Metabolic Health With Dr. Casey Means

In this episode of Brain Biohacking, host Kayla Barnes chats with Dr. Casey Means, Chief Medical Officer and Co-founder of metabolic health company Levels. Dr. Means shares her quest to maximize human potential and reverse the epidemic of preventable chronic disease by empowering individuals with tech-enabled tools that can inform smart, personalized, and sustainable dietary and lifestyle choices.

01:27 – The starting point

Dr. Means journey into the world of medicine was prompted by a desire to help others.

I initially got into medicine because I have always had immense awe at biology and the life sciences. And it’s always just really blown my mind. And that’s really what’s driven me forever is wanting to know more and learn more, and then use that information to help people. We are these incredibly complex machines that have 37 trillion cells, and it’s just incredible that it all works. So, that really drove me.

07:20 – What is metabolic disease?

Metabolic disease consists of any of the diseases or disorders that disrupt normal metabolism: the process of converting food to energy on a cellular level.

At its core, problems with metabolism, or metabolic dysfunction, or metabolic disease refers to problems with how our body makes energy from food. Again, 37 trillion cells in the body, at least human cells. We’ve got many more bacterial cells, but every single one of those 37 trillion cells needs energy in order to function properly. And when cells don’t function properly, our tissues don’t function properly, our organs don’t function properly. And that’s when diseases and symptoms emerge. So, at the most foundational level, we need our cells to work properly, and they need energy for that. And metabolic dysfunction is when that process is not working well. It’s core to every single cell type, meaning that metabolic dysfunction can look like almost anything in the body based on what tissue or organ system it’s showing up in.

10:01 – What happens when you consume food

Dr. Means discussed what happens inside the body when you eat a food item or meal containing carbohydrates.

So, when someone takes in a piece of food that has carbohydrates in it, which is one of the main three macronutrients protein, fat, carbohydrates. Those carbohydrates go into the stomach, they get broken down, they go into the small intestines and large intestines, and the body absorbs the breakdown of those carbohydrates, and that can be glucose. And so one of the final endpoints for different types of carbohydrates in the body is glucose, that goes into the bloodstream. And that initiates this interesting cascade, where our pancreas releases insulin, which is a hormone that allows the cells in the body to take up that glucose out of the bloodstream. And then, when that glucose goes into the cells, it can be processed by the mitochondria to form ATP, which is a usable form of energy in the body, or it can be stored in long chains of glucose called glycogen for later use, or it can be actually, converted into fat and stored as fat.

12:51 – Stable glucose lowers stress on the body

When you start to see more glycemic variability, fasting blood sugar goes up. This has several downstream consequences. The key is to keep glucose levels low and steady.

Hyperinsulinemia and high insulin levels alone can drive a lot of different problems in the body. It’s associated with driving cancers more aggressively with causing problems in our blood vessels and several other things. But the glucose going up on its own, that has issues as well. High glucose in the bloodstream leads to inflammation. High glucose in the bloodstream leads to what’s called glycation, which is where sugar can stick to things all over the body and cause dysfunction. It can also lead to oxidative stress, where we produce too many reactive molecules in the body. And so, all those things are a downstream result of glucose getting high in the bloodstream. To short circuit this whole process, we can focus on keeping glucose in a lower and stable range through what we eat and how we live, take the stress off this whole system.

19:54 – The role of Leptin

Dr. Means discussed the role of Leptin, a hormone that signals that we are full and satisfied after eating.

Leptin is a hormone that is very involved in our satiety and our sense of being full. And when we become more insulin resistant, we also tend to become more Leptin resistant, where we basically, don’t have the feedback loop to know that we are full or satiated. And so, we want to stay very, very Leptin sensitive over the long haul, so that we can respond to those signals that we have had enough. And certain foods like fructose especially, can really drive Leptin resistance in the brain and unfortunately co-opt and manipulate these signals that are messengers telling us like when we should eat and when we shouldn’t, whether we’re full or not. So, essentially, the goal is to keep things very sensitive throughout the body. And to do that the framework is to not overload those systems, not overload those pathways because the body will always down-regulate the receptors for things when they’re overstimulated.

23:41 – Energy comes from glucose or fat

Glucose is a main source of energy, but energy is also stored in fat, similar to a bank of energy we can use later.

So, I like to think of it, in basic terms that we have two main sources of energy in the body. We have glucose, which is processed by the mitochondria to form ATP. But we also have fat. And fat can be converted to ketones to be used for energy in the body. And remember, back to the premise that every cell in the body needs energy to function, we can get that from these two different main sources. Fat is kind of like our long-term storage bank for energy, where we have like, even in a lean person weeks and weeks and weeks’ worth of energy available in the form of fat, if we need it.

25:47 – Americans need more ketones

When you are always giving your body more glucose, you don’t build up ketones. Ketones have been shown to improve brain health and focus.

Interestingly, the average American, because we’re constantly eating refined carbohydrates and sugar literally around the clock, we never really give our bodies the opportunity to switch over from burning glucose to burning fat. Because fat is always going to be secondary if you’ve got glucose readily available. And so the average American does not have any appreciable ketones in their bloodstream, because we’re just constantly feeding it glucose. And I think that does do a disservice to the brain, because ketones have been shown to be a really efficient and clean energy source for the brain. And people often feel that when their ketones are elevated in their bloodstream, perhaps because they’re on a low-carbohydrate diet, or they’ve been focusing on generating of metabolic flexibility, their brain actually feels a little bit different. There’s this concept of having like a ketone high, where you feel really clear and really sharp and really focused.

33:36 – Focus on a nutrient-rich diet

The goal of any diet should not be to just hack the system and get a flat glucose line. The goal is to build a metabolically healthy body with clean, nutrient-dense foods.

Any dietary strategy you’re doing, whether it’s vegan or keto or paleo or carnivore, the primary thing we should be thinking about is, “What molecules are going into my body?” And through that lens, a clean keto or whole foods plant-based is really the only way to go, because you’re getting the most nutrients possible to serve your body. And the cool thing about the molecular information that you put in your body as food is that it’s got two purposes. One, it’s the building block of the body. It’s making the physical structure of every single iota atom of our body, but it’s also the chemical messenger that’s telling our genes how to be expressed. So, it’s like both the director and the building block, it’s just so incredible. So, from that lens, again, clean is the way to go, no matter what dietary strategy you’re looking at. So, for keto, if we’re doing low-carb, we want to be focusing on the highest quality foods possible whether that means organic produce, whether that means regeneratively, raised grass-fed meats, but that means pastured chicken eggs, whatever it is, but avoiding the toxins and the things that could harm our bodies, and trying to get in the maximum amount of nutrients possible.

43:24 – Top glucose hacks

Dr. Means shares her top tips to achieve metabolic health: avoiding refined and processed foods, and taking walks after meals.

I think number one hack, and this is aside from try not to eat refined carbohydrates and refined sugars, because that’s the ultimate hack is like, just don’t eat processed food. But that’s easier said than done. But I think the best life hack you can do, like eat real food, don’t eat processed foods. But to get to more tactical stuff, the biggest one is, take a walk after your meals, it’s game-changing. The really cool thing about muscle, and why building more muscle is really effective for metabolic health and like weightlifting is because muscle, we talked a lot about insulin and it helping take glucose out of the bloodstream into the cells. But muscle is this fascinating part of the body that actually doesn’t need insulin to take up glucose. So it will take up glucose just because of the muscle contraction. And so you get the double bang for your buck of taking glucose out of the bloodstream. And we know too much glucose in the bloodstream can cause problems without even spiking the insulin, which can then lead to more insulin resistance.

49:49 – The core pathways of metabolic health

Dr. Means shares that there is no silver bullet to achieving metabolic health. There are a number of variables that come together.

The thing about metabolic health, because it’s so foundational, it’s such a core pathway to our bodies. It’s not just one thing that’s ever going to be the silver bullet. It really is a holistic output of many variables going in. And the key variables that people should take into account are mainly seven things that I think about, which is food, stress, sleep, exercise, micronutrients, microbiome, and environmental toxins. Those are the main actionable things that I kind of focus on. Within each of those, there’s a lot too. Within food, it’s not only what you eat, but it’s also when you eat. So, are you eating carbohydrates in the morning versus the evening? For some people, they find that eating carbohydrates in the morning, they don’t have lots of glucose spikes, and if they eat them at night, the exact same food, because of how our insulin sensitivity changes during the day. For exercise, it’s when you’re doing it, and then what type you’re doing it, cardio versus resistance training versus more high-intensity interval training. So, there’s a lot in there, but those are all the things that I really focus on.

Kayla Barnes (00:00):

You’re listening to Brain Biohacking with your host, Kayla Barnes. We dive into all things optimal health, nutrition, peak performance, cognitive excellence, biohacking, longevity, and so much more.

Kayla Barnes (00:18):

An incredible conversation with my friend, Dr. Casey Means. Dr. Casey is a Stanford trained physician, Chief Medical Officer, and co-founder of the Metabolic Health Company Levels, and Associate Editor of the International Journal of Disease Reversal and Prevention.

Kayla Barnes (00:35):

Her mission is to maximize human potential and reverse the epidemic of preventable chronic disease by empowering individuals with tech enabled tools that can inform smart, personalized and sustainable dietary and lifestyle choices. Dr. Means perspective has recently been featured in The Wall Street Journal, New York Times, Men’s Health, Forbes, Business Insider, TechCrunch, Entrepreneur Magazine, The Hill, Metabolism, Endocrine Today, and more.

Kayla Barnes (01:04):

She held the past research positions at the NIH, Stanford School of Medicine, and NYU. Stay tuned for an incredible conversation of all thing’s metabolic health with Dr. Casey. So, before we jump in, there’s so many incredible glucose hacks, dive into what glucose is, and all things metabolic health, I would like to set the stage of how you got interested in medicine in the first place.

Dr. Casey Means (01:27):

I initially got into medicine, because I have always had immense awe at biology and the life sciences. And it’s always just really blown my mind. And that’s really what’s driven me forever is wanting to know more and learn more, and then use that information to help people. We are these incredibly complex machines that have 37 trillion cells, and it’s just incredible that it all works. So, that really drove me.

Dr. Casey Means (01:56):

So, I did my training, I went to Stanford for medical school. And then, I went on to do nearly five years of training in Ear, Nose and Throat, Head and Neck surgery. And in my time in the surgical world, I had this revelation about four or five years in where I was looking around at what I was doing every single day and the conditions I was treating. And I realized that almost all of them were fundamentally, inflammatory in nature.

Dr. Casey Means (02:24):

And the suffix for inflammation in medicine is itis and all the conditions were itises. It was sinusitis, thyroiditis, laryngitis, otitis media, and it’s like, huh, inflammation, it’s everywhere, and I’m prescribing a lot of medications to reduce inflammation, steroids do that, and we prescribe a lot of steroids.

Dr. Casey Means (02:42):

And when those things don’t work, and antibiotics don’t work, we go in and we bust holes in things and we suck pus out, inflammatory, goo in the body, and we call it a day. And it’s like, something about that didn’t totally feel right to me, because it didn’t really address the root cause, what is causing the inflammation? What is inflammation to begin with? It’s the body being perceiving that there is a threat, and fighting it, mounting this part of the body, the incredible immune system to deal with that threat.

Dr. Casey Means (03:18):

What is that threat? And why are these conditions rising in prevalence? And why aren’t we addressing that that root cause? So, long story short, I became obsessed with really root cause medicine. And really, that is functional medicine. I would say a lot of the way we approach things in the conventional system, and are very sort of siloed Oregon’s specific approach to health care is reactive.

Dr. Casey Means (03:44):

We wait until symptoms and diseases emerges. And then, we apply treatments or interventions that in some way ameliorate or mitigate those downstream symptoms. But we’re very rarely stepping back and saying, “What is causing this?” And when you do that, it’s interesting, it really goes back to why I got into medicine, which was that sense of awe, because when you go to the root causes, you start to think about what’s happening at the level of the cell? What’s happening in the whole body?

Dr. Casey Means (04:13):

These root cause things that are leading into all this physiology. How are all these conditions and symptoms that this patient has potentially linked by core physiology? And that’s really what functional medicine does. So, I became very evangelized in this, and really, came to this conclusion that I don’t really want to cut into people, make them unconscious, bring them to the operating room, cut into their bodies, hugely expensive surgeries, until I fully understand what is causing that patient to be there, and if there is anything I could do to prevent them from having to get there.

Dr. Casey Means (04:55):

And that is what really, has become my life’s work is that. And that really led me to thinking deeply about how can you inspire patients to understand their own bodies well, and then use that deep understanding to make choices that create conditions in the body, that really lead to this sense in the body, that there is not threat, that there is not things the body has to fight that calm and non-inflamed space for the body to be in.

Dr. Casey Means (05:29):

And really, medications can’t do that, surgeries can’t do it. It’s the choices we make every single day that you talk about so beautifully on your platform around what we eat, how we sleep, how long we sleep, how we manage stress, how much we’re moving our bodies, our exposure to environmental toxins, what our microbiome is doing, our micronutrient exposure.

Dr. Casey Means (05:50):

These are the choices we have that change the conditions in the body that ultimately, lead to whether we’re healthy or not, whether our bodies assign is in a sense of threat or not. And so, inspiring people to figure out what choices to make for their own body is my passion. And that’s really what levels springs from, which is a technology that helps people understand how food is affecting their glucose levels in real time. So, they can make better choices to keep their blood sugar more stable, which of course, we know, also helps on the inflammation front.

Dr. Casey Means (06:21):

So, that’s kind of the trajectory. And I think, once for many of us in the health and wellness space, like once that cat’s out of the bag where you start seeing like, “Oh, goodness, we’re really reactive in our system, and we need to be more proactive,” it’s really hard to put it back, back in. So, that’s where I’m at now.

Kayla Barnes (06:39):

Yes, I agree with all of that. And it’s so incredible that people can make such significant changes in such a short amount of time. So, just changing their food choices. And I think that it’s been so normalized of feeling like crap that people expect it. But when you bring in diagnostic tests like yours, they see that what they’re doing on a daily basis is not positive, or it’s not normal, so they can link that to how they’re feeling.

Kayla Barnes (07:07):

So, I want to go into something that is a huge issue in the US right now, metabolic disease, can you let everyone know what metabolic disease really is at the core?

Dr. Casey Means (07:18):

Yeah, absolutely. So, at its core, problems with metabolism, or metabolic dysfunction, or metabolic disease refers to problems with how our body makes energy from food. Again, 37 trillion cells in the body, at least human cells. We’ve got many more bacterial cells, but every single one of those 37 trillion cells needs energy in order to function properly.

Dr. Casey Means (07:48):

And when cells don’t function properly, our tissues don’t function properly, our organs don’t function properly. And that’s when diseases and symptoms emerge. So, at the most foundational level, we need our cells to work properly, and they need energy for that.

Dr. Casey Means (08:02):

And metabolic dysfunction is when that process is not working well. It’s core to every single cell type, meaning that metabolic dysfunction can look like almost anything in the body based on what tissue or organ system it’s showing up in.

Dr. Casey Means (08:16):

And the interesting thing is that, the way that we’re living in the Western world, our diet and our lifestyle and our exposures that are very unnatural in the past 50 to 100 years, compared to the entirety of the rest of human history, what we’re exposed to, in this industrialized modern world is so, so radically different than all of human history, that our cells are in crisis, by and large in our country.

Dr. Casey Means (08:43):

And a lot of these substances, like intense amounts of excess sugar, or chronic low-grade stress are hijacking these core metabolic pathways in ourselves and making it difficult for us to process and store and utilize energy properly. And so, that’s like big picture conceptually, what’s happening.

Dr. Casey Means (09:05):

When you actually, look at how we measure these things in our standard practice, there’s various markers of metabolic health that we use in standard practice as a proxy for this more theoretical thing that I’m talking about.

Dr. Casey Means (09:21):

And so, those things are looking at various cholesterol markers, looking at waist hip ratio, looking at blood pressure and looking at blood sugar. So, cholesterol, blood pressure, waist-to-hip ratio, and blood sugar are the markers that we use to determine if where someone is on the metabolic health spectrum. But fundamentally, it comes down to the basics of how we’re processing energy in the body.

Kayla Barnes (09:52):

Wonderful. So, what about glucose? Can you describe a little bit of the entire process? What happens when someone consumes a piece of food?

Dr. Casey Means (10:00):

Yeah. So, when someone takes in a piece of food that has carbohydrates in it, which is one of the main three macronutrients protein, fat, carbohydrates. Those carbohydrates go into the stomach, they get broken down, they go into the small intestines and large intestines, and the body absorbs the breakdown of those carbohydrates, and that can be glucose.

Dr. Casey Means (10:23):

And so, it’s one of the final endpoints for different types of carbohydrates in the body is glucose, that goes into the bloodstream. And that initiates this interesting cascade, where our pancreas releases insulin, which is a hormone that allows the cells in the body to take up that glucose out of the bloodstream.

Dr. Casey Means (10:42):

And then, when that glucose goes into the cells, it can be processed by the mitochondria to form ATP, which is a usable form of energy in the body, or it can be stored in long chains of glucose called glycogen for later use, or it can be actually, converted into fat and stored as fat.

Dr. Casey Means (11:02):

So, there’s a lot of different ways that glucose can go. But to get into the cell that requires in most cell types, this hormone insulin being released. The interesting thing about our modern world where we’re eating about 150 pounds of sugar per year, whereas historically, we may have been eating, just around 20 teaspoons of sugar per year. I mean, it’s just astronomical differences in the amount we’re consuming.

Dr. Casey Means (11:31):

We’re overloading the cells with this request to process all of it, basically. And what happens is your body ends up having to secrete insulin so much over and over and over and over again, to drive that sugar into the cells out of the bloodstream, that the cells actually, become numb to insulin. They become insulin resistant. And they put up this insulin block, basically saying, “There’s too much glucose around, too much is going to the cells, we are mitochondria, we cannot process this, we cannot store it, stop coming in.” And that’s the insulin resistant block.

Dr. Casey Means (12:03):

And the body says, “We’ve got to get this out of the bloodstream, there’s too much glucose in the bloodstream. So, we’re going to produce more insulin to try and drive that glucose into the cells.” And so, then you get this ratcheting up of insulin resistance and more insulin being produced to try and compensate. And that is really the start of the spectrum of metabolic disease, where you start breaking down these compensatory pathways.

Dr. Casey Means (12:29):

You start seeing people with their insulin going up, their insulin resisting resistance, worsening. And when you can no longer drive more glucose into the cells, the blood glucose starts going up. And that’s when we start to see you know, more glycemic variability, fasting blood sugar going up, and a problem with blood sugar, and that has several downstream consequences.

Dr. Casey Means (12:51):

Hyperinsulinemia, and high insulin levels alone can drive a lot of different problems in the body. It’s associated with driving cancers more aggressively with causing problems in our blood vessels and several other things. But the glucose going up on its own, that has issues as well.

Dr. Casey Means (13:06):

High glucose in the bloodstream leads to inflammation. High glucose in the bloodstream leads to what’s called glycation, which is where sugar can stick to things all over the body and cause dysfunction. It can also lead to oxidative stress, where we produce too many reactive molecules in the body.

Dr. Casey Means (13:23):

And so, all those things are a downstream result of glucose getting high in the bloodstream. To short circuit this whole process, we can focus on keeping glucose in a lower and stable range through what we eat and how we live, take the stress off this whole system.

Dr. Casey Means (13:41):

And so, what that looks like is learning how to eat in a way that does not create these big up and down spikes in glucose all the time that the average American is having. It means, of course, focusing on not ingesting refined sugars, avoiding refined carbohydrates and sticking to whole foods that don’t have such a high density of glucose in them, doing things to reduce the influx of glucose into the body after a meal, like taking a walk right after the meal to use some of the glucose, so the cells are having less stress of having to process all of it because you’re actually using some of it. It’s about balancing meals with fat and protein and fiber, so that you’re slowing the digestion of this huge onslaught of carbohydrates.

Dr. Casey Means (14:28):

So, those are just a couple of several, several strategies to reduce that glucose strain on the body and the ensuing insulin resistance and metabolic dysfunction that can occur. But I guess one last thing to mention on that with that, that compensatory pathway that happens with insulin.

Dr. Casey Means (14:50):

Something that’s interesting about that is that the body can go a long time, increasing its insulin levels to compensate for this excess glucose before you actually, see the glucose go up because you can imagine, if let’s say your body, you’ve got a perfectly functional pancreas, you can produce a lot of insulin, you can keep that glucose looking very normal for a long time before the system breaks, and you start seeing glucose rise.

Dr. Casey Means (15:17):

And so, there’s probably a lot of people living in the country right now whose doctors are telling them that their glucose is totally normal range, totally fine. And yet, their insulin levels in the background are probably very, very high to keep it at that level.

Dr. Casey Means (15:32):

And so, that’s where additional lab testing like getting a fasting insulin test can be really helpful on top of getting your glucose tested to know how hard your body’s working in order to keep your glucose at a certain level, because that will tell you a lot about where you are on that, that spectrum.

Dr. Casey Means (15:52):

Someone with a glucose, a fasting glucose of 80 milligrams per deciliter, which is totally normal, who’s doing that with an insulin level of 2 is much more metabolically healthy than someone who’s got a fasting glucose of 80, but their insulin is 30. Meaning, that they’re probably having to push out a lot more insulin to keep that glucose low. Meaning, that they’re likely more insulin resistant.

Kayla Barnes (16:14):

Wonderful. Yes, I agree with all of that. I want to get into the brain, specifically. So, what happens to our brains when we have a pretty significant glucose spike?

Dr. Casey Means (16:26):

Yeah. So, several things can happen. I think the one that’s most relevant to people’s experiences, or something that they’ve probably experienced is this idea of having a post meal crash, where after you’ve had a big meal, you might feel maybe an hour or two after like really lethargic, or like you need to take a nap, or tired.

Dr. Casey Means (16:51):

And this is an interesting phenomenon, which is really caused by having a big spike in glucose followed by a big crash in glucose. And going back to what we were just talking about, you have the big glucose load, your body secretes a ton of insulin, it soaks it all up into the bloodstream, and then you end up sometimes overshooting and going really low after that meal.

Dr. Casey Means (17:12):

And that area of reactive hypoglycemia can lead to the subjective sense of brain fog, of poor energy of tiredness, fatigue, maybe some anxiety or emotional ability. And I think, it’s something we all experienced. And if you’ve really worked hard to balance your blood sugar, many people find that these instances go away of that that post meal crash.

Dr. Casey Means (17:36):

So, that’s an interesting subjective thing that can happen in terms of our cognitive performance. Another thing people might notice, and that we know from the research is that that reactive hypoglycemia moment often leads to more cravings. We actually know that reactive dip after a meal is predictive of further cravings for carbohydrates.

Dr. Casey Means (18:01):

So, we get in this vicious cycle where we go high, we go low, and then we want to get back up to normal. So, we want more. And then, you’re just on this roller coaster, unfortunately. From the standpoint of physiologically, what’s going on the brain, certainly, the things… I mentioned around inflammation and oxidative stress, and glycation, like these are all things that can happen in the brain, similar to what can happen anywhere else in the body.

Dr. Casey Means (18:30):

So, we want to protect the brain from really, really high glucose spikes. And protect the tissue from an onslaught of insulin and glucose. Because what we know is over the long-term, and not just the acute subjective feeling of something like a post meal crash.

Dr. Casey Means (18:47):

Over the long-term, glucose has a significant impact on our cognitive performance and our long-term neurologic health because when the brain becomes insulin resistant, the brain has more difficulty producing energy and getting the energy it needs. It’s a very high metabolic organ, really high energetic needs.

Dr. Casey Means (19:08):

And so, we want to keep the brain incredibly insulin sensitive over the long haul, so that it’s very effective at converting and processing and generating energy. Because essentially, our mind and everything we think and do and feel is a result of whether our brain is efficiently getting and processing and using energy.

Dr. Casey Means (19:30):

So, when I’m thinking about balancing my blood sugar, making sure I’m staying incredibly insulin sensitive, a lot of it is focused on how it’s protecting my brain over the long term from having brain insulin resistance. And there’s several other things with food of course that can happen with diet and cravings. And the brain can also become what’s called leptin resistant.

Dr. Casey Means (19:54):

Leptin is a hormone that is very involved in our satiety and our sense of being full. And when we become more insulin resistant, we also tend to become more Leptin resistant, where we basically, don’t have the feedback loop to know that we are full or satiated.

Dr. Casey Means (20:09):

And so, we want to stay very, very Leptin sensitive over the long haul, so that we can respond to those signals that we have had enough. And certain foods like fructose especially, can really drive Leptin resistance in the brain. And unfortunately, co-opt and manipulate these signals that are messengers telling us like when we should eat and when we shouldn’t, whether we’re full or not.

Dr. Casey Means (20:35):

So, essentially, the goal is to keep things very sensitive throughout the body. And to do that the framework is to not overload those systems, not overload those pathways because the body will always down regulate the receptors for things when they’re over stimulated.

Dr. Casey Means (20:56):

So, taking that into our day-to-day life, it like making a short-term, potentially, what feels like deprivation choices now, to over the long-term, get just the long-term benefit of metabolic health and ability to respond to hormonal signals, which in the long-term, I think, leads to real power and freedom, because we end up being healthier for the long-term.

Kayla Barnes (21:26):

Absolutely. And I can attest, I’ve worn a glucose monitor at different points even years ago, when they were very difficult to get, and you’ve now made that so much, easier. And it’ll be even more available in the coming months or so you would say? It will be available to more of the public?

Dr. Casey Means (21:46):

Yeah, I mean, so we are looking to have full expansion for anyone able to purchase the product by probably end of first quarter 2022.

Kayla Barnes (21:56):

Amazing, but I can attest that when you… And one of the basic principles of a brain health diet, I always say is, you have to keep your blood sugar levels stable. And for everyone that looks like something different, right? I’m sure you could eat something and I could eat something. And we would have two very different responses.

Kayla Barnes (22:13):

But I have a couple more interesting questions about the brain. So, we know that the brain does run off of glucose, but it also can run off of ketones. So, in your personal opinion, number one, what’s better? And then, number two, do we need to kind of cycle at some points, some sugar in for the brain to function at optimal cognition?

Dr. Casey Means (22:34):

Yeah, the nice thing about the body is that it’s always going to produce glucose. And we’re never… Even if we eat zero glucose or zero carbohydrates, like some people who are on a very intensive ketogenic or carnivore type diet. The body actually creates glucose from other things, in part to give the brain… To make sure the brain always has the energy it needs to function.

Dr. Casey Means (23:02):

And the body does is in the liver through a process called gluconeogenesis, where it can take things like amino acids from protein and actually, convert them into glucose. So, that’s a pretty cool thing about the body that we’re never going to get down to like zero glucose in the body, and that’s never the goal. We would pass out and go into a coma and potentially die.

Dr. Casey Means (23:21):

So, the body has redundant pathways. But this is why someone on an extremely low carbohydrate diet can still see that their blood sugar is 70 milligrams per deciliter. And, but the thing, the question about ketones is so interesting. So, the brain can use ketones for energy? And ketones are a byproduct of fat burning in the body.

Dr. Casey Means (23:41):

So, I like to think of it, in basic terms that we have two main sources of energy in the body. We have glucose, which is, processed by the mitochondria to form ATP. But we also have fat, and fat can be converted to ketones to be used for energy in the body. And remember back to the premise that every cell in the body needs energy to function, we can get that from these two different main sources.

Dr. Casey Means (24:05):

Fat is kind of like our long-term storage bank for energy, where we have like, even in a lean person weeks and weeks and weeks’ worth of energy available in the form of fat, if we need it. And I think there is actually, reports of people who have done fasting over a year…

Kayla Barnes (24:26):

Wow.

Dr. Casey Means (24:26):

Literally, haven’t eaten anything for over 365 days, and just survived off breaking down the fat in their body. And this was someone who started out initially, a lot of excess weight and fat, but throughout the course that year, essentially, use that fully for their energy.

Dr. Casey Means (24:43):

So, it’s amazing how much, even in a lean person, there’s probably several weeks’ worth of storage for energy. Sugar, and glucose is more of our short-term energy, and it’s what we’re preferentially going to use before using fat because it’s easily accessible, easily usable, and that’s the blood, the sugar that’s in our bloodstream. And then, the sugar that’s stored in long chains of glucose in our liver and our muscle cells, and that’s called the glycogen.

Dr. Casey Means (25:06):

And that we only have like several hours’ worth of short-term sugar access for energy for. And so, we’ll use what’s in our circulating glucose store, then we’ll go in and we’ll break down the glycogen, for instance, during a workout. And only after we’ve really worked through a lot of that glycogen that’s stored glucose, will we then convert into tapping into our fat stores.

Dr. Casey Means (25:31):

And that process of using up the glucose, the short-term accessible glucose and having to transition into burning fat, that process is called metabolic flexibility, where we can actually, swap into burning fat or glucose based on what’s available to us.

Dr. Casey Means (25:47):

Interestingly, the average American because we’re constantly eating refined carbohydrates and sugar, literally around the clock, we never really give our bodies the opportunity to switch over from burning glucose to burning fat, because fat is always going to be secondary if you’ve got glucose readily available.

Dr. Casey Means (26:04):

And so, the average American does not have any appreciable ketones in their bloodstream, because we’re just constantly feeding it, glucose. And I think that does do a disservice to the brain because ketones have been shown to be a really efficient and clean energy source for the brain.

Dr. Casey Means (26:23):

And people often feel that when their ketones are elevated in their bloodstream, perhaps because they’re on a low-carbohydrate diet, or they’ve been focusing on generating of metabolic flexibility, their brain actually feels a little bit different. There’s this concept of having like a ketone high, where you feel really clear and really sharp and really focused.

Dr. Casey Means (26:43):

So, there’s something there around this different energy fuel source, affecting our subjective experience of cognition. I certainly, have felt that when I’ve gotten into ketosis. But it takes a lot of intentionality, because the work that you have to do to get there is figuring out how to put your body in a state where you’re actually, going to work through the glucose and flip into fat burning.

Dr. Casey Means (27:08):

And there’s many ways to do this. An easy one, of course, is to limit the carbohydrates and sugars that you’re eating, because then you’re not going to replete that glycogen and keep putting glucose into fill that tank, you’re going to work through it and have to move into fat burning.

Dr. Casey Means (27:24):

Another thing people try and is something like a fasted workout where overnight, when you’re not eating, you’re going to use up some of that circulating glucose in the bloodstream. You’re going to go into some of your glycogen stores for energy while you’re sleeping. You wake up, your tank is low in terms of glucose.

Dr. Casey Means (27:40):

And then, if you immediately work out, you’re already starting at this low glucose state. And so, in your workout, you’re most likely going to have to tap into your fat stores for energy. So, that’s like pushing your body for to start down this process of metabolic flexibility by putting it into strange situation when you’re already low on glucose.

Dr. Casey Means (28:03):

But, and then, of course, like ketogenic diets, really low-carb diet is going to also get you into ketogenesis. So, I think there’s definitely, value to it. I don’t think there’s a situation in which the brain would ever be running exclusively on ketones because the body is always going to generate glucose in circulation. But I do think it has been shown to be positive in terms of subjective cognition.

Dr. Casey Means (28:30):

And, of course, ketogenic diets where the brain is getting a lot of ketones is actually, used therapeutically in some medical conditions like epilepsy, because it seems to have a really positive effect on this hyper aroused state of the brain, in certain seizure conditions, and a lot of people are thinking more deeply about ketogenic diets for other neurologic conditions. So, it’s a fascinating time, but I think the average person can benefit from this by just exploring how to become more metabolically flexible.

Kayla Barnes (29:07):

I agree, and I love the way that I feel I’m often in ketosis, I do cycle because I don’t want to keep in a ketosis for a super extended period of time. Do you think that it can become hard on your body even though we can create our own sugar source? Do you think for example, if you were doing that for a year and you didn’t have a lot of body fat to start with? Do you think that would be a little bit taxing on the body?

Dr. Casey Means (29:31):

Yeah, it’s an interesting question. I don’t actually know the answer too. I think that it really depends on the person, the gender, what else is going on in their lives, because being in a very low carbohydrate state can be a stress signal, I think on the body at certain times. Because you are putting your body under these conditions of like, instead of just giving it easy accessible energy, you’re forcing it to do the harder path in a sense.

Kayla Barnes (30:04):

Right.

Dr. Casey Means (30:05):

And also, carbohydrates are building blocks for hormones and for other things. And so, you can certainly hear from women, especially who have gone on ketogenic diets and gotten really hard, really low-carb, developing problems with hormones and finding that when they bring a little bit more carbohydrates back into their life, that they do a lot better.

Dr. Casey Means (30:29):

And so, it’s really I think, something to talk to your doctor. And if you are initiating a pretty intensive dietary change, like trying to get into ketosis to make sure you’re monitoring things like your hormone and your hormones and your other blood markers really being in tune with what’s going on in your body. I think your approach of cycling is exactly, what I’ve landed on in my life too, where I measure my ketones almost every day. I measure my blood sugar.

Dr. Casey Means (30:56):

I have a really good awareness of what it takes for me over the course of a couple of days to generate some ketones. I focus on a more fat, heavy, low carbohydrate, more protein. And I eliminate refined carbs and sugars and whatnot. And I usually, work out a little bit more fasted, and I can easily get my ketones up to 1 to 1.5, sometimes, up to 2. And I consider that a win.

Dr. Casey Means (31:23):

If I’m there for a day or two, I know I’m keeping those metabolic flexibility pathways active. I’m keeping my fat burning pathways active. And so, then if I go back into having some more carbohydrates get out of ketosis, I’m at least knowing that my body knows how to get in and out in and out.

Dr. Casey Means (31:41):

And one of the key things here is that, on those days that I am going a ketosis, I know that I’m giving my body a break on this hyperinsulinemia process that we were talking about earlier, because one of the key interesting things about insulin is that aside from its function of getting glucose into the cells and taking it out of the bloodstream into the cells, a secondary purpose of insulin is to block fat burning, because of course, it’s a signal orchestrating for the body saying we’ve got glucose available use that for energy, so we don’t need to use fat.

Dr. Casey Means (32:11):

So, insulin being high, another large both individual and societal ramification of having high insulin levels is that it’s going to block us from burning fat. And, of course, when you keep your insulin levels lower, that is going to be a great signal to the body into the cells to have to reduce its insulin resistance.

Dr. Casey Means (32:32):

And so, by going in and out of ketosis, and cycling a little bit, you know that you’re giving your body intermittent periods of time where insulin is low, because by definition, the insulin needs to be low for the ketones to go up. And so, it’s just this nice signal that you’re taking the accelerator off this high insulin process that’s happening so much in our bodies normally, if we’re eating a standard American diet.

Kayla Barnes (32:59):

Absolutely. And, of course, there’s definitely clean keto, which is what I practice, and I’m sure you practice, but for anyone listening, if you want to talk a little bit about what a clean keto blood sugar stabilizing diet would look like?

Dr. Casey Means (33:13):

Yeah, sure. So, the way I look at keto, and the way I look at food in general is that, food is molecular information like that’s what food is. It’s chemical information that we’re putting into our body. It’s not just macronutrients that we’re using to pull little levers on glucose and insulin.

Dr. Casey Means (33:36):

And so, any dietary strategy you’re doing, whether it’s vegan or keto or paleo or carnivore, the primary thing we should be thinking about is, “What molecules are going into my body?” And through that lens, a clean keto or whole foods plant-based is really, the only way to go because you’re getting the most nutrients possible to serve your body.

Dr. Casey Means (33:59):

And the cool thing about the molecular information that you put in your body as food is that it’s got two purposes. One, it’s the building block of the body. It’s making the physical structure of every single iota atom of our body, but it’s also the chemical messenger that’s telling our genes how to be expressed.

Dr. Casey Means (34:15):

So, it’s like both the director and the building block, it’s just so incredible. So, from that lens, again, clean is the way to go, no matter what dietary strategy you’re looking at. So, for keto, if we’re doing low-carb, we want to be focusing on the highest quality foods possible whether that means organic produce, whether that means regeneratively, raised grass fed meats, but that means pastured chicken eggs, whatever it is, but avoiding the toxins and the things that could harm our bodies, and trying to get in the maximum amount of nutrients possible.

Dr. Casey Means (34:55):

So, good sources, good quality and eating unrefined versions of things. You could probably, get into ketosis by chugging canola oil, right? It has no carbohydrates. It has no… It’s just all fat. However, that is not going to create a metabolically, healthy body, because there’s no micronutrients. It’s going to generate lots of oxidative stress like that would be not something that’s really serving the long-term goals.

Dr. Casey Means (35:20):

The goals is not to just hack the system and get a flat glucose line. The goal is to build a metabolically, healthy body. And that’s the holistic picture. That’s making sure micronutrients are on point, making sure the microbiome supported, making sure there’s an absence of environmental toxins, and all of those things.

Dr. Casey Means (35:38):

So, my version of keto, I’m primarily plant-based. And so, my version of keto looks like eating lots of plant foods that I know don’t spike my glucose at all. So, that looks like a lot of avocado, olives, coconut based products, cauliflower rice, broccoli rice, green leafy vegetables, tofu, some low-glycemic fruits, for me like unripe pears and some apples and a small amount of berries don’t spike my glucose at all, especially if I pair them with fat and fiber like chia seeds or almond butter.

Dr. Casey Means (36:18):

And then, I can also get away with a little bit of fruit and a little bit of beans and legumes, actually. So, if I eat a small amount of beans and legumes with enough fat and additional fiber, again, like chia seeds, flax, Tahini, things like that doesn’t spike my glucose.

Dr. Casey Means (36:35):

So, my version of getting into ketosis and by ketosis, I mean around somewhere between 1.3 and 2 on my Keto, my blood ketones, that’s pretty much what I’m focusing on, a lot of greens, cauliflower rice, broccoli rice, tofu, fats, avocado, et cetera. And then, just a tiny amount of beans, legumes and fruit.

Kayla Barnes (36:58):

Very similar to my diet, I do have some… I eat liver quite often, it’s very nutrient dense. The taste takes quite a bit of getting used to. But, so you must have so much data based on all of the logs on levels. What are some of the worst foods for your glucose? And maybe, the most surprising too?

Dr. Casey Means (37:20):

Oh, my gosh, yeah. So, this is one of the most interesting parts. So, we have about 50 million glucose data points at this point and 200 million health data points. And what I’m so excited about is how this type of population, anonymized population level data is going to totally shift our food system, right? Because right now, we’re going into the store and just looking at the marketing language and the ingredients and making a guess, about how it’s going to be for us and our goals.

Dr. Casey Means (37:51):

And I think in two years, that’s not going to be the way we look for food at all. We’re immediately going to look up, like, what is the aggregate impact of this food product on people’s blood sugar? And for people who are like me, in terms of certain features, how did they respond to this food?

Dr. Casey Means (38:08):

And so, I am very excited for that world. And I think we have hints of how that might happen by our data set so far. One example that I think is really, interesting is actually, if you talk about it by type of meal or food. So, breakfast is something I’ve seen some fascinating things from our data set, emerge.

Dr. Casey Means (38:29):

The first being that like, it is very clear what is a metabolically healthy breakfast and not metabolically healthy breakfast from the data set. And the things that show up on our worst scoring foods are a lot of common American breakfast foods, pancakes, waffles, donut, pastry, bagel, all of them in our top, like 100 worst scoring foods. Meaning, a really high blood sugar response, really high delta between baseline and peak.

Dr. Casey Means (38:58):

And these are the foods that are going to basically, cause someone to go up, and then crash and not feel good an hour or two after breakfast. A lot of cereals in their Cheerios, specifically is one that has a monumental glucose spikes. So, basically, anything that is like white and based on refined flour is probably not a good breakfast choice.

Dr. Casey Means (39:19):

On the flip side, in our best scoring foods, we see a lot of other breakfast foods and some of the words in there that you’ll see is like frittata, eggs and avocado, eggs and greens, eggs alone. We see chia pudding in our top like our best scoring foods, which is a breakfast I love, so that’s like using coconut milk and chia seeds to make a pudding.

Dr. Casey Means (39:43):

And chia has virtually, no carbohydrates and lots of fiber which is wonderful. And we see also interestingly, Kelly LeVeque who’s a wonderful nutritionist. A lot of people in our system log the Fab Four Smoothie, which is her smoothie recipe that she’s created, which is basically like… I’m probably, going to get this wrong, but it’s like about making sure each smoothie is getting greens, a certain amount of fat, a certain amount of protein.

Dr. Casey Means (40:11):

And then, there’s a fourth component that I’m forgetting, but it’s basically like, it’s not a very sugar forward smoothie. It’s about getting lots of micronutrients, protein fat, and a very balanced smoothie. People have virtually, no glucose response to that.

Dr. Casey Means (40:26):

So, it’s not like everyone just needs to eat eggs and bacon for breakfast, to have a healthy blood sugar balancing breakfast, it can be something like chia pudding, a green smoothie, or whatnot. So, so that’s one example where the data set really shows us the direction we should be going for breakfast.

Dr. Casey Means (40:44):

And another one that I love is, a lot of people log bars, like workout bars. And we probably, have 80 different types of bars that are logged in the data set. And the spectrum of no spike to huge spike is vast.

Kayla Barnes (41:03):

Advanced.

Dr. Casey Means (41:04):

And yeah, and what’s funny is that, I think I would guess every person eating those bars, these like health bars, thinks that they’re all the same, right? Like, oh, I’m grabbing a quick, Clif Bar, like it’s in a nice brown, recycled looking package. It’s probably great for me. But we find that Clif Bar has the highest spike actually, higher than a Snickers bar.

Dr. Casey Means (41:29):

And that person choosing that is not thinking that they’re necessarily making a worse choice for their glucose and Snickers, but the data shows us that. Whereas, someone we see perfect keto bars, Quest bars, Bulletproof bars. There’s several other brands that basically, have almost no glucose response.

Dr. Casey Means (41:49):

So, if I were going to the store in the future world, I would be looking at this type of information and saying, “Yeah, there’s a lot of priorities.” Of course, it’s not just glucose, I want to also make sure there’s no refined seed oils, I want to make sure that it’s organic, and all these things.

Dr. Casey Means (42:02):

But to actually, have that information about glucose, because a lot more power, because the type of person I feel my heart goes out to is like, they’re trying to make a good choice. They’re trying to lose weight. And unfortunately, the marketing doesn’t match up with the reality of what it’s doing to their body. And so, they get bamboozled. And I think that this type of accurate data is going to help circumvent that in the future.

Kayla Barnes (42:28):

Absolutely. It would be a great add on is, if you could scan the item, and then it would give you the feedback of the glucose response based on your specific typing.

Dr. Casey Means (42:40):

Totally. I would love to see that so much.

Kayla Barnes (42:44):

Yeah, it’s going to be such a game changer, because you’re right. The big food and the marketing and everything is marketed as healthy now because they see the opportunity in the market. But in reality, when you just take a look at the ingredients, its chemicals, its filler, soybean oil is still the number one oil used in the United States. And it’s shown to cause genetic changes in the brain.

Kayla Barnes (43:04):

So, definitely, using power and information as power with what you’re offering is absolutely, incredible. So, I know that you weave some of these in, but what are the top glucose hacks?

Dr. Casey Means (43:17):

Oh, man. Oh, this is fun. I’m sure you can add something to this as well. But I think, number one hack, and this is aside from try not to eat refined carbohydrates and refined sugars, because that’s the ultimate hack…

Kayla Barnes (43:33):

Yeah.

Dr. Casey Means (43:33):

… is like, just don’t eat processed food, but that’s easier said than done. But I think it’s like, the best life hack you can do, like eat real food, don’t eat processed foods. But to get to more tactical stuff, the biggest one is, take a walk after your meals, its game changing.

Dr. Casey Means (43:52):

The really cool thing about muscle, and why building more muscle is really effective for metabolic health and like weightlifting is because muscle, we talked a lot about insulin and it helping take glucose out of the bloodstream into the cells. But muscle is this fascinating part of the body that actually, doesn’t need insulin to take up glucose.

Dr. Casey Means (44:10):

So, it will take up glucose just because of the muscle contraction. And so, you get the double bang for your buck of taking glucose out of the bloodstream. And we know too much glucose in the bloodstream can cause problems without even spiking the insulin, which can then lead to more insulin resistance.

Dr. Casey Means (44:24):

So, use your muscles as much as you possibly can. And just a 30-minute or 20-minute walk right after a meal can do wonders for making your blood sugar spike lower than what it would be if you just sat for a couple hours after the meal. And we did this awesome experiment at Levels called the Coke Levels, Coke experiment where we sent a bunch of people two cans of Coke and asked them to drink one on one day, and then on a very similar day at the same time, like same sleep, same amount of hopefully, stress and all those variables, drink the Coke, and then take a walk right afterwards.

Dr. Casey Means (44:56):

And we saw like a 35% reduction in the integral glucose spike. The average I think, went down from 162 milligrams deciliter peak to like 132 milligram per deciliter peak. So, that’s a big difference. And so, yeah, just get your family up after your meal. And before doing the dishes or anything, just take a stroll around the block, like, it’s really lovely. And a lot of cultures do that. And we’ve lost that.

Dr. Casey Means (45:22):

Another thing that’s emerged from the research is that, it’s not just about having like one workout a day, that’s actually not. It’s way better than sitting 24 hours a day. But what’s more important is moving in little bits throughout the day, like more functional movement. And you can imagine, throughout most of human history, people have been on their feet, like whether it’s working the land, or it’s just more physical labor.

Dr. Casey Means (45:48):

And we’ve lost that. We’re sitting all day, and then we do our 30-minute Peloton ride. But the body needs to move throughout the day for optimal metabolic health. Because then, what you’re doing is your body is constantly this muscular glucose sink, taking glucose out of the bloodstream constitutively, and keeping the pathway’s active.

Dr. Casey Means (46:05):

So, even moving intentionally two minutes every half hour throughout the day, those people have better 24-hour glucose levels than people who just work out one time per day. So, spaced it out, move more. The second really important, like actionable take home tip is balancing our meals.

Dr. Casey Means (46:27):

So, making sure we’re not eating naked carbohydrates. And what I mean by that is, like a banana all by itself, that’s a naked carbohydrate. The primary macronutrient you’re getting is carbohydrates, not a lot of fat, and protein. And certainly, not a ton of fiber in a banana alone.

Dr. Casey Means (46:44):

So, take that banana, and put some fat protein and fiber on it. So, that could look like some almond butter and some chia seeds sprinkled on top, it could look like putting it in a full fat cashew yogurt with some flax on top, but that’s going to slow digestion. The fiber is actually, going to potentially block some of the glucose from getting into the bloodstream altogether, which is amazing. And just make it less of that big up and down spike and more of a gentle progression.

Dr. Casey Means (47:15):

So, if I’m eating fruit or other carbohydrates, like let’s say a potato or sweet potato, I’m always going to be adding fat, protein and fiber. And I’m going to make sure I’m taking a walk after it.

Kayla Barnes (47:26):

What about if you add fiber powder? Will that work equally if you don’t want to add on necessarily like more calories through like a fat or an almond butter or something if you just do the fiber powder?

Dr. Casey Means (47:39):

It’s a really great, great question. And I don’t actually, have any data to back that up. Although, it may have been done. The most of the studies that I’m thinking about are looking at whole food forms of fiber, like with a meal. But I’ll look into that. And maybe, we can include some in the show notes. I have to assume the answer is yes. Although, I think it depends in part on whether it’s soluble or insoluble or what type of mix it is. But, I mean, by and large, more fiber, the more fiber the better. So…

Kayla Barnes (48:11):

I’ll run that test for you, too, when I get my new shipment, I will…

Dr. Casey Means (48:15):

Awesome.

Kayla Barnes (48:16):

I’ll start doing that because I have done that in the past, but I’ll be more intentional about it with what I’m eating. And I usually, keep a really strict diet. But for self-diagnostic purposes, I will foray into some higher carbs. And sometimes, I do eat green bananas, do you find that those are better than a regular banana?

Dr. Casey Means (48:33):

Totally. I’ve actually become very into eating unripe fruit, which sounds super weird, but I think you get used to the taste. And actually, I end up now liking the weird, chalky taste of a greener banana or a plantain. And it’s just such a different glucose response.

Dr. Casey Means (48:50):

So, I’ll make sure I’m getting, like I said, pears that are not squishy and bruised, like really crisp and almost eating them like an apple that that is actually, a game changer for me. So, but yeah, if you know us food that… Like for me, I know a banana spike me. I know a sweet potato spike me. So, that’s an experiment where you could take the fiber powder and either eat it with it or right before it or drink it beforehand and do a really nice and have one experiment around that.

Kayla Barnes (49:20):

Mm-hmm (affirmative). Those are my favorite experiments. Very into self-quantification. So, okay, we talked a lot about how we can kind of if someone actually, has metabolic disease or dysfunction, what we can do? Of course, we can use Levels, we can track our blood sugar, but what are a couple of your other top tips for helping to reverse this or if they feel it coming on to get ahead of it before it actually, really sets in?

Dr. Casey Means (49:49):

Yeah, so the thing about metabolic health because it’s so foundational, it’s such a core pathway to our bodies. It’s not Just one thing that’s ever going to be the silver bullet. It really is a holistic… It is the output of many variables going in. And the key variables that people should take into account are mainly, seven things that I think about, which is food, stress, sleep, exercise, micronutrients, microbiome and environmental toxins.

Dr. Casey Means (50:23):

Those are the main actionable things that I kind of focus on. Within each of those, there’s a lot too. Within food, it’s not only what you eat, but it’s also when you eat. So, are you eating carbohydrates in the morning versus the evening? For some people, they find that eating carbohydrates in the morning, they don’t have lots of glucose spikes, and if they eat them at night, the exact same food, because of how our insulin sensitivity changes during the day.

Dr. Casey Means (50:49):

For exercise, it’s when you’re doing it, and then what type you’re doing it, cardio versus resistance training versus more high-intensity interval training. So, there’s a lot in there, but those are all the things that I really focus on. So, and stress is a really interesting one that’s worth exploring, because I see a lot of patients who… They have their food like, totally, totally dialed in.

Dr. Casey Means (51:14):

And they’re still not seeing the glucose levels they want or the metabolic health that they want. And those are the patients who often there’s some underlying stress aspect going on, that is just dominating. There’s so much there that there’s really like, no amount of dietary optimization that can overcome what’s going on with how stress is affecting our metabolic system.

Dr. Casey Means (51:38):

And so, that’s we’re really doing some deep, deep work around, of course, mind, body practices, like deep breathing, but also doing some of the deeper therapeutic work around healing core wounds psychologically, and really understanding what is driving a baseline reactive state in their body. I think, that’s really, really important to dig into.

Dr. Casey Means (52:01):

We have to remember that anything that creates a sense of threat in the body, whether it’s psychological, or a food trigger, is going to generate this baseline inflammation. So, sometimes, it really does come back to the psychological side of things.

Dr. Casey Means (52:17):

But the nice thing about knowing about all those different lovers is that, you don’t have to get everything perfect all the time. That’s impossible. But you have a lot of different buckets to choose from, as you’re shaping your day. And I just basically, focus on trying to get as many of these things in as possible. How am I supporting my microbiome today with fiber, probiotic foods, prebiotic foods and avoiding toxins that are going to hurt my microbiome?

Dr. Casey Means (52:39):

In terms of stress, did I get my 10-minute meditation? And today, did I do some journaling? Did I go to therapy, whatever. For my food, it’s like, did I get a bunch of micronutrient rich foods in antioxidants and avoid refined carbs and sugars and not eat too late in the evening, when I know I’m going to have a bigger spike?

Dr. Casey Means (52:58):

So, it’s just like how to… You can choose from these different areas and feel what’s most alive for you that day and double down on that, because all the lovers have a positive impact. And it’s not about perfection. But I think knowing that there’s a lot of different options that are going to affect metabolic health positively, can sometimes be empowering for people.

Kayla Barnes (53:18):

Definitely. It’s a very multifaceted approach. But I think that you’ve given so many of the listeners today incredible tools to start making an impact or start to really, tweak and refine if they’re already on that journey. So, thank you so much. It’s been an absolute pleasure. I’m going to put all of your details a link to Levels in the show notes, and thank you again for coming on today.

Dr. Casey Means (53:41):

Thank you so much for having me on, Kayla.

Kayla Barnes (53:47):

Brain Biohacking was created and is hosted by Kayla Barnes. This podcast is for informational purposes only. Views expressed on this podcast are not medical advice. This podcast including Kayla Barnes does not accept responsibility for any possible adverse effects from the use of the information contained herein.

Kayla Barnes (54:06):

Opinions of their guests are their own, and this podcast is not endorsed or accept responsibility for statements made by guests. This podcast does not make any representations or warranties about guest qualifications or credibility. Individuals on this podcast may have a direct or indirect financial interest and products or services referred to herein. If you think you have a medical issue, consult a licensed physician.