol drinking pattern, their risk of mortality is drastically reduced

in the same way that physical activity drastically reduces mortality risk from alcohol.

When we consider across the board that, yes, residual compound is going to come into this,

but when we consider across the board that while the big bandwidth we previously talked

about of having maybe up to two and a half to four and a half drinks per day, still probably

not worth the risk, I would say, because of that increase in cancer risk.

There's also Mendelian randomization.

There's also Mendelian randomization studies, which show that risk does increase, albeit

marginally, after, say, one drink per day, but it actually falls down to one drink.

Maybe it's just that abstainer bias and stuff like that, but what that's pretty much telling

us is that there's probably a likely lower threshold of around one drink per day.

For the cancer outcomes, as we've already discussed, it's probably somewhere between

half and one drink per day.

So we wouldn't want to necessarily be at that upper threshold for mortality, but according

to all the other data, hey, it's likely that if we are having those safe amounts of maybe

half to one drink per day, on average, and we're eating well, we're exercising, we're

sleeping well, doing all those things, would any potential negative effect, which we can't

really actually see in the research anyway.

But if there is some specter of that, is it going to be meaningful anyway?

I'd say probably not.

Yeah, I feel like, and I guess people would wonder why it's even worth having the discussion

if alcohol is a toxin, then why don't we just, for safies, just to be safe, just say that

there's no safe amount.

And that's a really good point.

And I could completely buy into why people would say that, and that's why I wouldn't

be overly critical of people.

Saying, hey, just to be completely risk-averse, why bother?

But the reality is, some people like, you know, they like it.

Some people like the taste.

Some people like to have a beer.

Some of us like the gentle, relaxing effect of, say, one beer.

And if that's not promoting any great increase in mortality or morbidity risk, then what's

the point?

And I often will frame it this way, is that there are so many targets for health, potentially.

We can't do them all.

It's just not feasible.

People have limited bandwidth.

They have limited cognitive ability.

You know, cognitive load grows exponentially with all the other things we're trying to

do.

And so if something is just really not meaningful, then why would we put all that time and effort

into trying to change it, if it is, in fact, an effort for us?

You know, there might be some potential benefits.

And I know this idea has been supposedly put to rest.

But if someone does enjoy the occasional drink, and that is socially lubricative for them,

if that has psychosocial benefits in some way, then maybe for that person, it does actually

help.

You know, why is it that we see people following a healthy diet who also have that Mediterranean

style drinking pattern?

Getting pretty good outcomes.

Now, it may not be that the alcohol is actually providing anything definitively beneficial.

But again, it points to the idea that maybe it's not doing anything meaningfully harmful

at all.

And this, you know, speaks again to what you were talking about with absolute versus relative

risk.

And I would even simplify that even further as to just the magnitude of the risk.

Yeah, okay.

And what's the difference there?

Well, you know, it's similar.

When you put it into the relative.

This is absolute risk numbers.

It makes it clearer for people.

But if we're seeing a, you know, let's say we're seeing a risk of 1.03 with a 95% confidence

interval of 1.01 to 1.05 or something.

What we're talking about there is like a 3% increase in risk, right?

But is that meaningful in terms of?

The amount of days lost off your life?

Is it meaningful in terms of the actual increase in numbers of people who are dying?

I mean, you could make a claim either way.

But more importantly, it's so small, it may not even be true.

Right?

And when it's that small, and the research is based so much on those cohort studies,

with so many residual confessions.

Maybe it's just

losing their Vegeta, or losing our

rights, or losing value, right?

So,

And that's where when we look after investors, the retail and retail brings them up to 1%,

right?

So,

theiu

think the

Sa

the message that's going to serve the most people most of the time right and i don't think we can

be looking at well yeah but your incidence of you know right hand pinky finger cancer will go up by

20 but if every other thing is not really affected is that likely and is that going to cause any

meaningful effect on overall mortality outcomes probably not so i think you know we start with

mortality data and then we look at that pragmatically and i think we do go down to

the lowest common denominator so would i feel comfortable drinking four and a half drinks per

day given that that's the threshold you know as shown by the meta-analyses no i wouldn't

because i've got my own genetic stuff my own considerations but also i'd look at the other

studies which show that hey maybe the tipping point is actually lower than that maybe it is

around one drink per day irrespective of gender or sex and so i would go to the

lowest common denominator but i'd also consider you know do i want to if i do have some unknown

familial or genetic proclivity to cancer do i even want to risk that not really so maybe i do

want to stick it around you know half a drink or less per day but even within that that allows for

some more freedom and flexibility than just telling people no and i think that's really

important because like i say i think drinking habits are changing thankfully

um you know i remember um what's this i i hope this is not apocryphal i hope this is actually a

true memory that i have as a kid but i remember watching i won't say who it was because i don't

want to throw the guy under the bus he's a legend but one of the greatest all blacks of all time came

along to speak to us when we were kids at a um you know junior boys rugby event and he took up to

the podium for his probably five minute speech two pints and he finished them right if i drink two

pints it's basically two pints and i'm like oh my god i'm so sorry i'm so sorry i'm so sorry i'm so

sorry four beers i'm gonna be buzzed yeah yeah but that was the culture just and doing it in

front of kids and you know you had the rugby teams and the league teams and all the you know

professional teams sponsored by alcohol companies and cigarette companies back in the day tobacco

companies and we had you know you know what it's like we're a similar age when you're younger we

had a very strong drinking culture strong in a negative way in this sense and i think we all

had what would now be considered to be problematic drinking patterns right drink too much episodic

binge drinking all that kind of stuff you know when i was younger if you turned up to a party

with light beers are you gay it's like stupid you know stupid horrible homophobic and misogynistic

things it's just so ridiculous whereas now that's the norm you'd see people coming to a party with

light beer going out to a barbecue with zero

beers you know non-alcoholic options it's just so much more normal now which is great and i think

the the beauty of that is that not only is that a good shift in culture for health but it also

allows that flexibility for people who do want to occasionally have a drink because it might give

them some other benefit they can do that and still be well under what we would consider any meaningful

risk threshold because if you're having two drinks a week like i really don't think that that is

you know it's it's it's it's it's it's it's it's it's it's it's it's it's it's it's it's it's it's it's

an issue you should be worried about yeah it's interesting isn't it like i remember back in the

day when i used to have a lot of clients and i would see people and they were you know this was

maybe 15 years ago 16 years ago and you know they'd come into my office and they have corporate

jobs and they're out wining and dining clients and it's very normal for them to get through a

bottle of wine a night themselves get up the next day go ahead go back to work do they were

functionally they were they were essentially they were they were they were they were they were

actually functional alcoholics although they didn't obviously see themselves as such and i do

think that has shifted somewhat albeit i'm not seeing as many people so maybe that hasn't but

i'm i'm pretty sure that that has sort of shifted over the years and i'm sure there's still a lot

of people out there who have you know problematic drinking behaviors who don't realize it i remember

running not running people through the screening test but you know people would run themselves

through the screening test for

alcoholism and be really surprised that they were categorized as such even though they just thought

that they were doing the norm and they were just doing the norm you know what we all potentially

did back in the day and like i say thankfully that has really shifted and you know again that

the key thing is that it allows that flexibility and i think the i used to say when i was teaching

and this got me in a bit of trouble there's probably a safe dose of anything right the

thing that got me in trouble is i was like you know cannabis yeah whatever there's there's a safe

dose it might be so minuscule as to to be inconceivable but there is you know that safe

dose and i think when the data points in one direction but everyone is saying something else

that is just patently untrue that's when as a scientist i kind of think well let's explore

that further because you're drawing the wrong conclusion from this and the biggest take-home

is that there is no healthy dose of alcohol probably according to the research but there

may well be a safe dose and we can probably point to what that is even if we are taking a really

risk-averse approach and it doesn't mean that we necessarily have to say none because you know

let's say in clinical practice we say that to all of our clients don't drink it's not going to work

and it's going to turn people off and then we get

confluence of of issues there where you know you would have seen this in practice where if someone

fails on one element of their plan it often translates to the rest of the plan uh i've

screwed it up i'm just going to go go rogue now whereas when they had that flexibility and

particularly when they're able to do that with very specific tactical interventions that can

allow them to have the guardrails and you know the the approach that i've used has translated

really well to a lot of my clients and i think that's a really good point and i think that's

it's like well how much would you consider to be here's you know what the evidence is and how much

would you consider to be what your sort of threshold or limit would be let's maybe pull

that back just a little bit and how do we work that now and it might be that you know a male

with no other health factors no risk that we can see or large risk for for cancers and things

might say well you know what i'd feel comfortable cutting back

right now and i'm not going to do that i'm not going to do that i'm not going to do that i'm not

going to do that i'm not going to do that i'm not going to do that i'm not going to do that

to buying one dozen light beers a week so one dozen light beers approximately six drinks

a week it's probably not too bad and that's well within the the risk thresholds for that individual

likely now maybe over time they're going to realize that you know what i don't even need

that maybe i could just get that dozen a month and that might work really well but

it still allows again that that risk threshold to be there and i think that's a really good point

flexibility and it means that there's not such a strong imperative on that one thing

in the same way that we will often see in practice people come to us who have been told don't drink

coffee why that that's an even easier one to combat because it's like dude there's no evidence

for that suck all the joy out of their life why don't they exactly you know cliff i what i think

of when i'm when i'm discussing this topic obviously as someone who enjoys a drink it's

it warms my heart to see the evidence that endurance um or aerobic activity is is protective

in in some capacity what i think a big picture problem with messages like zero tolerance or

zero alcohol is the only safe dose is that it sort of erodes trust because to your point that's

actually not what the data says and so if the data says one thing yet the public health message

says something different

then people are not going to then that just sort of erodes the trust in the people making

those decisions and putting those messages out i think yep 100 and it also silos

health positive people in this sort of absolutist basket and i think that's an issue

in the health and nutrition space is that there are those people who are real purists

you know you should not have any sugar you should not have any coffee

you should not drink any alcohol you know it's all these thou shalt not and yes some people do

that and all power to them i don't care but where there's not demonstrable harm from those things and

in some cases it's just completely futile for a lot of people the caffeine one again is such a

prime example of that because yes there are people who are really sensitive to caffeine

and yes for some people they should abstain but they're not the majority of people in fact they're

probably a very small minority for most people they're not the majority of people they're not the

as we've discussed many times having a coffee or two in the morning even dare i say it if they

have it on an empty stomach is probably not going to do a damn thing negative for their health

if anything we'd probably look the other way where the evidence trends towards showing benefits over

the long term and it's not going to adversely affect their cortisol responses and all that

kind of stuff it just doesn't really matter and you know this is where we get back to

um really zooming out which is what i get

all my students to do zoom out man like you got to zoom out and look at this person's diet and

lifestyle pattern what are they doing and when we see and you know we're specifically with respect

to alcohol what patterns are conducive to the best outcomes yes it's drinking less but it doesn't

have to be zero let's say it's one to two drinks maximum on three to four days of the week

co-ingested with um with food

is a really important mitigating factor as well this is potentially one of the reasons why in

different populations we see different outcomes because in some cultures like here in the states

and other you know of those types of um i guess anglo-centric originally countries we tend to drink

to have a couple of beers or whatever right and a lot of other cultures you seldom have

alcohol without food and that is actually a big mitigating factor and that's why we see a lot of

people who drink a lot of alcohol and that's why we see a lot of people who drink a lot of alcohol

especially when those foods are healthier and especially when the dietary band is healthier

and especially when people are exercising and sleeping well so all of these things again

coalesce so you know we we need to always be zooming out rather than focusing on that one

specific thing who knows maybe i haven't looked into this but maybe coffee has a mitigating effect

as well i did put into chat gpt i'm like what's going to be worse for me a coke zero or a wine

at this time of night um and it spat out the wine was going to be worse for my sleep um i'm curious

about this meditation i'm curious about this meditation i'm curious about this meditation i'm

wondering if this is just another solid vote for day drinking if i'm honest like are people just

drinking at lunch are they drinking at lunch and that is the thing they do in all of my romance

novels that i read my middle-aged woman romance novels well i think that that probably plays

into it you know maybe not drinking quite so late but not necessarily in the morning um but not not

drinking quite so late you know with food and maybe the time that i'm drinking at lunch is

maybe the time that i'm drinking at lunch is

alcohol does play some role although i'm i'm skeptical of that even though there is research

to suggest that you know beer and cider is worse or liquor you know spirits are the worst

beer and cider maybe not quite so good as wine i i wonder whether that is just so

confounded i think so everyone i speak to feels far better when they avoid red wine

of any wine it's red wine that really makes a difference i always feel so much better

i i definitely notice myself if i'm drinking beer it's an easy it's it's far um less affected

my sleep is far less affected actually but that's in my personal experience but white red wine

that surprises me that beer comes out as being again it may well be related to

again you know stepping out what what patterns are associated with that

and people tend to have wine with meals maybe if they're a wine drinker they might tend to be

maybe more affluent yeah oh good call maybe maybe they're more likely to be following a

more mediterranean style healthy diet pattern or some other healthy diet pattern you know

who knows there's a lot of different things that can play into that um you know people

underestimate their serving sizes anyway but maybe if people are drinking liquor i don't know

maybe that's an easier to underestimate i'm not sure i'll have to sort of dig into that

but you know i don't want to say that i don't want to say that i don't want to say that i don't want

to make excuses for alcohol either because again alcohol is a toxin so we know that but some other

things will affect how an individual feels right i know that if i have more than say

two or three drinks i'll feel a little bit shady in the morning not too bad but shady and i notice

it now whereas i wouldn't have noticed it as much when i was younger probably because my recovery

ability was better but also because we were more commonly drinking and you just sort of accepted it

now i'm not prepared to accept that either

i don't know that if i have a a beer that's higher nickel because you know i know i talk about it all

the time but it's just an interesting thing because i have a nickel allergy if i have a

beer that's higher in nickel i'll feel pretty terrible more or less straight away whereas if i

have a golden rum or maybe a really um not not light in terms of alcohol content but a light

golden lager that's lower in nickel you know made from different grains not just malt or barley malt

i'll be fine a lot of people will be more reactive to certain congeners as well which are you know

those metabolic cofactors that are produced during fermentation they're going to differ per the

grain or the base that's fermented so that's why some people will have issues with say whiskey

and they won't have the same issue with vodka it's not just a myth although sometimes people

say you know you can drink vodka without a hangover no you can't no it's alcohol it's

going to give you a hangover but if you're talking about maybe having a hangover you're going to have

one drink and you're getting a hangover then yeah maybe that is because of the congeners

right so there are going to be differences in terms of people's direct perception of alcohol

and their effects and how it's going to affect their quality of life and cognition and those

types of things and that's that's all important too because that then plays into risk mitigation

because what are we really looking to do it's not just about long-term health it's also about how

do you feel if you feel better that's good and in that respect

having that if you want to drink if you don't cool but if you do want to drink and you're doing

so safely then finding those drinks that work best for you that aren't going to make you feel like

crap as well that's obviously a good thing because then it might play into some of the potential

positives you know i know that some recent commentators mainly in this is a sort of

sociology space rather than the health space have said that one of the reasons that young men

are so disaffected now is that they're not going out and drinking with their mates

now i think that's garbage but because i think men going out in groups and getting hammered

together as a lot of us used to do is not positive for society it's not positive for anyone it's not

positive for their partners it's not positive for women overall it's actually a shitty situation but

if we're talking about maybe people not going out for that one beer with their buddy or their

friend whatever i say buddy because it's typically people are going to default to

men and i don't think we should default any anything to gender but if people are just you

know averse to that because of the fear of drinking then yeah that's not going to be a

positive thing and if maybe the social lubrication of you know feeling that little bit more relaxed

at the end of the day because of the one drink is going to help you to maybe express your emotions

to your friend or whatever then sure on a case-by-case basis maybe there is something there

having said that if that one drink causes you to be an arsehole then yeah don't drink

100 that's i think that there is i 100 agree with i will say cliff that i think that um

when we um dial in and focus on one thing to your point like where should people

pay most of their attention to yes this is important i don't know guys i just think

being active really does uh make such a difference to your overall health and it's like

it touches almost every part of your health and longevity

so to my mind maybe we should just spend more time and attention getting people

out there being active which would probably be far more effective than telling people they can't

drink alcohol yeah i think there are potentially a lot of different linchpin behaviors i feel like

activity would be one of the biggest and it's certainly got some of the biggest impacts on

long-term health right so 100 i think you know making

big changes in our lives and i think that's a big part of it i think that's a big part of it

where people can to an otherwise poor diet is going to have a way bigger impact than maybe

marginally decreasing alcohol intake i think there are other things that have really big

effects on overall health and on every aspect of health within it that people don't necessarily

recognize recognize the the real profundity of right and i i think we've discussed this before

but um my good buddy guy i respect you know

definitely um dr joe klimczewski talked about the lack of efficacy for

health and particularly body fat loss of uh non-diet interventions like health at every

size and stuff like that really good for psychological health not so good for metabolic

health but one thing one non-diet intervention he didn't talk about which i brought up in a

panel later was um mindfulness and meditation which is really effective for improving

health and i think that's a really good thing to talk about and i think that's a really good thing

because people tend to eat a heck of a lot better when they're practicing mindfulness and in some

research they do better with their diets and better for say fat loss metabolic health than

they do if they're following a diet intervention so we're talking about alcohol how does that play

into things well where people are more mindful they're less likely to be engaging in as many of

the problematic behaviors as maybe coping mechanisms or because it's an almost you know

semi-autonomic response or reaction to the health of the body and so i think that's a really good

example of where people are more able to have that little junction where they can step back and say

oh maybe i don't actually need that drink right now so you know this is just one example of where

all those health factors coalesce and where we might have linchpin behaviors that are going to

translate across various health factors and how that plays into what should we do first right and

if someone's like sleeping really poorly and that's causing them as it often does for them to

eat really poorly

which is causing them to have you know more shitty sleep and that's meaning at the end of the day

they're finding it really hard to relax so they have a couple of drinks i mean maybe the thing

that's really going to help them is to get on top of their sleep then they might end up eating better

and then maybe they might end up drinking less and then be able to get to a place fairly comfortably

through those linchpin actions that they are having a much better overall pattern which is

exactly you know what we've been talking about right yeah yeah nice

one cliff so um what's the take-home what's the take-home clifford i've already told you mine

drink at lunchtime and exercise they're my take-homes hey well i think that's really good

advice right yeah and i think where where we look where we would end up i think if we're looking at

the research pragmatically is that if we're having no more than say

well what would it be actually

one drink three to four days a week let's say one drink three days a week yeah one drink every

second day if you do it that way you have three three drinks one week four drinks the next week

yeah yeah what i um used to say to my clients which i think was a pretty good middle ground was

you know no more than two drinks with more days of the week alcohol free than with alcohol

that keeps people jet-lagged and i think that's a really good thing i think that's a really good thing

generally pretty much there or thereabouts with those risk thresholds and then we could add on top

of that wherever possible have some food some healthy food with you know alongside alcohol

then obviously all the other stuff we would work on eat a healthy diet overall

get some exercise hey things are probably going to be pretty okay yeah no i love it and that really

speaks to um what i pretty much advocate as well i mean clearly alcohol in terms of your

drinking habits and how you're going to live your best life if it's going to impact behaviors that

then impact on what you you know how you want to live your best life then you need to really sort

of consider that which is of course everything that you've just discussed so i think that's a

nice i don't think it i don't think it's a middle ground but i think it's a good a good place to land

on yeah and if your drinking affects anyone else negatively then that's you know that's not okay

and you should rein it in yeah no i love it i love it cliff so now where can people find out

just remind me

i mean i think you've been on the show like about 10 times at this point which is so good um maybe

not quite so many but almost i reckon more than that really oh i'm gonna need to do the math yeah

i know um uh and of course this is going out on your pod as well but let people know where they

can find you well they can find me mostly at the holistic performance institute which is just

holisticperformance.institute and we'll have this um full review on alcohol and mortality up in

you know very aligned with Mikkipedia i love it our um database of living review articles it'll be

going up probably next week wonderful well we will put links over on Mikkipedia to that as i'm sure you

will on your pod as well and we'll have obviously all the info about Mikki Mikkipedia in the show

notes links out to Mikki's amazing programs and and this amazing podcast amazing which always

recommend we reckon we if someone's got the triumvirate of the

Mikkipedia translating nutrition and iron culture by mass they're pretty much covering everything

they really are maybe sorry i gotta call out danny as well sigma nutrition yeah nice one i love it

even if we disagree on some things he has a bloody good podcast awesome cliff oh and the one last one

is of course i mean brandon de cruz if you really want to go into the weeds on any topic he's

amazing yeah love the way that that oh now we're starting to open the floodgates there's going to

be more and more i know stop stop

stop already cliff you have a great day you do mac

all righty hopefully you uh really enjoyed that um i just i think you do really why wouldn't you

because i mean i do so if you're anything like me and you're listening to the show you will too

um i just want to tell you actually that i'm

i have a glp1 webinar that is taking place on sunday the 4th of october 12 p.m new zealand time

completely free come along learn nutrition supplement and training related information

if you're someone thinking about coming on going on a glp1 if you're wondering how to manage these

things when you're on it or you're thinking about whether or not you're going to be tapering off

what are the things you need in place i've got it all there for you there so

pop a link in the show notes to that as well and um would love to see you along all right guys

enjoy the week you can catch me i'm on instagram threads and x at Mikki Williden facebook at

Mikki Williden nutrition or head to my website mikkiwilliden.com book a call there all right

guys you have the best week see you later

you