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May 6, 2024 • 2hr 56min
Dr. Casey Means: Transform Your Health by Improving Metabolism, Hormone & Blood Sugar Regulation
Huberman Lab
In this episode, Dr. Andrew Huberman interviews Dr. Casey Means, a Stanford-trained physician and expert on metabolic health. They discuss how metabolic dysfunction underlies most chronic diseases and how to improve metabolic health through lifestyle changes and understanding key biomarkers.
Dr. Means explains that metabolic health is about how efficiently our cells convert food and environmental inputs into usable energy. She argues that the modern environment with processed foods, sedentary lifestyles, chronic stress, and circadian disruption is causing widespread metabolic dysfunction, even in people who appear outwardly healthy.
The conversation covers the science of metabolism, practical tips for improving metabolic health, and how addressing root causes through lifestyle is key to reversing the chronic disease epidemic.
Dr. Casey Means: Transform Your Health by Improving Metabolism, Hormone & Blood Sugar Regulation
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Key Takeaways
- Metabolic dysfunction is at the root of most chronic diseases and health issues in the modern world. It's caused by environmental factors like poor diet, lack of movement, chronic stress, toxins, and disrupted circadian rhythms.
- The "trifecta of bad energy" underlying metabolic dysfunction consists of mitochondrial dysfunction, chronic inflammation, and oxidative stress. Addressing these core issues is key to improving metabolic health.
- Simple lifestyle changes can dramatically improve metabolic health in a short time, including:
- Eating more whole, unprocessed foods
- Getting regular movement throughout the day
- Improving sleep quality and quantity
- Managing stress and creating a sense of safety
- Spending more time in nature
- Continuous glucose monitors and other biomarker testing can provide valuable insights into metabolic health and help guide personalized lifestyle changes.
- Improving metabolic health requires addressing root causes through lifestyle changes, not just treating symptoms with medications. Many common medications for chronic diseases do not address underlying metabolic dysfunction.
- Creating a sense of safety, reducing chronic stress/fear, and spending time in nature are underappreciated but powerful ways to improve metabolic health by shifting the body out of a defensive state.
Introduction
In this episode, Dr. Andrew Huberman interviews Dr. Casey Means, a Stanford-trained physician and expert on metabolic health. They discuss how metabolic dysfunction underlies most chronic diseases and how to improve metabolic health through lifestyle changes and understanding key biomarkers.
Dr. Means explains that metabolic health is about how efficiently our cells convert food and environmental inputs into usable energy. She argues that the modern environment with processed foods, sedentary lifestyles, chronic stress, and circadian disruption is causing widespread metabolic dysfunction, even in people who appear outwardly healthy.
The conversation covers the science of metabolism, practical tips for improving metabolic health, and how addressing root causes through lifestyle is key to reversing the chronic disease epidemic.
Topics Discussed
The Metabolic Health Crisis (6:32)
Dr. Means explains that metabolic dysfunction is at the root of 9 out of 10 leading causes of death in the U.S. Recent research shows that 93% of American adults have suboptimal metabolic health. This is caused by environmental factors that have changed rapidly in the last 50-75 years:
- Shift from whole foods to ultra-processed industrial foods
- Sedentary lifestyles (sitting 80% of waking hours)
- Chronic low-grade stress
- Exposure to environmental toxins
- Disrupted circadian rhythms and sleep patterns
- Lack of time in nature (Americans spend 93% of time indoors)
These environmental changes synergistically damage mitochondrial function, leading to cellular energy deficits that manifest as various chronic diseases.
The Trifecta of Bad Energy (14:17)
Dr. Means describes the "trifecta of bad energy" underlying metabolic dysfunction:
- Mitochondrial dysfunction - Impaired ability of mitochondria to efficiently convert food to usable cellular energy
- Chronic inflammation - Persistent low-grade inflammatory response triggered by cellular stress signals
- Oxidative stress - Buildup of damaging free radicals and reactive oxygen species
These three factors create a vicious cycle, with each worsening the others. Addressing this trifecta is key to improving metabolic health and reversing chronic disease.
Problems with the Current Medical System (24:02)
Dr. Means critiques how the current medical system is failing to address the root causes of chronic disease:
- Over-specialization into siloed fields ignores the common metabolic roots of many diseases
- Focus on treating downstream symptoms rather than underlying cellular dysfunction
- Reliance on medications that don't address root causes and may worsen metabolic health long-term
- Lack of emphasis on lifestyle interventions and patient empowerment
She argues for a paradigm shift to focus on metabolic health as the foundation of overall health.
Improving Mitochondrial Capacity (27:57)
Dr. Means explains how to improve mitochondrial function and metabolic health:
- Increase number of mitochondria (mitochondrial biogenesis)
- Improve efficiency of existing mitochondria
- Increase capacity of mitochondria to process energy substrates
Key strategies include:
- Regular exercise, especially resistance training and high-intensity intervals
- Eating nutrient-dense whole foods
- Getting adequate sleep
- Managing stress
- Cold/heat exposure
- Spending time in nature
The Importance of Regular Movement (35:03)
Dr. Means emphasizes the critical importance of regular movement throughout the day, not just structured exercise:
- Walking 7000+ steps per day is associated with 50-70% lower mortality risk
- Taking short 2-3 minute movement breaks every 30 minutes significantly improves 24-hour glucose and insulin levels compared to longer exercise sessions
- Regular movement stimulates glucose uptake by muscles and improves insulin sensitivity
She recommends aiming for at least 3 short walks per day and finding ways to build more movement into daily activities.
Key Blood Tests for Metabolic Health (58:21)
Dr. Means discusses important blood tests for assessing metabolic health:
- Fasting glucose
- Fasting triglycerides
- HDL cholesterol
- Hemoglobin A1c
- Total cholesterol to HDL ratio
- Waist circumference
- Blood pressure
She explains how to interpret these markers in the context of cellular health and mitochondrial function. Dr. Means recommends getting these tests 3-4 times per year to track trends over time.
The Importance of Food Quality (1:16:46)
Dr. Means emphasizes the critical importance of food quality for metabolic health:
- 60-75% of calories in the average American diet come from ultra-processed foods
- Ultra-processed foods are designed to be addictive and lack nutrients cells need to function properly
- This drives overconsumption as the body seeks missing nutrients
- Eating whole, unprocessed foods from good soil is key for meeting cellular needs and regulating appetite naturally
She recommends focusing on 5 key components in the diet: fiber, omega-3s, healthy protein, probiotics, and antioxidants.
Problems with Ultra-Processed Foods (1:32:03)
Dr. Means explains how ultra-processed foods confuse our bodies:
- They provide calories but lack nutrients cells need to function
- This drives overconsumption as the body seeks missing nutrients
- They contain novel food-like substances our bodies don't recognize
- This triggers inflammation and cellular stress responses
- They are designed to be hyper-palatable and addictive
She likens ultra-processed foods to "polypharmacy of food" - a confusing mix of stimuli our bodies aren't equipped to handle.
Controlling Cravings (1:39:10)
Dr. Means discusses strategies for controlling food cravings:
- Eat nutrient-dense whole foods to meet cellular needs
- Support production of satiety hormones like GLP-1 through diet
- Avoid large glucose spikes that lead to crashes and subsequent cravings
- Support a healthy gut microbiome
- Address psychological/emotional drivers of cravings
She explains how continuous glucose monitors can help identify foods that spike glucose and lead to subsequent crashes and cravings.
Thoughts on GLP-1 Agonists (Ozempic, etc.) (1:51:42)
Dr. Means shares concerns about the widespread use of GLP-1 agonist medications for weight loss:
- They don't address root causes of metabolic dysfunction
- There are concerns about muscle loss and other side effects
- They're extremely expensive ($20,000/year)
- Lifestyle changes can naturally increase GLP-1 production
She argues that addressing root causes through lifestyle is a more sustainable approach than relying on medications.
Benefits of Cold/Heat Exposure (2:00:54)
Dr. Means explains how temperature exposure can benefit metabolic health:
- Cold exposure stimulates mitochondrial biogenesis and activates brown fat
- Heat exposure activates heat shock proteins that protect against oxidative stress
- Temperature fluctuations provide a hormetic stress that makes mitochondria more resilient
She views cold/heat exposure as valuable tools, though not as critical as nutrition, sleep, and exercise.
Benefits of Fasting (2:07:27)
Dr. Means discusses potential benefits of time-restricted eating and fasting:
- Eating in a 6-8 hour window improves 24-hour glucose and insulin levels
- Fasting periods allow insulin levels to drop, improving metabolic flexibility
- Fasting can stimulate autophagy and cellular cleanup processes
She recommends a gradual approach and listening to your body when implementing fasting.
Insights from Continuous Glucose Monitors (2:17:03)
Dr. Means explains how continuous glucose monitors (CGMs) can provide valuable insights:
- See real-time effects of food, exercise, stress on blood sugar
- Identify "problem foods" that spike glucose
- Understand personal glucose patterns and glycemic variability
- Track improvements from lifestyle changes
She views CGMs as powerful tools for personalizing diet and lifestyle choices.
The Importance of Mindset and Nature (2:37:39)
Dr. Means discusses the critical importance of mindset and connection to nature for metabolic health:
- Chronic psychological stress and fear trigger cellular defense responses
- This diverts energy away from repair/regeneration processes
- Creating a sense of safety allows cells to focus on repair and optimal function
- Spending time in nature reduces stress and provides perspective
- Connecting with nature's cycles fosters a sense of abundance and harmony
She recommends aiming to spend 50% of time outdoors and finding ways to connect with nature daily.
Conclusion
Dr. Means presents a compelling case for addressing metabolic dysfunction as the root cause of most chronic diseases. She argues that simple lifestyle changes targeting mitochondrial health, inflammation, and oxidative stress can dramatically improve health outcomes. Key strategies include eating whole unprocessed foods, getting regular movement, prioritizing sleep, managing stress, and spending time in nature.
By empowering individuals with knowledge about metabolic health and tools like continuous glucose monitors, Dr. Means believes we can reverse the chronic disease epidemic and create a healthier society. She emphasizes that improving metabolic health is not just about weight or diabetes risk, but about optimizing cellular function to support overall wellbeing and longevity.
