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Join us for this enlightening episode of VRTAC-QM Manager Minute, where we explore the transformative power of Value-Based Purchasing (VBP), also known as Performance-Based Payment (PBP). In the studio, we have Chip Kenney, Co-Project Director of the VRTAC-QM, and Lisa Mills, a consultant and subject matter expert in VBP, sharing their expertise. VBP is more than just a financial model—it's a strategic shift designed to drive better outcomes for individuals with disabilities. By aligning provider incentives with measurable performance outcomes, State Vocational Rehabilitation Agencies (SVRAs) can enhance the quality of services, improve consumer results, and optimize costs. Tune in to hear Chip and Lisa discuss how SVRAs can harness the power of this approach to revolutionize service delivery and create a meaningful impact. Whether you're considering adopting VBP or seeking to refine your approach, this episode is packed with insights you won't want to miss! Value-Based Payment Methodologies to Advance Competitive Integrated Employment: A Mix of Inspiring Examples from Across the Country   Listen Here   Full Transcript:   Chip: Virginia reached out and they wanted to include value based purchasing specifically in their Disability Innovation grant. I said, this is an opportunity we can't pass.   Lisa: Is there anything about our payment structure that incentivizes or rewards this kind of quality that we're saying we're not getting, thus reduce the amount we're investing in unsuccessful closures.   Chip: When we can get to that point where we can identify and measure and demonstrate and get quality outcomes that will move this whole system a gigantic step forward.   Intro Voice: Manager Minute brought to you by the VRTAC for Quality Management, Conversations powered by VR, one manager at a time, one minute at a time. Here is your host Carol Pankow.   Carol: Well, welcome to the manager minute. Joining me in the studio today are Chip Kenney, Co-Project Director of the VRTAC for Quality Management, and Lisa Mills, Consultant and Subject Matter Expert to the QM on Value-Based Purchasing. So here's a little context for our listeners. Value-Based Purchasing, also known as Performance-Based Payment, is a model that offers financial incentives to providers for meeting certain performance measures. And as state rehab agencies look to improve outcomes for individuals with disabilities, the quality of purchased VR services, and overall cost effectiveness. A Performance-Based approach might be an option, so I don't want to steal their thunder, and I'm going to let my guests discuss what they're doing today. So let's dig in. Lisa, lets' start with you. Can you tell us a little bit about yourself and how did you find your way kind of into this VR space?   Lisa: Sure. So I've been in the world of disabilities for my career, for the entire career. So, 33 years, I think where now I've lost count. But about 20 years ago, I got really interested in employment working with Self-advocates way back before there was such widespread support for ending Subminimum wage. You know, the support that we do see now, but that was at a time when that it wasn't even being discussed. But Self-advocates were very clear that they wanted to earn more money and have more opportunities. So I got interested in supported employment and why we weren't using it very much. And so I started working with Medicaid and long term support agencies on improving employment services and outcomes. Back then, there was something called the Medicaid Infrastructure Grants, which allowed states to create Medicaid buy ins for working individuals with disabilities. So I really dug in around what were we doing around employment services. And of course, that brought us to the relationship with VR. And about 16 years ago, I started working on customized employment and developing ways to pay for customized employment, and worked with a couple VR agencies at the time on payment structures for customize. And then most recently, I'm a mom of a transition age son who used VR supported employment services to get his first and second jobs, and he's been employed in competitive, integrated employment since 2020. He's about to turn 21 and that has changed his life. So I'm a firm believer.   Carol: Good for him. That's really cool to know. I always love it finding out the stories people have, because you never know, we all get here a different way. But I love your path. So Chipper over to you. And I'm going to say Chipper because I'm naughty. He Chip is my colleague. So for our listeners I do like to rib Chip a bit. So Chip, how did you find your way into the VR space?   Chip: So very similar to Lisa. My whole career has been in public rehabilitation for a bit then technical assistance centers, but fast forwarding to about 2009 was interested in customized employment and its applications, and the need for VR systems to have an employment system that really addressed what people with the most significant disabilities needed to be successful, and I was sort of glommed on to that space ever since. And then with the passage of WIOA, it just seemed a really necessary connection that VR agencies and systems have something new they can offer. People who would have considered going into sheltered employment now are coming out. What are you going to offer them that's new and different from when they went in and have been at it ever since, mainly focused on the implementation side of it, because there's a bunch of trainers in that space and they're all really good. But we learned early on that it takes an infrastructure to embed, implement and sustain customized employment over a period of time. And so that's been my focus the last several years. I mean, we're still learning a lot. And rate structure is part of that, which, I mean, I've known Lisa for years too, but rate structure is something every agency struggles with. And when the opportunity came to work with Lisa on this and move this forward, I thought, this is a big missing piece that we have to fill.   Carol: Absolutely, I'm underscoring that 100% because we know we get a lot of rate work with our QM work and the whole idea and customized employment with that sustainability. You can have the great idea. And we're going to do the thing and we're all excited. But then what happens. Year one and two and three and four as it goes on and it all fades away. And we don't want that to fade away. We need to have that good sustainability plan. So Chip, how did you get involved in bringing Lisa on board? What was kind of the impetus of that?   Chip: Virginia reached out. The state of Virginia reached out to us and they wanted to include value based purchasing. And they mentioned that specifically in their Disability Innovation grant, and somebody referred them to me. I mean, I knew a bit about it, but then as soon as I saw the Lisa connection and started reading her work on it, I said, this is an opportunity we can't pass, even though I don't have any experience. But Lisa brings all that and the knowledge and the background and said, it's really important to be a part of this.   Carol: Very cool. So, Lisa, I understand you have a very unique superpower. You can speak and interpret languages across multiple partner systems. How did you develop that?   Lisa: Well, I guess I'm a bit of a policy wonk. I did a lot of interviewing of people from different systems to try to understand what was going on with partnerships, what were the challenges. And this was probably 12, 13 years ago. I was doing some work with ODEP at the time, blending and braiding. And when I was doing a lot of my interviews interviewing the different partners, including VR, I figured out that a lot of what was going on at that time was sequencing. It was really not blending or braiding, and if we wanted to get to braiding and ultimately to blending, I felt like we really had to find what was going on then as something foundational, you know? And that's where I kind of coined the term sequencing and said, this is really what we're doing, but we can help people understand then what it means to switch from sequencing to braiding, what it means to switch from braiding to blending, and really start to get people interested in the advantages of moving away from sequencing. So it really was just wanting to dig into each system enough to figure out what solutions might improve collaboration and outcomes. Sometimes it can be easy to lay out all the issues, right? Everything that's not working, but to really dig into each system and figure out where could we align ourselves, where are we aligned, and we just don't realize it? That was more, I guess, the policy wonk side of me.   Carol: I love that because I think I've been on lots of work groups over the years, I mean, I just have when we've worked between, you know, departments of education and your state Department of like maybe developmental disabilities or whatever you are calling it back in the day. And then in the VR system when we all had different ways of describing everything and we could get stuck in the what's the problem? Here's all the problems. We got problems. We have a million problems. Here's all the hundred problems we have to get through before we can get to a solution. But if you go in and go, I love that. Like, how are we aligned right now and what are the things that we could build off of right now instead of always focusing on that whole myriad of things? But I think understanding each other, how we speak about things and we may say the same word, but it means something different to each of us. Once we can kind of clear up that dictionary and talk the same language, it makes it much easier to comprehend what's going on in each other's systems and how that can then work together. I love that you have that. So what is the essence of Value-Based Purchasing?   Lisa: So to me it's quality service combined with efficient service that results in quality outcomes. So I think about that. Efficiency without quality that would not lead to quality outcomes. We'd hurry up and do things, but we wouldn't really see the quality outcomes we wanted to see. And at the same time, if you have a quality service that goes on and on and on, you lose the cost effectiveness and you typically you lose the job seeker. They're going to give up or go find a job some other way. So to me, we have to recognize we need both quality and efficiency in the way services are delivered and that we have a set of quality outcomes we want to achieve. And we have to ask ourselves, to what extent are we getting those quality outcomes? And to me, if we can figure out a payment structure that balances rewarding quality and efficiency and is really clear about what is quality and service delivery, what is efficiency and service delivery, and then what are we looking for? As quality indicators and outcomes? We can design a payment structure that really will deliver on that. And I think as you start to think about that, you realize how the existing payment structures really aren't set up to do those things for various reasons. And that really, I think, helps people buy into the idea that there might be a better way to do this. And this idea of value based purchasing might actually have some legs.   Carol: So that payment structure piece, that's my interest. How did you really dig in and kind of figure it out? Because it sounds good and I understand all the things you're saying about quality outcomes, but how when it comes down, like putting the rubber to the road, do you get at the nuts and bolts of figuring out the payment structure?   Lisa: So everybody always wants that. Next they say, so tell me what it is. And I always say it is what you need to develop locally in your system. You need buy in from those who are purchasing and those who are providing, and you've got to bring them to the table in a constructive way. So in a really collaborative way, sometimes we talk about it as co-creation and you dig into what do we agree is quality service, how do we differentiate quality service from service that we would say is not high quality. And then what do we agree is efficient service? How do we differentiate efficient service from service we would say is inefficient but very important to VR agencies, at least those I've spoken to. Are these quality outcomes, the career path outcomes, the jobs with benefits, the jobs with more hours and better pay? You know, some of these things, you're just not necessarily seeing a lot. You're getting outcomes that you can count as a 26 closure, but they aren't the kind of quality outcomes that, and you see some revolving door effect of certain people who and I know that's a big issue in some states or you see a lot of dropouts in the process. So in every state it's important to sit together and figure out what should we be doing better, what does better quality look like, and then what is quality and efficient service look like? That's how you get the buy in to establish a payment structure that where people want to implement it and intend for it to work. I can certainly share examples of how that co-creation works going on elsewhere and what the ultimate outcome was, but that is what happened there. And I really like the idea that and really believe that you've got to do a local co-creation process to get to something everybody's bought into and something that has a high probability of working. I would never say, oh, Value-Based Purchasing is this. It's only this. Or you just take this model from this other state and you plunk it down here. That won't work.   Carol: Yeah, I can see why you sing to Chip's heart there. Because he's all about systems work, you know, and that whole and everybody's systems in your state are so different. How you're set up, what your relationships are like between your providers and yourself and other entities and all of that. So I do like that you're speaking to that and you can't just pick up and replicate because you've got all your nuances that are happening in your state, and you need to understand those before you can get to the agreeable solution. That makes a lot of sense.   Chip: And it's not only that, and we're finding this to be true now that providers are not a monolith, that there's not a state where you can go, okay, every provider looks like every other provider. There are a lot of uniquenesses, a lot of variables that have to be taken into account to bring at least the majority of them on board. And that's we're finding that to be true as every state system is different, every provider network or non-network is different.   Carol: Absolutely. And even when you think about the states, kind of just the like the geographic challenges they have and the things that are going on, we've saw such an increase, especially after Covid with people moving and some of the states go like our cost of living in certain areas has gone up exponentially, like 300% or something. And so you've got everybody like, decided because they could work from anywhere. We're all moving to this town and then other areas become depleted, maybe from people, and there's less resources available and harder to get providers to serve an area even though you have customers there. I just feel like we have a lot of geographic and economic challenges across states, even tiny states. It's been super interesting. We've found that work as we've been just doing plain old rate setting with states, so let alone what you guys are digging into. So what are some of the biggest challenges in implementing this value based purchasing?   Lisa: I would say the time it takes to do it right. I think sometimes state agencies and I'm not singling out VR, but they want quick solutions. You know, they think about it for a long time and then they say, okay, we want to do it. Let's get it done. Can we get this done in three months or can we, you know, and you have to say probably not in a way that would be successful. And so it is something not to take lightly and to really commit to invest in. I think there's a lot of additional benefits to doing this, including provider relationships and the learning that goes on. Providers now understand what it's like to step in the shoes of a funder. Funders understand what it's like to step in the shoes of a provider. I always think that helps with everybody getting on the same page and agreeing to a model they think will work, but it takes patience, it takes partnership. Some states are, they're very uncomfortable with bringing providers in. They tend to develop things and then release them to providers. So you've got to have a level of trust when you identify the providers you want to involve. I always encourage to identify who are your high performers. They are the providers you want this model to work for because you want more high performers and you want those that you have to expand their footprint, for example, to go into geographic areas that are underserved or to hire more staff. So always thinking about partnering with the high performing providers. But there's a bit of reluctance, you know, and risk in doing that and saying we're going to create something together. Lots of outside the box thinking. It's really hard to get away from payment models that you've been invested in for a long time. Milestone fee for service. Just to think beyond those can be very difficult, but I think once people start to and that's something I do, is kind of bring ideas and thoughts and stimulate thinking to get them to move away from those models and really say, what should we be paying for? What is important to value in the payment structure? I think it really gets to be very exciting, or at least I think so. You really need data to you cannot develop a model without good data. Sometimes the data is readily available. It's reports that VR agencies are already pulling out of their system. Other times the data's in the system, but they don't typically pull it. And so we have to work with them. And it helps to have a data analyst to assist with this process, to be able to pull pieces of data or data analysis and different ways that informs what we're doing. We want a data driven approach. And sometimes, of course, you probably know that data analysts are very, very busy or they're off doing something else. And it may be hard to get them committed to the work.   Carol: Have you seen improvements since? I'm just thinking since WIOA and kind of the requirements that RSA has put on state agencies about collecting a vast amount more of data. Have you seen improvement as you're working with states that they actually have data they may not have had years ago that you can get at. I mean, there might be a little bit of a problem with the staffing or getting your data analysts to pull it, but that availability of the data you need to really to dig into this, that it's actually there.   Lisa: Yeah, I do think the systems are pretty sophisticated, and it's a matter of helping them understand how to use more of the data they have, because we have the standard WIOA measures. We have the way that VR talked about its performance prior to WIOA but I think we're digging in to get it more data elements that help us understand. One of the most important things to understand is demographic information and how that affects maybe how difficult or how easy it is to serve someone. So, for example, adding criminal background to someone's demographic profile, or we know from history that, you know, that does create a challenge. So it's weeding out what are the things that differentiate people who VR would serve and try and understand better how that relates to cost. The other thing that's really important that I don't typically see is what's the average cost of a successful case? So I see this is the average cost of successful closures. So taking all successful closures and dividing it by the number and then average cost of unsuccessful closures, then average cost of a case. But for me what matters most is what are we paying for a successful case if we're including everything we're paying. So including all the that we're spending on unsuccessful closures in that and saying, basically this is what it costs to get a successful case, because we also have to pay for the unsuccessful closures and trying to focus on how do we reduce, how much we're paying for unsuccessful closures, and to really make sure more of the money that we're paying flows to successful closures. There's a little bit of complacency that goes on with every system where if we just compare ourselves to other states, we may say, look, we're doing better. We should be happy with our performance. We are better than 75% of the states. But if we stand back and compare that to people without disabilities and their participation in the workforce, I think that's when we say we're comparing it to school. Like if you got 60% on a test, would you pass it or would you fail it? So I think we have to challenge ourselves to say we may be doing better than so many other states, but we are not performing at a high level and we want to move up. We want to not just judge ourselves by other states. Now, 100% success is unrealistic. I don't think there's anybody who would disagree with that, but it's important for the providers and the funder to come together and say what kind of improvement above where we've been. Do we want to try to incentivize? Do we want to see and to develop the payment structure, to say we believe this structure will directly influence our ability to move those percentages up over time and thus reduce the amount we're investing in unsuccessful closures without reducing the number of people were serving, without cherry picking, but truly improving outcomes.   Carol: I love that that is a good way to challenge the thinking that's going on out there, because people sort of, I don't know, poo poo or they just this is over there in that bucket and they let it be. And we're kind of complacent with just, you know, we're doing better but is better. What's the next state like. You know, like better than what. And so what does that matter.   Chip: But I think I mean, the key to me is the concepts of quality, the quality of services and quality outcomes. And if you can define and you can measure and you can demonstrate quality of services and quality outcomes, it seems like you don't need to compare yourself with other states. You can say this is quality in our state. This is what we're doing. This is how we're doing it. These are the outcomes. So state by state national comparisons are way less important. So when we can get to that point where we can identify and measure and demonstrate and get quality outcomes that will move this whole system gigantic step forward.   Carol: 100% Chip. So what would be your best advice for states as they're listening. Right. You know, they're listening in and they're thinking, well, I want to do something, but I don't know what to do. Like what would be the next steps? What should they do?   Lisa: To me, it's, start the conversation. I find that the process of bringing state people together with providers, that they're all learning together about this different way of thinking, And it helps because it does take a little bit to get your mind around what Value-Based Purchasing is and how it's different from milestone payments or fee for service. And I've often seen like people have come up to me sometimes and said, you know, it was the third time I heard you talk that the bells finally went on, you know? And I said, that's fine. I think it's just the way it is. It's complicated in a way, because it's so different. So getting the conversation started and thinking about, you know, asking yourself questions like, is there quality in the outcomes that we want as an agency that we're not getting quality and service delivery? We don't feel we're getting quality and outcomes we're not getting. Then think about your payment structure and say, is there anything about our payment structure that incentivizes or rewards this kind of quality that we're saying we're not getting? Sometimes maybe there's something there. Sometimes you could say, no, there's absolutely nothing in the payment structure that does that. And then I always say, think about the providers that you think are doing the best work for you. Are they financially benefiting? Are they doing better financially. And in some cases I've seen no, there's no difference. I'm performing better, but financially that's not being recognized. And in other cases I've seen they're actually earning less because they're doing such a good job and they're very efficient. You know, they're producing quality with efficiency. They're actually doing more poorly financially than some of the providers who are performing at a lower level of quality. So I think when we start to think about those questions, people see that the need to try to figure out a different way to do things, then they're willing to, you know, let's talk about what this Value-Based Purchasing is what the principles are, how it's different, and begin to think about how we might bring our high performing providers into a conversation with us about this.   Chip: My advice for states is that you're in this for the long haul. To Lisa's point very early in this discussion that this isn't a quick solution. That's something that can just be laid in the state and just immediately adapted. It does take that level of discussion, that level of understanding, collecting data. It's complex. And sometimes I think to myself, why am I choosing to get involved in the complexity of Value-Based Purchasing overlaid the complexity sometimes of customized employment, but I think in the end result we will have a much better system, much more equitable service delivery system for everyone, including providers, including customers and job seekers. But just keeping the discussion going on things like this, things that CSAVR presentations Getting this into the national discussion, I think, is the first step.   Carol: Those are really good tips. Where outside of VR is Value-Based Purchasing being implemented?   Lisa: So definitely in the Medicaid world, most of your listeners are probably aware of that, but mostly in the Medicaid world, it's on the acute primary care side. So hospitals and doctors, primary care physicians and things. So I always caution people there's things we can learn from that and those examples. But it's not a wholesale import those approaches over to VR. I don't think that would work. But there are some principles or strategies that we can use, like there's a concept called shared savings. There's some other things that I think we can think about and use, but we still have to develop something that's specific to employment. In my work on this around employment on the Medicaid side has been with the long term services and support agencies, the DD agencies, the mental health agencies, managed care organizations who are doing LTSS and employment is a perfect place to start with them around their thinking, around Value-Based Purchasing. They're facing some pressure. I would say some to use Value-Based Purchasing because it's seen to be working on the acute primary side of Medicaid. So they're saying, why aren't we using it in LTSS? And they want better quality and better efficiency too. They want to see people supported to achieve their highest level of independence. They want their high performing providers to do well. So we worked on it with employment because it's so obvious that fee for service, which is the typical payment model, disincentivizes all the things that we associate with high quality supported employment, the better you are at getting people jobs, the better you are at coaching and fading because you're good at it. We reward providers under fee for service with less money. And those providers are performing more poorly, end up with more money. So it's not hard to get people to see why fee for service doesn't work for supported employment. So we've worked on models for job coaching that pay for hours worked rather than hours of coaching, so that providers are appropriately financially compensated if they do better at fading, which goes back to what kind of job did they get people, as well as how good they are at coaching. That model incentivizes them to get people more hours. So if you start with 12 hours a week, that doesn't mean you stay with it. If they're doing well, the employer wants to increase that. The person wants that they can get paid more in the model. Fee for service providers don't get any financial remuneration for increasing people's hours worked, even though we say that's a goal. So that's been a lot of where we see some of the value based models developing. We're paying for things up front services like exploration, which I'm really happy to see the results of states that have added exploration and exploration to their waivers, because we now have a way to tackle people who say no thanks in a planning meeting or I'm not interested, or their families say that we've been paying for developing payment models for that. That's an outcome payment. So they complete the service, then they get paid based on the quality of the information they submit and the efficiency. So there are ways to align what we're doing. Providers certainly appreciate that they would like to be paid the same way. Typically once they experience being paid in a Value-Based structure. So that's where it's happening. But think about just the general business world. There are so many examples of payment based on performance or quality, right. Sales Salespeople earn incentives for sales. So business has long been doing this in terms of creating those kinds of incentives and even nonprofits. Now, United Way and others are funding nonprofits based on outcomes and deliverables. They're no longer funding them to just provide service. So I think if you look, we're seeing it everywhere, really.   Carol: So you brought up a whole lot of points. If people are interested in more information, do you have resources we could send them to?   Lisa: Well, in 2021, I did a publication that looked at examples from around the country that I'd been in some way involved in. That's on the Lead Center website as well as there are a series of webinars we did at the time with representatives from various states. I have a lot of information about what's going on in the Medicaid side. Et etcetera. So I guess I would say that was my thinking in 2021, I continue to learn and evolve my thinking, and I think we're at a point now where we're trying to do in Virginia, is move beyond both fee for service and milestones, because neither are working very well, right? So you've got some state VR agency saying we're paying fee for service. It's not working. Should we move to milestone? But if you talk to states who are using milestone, they will also say it's not working very well. Some of them are thinking about going back to fee for service. And I'm thinking, I don't think we should do either. I think we should work together to figure out what's the next way we attempt this that addresses the shortcomings of both. And I think that pathway is Value-Based Purchasing.   Chip: and helping moving states to. Well, I'm a little concerned about the unknown. What we have may not be working now, but it's the known. I don't really know what's ahead, but I think where in Virginia at least, has done a really good job of creating that safe space. Like, let's explore this together and keep this comfort zone of what we currently have, but move forward into something that's more equitable and beneficial for them.   Carol: So, Chip, if people wanted to reach out, what would be the best thing? Should they contact you or what would be best?   Chip: Either one of us is if it's a state agency, probably me if it's others listening to this. Lisa.   Carol: Do you want to give them your email address?   Chip: It's r k e n n e y at SDSU (San Diego State University) dot EDU.   Carol: Awesome. And, Lisa, do you mind sharing your email address?   Lisa: No, but I'll warn you, it's long. So here we go, Lisa Mills l L i s a M i l l s, all one word, at M as in Michael, T as in Tom, D as in David, D as in David, dot On Microsoft, all one word, com. And that was my IT friends who gave me that ridiculously long email, which I hate.   Carol: Holy smokes, that is long. Well thank you both. I really appreciate it. And I will put a link in our podcast announcement out to your publication from 2021 as well. Then folks could at least see that. But thanks for your time. I really appreciate the conversation.   Lisa: Thank you.   Chip: Thanks. We really appreciate this opportunity.   Outro Voice: Conversations powered by VR, one manager at a time, one minute at a time, brought to you by the VR TAC for Quality Management. Catch all of our podcast episodes by subscribing on Apple Podcasts, Google Podcasts or wherever you listen to podcasts. Thanks for listening!

Patrick explores Luke 17 and clarifies the true meaning behind the verses on one being taken and one left behind. Patrick breaks down the misconceptions around the supposed 'rapture' and explains how it actually relates to Jesus's return and the final judgment.   Michael (email) – It seems to me that when one sees things that are just wrong, doing the right thing is more appropriate than applying patience and humility. (00:36) Lisa - Is baptism in a Sedevacantist Parish valid and what should you do if you find out you were baptized in SSPX? (08:37) Ann - Can you go to heaven if you don't believe in angels? (15:36) Diana - You recommended the book The Dogma of Hell. Can you give me courage to read it? (24:03) Rose - Can you explain the meaning behind today's Gospel? (29:33) Susan - What are some good Catholic teaching materials for adults with special needs? (40:19) Francesca (8-years-old) - If God is in everything and everyone, why is He not a girl? (42:03) Angela - My friend is living with a guy but doesn't want to marry him for financial reasons. How do I tell her she needs to get married to him? (46:27)

Father Dave Heney joins Patrick for an Ask Me Anything session. Why is knowledge important to our faith life? (8:46) Kyle - I teach confirmation and one of the students is a High functioning artist atheist. How can I best help him without pushing him away from the faith. (12:44) Aida - When children die at a young age, why are they not required to have confession before they get their last rites? Email about how suggestions for a trip to Rome Wendy - I was never given the option to take a Saints name when I converted. Why not? (24:44) Break 1 How can you debate bible alone? (28:59) Gil - Are we really forgiven and we start fresh, or are we judged for everything even the things we were forgiven earlier? Val - Communion: What are the best practices? Should I kneel? Receive in the hand? (37:02) Break 2 Ray - Confession: 3 times the Father was busy and couldn't stay to finish the confessions. Can I still take the Eucharist if I didn't get to confess? (40:38) Teresa - I know very little about our religion. I don't understand the body and blood of Christ. Isn't it symbolic? Lisa - Is it sinful not to wear a cross to work if you're in an environment that is anti-Catholic (49:05) How can someone's sins be forgiven after they are dead?

Click here to connect with the Our Given Purpose Ministry⁠ The Bible In A Year Daily Reading Plan Saturday, April 1, 2023 Deuteronomy 18:1- 20:20, Luke 9:28-50, Psalm 73:1-28, Proverbs 12:10 Finding Strength in an Unchanging God by contributing writer: Lisa C. Gant ⁠Connect with Lisa⁠ Is the CEO and founder of Gant Editorial Services. --- Send in a voice message: https://podcasters.spotify.com/pod/show/torrie-w-slaughter/message

Welcome back to our weekend Cabral HouseCall shows! This is where we answer our community's wellness, weight loss, and anti-aging questions to help people get back on track!   Check out today's questions:    Shirleyta: I have suffered for BMS for 1.5 years.. what should I do, Doctor? What kind of specific Doctor do I need . Thank you for your kind attention.   Fiona: Scans show fatty liver but I don't consume any alcohol, my diet is organic and plant-based with no processed foods. How is this possible?   Anonymous: Hi there! Firstly, thank you for all the knowledge and wisdom you share! I have been working on healing my gut for about 3 months now. I have noticed some changes like more energy, less cravings, better sleep. However, I am still really struggling with my skin. My skin periodically gets this sort of rash that looks like sebaceous filaments and water retention. I know sebaceous filaments are natural but they are not always this prominent. Are there foods that cause this? Also, I have noticed that i have a sensitivity to lectins and a lot of the protein sources on the Dr. Cabral detox are a bit high in lectins(beans, legumes, chia seeds). I listened to your podcast on eliminating them for a while if one is sensitive and then reintroducing them later on. How can I modify the detox so that I still get enough protein while also avoiding lectins? Thank you so much in advance!   Moriah: I was just listening to your podcast and you said something word for word what I said to myself a year ago… “I won't take antibiotics unless I'm dying” Last year, antibiotics caused me to catch a c diff infection and I've never been so sick, the antibiotics they gave me to cure the c diff, didn't even work and I got a second infection, I literally felt like I could have died. A local naturopath finally helped me heal my gut and repair my issues. Just wanted to say thank you for speaking out about the danger of unnecessary use of antibiotics   Lisa: Is it ok to use cbd oil while pregnant? I have been using cbd oil for 2-3 years to help me sleep at night and I can't sleep well without it. Thoughts on taking it during pregnancy ?   Anonymous: Hi. I have been listening to your podcast for a while and it has really been helping a lot with my health issues. In numerous podcast episodes, you have mentioned that keto and long intermittent fasting isn't good for female hormones. I have extreme insulin resistance and I have had it for years. I have tried keto with vegetables for about 3 weeks now along with intermittent fasting of 16 hours in order to try to reduce my insulin resistance, hair loss at temples, and skin rash. However, i seem to be gaining more weight around the belly even though I have not been consuming any carbs other than low glycemic vegetables. What could be causing this? I thought that belly fat especially love handles were caused by high insulin? Also, what method would you suggest for healing extreme insulin resistance for a female? Thank you so much in advance!    Thank you for tuning into today's Cabral HouseCall and be sure to check back tomorrow where we answer more of our community's questions!    - - - Show Notes & Resources: http://StephenCabral.com/2283 - - - Get Your Question Answered: http://StephenCabral.com/askcabral   - - - Dr. Cabral's New Book, The Rain Barrel Effect https://amzn.to/2H0W7Ge - - - Join the Community & Get Your Questions Answered: http://CabralSupportGroup.com - - -  Dr. Cabral's Most Popular At-Home Lab Tests: > Complete Minerals & Metals Test (Test for mineral imbalances & heavy metal toxicity) - - - > Complete Candida, Metabolic & Vitamins Test (Test for 75 biomarkers including yeast & bacterial gut overgrowth, as well as vitamin levels) - - - > Complete Stress, Mood & Metabolism Test (Discover your complete thyroid, adrenal, hormone, vitamin D & insulin levels) - - - > Complete Stress, Sleep & Hormones Test (Run your adrenal & hormone levels) - - - > Complete Food Sensitivity Test (Find out your hidden food sensitivities) - - - > Complete Omega-3 & Inflammation Test (Discover your levels of inflammation related to your omega-6 to omega-3 levels) - - - > View all Functional Medicine lab tests (View all Functional Medicine lab tests you can do right at home for you and your family)

Roe v. Wade: Supreme Court draft opinion that would overturn abortion rights leaked Tom - I think there are options for spending for good organizations that align with your morals but it is a lot of work. Debra - What should I do about a mother who wants to have God Parents for her child who aren't practicing Catholics? Matt - Do you know of any studies that correlate abortion with the decline in the work force? ALSO I read an article that discussed the lower birthrate with the decline in work force. Lisa - Is it true that all firstborns have more blessings than other siblings? David - Do you know of anyone who has come to the catholic faith who was a Jehovah Witness who wrote a book?

What Sets Great Leaders Apart Interview with Leadership Coach Lisa Anna Palmer “Progressive leaders realize that to build high-performing teams and achieve the success they need to live and work based on fundamental business principles that flow from a love for humanity and the desire for human connection. It is compassion, courage, and competence as a leader that inspires employees to do their very best and give the company a competitive edge. It is profundity, passion, purpose, and perseverance that helps leaders and employees to tap into what is important to them and to pursue their vision regardless of the obstacles they may encounter along the way. It is professionalism, play, philanthropy, and prosperity that engages people to push their limits and to give their very best at work for one another, for clients, and for society. These are the secrets to attracting, retaining, and motivating a talented workforce in the twenty-first century – This is the wisdom that sets great leaders apart.” Excerpt from Light A Fire In Their Hearts by Lisa Anna Palmer Lisa Anna Palmer, with over 25 years of experience in human resources, organizational development, and executive leadership training, is the international best-selling author of Light A Fire In Their Hearts: The Truth About Leadership (Morgan James Publishing). A decade ago she founded Cattelan Palmer Consulting. She is now the founder and CEO of the Light Your Leadership Inc., which serves leaders and employees of organizations within the private, public, and non-profit sectors. Palmer started her career as a consultant for PwC, as part of the Organizational Renewal Group, where she led reengineering teams and conducted international best practices research on HR policies, teams, communications, and other related topics. For nearly 14 years, Palmer worked with government employers, including Canada Mortgage & Housing Corporation, and the Royal Canadian Mint. Based in Ottawa, Ontario, she consults with companies and individuals in both Canada and the United States. Palmer has shared the stage with globally renowned speakers and has presented to high-ranking dignitaries. She was selected as one of the Top 100 Canadian Professionals for 2020. A highly-requested speaker, she recently spoke at Canadian National Convention for Junior Chamber International, Extreme Leadership Conference in San Diego, Distinctive Women in Canada Conference (GTA), and Canadian Pakistani Affiliate Chamber of Trade. With a B.A. in Psychology, she is a Certified Extreme Leadership Facilitator, Certified Pro-Active Coach, Certified Passion Test Facilitator, and Cross-Cultural Competencies Facilitator. Fluent in three languages, she trains and leads teams responsible for HR Management, Talent Acquisition, Talent Management, and HR Strategy & Policy. Palmer, who has contributed chapters to four best-selling books in the 365 Days series, by Jodi Chapman and Dan Teck, has been interviewed by television and radio shows, and podcasts, based in Canada and the United States. Lisa Is also a proud Ambassador of the “She Did It!” Movement and a C-Suite Executive. For more about Lisa Anna Palmer go to https://lightyourleadership.com/ Learn more about your ad choices. Visit megaphone.fm/adchoices

Raw & Real with Dr Lisa  Is your past haunting you and taking a toll on your energy, health relationships and money? What if you could simply kiss it goodbye? I've been working with people as a psychologist and facilitator of change for over 26 years and I've seen them struggle with their past until they kissed it goodbye and were able to start building the life of their desires. The ROAR Technique® I created has the ability to go deep and transform what was a dark chapter of your life into a beautiful scene bathed in sunlight. Did you know you can learn this Technique for your own wellbeing or choose to become a practitioner and add this to your business? The first step is a 4-Days class called Living Your ROAR®! Living Your ROAR® – Online! May 20-23 Learn more here: https://www.drlisacooney.com/offers/xkoknMeq/checkout     Dr. Lisa's Book: Lies Of Money Purchase here AccessConsciousness.com www.drlisacooney.com/   *Listen now on the Inspired Choices Network app!  https://linktr.ee/inspiredchoicesnetwork ~ More About Raw & Real with Dr Lisa ~  Dr Lisa Cooney is a Doctor of Psychology and Licensed Therapist with 25 years' experience.  She is a bestselling Author and the creator of the ROAR™ (Radically Orgasmic Alive Reality) methodology to move beyond abuse & trauma. Dr Lisa travels the world facilitating dynamic, fun, life changing classes that share practical tools and accompany people to actualize the lives they have always dreamed of and didn't dare to hope to have.  And she always encourages others to choose different! “Be You!  Beyond Anything! Create Magic!  Live your ROAR™!” Dr. Lisa has empowered thousands of people in breaking free from all forms of abuse to create infinite possibilities for themselves and live a life they truly enjoy. In her work, Dr. Lisa weaves an eclectic collage of cross cultural, multi-faith, collaborative and participatory spiritual approaches leading individuals towards tangible and practical results that change and transform their world.  She is strongly moved to bridging global discrepancies of conflict and violence through tangible forms of conscious, mindful communication and discourse. She looks forward to guiding individuals to become their most authentic self, their highest light self.  Dr. Lisa invites people to remember who they really are and create their life according to that intrinsic knowing in loving and compassionate communion. The author of three books:  Radically Alive Beyond Abuse, Lies of Money, and Creating After Abuse (coming Spring 2021!), Dr. Lisa is an internationally acclaimed facilitator, speaker, and group leader. Come get Raw and Real with Maverick of Consciousness Dr Lisa! www.drlisacooney.com To get more of Raw & Real with Dr Lisa, be sure to visit her podcast page : https://www.inspiredchoicesnetwork.com/podcast/raw-real-with-dr-lisa

This is Episode 43, and we’re talking about MINDSET

From our physical appearance to our body's mechanical functions, our whole being is encoded into our genes and kept in each cell that makes us. These basic biological units have their system to keep everything functioning and our body alive and moving. They have housekeeping functions: cells perform autophagy to get rid of accumulated waste materials. Maximising the effects of these processes can help in increasing your longevity. When the autophagic processes fail, it can damage important parts of the cell such as the DNA and accelerate ageing. In this episode, Dr Elena Seranova explains the science behind autophagy and how it connects to NAD and sirtuin genes. She also shares her own experience and research on using this knowledge to live a longer, fuller life. Join us in this episode to learn more about autophagy and how this process is useful in increasing your longevity and giving you a boost in life.   Get Customised Guidance for Your Genetic Make-Up For our epigenetics health program that is all about optimising your fitness, lifestyle, nutrition and mind performance to your particular genes, go to https://www.lisatamati.com/page/epigenetics-and-health-coaching/. You can also join our free live webinar on epigenetics.   Online Coaching for Runners Go to www.runninghotcoaching.com for our online run training coaching.   Consult with Me If you would like to work with me one to one on anything from your mindset, to head injuries, to biohacking your health, to optimal performance or executive coaching, please book a consultation here: https://shop.lisatamati.com/collections/consultations.    Order My Books My latest book Relentless chronicles the inspiring journey about how my mother and I defied the odds after an aneurysm left my mum Isobel with massive brain damage at age 74. The medical professionals told me there was absolutely no hope of any quality of life again, but I used every mindset tool, years of research, and incredible tenacity to prove them wrong and bring my mother back to full health within 3 years. Get your copy here: http://relentlessbook.lisatamati.com/  For my other two best-selling books Running Hot and Running to Extremes, chronicling my ultrarunning adventures and expeditions all around the world, go to https://shop.lisatamati.com/collections/books.    Here are three reasons why you should listen to the full episode: Discover how cells stay healthy. Find out Dr Elena's tips and advice in increasing your longevity by activating autophagy. Learn more about the science behind NMN supplements and their revitalising effect.   Resources Read about Dave Asprey’s work around the keto diet. Lifespan by Dr David Sinclair Pushing the Limits Ep 170: The Search for the Perfect Protein with Dr David Minkoff Visit NMNBio if you want to learn more about NMN supplements in New Zealand.   Episode Highlights [04:33] Getting to Know Dr Elena Seranova Dr Elena Seranova is an interdisciplinary scientist.  She holds a degree in Psychology, MSc Translational Neuroscience, and a PhD focusing on autophagy and cell biology. With her expertise in her field, she co-founded a biotech startup and is now the the founder of NMN Bio in the United Kingdom.  [06:06] What Is Autophagy? Autophagy is a catabolic pathway that degrades unwanted materials within the cell. The cell needs to avoid the build-up of unnecessary materials. There are different pathways for activation like mTOR (mammalian target of rapamycin) and PI3K (Phosphoinositide 3-kinase). Impairments at various stages of autophagy lead to its failure and cell death. Once autophagy fails, apoptosis, or programmed cell death, can activate. [11:25] NAD as Fuel for Sirtuin and PARP PARP and sirtuin are different classes of enzymes that use NAD for multiple vital processes, including DNA repair (both) and gene expression (sirtuin). Sirtuin 1 is one of the pathways that can initiate autophagy. initiates the autophagic process. When DNA is damaged, PARP activates and depletes NAD stores. The decrease in NAD levels inhibits sirtuin's ability to carry out its functions, including autophagy, accelerating a cell's death. [15:34] What Is NAD? Nicotinamide adenine dinucleotide or NAD is a substrate for enzymes. It plays a vital role in different reactions within the cell. You can supplement NAD levels using boosters such as nicotinamide mononucleotide (NMN). [18:44] mTOR-Independent Pathways Activation of autophagy using Sirtuin 1 is an mTOR-independent pathway. It is essential not to activate autophagy through mTOR pathways. mTOR is responsible for cell growth and translation. [25:04] How to Activate mTOR-Independent Autophagy Autophagy is dependent on nutrient starvation. Intermittent fasting can activate it. A generally healthy lifestyle includes supplement intake, proper sleep, and healthy foods. Avoid too much sunlight because it damages the skin and DNA. It activates PARP enzymes. Take a tablespoon of extra virgin olive oil which contains oleic acid. This good fat has the same effects as resveratrol. Induce artificial stress through cryotherapy, saunas, and exercise to activate sirtuin 1.  [33:22] Why Did Dr Elena Decide to Bring NMN to the Market? She came across NAD and NMN during her doctorate studies and saw their importance. Her own experiences showed better focus and energy levels after taking NMN supplements. There are not enough reliable suppliers that offer good regulation and quality control. She wanted to provide the best for herself and her family. NMN Bio has complete transparency on suppliers and quality regulation [38:28] Can Weight Loss Occur from Taking NMN? Lisa Tamati's experience in taking NMN shows fat loss but no muscle loss. Dr Elena's mice studies show evidence that NMN can improve insulin sensitivity and lipid metabolism. [40:42] Do NMN Supplements Have Any Downsides? They found no side effects in studies with mice despite an increase in dosage. Current studies are still ongoing to determine the ideal dosage for humans. Most people take 500mg to 1g. Doubling this still shows good tolerance. Take supplements in the morning as NAD affects the circadian rhythm. [53:57] How Do Autophagy, NAD and Sirtuin Genes Fit Together? Autophagy recycles various damaged organelles. Sirtuin 1 genes activate autophagy and mitophagy. NAD functions as a substrate for sirtuin enzymes to work. NMN supplements can increase NAD levels. Listen to the episode for the full explanation of how these three work together. [58:43] Can NMN be Taken as an Infusion? This is not something that Dr Elena has studied in-depth and she is curious as well about how viable this procedure will be.  There is a low concentration of energy in intravenous injections, but it's present. Oral administration is more reliable in giving boosts and it costs cheaper. [01:00:01] Do Antioxidants Help in Increasing Your Longevity? Studies have shown that antioxidants don't suppress ageing. Lifestyle intervention and autophagy activation are proven ways to slow ageing.   7 Powerful Quotes  ‘Lysosome is another acidic organelle that contains acid hydrolases that are able to digest this cargo...and if it doesn't work, well, the cell is basically in trouble because you have all this garbage floating around, and there is nothing to remove them. So this is why autophagy is important. ‘When things are preserved across species, then that gives a scientist an indication that this is probably a very important biological function’. ‘I think that in order for your body to function properly, you really need to have a kind of a healthy routine in general’. ‘So I think that when it comes to being healthy, and activating your autophagy levels, and having a healthy lifestyle in general, you need to start with the basics first.’ ‘Another small tip that I can give is to actually avoid sunlight, which is something that people don't really consider. What happens when we're exposed to sunlight, when our skin is exposed to sunlight for prolonged periods of time, we start getting the DNA damage’. “The important part is not to just increase your age, it’s to increase your healthspan.”  ‘And if you have if your mitochondria are not healthy, and they're dying, and you're not having enough mitochondria in your cells, then you are going to be sick.’   About Dr Elena Seranova Dr Elena Seranova is a scientist, serial entrepreneur and business mentor who has founded multiple innovative biotechnological businesses. She first studied at the University of Ioannina with a major in Psychology. She started a private practice before developing an interest in neuroscience. She continued her studies and earned her Master’s Degree in Translational Neuroscience at the University of Sheffield. She now also holds a Doctorate Degree in Stem Cell Biology and Autophagy from the University of Birmingham. Her expertise in these fields has led her to become the co-founder of a biotech start-up, SkyLab Bio. She has written a number of peer-reviewed articles and multiple research articles on autophagy throughout her career. Aside from these accomplishments, she started her own business, NMN Bio. Her own experiences with the use of supplements have inspired her to expand the market to supply the public with cutting-edge anti-ageing supplements. NMN Bio reaches New Zealand, UK, and Europe.  Dr Elena found her passion for drug discovery and autophagy. She has endeavoured to share this with the public through her research and work as an entrepreneur.  To learn more about Dr Elena and her work, visit her website.    Enjoyed This Podcast? If you did, be sure to subscribe and share it with your friends! Post a review and share it! If you enjoyed tuning in, then leave us a review. You can also share this with your family and friends, especially those interested in increasing their longevity, so that they can practice the activation of autophagy in their lifestyle. Have any questions? You can contact me through email (support@lisatamati.com) or find me on Facebook, Twitter, Instagram and YouTube. For more episode updates, visit my website. You may also tune in on Apple Podcasts. To pushing the limits, Lisa   Transcript Of The Podcast Welcome to Pushing the Limits, the show that helps you reach your full potential, with your host Lisa Tamati, brought to you by lisatamati.com. Lisa Tamati: Well, hi everyone and welcome back to Pushing the Limits. This week I have Dr. Elena Seranova, who has already been a guest on the show. And today, we're talking about autophagy and NAD, and the interplay between these two. Now that might sound extremely boring, but it isn't. It's all about longevity and anti-aging. So, we're going to be talking about the science between about NAD precursors and the sirtuin genes, and how to upregulate the sirtuin genes, and all about autophagy, which is really the recycling of old and damaged parts and proteins of a cell that need to be gotten rid of. So, it's a bit like having a good garbage disposal unit happening. And there are many ways to activate autophagy, which we go into in this episode. We talk about intermittent fasting, we talk about cold and hot and hormetic stressors like exercise and yes, of course fasting. But also, mTOR independent pathways to activate autophagy, it'll all be revealed in this interview.  Now this does get a little bit technical in the first 20 minutes or so. But hang in there and listen to this a couple of times. Because if you want to slow down aging, if you want to slow down the generative decline of your body and you want to have a long and healthy lifestyle, then this stuff is really, really worth paying attention to and trying to understand.  We talk about NMN, which is nicotinamide mononucleotide, which is a supplement that is now available, is a longevity compound to upregulate the sirtuin genes. And we're really lucky to check that out. You can go and find that supplement, which has been made and produced by Dr. Elena Seranova and her company, NMN Bio. So if you head hop over to nmnbio.nz, we're now importing this into the country. So, this is one way that you can really fight aging and degenerative decline that we all fear and don't want.  And when you listen to this episode and really listen to it a couple of times, you'll understand some of the incredible anti-aging things that are coming down. This is not pseudoscience. Dr. Elena is one of the most amazing neuroscientists out there. So please listen to this episode, enjoy it, get a lot out of it and get the takeaway. So, if you don't understand some of the terminology, don't worry, keep going. And by the end, you'll start to pick up certain bits and pieces. And if you listen to it again, you'll be able to pick up a little bit more and a little bit more. And at the end of the day, it's about the takeaways, what can you do to slow aging down and all that information is in there. So, I hope you enjoy this episode with Dr. Elena.  Before we go over to that we are all about health optimisation, high performance, athletic performance. So, if you need any help with any of those areas of your life, please reach out to us, Support at lisatamati.com. Go and check out our website, lisatamati.com. You'll find all our programs, our Epigenetics Programs, our online run training system that's customised and personalised totally to you, and check out what we do. We love helping you be the best version of yourself that you can be. Now over to the show with Dr. Elena Servanova.  Lisa: Well, hi everyone. Lisa Tamati here and very excited to have you hopefully join us this morning. It's 7:30am in the morning here in New Zealand. And where Dr. Elena Seranova is, it's very late at night. How are you doing, Dr. Elena?   Dr Elena Seranova: Good, good. How are you? Happy to be here again. Lisa: Yeah, very excited for today's topic. So, we're going to be doing a discussion around autophagy and NAD boosters and sirtuin genes. So it’s going to be a really interesting discussion that is really beneficial for you if you want to know how to live longer, live healthier, and optimise your body and your mind and your potential. So, Dr. Elena, can you just tell us briefly a little bit about yourself?  Dr Elena: Sure. So, I started my journey as a psychologist. So I'm an interdisciplinary scientist. I majored in psychology at first and then I had my own private practise for five years which turned out to be a successful wellness centre. And I really got fascinated by neuroscience and the brain. And for this reason, at first I started studying the brain myself and then I found an amazing master's degree at the University of Sheffield in Translational Neuroscience, which basically combined the research and neurodegeneration with applications that could translate into therapeutics. So, this is what translational neuroscience means, is basically the combination and the outcome of the research—the hardcore biology research that can be utilised for therapeutic approaches and patients.  I really enjoyed that. So that was quite cool, being in the lab and doing molecular biology experiments and so on. So, I kind of fell in love with the lab, and I decided to do a PhD as well. I continued my studies in autophagy and stem cell biology and it was quite challenging, but at the same time, I really enjoyed it. And I can definitely say that science is a big part of my life. Lisa: Definitely your thing. Okay, so autophagy and stem cells. So in relation to neurodegenerative diseases in that case? Okay, but what is autophagy? Because a lot of people will be listening to it and go, ‘What the heck is that big word, autophagy’? It's sort of big word in biohacking circles, but perhaps not in the general public. Can you explain what autophagy is exactly?  Dr Elena: Yes, sure. So, autophagy is a catabolic pathway that degrades dysfunctional organelles in the cell or protein pro aggregates. So, any material that is basically unwanted in the cell, autophagy can degrade. It's like the stomach of the cell.  Lisa: So, it’s like eating it? It's eating, sort of...  Dr Elena: Yeah, exactly. And what happens when autophagy is activated, we actually have the formation of the so-called phagophore, which is a membrane structure that basically engulfs different organelles and materials that need to be degraded to form the so called autophagosome, which is a round organelle that basically has this cargo that needs to be digested. That eventually fuses with lysosome.  And lysosome is another acidic organelle that contains acidic hydrolases that are able to digest this cargo. And this process is very essential for the cell, it’s very vital. It's evolutionary conserved in all species, from yeast to models. And if it doesn't work well, the cell is basically in trouble because you have all this garbage... Lisa: Floating around.  Dr Elena: ...floating around and there is nothing to remove them. So, this is why autophagy is important. And we have different pathways that autophagy can be activated through as well. So, one of those pathways is mTOR, mechanistic target of rapamycin. And then we have other pathways that can activate this process such as AMPK, GSK3, and so on.  Lisa: So is this like, sorry to interrupt, but like because I know that people out there might be like, ‘Wow, that's a lot of big words and a lot of information’. So, is it like that the cell has to do a housecleaning, and it's got stuff inside the cell that is not working optimally, and needs to be gotten rid of, or is it the whole cell? So, it's not apoptosis. So it's not where the host is disintegrating? Dr Elena: No. Yeah, it's actually a—it's a pre-apoptotic pathway. So, before apoptosis is activated, we have autophagy. And if autophagy fails in what it needs to do, then we have activation of some apoptotic pathways. So, it's one step before that. And if everything goes well, and autophagy is functional—and by the way, in different diseases, we might be having different autophagy impairments at different stages of autophagy. So, it's either the initial phagophore formation, for instance, that it's not working well, and it can’t engulf the cargo, or it's insulator stages of autophagy, such as the acidic hydrolysis and the lysosomes that are actually not that acidic. So their pH is not acidic enough to digest the cargo. So, we might be having different defects in the autophagy pathway in different diseases. Lisa: That leads to apoptosis. Am I right?  Dr Elena: And yeah, if autophagy is not doing its work correctly, then eventually we will have apoptosis. And actually, this is what we're seeing in in vitro models of neurodegenerative diseases as well. So, for instance, if autophagy is not working well.  And we have, let's say, dysfunctional organelles, such as mitochondria—dysfunctional mitochondria that are not working well. Let's say they are depolarised. And there is an excess production of reactive oxygen species going on. Now, if nothing can degrade these dysfunctional mitochondria, you'll keep on having this accumulation of reactive oxygen species, which eventually will lead to DNA damage and deactivation of PARPs. And it's basically a death spiral that will keep on leading the cell towards death.  Lisa: Okay, so what is a PARP? You mentioned PARP there. And just for the listeners, too. So, apoptosis is basically cell death, programmed cell death. So, this is not—what's the other one necrotic or something?  Dr Elena: Necrosis?  Lisa: Yeah, necrosis, where the cell dies for—necrosis. But this is sort of a natural programmed cell death. But we only want that if we're actually renewing the cells and we are wanting new stuff. So, before that, the body tries to do this autophagy process, is that how it works? And then what so what is PARP? What is PARP, because that’s the word again... Dr Elena: PARPs are a class of enzymes, and in order for them to function, they need a molecule called NAD, so nicotinamide adenine dinucleotide. And they're actually competing for NAD in the cell. And whenever we have increased DNA damage, we would have the PARP activation as well. And this would lead to NAD depletion, which kind of brings me to my next point about what other enzymes consume NAD. And one of those enzymes are sirtuins, which are the so-called longevity genes that are basically responsible for multiple processes in the cell, including epigenetic regulation of gene expression.  So, they do—because sirtuins are a class of enzymes that are also dependent on NAD, and they're all the deacetylase enzymes, meaning that they remove acetyl groups from the DNA. And as a result, they control which genes will be expressed in which tissues, which is very crucial for the cellular identity and for the proper function of different cells.  So, sirtuins in a healthy cell, so sirtuin should be upregulated and they should be having this housekeeping gene—housekeeping function where they basically control what's going on with the DNA repair and also with the gene expression as well. And if we do have—when we do start having impaired autophagy, and let's say there is increased reactive oxygen species, because there are increased dysfunctional mitochondria in the cell, you will have in more activation of PARPs, and all of the NAD will start being drained from... And sirtuin will not have enough energy to function. So, those are actually quite an elegant interplay between autophagy and NAD and sirtuins.  Lisa: Okay. Okay, can I just want to like put that back to you, so that we can slow down because we are going technical quite fast. And I think a lot of people might be like, ‘What the heck are they talking about’? So, the sirtuin genes, basically longevity genes, and then one of the jobs is DNA repair. And another of the jobs is to say which genes are actually being activated right now. And these sirtuin genes are also responsible, I think, for cell replication, is that correct? Dr Elena: The sirtuins are responsible for multiple functions, directly or indirectly. So, for instance, the sirtuin 3 gene is also responsible for mitochondrial biogenesis. And it's implicated in the amount of mitochondria that are being produced by the cell, which is related to cell replication eventually, because you do need to have enough ATP levels to replicate. Lisa: Right. Yeah. So, this has definitely to do with ATP production as well and mitochondrial health. So, these are doing all of these jobs, the sirtuin genes, they're very, very crucial genes in our genome. And these are preserved across every species, I believe? Every species on the planet?  Dr Elena: Yeah. Also from yeast to humans, it's also—sirtuin genes are preserved very well. Lisa: And when things are preserved across species, then that gives a scientist an indication that this is probably a very important biological function and we need to have a look at this one because it's—from what I understand.  Okay, so when you have activated PARP because you're not doing autophagy well and there's things going wrong, it's taking the NAD. So NAD is basically like a fuel source that both the sirtuin genes. And when PARP is activated, it's using to fuel its job. And so, this is competition for competing fuel sources. So, like if you imagine, you've only got one tank of fuel for your car, but you've got to go in two different directions and do two different jobs. You go, ‘How am I going to divide up my energy’? So, then it becomes important as to how much NAD we have in the body? So, what is NAD again? That says nicotinamide adenine dinucleotide? But what is that and how does it work?  Dr Elena: Yeah, it does serve as a substrate for all of these enzymes, including sirtuins and PARPS and is basically a master regulator of metabolism. So, it's a very important molecule and it serves as—without NAD, the cell is not able to function properly just because this crucial molecule is implicated in so many different reactions. So, NAD is found in all living cells and organisms. This is also evolutionary conserved across species. And it exists in two forms, NADH and NAD+, which is the reduced and the oxidised form, respectively. And both of them are important. And both of them are implicated in multiple cellular reactions.  Lisa: Is it going backwards and forwards in a cycle, NADH, NAD+, by donating electrons back and forth, sort of thing?  Dr Elena: Yeah. Through electron transport chain in the mitochondria, yeah. So, this is why it's so important. And so, what we're seeing now in the latest advancements in longevity research is that we actually can supplement with different precursors of NAD, such as nicotinamide mononucleotide, for instance, NMN. And this is the supplement that my company...  Lisa: See, you've now got that available on the market because this is such a crucial thing. Dr Elena: Exactly. And I think that it's really interesting to also say that when it comes to the interaction between autophagy and sirtuins, there is also another regulation of autophagy there. So sirtuin 1 is actually responsible for activating some transcription factors such as TFEB and FoxO3 that have to do with initiation of the autophagy process.  So, for this reason, when we do have dropping levels of NAD, decreasing levels of NAD, and there is not enough NAD for sirtuins to do their job. And let's say again—let's talk about that previous example in neurodegeneration when you have increased reactive oxygen species, and you have increased the level of stress and oxidative stress and decreased activity of sirtuins.  And not only the situation is already bad, but because sirtuin 1 doesn't have enough energy to function and to activate the TFEB and the FoxO3 transcription factors to initiate autophagy, now you have all of this dysfunctional mitochondria floating around and autophagy starts being impaired as well because we activated enough. So, it's a negative feedback loop which actually accelerates the scenario where the cell is going towards cell death, basically. Lisa: So that means like, if you don't have enough NAD, then your sirtuin 1 gene is not going to be able to initiate autophagy and clean up the cell and you're going to have dysfunctional mitochondria. Is that independent of the mTOR pathway? Or is that—am I getting confused?  Dr Elena: So, okay. So, good question. So, what happens is there are some molecules that activates sirtuins. So, for instance, sirtuin 1 is activated by resveratrol, and this is something that has been demonstrated many years ago. So, when you have sirtuin 1 dependent activation of autophagy, you will be having it through an mTOR independent pathway. Lisa: So it's a fasting mimetic resveratrol.  Dr Elena: Yeah, yeah. Yeah, absolutely. So, because we now know that the mTOR activity is not affected by intake of resveratrol. And this is quite crucial because actually, even if we want to activate autophagy, we shouldn’t do it through the mTOR pathway, this is not the preferred way, because mTOR is also responsible for growth and translation in the cell. So, this is not—it's also quite a key player in the cell. So it's a serine threonine kinase, and you actually don't want it to be activated at all times because this may lead other conditions. So, what we're focusing on at the moment is to find molecules that can activate autophagy in an mTOR independent manner. Lisa: Okay, so. So if the mTOR—cause MTOR is usually what's for growth it’s anabolic, it's causing growth. So for example, a bodybuilder goes to the gym, they're in an anabolic state, they are in an mTOR growth state. And when you have autophagy, that's sort of the opposite. So, it's a catabolic state where it's starting to eat itself. So, it’s mTOR, most people like do fasting for that reason to activate autophagy? Dr Elena: Yeah, this is another good point there. So, when we're fasting, and there is actually conflicting evidence out there as to when autophagy is fully activated. Usually, people say that around 24 hours, you start having the autophagy activation. There are others that swear by the ketogenic diet, and say that if you don't consume any carbs, you will get autophagy activation anyway. However, from what other researchers have found is that, if you are in a ketogenic diet, and you do consume meat, it depends on what kind of meat you consume that will either activate autophagy or not. And it all has to do with levels of different amino acids in the cell because autophagy is quite sensitive to nutrients and to nutrient starvation to be activated. If you have an abundance of amino acids, again, it will not be activated.  So, for instance, one amino acid that activates autophagy very well is leucine. And if you're eating certain meat that are rich in leucine, this is probably not good for your autophagic state. Something else to keep in mind, and I've heard, I think it was Dave Asprey saying that if you can manage to be on under 15 grams of protein per day, you will probably keep the autophagy going.  Lisa: Because a lot of people on keto think I can eat a lot of protein, which is a mistake, really. It isn't about having—that's interesting, because I had Dr. David Minkoff on my podcast, Pushing the Limits a while ago, and he has a product called PerfectAmino, which is really a 99% usable form of amino acids and combination. And I was interested, ‘Well hang on, if I'm heading there, which is going a lot of good things in the body. But is that going to inhibit my mTOR, or autophagy’? Sorry, because I've got too much leucine in there? Dr Elena: This is a very good point for all of this process food as well. So, for instance, there are some ready meals you can get or some protein bars that claim to have all the low carb and everything. And then they slam a badge on their pack saying that it's vegan as well. But then, why is it vegan if it has all the amino acids because that's one of the selling points when you're actually on a vegan diet, or you have some days where you are on a vegan diet. You want to get yourself in a state of partial amino acid depletion to get this beneficial effect of enhanced autophagy. And on intercellular toxins and so on.  Lisa: Right, so for certain periods of time, you want to do this, and it's a cycling thing, you don't want to be completely deficient of aminos for too long because then your body will start to break down. Dr Elena: This is what I do personally as well. So, during the week, so I am a fan of cattle/carnivore diet. So, this diet is quite comfortable for me and I enjoyed it quite a lot. But then during my week I try to have some days where I'm either vegetarian or vegan, just because I want to have those benefits.  Lisa: Yeah. Up and down. And then this seems to be a theme in biology all the time is that it's not one thing. It's not staying on keto for ever and ever, amen. It's about doing cyclic keto or cyclic vegan and it’s cyclic. And our body loves this push and pull—when there’s recovery and there’s growth and then clean up phase, growth clean up. So autophagy can be activated through fasting. It can also be active through having resveratrol and upregulating the sirtuin 1 gene, how else can we activate autophagy? Dr Elena: So there are different ways, there are different things you can really implement in order to activate autophagy. And I think that it all has to do with how you build your lifestyle in general. So, I think that in order for your body to function properly, you really need to have a kind of a healthy routine in general. And an analogy that I can give you there is that there are people that would buy a couple of supplements, and then they would be so proud of it. And then they would say, ‘Oh, yeah, but I'm taking those supplements now, and I'm so healthy’. And then their biorhythms are all off. They sleep at 5am every day. And they're eating crappy foods or super processed foods.  Lisa: Yeah, it’s not going to work.  Dr Elena: It’s all good. So, I think that when it comes to being healthy and activating your autophagy levels and having a healthy lifestyle in general, you need to start with the basics first.  So, the intermittent fasting is definitely the first step to take in order to become a bit healthier. And from the research that I'm reading, and from the things that I'm implementing, I definitely believe that both anecdotal and scientific evidence point towards the fact that intermittent fasting is actually the way to go. I mean, there are conflicting opinions out there and there are pros and cons in every diet, and so on. And I get that. But I personally believe that with intermittent fasting, if you try to narrow down the window where you're uptaking food, this is very, very good for you. So, this is step number one.  But then again, so either you're trying to raise your NAD levels, or you're trying to activate your autophagy, because those pathways are quite intertwined. And what you eventually want to do is you want to have increased levels of sirtuin, and sirtuin 1 in particular, and sirtuin 3, of course, and so on. And for this reason, in order to preserve this pool of NAD that is available for the sirtuin 1 to activate itself and activate the autophagy pathway.  Another small tip that I can give is to actually avoid sunlight, which is something that people don't really consider. But what happens when we're exposed to sunlight, when our skin is exposed to sunlight for prolonged periods of time, we start getting the DNA damage. And when you get the DNA damage, you have PARP activation, and then again, you NAD pool... Lisa: Wow. I never connected those dots. That's really interesting. So, because—I mean, we need sun. We need sun for vitamin D and for our mood and all that sort of stuff. So, you're not saying don't have any sun.  Dr Elena: Yeah, sure.  Lisa: But because the sun is causing DNA damage, it's going to cause more PARP activation, it’s going to have the sirtuin genes going to repair the DNA, that's going to use up the body's resources is what you're saying.  Okay, wow, that makes sense. Makes sense. And then by the same token, like things like smoking that breaks DNA, like no tomorrow. This is why smoking ages you is because of all the DNA breaks. And this is why, when you're in the sun for hours every day, you get wrinkly skin and you get collagen lost and all the rest of the things that are happening. So, anything that's going to be causing DNA breaks is going to cause you to age quicker.  Dr Elena: Exactly.  Lisa: Using up the resources basically. Wow, okay. Dr Elena: So it's obviously—you don't have to become a vampire and dissipate walk in the sun when you want to go somewhere. But sunbathing for hours is definitely not something you want to do with—to get your body go through, basically. So that's another tip.  And then something else, really, really simple that can be implemented on a daily basis in order to maintain your sirtuin levels, and as a result, your autophagy levels, and your NAD levels is also to take a tablespoon of extra virgin olive oil, which contains oleic acid. And it basically does the same job as resveratrol. And it's interesting—I think that there's been a recent research article out that shows that like oleic acid might even be more efficient than resveratrol, in terms of activating sirtuin 1, which I think it's really, really cool.  Lisa: So yeah. Well, combine the two. I do. Dr Elena: Yeah, absolutely. You can do that. And then, you need to make sure that the extra virgin olive oil is actually of a very good quality because there is a bunch of...  Lisa: There is a bunch of rubbish out there. So, make sure it's from an orchard that you know, it's cold pressed, it's all those extra virgin, it's all that sort of good stuff. And not—how do they do it with solvents and stuff? Or that it's come from multiple orchards and being cut with other oils. It's a really, really important point. And then oleic acid does so much good things in the body. But isn’t that fat, Elena? Like lots of people are like, in their minds are going, ‘But oil is fat. It’s the same with MCT oil. Isn’t that going to make you fat when you eat fat’? Just going to put that around.  Dr Elena: There are good fats and there are bad fats. So, olive oil is good fat. MCT oil is a good fat. Avocado is a good fat. So, not all thoughts are made equal. So, this is definitely something important to keep in mind, especially with a good quality extra virgin olive oil.  Lisa: Because each one of our cells is a membrane that has a phospholipid, isn't it? So we need that,  actually, this building of ourselves into the integrity. Dr Elena: We have a phospholipid layer in the brain as well. And this is why we actually supplement with omega 3 fatty acids, because this is what it does. So, this is what omega 3 fatty acids do. They go into the phospholipid membrane, and then they basically... Lisa: Make the integrity of that membrane better. Dr Elena: Yeah, they contribute to the healthy phospholipid layer in the brain.  Lisa: So that's why it's very important for neurodegeneration to have omega 3s going in and again, people get quality omega 3s. Not your cheap supermarket ones that are perhaps oxidised and have been sitting on the shelves for six months. So really important to get a reputable source here. And omega 3 is of course in fishes as well, and krill, and so on.  Okay, so but is there a downside to fat? Because I studied epigenetics and a lot of people's profiles come back with don't have too many fats. And it's been one of those things in my head is like ‘Why would some people not come back with you shouldn't have too much fat’? I mean, there are things like gall bladders been removed. That's a pretty specific thing. But is there a genetic component? And probably not your wheelhouse, really, but is there a genetic component to your ability to process fat? Dr Elena: There is a genetic component, and I've actually seen this with a family that has a history of very problematic digestion of fat, and so on. Absolutely. But yeah, again, not all fats are made the same. And when you cut off the bad fats from your life, things change and everything changes really. Lisa: Yeah, it really is very satiating, too to have a little bit of fat and that can really help with cravings and blood sugar spikes—we're getting off topic.  So you have a company, NMN Bio, which produces nicotinamide mononucleotide supplement. And you've got a whole range of other stuff coming as well. Why did you decide like, you need to get this out there on the market? Based on your research and your knowledge around this area, why is it important that people take NMN if they're serious about slowing aging? Dr Elena: So first of all, I came across the biology of NAD and NMN during my PhD studies and my research kind of led me into this field because I was studying autophagy neurodegeneration. And actually, I still cannot disclose my research.  Lisa: Yeah, it’s not published yet.  Dr Elena: My research paper from my PhD is not published yet, but hopefully soon, so we're about to submit it quite soon actually. So for this reason, I started studying the biology of NAD and I actually saw how important and how crucial NAD is to the cell and what happens when we have a lack of NAD and depletion of NAD pools in the cell. And I've been supplementing with different kinds of vitamins and supplements my whole life really. So, I was watching closely this space for a while, and I was taking different supplements myself for a while.  And so, when I came across NMN and I realised that actually there is this strategy where we can supplement with a precursor in order to increase our energy levels, I found it really, really interesting. And I thought to give it a go myself and try it out and see the results. And then what shocked me was that the immediate effect of the supplement—so within a few days, you can already feel a difference in your energy levels and your focus. And this comes from the fact that sirtuins are responsible for so many molecular processes in the cell. And this is why you have this effect, including the mitochondrial biogenesis, which gives you basically increased ATP, consequently.  Lisa: You get actually more mitochondria. So, like, if you got heart disease...  Dr Elena: The production of more mitochondria, and then they produce more ATP as a result. And then you have this magic energy, yeah. This is why I thought to bring this product into the market. And the other reason was that there was not enough reliable suppliers on the market, which is crazy, because it's actually quite a popular supplement. It's been on the rise, the interest was rising for the past couple of years, but what we're seeing is there is a lot of white labelling companies that don't offer any certificates of analysis and so on. And also, you have even big companies not offering proper certificates of analysis, which was me like, it was…  Yeah, I don't understand. You have a big company, and you have just the purity report from like, 18 months ago, and you don't have any other analysis, such as heavy metals, or pH or microorganisms. So, the consumer is actually not confident in buying from you. And I wanted to deliver the best quality for myself and my family. And then I said, ‘Wait a minute. This is not done, right’. And this is why I launched the company because I wanted a company that was completely transparent. And I even say it on the website, that if you're interested in finding out who our suppliers are, and so on, and have any questions about our supply chain, just feel free to reach out to me. And I would be happy to disclose all of those things. There are other companies that you can't find any registration number, or who the founder is, and so on. And it's quite confusing, really, because like you— you don't know who you deal with.  Lisa: This is the same with the whole supplement industry. On the one hand, it's good that it's not regulated by the FDA, and whoever else, there are authorities around the world. Because like, then—they are turned into the pharmaceutical industry, which don't get me started. But on the other hand, there's not enough regulation around the quality control.  And one of the things when I was searching for NMNs, searching the world for it, I had to go overseas and import it to friends in America and get it out of there. And this is why I like—was super excited to discover your work. And then, we've since now made it available down here. So, we're going to branch down here in New Zealand for New Zealand, Australia. And I wanted someone who I could trust, who has all the scientific knowledge behind it, there's all lab tests, etc. And that was really important for me for quality.  Just on a side note. So I've been taking NMN now for—I think—so five, close to six months. I've had a massive weight loss and so as my mum. Why would that be? Like, I didn't take it for weight loss. I wasn't overweight, per se. But I had a couple of kilos that I was quite clear to get rid of. And what I've noticed—because I'm an athlete, that's my background—I haven't lost an ounce of muscle, which has been really awesome because most people are struggling to keep muscle mass, lose fat mass. My mum has lost 11 kilos. And she is of a genetic body type that really struggles with weight loss. She's conservation metabolism, from a genetic point of view, very, very hard for her to lose weight. So, I've never seen this in the history of her entire life, since I've been around. The weights just dropped off her.  Is this some sort of upregulation in the metabolic pathways? Is it improving the insulin resistance? What's it doing there to cause such weight loss without muscle loss? Dr Elena: Well, in my study so far, there's definitely evidence that it does improve insulin sensitivity, and it also improves the lipid metabolism profile. So those two are very important. And unfortunately, we don't have those studies in humans yet. But more clinical studies are on the way, and hopefully we'll have very good results this year with the NMN besides the safety studies that we already have in humans.  So in mice, what we're seeing is that there is basically a reverse of type two diabetes, which is really impressive. And if you want to correlate this data into humans somehow, I would say that, obviously, I'm not a medical doctor, and this is not a medical advice, but I would say that it does have to do something with the metabolism, and it basically improves the way your body metabolises everything. And...  Lisa: Worth trying and there's no downside to NMN. There's no, it's a vitamin B derivative, well then you will say to me, ‘Well, can I just take B3 and be done’? and it's like, no, it doesn't work like that, which should be a lot cheaper. Dr Elena: That’s the other impressive thing about this compound is that it actually doesn't have, if any, side effects at all. So even in studies with mice, where the dosage that they use in mice is actually much higher than it is in the one that we usually have in humans. So, for instance, if someone would take 500 mg, or one gram of NMN per day in humans. And then in mice studies, they use something like 200 mg per kilogram of weight, which is much, much more, and it still doesn't have any side effects. Lisa: Does it mean that we need higher dosages? Like in the human, or has it only been tested to one gram and why has it not been tested higher, if that's the case?  Dr Elena: No, I think that there are studies underway for this as well. So eventually, we will find what is the ideal dosage for humans. I think that from anecdotal evidence, people can already see results from 500 mg or one gram and so on. There are people that take more. So, some biohackers say that they take two grams or four grams, and is still very well tolerated. But yeah, so far, it does not produce any side effects in terms of… Lisa: Any downside. Dr Elena: Basically. And, for instance, for myself, my stomach is quite sensitive. So, when I'm on an empty stomach, I can't take vitamin C or caffeine and I get nauseous and so on. And this is not the case with an NMN. So, I can take it first. It is very well tolerated on an empty stomach, very mild. I really love it. There’s so many reasons to love it.  Lisa: Yeah, yeah, yeah, I have my morning and night. So, I'm on a gram a day. And is there any reason not to take it at night? So I split the dose—reasoning, thinking, keeping the levels up?  Dr Elena: I mean, I would probably take it all in the morning, I think. There's been a study out that it can affect the circadian rhythms as well. And interestingly, it actually affects NMN—sorry—NAD levels affects the circadian rhythm. But it's not the other way around. So, NAD actually dictates the circadian rhythm in the body. So, for this reason, I would suggest to take it in the morning because then your whole body synchronise, then you wake up and you tell to your body that look, it's the morning now, and we're going to have increased NAD level. Lisa: Increase. Ohh okay. So, okay, I got that wrong. I haven't noticed that I've had worse sleep or anything like that, or any rhythm has been out. But I would definitely swap to doing—my thinking process around that was keeping the tissue saturated over a 24-hour period, as opposed to all at once and then perhaps dropping, but I don't know. What is the half-life of it? Do you know? Is there any sort of evidence around that? Dr Elena: I actually, not sure. No, no.  Lisa: There’s no evidence yet. And so yeah, there's a ton of studies still being done that are currently, like this year, like going to be coming out, which is going to be really exciting. So that we're going to get more evidence. I mean, there's this stuff that I've been reading around fertility in animal studies, and they're starting to do human studies, which I personally am very interested in, in reversing aging of the ovaries and even with... I mean, the mice study was incredible around fertility, where the mice were postmenopausal, they actually knocked off any existing eggs with chemotherapy. And then gave them NMN and the mice went on to have babies. And there was a whole study. Dr Elena: This is why I get so excited about NMN and this is why it's my first product because frankly speaking as a scientist, I've never seen results like that with a natural compound.  Lisa: No? Dr Elena: Because there is a bunch of natural compounds out there, there is a bunch of other supplements. And what we're talking about spermidine the other day...  Lisa: Yeah, yeah, it's interesting.  Dr Elena: ...another autophagy activator. Quite an interesting supplement, yes. By the way, it's also an mTOR, independent autophagy activator, which is good. Lisa: Another very good reason to take that as well. And we were looking into that aren’t we, Elena about adding that?  Dr Elena: Yeah, absolutely. We will look into this, but again, you don't see results, like the ones that you see with NMN in multiple studies from other compounds, it's really fascinating. Lisa: Wow, so yeah, so there are other products that are going to... And this is a super exciting thing, like were our grandparents or our parents even didn't get the chance, like, with aging was aging, and there was nothing that you really could do to influence how fast you aged. They weren't aware of it. And later on, it's become well, if you eat better and you exercise a little bit more and you stop smoking and, and stuff, you’ll age slower. But now we're taking exponential leaps in our knowledge. I mean, I fell into this realm when I was reading Dr David Sinclair's book, who is a very prominent scientist at Harvard Medical School, and made his book, Lifespan, which I totally recommend people reading. I was just like, ‘Oh my gosh, if I can stay healthy now’, because I'm 52, ‘if I can stay like, really, in top shape for another 10 years, by then we're going to have stuff that will help me live really long’. And that really excites me. And not just live long, but live healthier.  Dr Elena: That’s the important part. The important part is not to just increase your age, it’s to increase your health span. So, the time that you're spending being healthy. And what you're referring to is actually called the aging escape velocity, where basically we’ll have more advanced research coming in every year of our lives. And this will eventually expand our lifespan, which is amazing. And I also think that if we preserve ourselves well, we might as well see this in our lifetimes, which will be amazing.  Lisa: Absolutely. And I want another few decades, please. Listening to Dave Asprey, who by far, got... Dr Elena: I want another like, few hundreds.  Lisa: Yeah, well, I mean, I know it sounds ridiculous right now. But if you listen to Dave Asprey saying conservatively, and Dr. David Sinclair, too, like, conservatively, we could live to 150, 180, and beyond. Then once they crack the code, and they're actually able to turn the cells back to which they are working on right now. And which they can actually go in the petri dish, from what I understand like with skin cells and make them immortal. And they can't do it in humans because it's too risky, they could turn you into a tumour and stuff. But with the Yamanaka factors that were discovered a decade or so ago, they're actually able to turn the clock back to the point of you being a 20-year-old again. And this is like, ‘Wow, this is pretty exciting. Being able to regrow nerves, spinal injuries, people who have gone blind from macular degeneration’ — all of these things are coming down the line. This is very, very exciting.  Dr Elena: There are several advancements in this field. So, as I said, my PhD is also in stem cell biology. So, I was working with human embryonic stem cells in the lab, and what they can do on a dish is just mind blowing. Because what I was able to do was to take human embryonic stem cells, and then dictate their fate, basically, with different growth factors, and then differentiate them into neural precursors at first. And then to push them further in order to become terminally differentiated neurons. And like four weeks later, you basically have a human brain in a dish and it's a primary human cells. And it's an amazing, physiological irrelevant human platform as well to study disease. And this is what I was doing during my PhD.  So, I’ve seen it with my own eyes. And every time I would do, I would go through this process, I would differentiate the human embryonic stem cells into neurons. It would be as exciting as the first time because of what it represents, because it does represent the progress that we've made so far. And I personally started human embryonic stem cells for the sake of drug discovery. So, I wasn't interested—my project was not focusing on different therapeutic applications. However, I know that there are many advancements in this field as well. So, we do have clinics in America, where you can have a total body rejuvenation, stem cells, and so on. And this technology is definitely advancing.  And I've been actually thinking about the application of this for myself. So as you know, I recently had a dental injury. This is something to keep in mind for the future. So perhaps in the near future, I can just inject myself with a bit of a stem cells there...  Lisa: And that’s already happening to a degree. I mean, I've got a doctor friend up north, who's doing stem cell replacement for joints, and so on, for degenerative joints. Because stem cells, basically, for people who don't understand why this is important. The stem cell is the original like cell, but before it decides, ‘Am I going to become a skin cell, or a neuron or a liver cell’, it differentiates. So, it's a pluripotent stem cell, it can become anything. And so, in the lab setting, you're going to be able to say, ‘Well I want your cell to become a liver cell’. Will we eventually be able to grow organs that can be used for transplantation? Is that sort of one of the end goals?  Dr Elena: Absolutely. And it's already been done with some organs. So for instance, I've heard that there is a research group that basically 3D-printed a functional thyroid gland from stem cells.  Lisa: Wow. 3D-printed. So, the printer gets these differentiated cells somehow, and then makes it into a functioning organ that they will eventually—they're going to be able to actually transplant this into people and save the whole organ donation, horrific troubles that we have currently.  Dr Elena: Yeah, exactly and I think that we're not too far away from this from whole organs being recreated in the lab. We already are able to actually do a 3D culture in the lab and create the so called organoids. So for instance, from stem cells, you can do a brain organoid, where you have a liposphere and it basically consists of different kinds of cells that you see in the brain. So it would have neurons, it would have glial, it will have astrocytes, and then it would have this brain organoid and then you can study it.  So, we're already getting there. We’re close, we’re much closer than we thought we were 20 years ago. And I think that we're not far away from having different kinds of organs being grown in the lab for transplants and so on.  Lisa: Hopefully not our brains because it's the seed of who we are. Honestly reading Dr Sinclair's book, I was like, ‘Am I in a Star Trek movie or something’? because it is pretty, pretty amazing. But when you do this, you also ask that to understand the whole process and how the whole thing functions, and then you can actually really slow down neurodegeneration and optimise things.  And so the NMN that we're talking about right now is the beginning of this really exciting road, which we're going to be staying abreast of. And hopefully adding to what we have available to the consumer right now for prices that are not moon money, that it's out of anybody's reach, but actually what you can do today so that you can preserve your health. So that in 10 years’ time, when the real crazy stuff starts coming on line, you'll be able to live longer and healthier lives. And that's the whole goal of it.  So before we just wrap up, I just wanted to reiterate again, so how is autophagy—can you just put that—how is autophagy related to NAD and sirtuin genes? Can you just put that two pieces together again, just repeat that a little bit? Dr Elena: Sure. So basically, what happens is that you do need autophagy to recycle different damaged organelles in the cell when something goes wrong. So, and this is quite prominent in neurodegeneration because the reason we have—let's say, aggregate from proteins in neurons and dysfunctional mitochondria and so on is because neurons are terminally differentiated cells. This means that they don't divide anymore. So, they rely on autophagy in order to have their housekeeping function because they can't divide the junk away. Okay. So that's the reason why autophagy is important in terminally differentiated cells such as neurons.  Lisa: So there's no hay flick limit for a neuron. There is just only one—when a neuron becomes a neuron, that's a neuron. Okay. Dr Elena: Yeah, yeah. And then that's it. And what happens with the activation of autophagy, one of the signals is—comes through sirtuin 1, which basically can activate the transcription factors that are related to autophagy activation, which is the TFEB transcription factor, EB and FOXO, which are basically influenced the activation of autophagy. And more specifically, the mitophagy as well. So, mitophagy is the arm of autophagy that is responsible for the mitochondrial clearance in the cell. Lisa: Yep, so mitochondria, just for people, are the powerhouses of the cell. This is where a lot of—so all of the energy is produced, if you like. And so, this is why mitophagy, as opposed to autophagy, so mitophagy is doing the same process, but within the mitochondria to keep your mitochondria healthy. And if your mitochondria are not healthy, and they're dying, and you're not having enough mitochondria in your cells, then you are going to be sick. And that could be heart disease, it could be neurodegeneration, that could be anything. So, keeping your mitochondria healthy is the basis of all bloody disease, blatantly.  Dr Elena: Yeah, exactly. So then, if you have impaired autophagy in the cell, and then you also have some sort of DNA damage going on, such as the one from reactive oxygen species, for example. And then what you have is the activation of the PARP enzymes. And PARP enzymes heavily rely on NAD levels in the cell in order to function. And NAD is also a substrate for the sirtuin genes that are responsible for also regulating a bunch of very healthy, a bunch of processes in the healthy cell. And for this reason, if you do have increased activation of PARPS, you will eventually get this NAD drain out of the cell. And this will not be enough in order for the sirtuins to function properly. And this will also deplete your autophagy. So, both NAD levels and autophagy are important to the cell. And fortunately for us, we can actually replenish the levels of NAD by supplementing with an ad precursor such as an NMN. Lisa: Okay, and so NMN has been proven to be by most of our bio available, because there's also like nicotinamide riboside which is used in a number of supplement companies that I know have nicotinamide riboside, but not many, there are some now, but have nicotinamide mononucleotide. Nicotinamide riboside is also a great molecule, but it's two steps away from becoming NAD. As long as it’s available.  Dr Elena: Yeah, so nicotinamide riboside needs to be phosphorylated and fast converted to nicotinamide mononucleotide first. And then this will enter the cell and then this will increase the levels of NAD in the cell. And for this reason—so first, this area of research was focusing on the NR molecule, the nicotinamide riboside. But then when they started studying NMN, they actually saw that there is increased bioavailability and there is increased levels of energy that come after supplementation with NMN. Lisa: Can you take—because NAD is a molecule, you cannot just take it as a capsule, and then it's all good to go. Can you take it as an infusion because I have heard of NAD infusions. I mean, it’s not available here.  Dr Elena: Well, and I'm curious myself about this, and I haven't done it, I haven't tested it. And from what I've seen—so the concentration of NAD in those intravenous injections is quite low. And I think that the same way that we have many opportunistic companies in the supplement field, we also have many opportunistic clinics that offer this kind of treatments. So, again, this is not something that I have studied in depth, and I actually don't know how much will it help. But yeah, I mean, this is another way to boost NAD, I guess, and you can try it out.  But with oral administration of NMN, we do have evidence that it can boost the levels of NAD in the tissue and in liver tissue and muscle tissue, and so on. And also, it's much easier to do and it's obviously much cheaper because those injections cost a lot. Lisa: Yes, yeah. Just one last question in relation to antioxidants, because I mean 10 years ago or so we used to think our reactive oxygen species ,oxidative stress happens through the electron transport chain. When we're metabolising, and so on, we get all these oxidative stresses and free radicals running around. And if we take antioxidants, we're going to be counterbalancing that. Does supplementing with antioxidants, like vitamin D, like glutathione, like vitamin C, and so on, alpha lipoic acid, is that going to contribute, too, to the slowing of aging, because it's going to down regulate the PARP enzymes? Dr Elena: People were very optimistic about antioxidants, something like 20 years ago. And everyone was talking about it and so on. But actually, the big studies that have been done, have shown that by taking antioxidants, you actually do not suppress aging. And there are some biomarkers that might have changed in those studies. But most of the biomarkers that they measure stay the same. Basically, saying that antioxidant is not the... Lisa: Not the holy grail. Dr Elena: ...that everyone was thinking about.  Lisa: Was hoping, yeah. Not to say that antioxidants don't have their place because they definitely do. Especially if you have a lot of oxidative stress, and you need to, like with vitamin C, if you're infected, or—I've done a whole series on vitamin C. But then it's not the holy grail for stopping the aging process, but it probably does help with not having so much PARP activation. I don't know, as a non-scientific brain, I'm just connecting dots.  Okay, so I think it's probably we've— so from a lifestyle intervention, apart from taking NMN and resveratrol, and oleic acid or olive oil, intermittent fasting, is there anything else that we can add to our anti-aging regime on a lifestyle intervention side?  Dr Elena: Intermittent fasting, and then avoid exposure to sunlight, as we said. And sirtuin genes are being activated from any kind of stress. And what we can do is we can also induce some sort of an artificial stress, which could be done, let's say with cryotherapy. This is what cryotherapy does. When you're exposed to cold, you also have this stress signal that activates sirtuins, or the other way around, so you can try out a sauna. And this will also have the same effect. So, I think this is also something to keep in mind.  Lisa: Breathing, breathing. So, sort of tumour breathing, or, like what one half does all of that sort of stuff. So, there’s hormetic stressors, there’s exercise obviously, that cause a cascade of changes and make you stronger. And yeah, it's sort of a balancing act. You don't want to be doing exercise for Africa or really freezing yourself to death, but you just want to have a little stress to cause a change in the body. So these hormetic stressors can be very, very helpful.  Okay, well, I think we've covered a very, very, very complex topic and I hope we didn't lose everybody on the way. But at the end of the day, take NMN, take resveratrol, take olive oil, do your exercise, get in the sauna, if you have a chance to do cold therapy, do that as well. Get your exercise, get your antioxidants in there as well, to a certain degree and you're going to be able to live long enough but until other things come online, and you'll be able to improve everything.  Dr Elena: Sounds good.  Lisa: Brilliant. So Dr. Elena, thank you very much. Dr. Elena has been on the show, NMN Bio. So we have nmnbio.co.uk in UK and in Europe, and nmnbio.nz if you're down at this end of the world. We'd love to help you over the air. If you've got any other questions, please reach out to us. And thanks very much for being here today. It's been really exciting. Dr Elena: Thank you, Lisa, thank you so much for having me. That's it this week for Pushing the Limits. Be sure to

Many popular diets and exercise crazes assume that they're going to work on everyone who tries them. However, every human being is unique. Health isn't one-size-fits-all. What works for one person may not work for you — it might even be detrimental! That's why we need to personalise our health programs to suit different body types. Dr Cam McDonald joins us in this episode to discuss the importance of understanding your biology to personalise your health program. He talks about the role of genetics and epigenetics in determining your bodies' specific tendencies towards stress and food. We also delve into the different body types and what diets and exercises are most suitable for each one. Tune into this episode if you want to learn more about personalising your health program based on your genetic make-up.   Get Customised Guidance for Your Genetic Make-Up For our epigenetics health program all about optimising your fitness, lifestyle, nutrition and mind performance to your particular genes, go to  https://www.lisatamati.com/page/epigenetics-and-health-coaching/. You can also join our free live webinar on epigenetics.   Online Coaching for Runners Go to www.runninghotcoaching.com for our online run training coaching.   Consult with Me If you would like to work with me one-to-one on anything from your mindset, to head injuries, to biohacking your health, to optimal performance or executive coaching, please book a consultation here: https://shop.lisatamati.com/collections/consultations.   Order My Books My latest book Relentless chronicles my mum Isobel’s inspiring journey of defying the odds after an aneurysm left her with massive brain damage at age 74. The medical professionals told me there was absolutely no hope of any quality of life again, but I used every mindset tool, years of research and incredible tenacity to prove them wrong and bring my mother back to full health within 3 years. Get your copy here: http://relentlessbook.lisatamati.com/ For my other two best-selling books Running Hot and Running to Extremes chronicling my ultrarunning adventures and expeditions all around the world, go to https://shop.lisatamati.com/collections/books.   My Jewellery Collection For my gorgeous and inspiring sports jewellery collection ‘Fierce’, go to https://shop.lisatamati.com/collections/lisa-tamati-bespoke-jewellery-collection.   Here are three reasons why you should listen to the full episode: Learn why personalisation is important in creating a health program for different body types. Discover the role of genetics and epigenetics in determining your body’s specific tendencies. Find out what kinds of food and activities are most suitable for different body types.   Resources Take the ph360 HealthType Test to discover your body type and get your Personalised Health Plan! Check out ph360’s website to learn more about their services on personalising your health program. Connect with Dr Cam: Website | Instagram | Linkedin | Email | Phone: 0411380566   Episode Highlights [01:31] Why Personalisation Is Key Every individual is different, but we keep applying the same health approaches to everyone.  Misalignment between the body and its environment causes diseases. Personalising your health helps you align yourself with your environment.  [06:45] The Science of Chronobiology Chronobiology is how our biology interacts with time.  Examples of chronobiological processes are our circadian rhythm, menstrual cycle, and ageing. Our bodies have a rhythm that follows along with sunlight.  When people are active at night, it disrupts their system. This disruption creates hormonal irregularities, leading to diseases.  Listen to the full episode to learn more about chronobiological processes and how they affect our health. [18:24] The Genetic and Epigenetic Component of Circadian Rhythms People have different chronotypes which are based on when their bodies can tolerate stress. Some people are ‘Activators’. Their bodies respond best to adrenal systems. In turn, they have energy that matches their strength throughout the day.  ‘Diplomats’ have bodies that respond better to their digestive and nervous systems. These people are more at risk for fluid retention, tiredness, and weight gain. Muscle and fat production relies on the hormones stimulated by food and exercise.  [27:50] About Food Timing ‘Crusaders’ have bodies that are neurally-driven and are not prone to obesity. Because Crusaders are more likely to lose muscle, they are recommended to eat several small meals per day. ‘Guardians’ have thick joints and big muscles. However, they also have the greatest capacity to store fat. Guardians are recommended to have two meals per day (breakfast and lunch) and a very light, if not non-existent, dinner. [38:41] Intermittent Fasting for Crusaders and Guardians Because Crusaders are always on the edge of their fuel supply, intermittent fasting will impact their stress levels more.  Crusaders should only do one day of intermittent fasting per week. Guardians, however, can go for extended periods of fasting because their rhythms are slower.  Being in a peaceful environment helps manage stress levels and makes intermittent fasting more tolerable. Intermittent fasting and autophagy do not necessarily work for all.  [45:08] More About the Guardian Body Type Because Guardians have strong and resilient bodies, they’re more likely to survive if there were a lack of food supply.  A Guardian’s body is that way because in nature, they protect their community. ‘Sensors’, another ectomorph body type like the Crusaders, prefer nutrient-dense foods like vegetables. Guardians, however, like high-calorie foods more because they provide a feeling of safety. [54:48] Dominant Hormones for Different Body Types The dominant hormone for Guardians is prolactin—a ‘caring’ hormone. Diplomats search for a balance in serotonin—a hormone that you get as a reward for pleasurable things. This makes them assess an activity carefully if it’s going to be rewarding.  Activators search for adrenaline, so they always want excitement and action. Crusaders' dominant hormone is dopamine, which creates drive and focus. Listen to the full episode to learn more about the different body types (like ‘Connectors’ and ‘Sensors’) and their dominant hormones.   7 Powerful Quotes from This Episode ‘We know that everyone's different, but then when we go to actually doing the thing, we apply the average, or we apply what we think is appropriate thinking that everybody else is the same. So we have this disconnect between knowledge and action.’ ‘The mind is also on a clock of its own. Essentially, if you're exercising at the wrong time, you set up the wrong kinds of hormones, then you can actually create complete stasis in your health.’ ‘There’s a full continuum of where people are. This is based on not just their wants to wake up. . . it’s actually as to when a body can tolerate stress, and how that stress should be placed on them.’ ‘Whether you put muscle or fat tissue on, it's actually not to do with your food or your exercise, it's got to do with the hormones that those foods and exercise stimulate.’ ‘It's not a one size fits all when you hear everybody talking about intermittent fasting or doing these things—autophagy, inhibiting mTOR, and all those sorts of things.’ 'The reason that their (Guardians') body is built the way it is is [because] when we go through famine as a community, their body goes into conservation. They essentially start growing, or they start slowing down their metabolism so that they can provide food for everybody else.' ‘If you put your body in the right environment, get the right foods, eat at the right times of the day, work and do your mental stuff, you'll get health and you'll get optimal performance and you'll get longevity.’   About Dr Cam McDonald Dr Cam McDonald has spent the last decade furthering his knowledge and skills to promote health in an easy and obvious way for people in all areas of life. He’s a dietitian and exercise physiologist, with a long-standing personal passion for health, genetics and environmental influences. His goal is to support all people to live up to their full physical potential. Dr Cam has a firm focus on people becoming more aware of themselves, their natural strengths and their optimal behaviours for their best health. He is an informed speaker who has a passion for health and the inspiration to do something about it. Want to know more about Dr Cam’s work? Check out his website or follow him on Instagram and Linkedin. You can also reach him through email (cam.mcdonald1@gmail.com) or phone (0411380566).   Enjoyed This Podcast? If you did, be sure to subscribe and share it with your friends! Post a review and share it! If you enjoyed tuning in, then leave us a review. You can also share this with your family and friends so they can find out the right way to eat, diet, and exercise for their body type. Have any questions? You can contact me through email (support@lisatamati.com) or find me on Facebook, Twitter, Instagram and YouTube. For more episode updates, visit my website. You may also tune in on Apple Podcasts. To pushing the limits, Lisa   Full Transcript of The Episode Welcome to Pushing The Limits, the show that helps you reach your full potential with your host Lisa Tamati, brought to you by lisatamati.com. Lisa Tamati: Hi, everyone and welcome back to Pushing The Limits this week. Today I have another very special guest, also a repeat offender on the show: Dr Cam McDonald, who is the CEO of ph360 in Australia. He is a exercise physiologist, as well as a nutritionist. This guy's a bit of an overachiever, as are many of my guests, It might add. And Dr Cam has spent the last decade furthering his knowledge and skills so as to promote health in a way that makes it easy and obvious for his clients. So Dr Cams blends his background as a dietitian and exercise physiologist with his long standing personal interest in health, and his passion for understanding the latest research in genetics, and environmental influence on health. Now, Dr Cam is one of my teachers, and he is a mind full of information on the way your genes and how your genes are expressing. So today we're going to be talking about all about genes, again, personalized health, how you can tailor things to your personal situation and your personal life.  Before we go over to the show, I just want to remind you, if you want to check out our Epigenetics Program, please go to lisatamati.com, hit the Work with Us button and then you'll see all of our programs. And one of those is our epigenetics health optimisation program, which is all based on your genetics. And so you can understand and learn how to optimise your potential, your health, your performance, your diet, your exercise regime, and so much more. So check that out, especially after listening to this podcast, you're gonna want to check that out. So make sure you go to lisatamati.com, hit the Work with Us button and check out our epigenetics program. I'd also like you to check out our running program, if you are a runner out there and you haven't got a coach and you don't know where to go and you haven't got a structure. Maybe you're doing your first five K's, maybe you're just starting out, maybe doing 100 miler, I don't care, we take them all. We do customize, personalized plans, based on your needs, your lifestyle, your injuries, your goals, and make that specifically for you. We also do a full video analysis to help you improve your form. And you get a one on one consult with me. And then ongoing support with the team. So please check that out. Check out the package, runninghotcoaching.com. runninghotcoaching.com is the place to go to, there. And check out our running program. Right now over to the show with Dr Cam McDonald for a very exciting interview. Lisa Tamati: Well, hi everyone and welcome back to Pushing The Limits. I'm super excited to have you here with me again. Today, I have another superstar, Dr Cam McDonald, all the way from Australia. And he is one of our mentors and teachers here. He is the CEO of ph360.me. So people are listening out there, you've probably heard one or two episodes where we've talked about genetics and epigenetics and how to understand your genes. Well, that's what we're going to be talking about today. And Dr Cam is an absolute expert on this. So welcome to the show, Dr Cam.  Dr Cam McDonald: Thanks, Lisa. Lisa: Great to have you again. Dr Cam: It's great to be here. It's been a long time between chats, but there's been an awful lot of interaction between. It's always been great. Lisa: Yes, so you're our repeat offender on the show. But I think it was a good couple of years ago now. So I mean, meanwhile, we've dived deep into the world of epigenetics with you and learned from you and learned a ton of stuff. Way overdue that we had this conversation and started to share a little bit of your knowledge and the amazing things that we can now do with genetics and understanding how we run.  So everything in regards to epigenetics and genetics is all about personalising everything to your specific set of genes. And this has really been a game-changer for us personally and professionally, for our athletes, for people that we're working with, in the corporate setting and everything because everything should be personalised now, shouldn't it? Should we start there? I think that's a good place. Why is personalisation key? Dr Cam: Yes, I mean there's a number of reasons why we definitely should be personalising. But the first is that we actually have the knowledge now, that's one thing. We have an understanding of how we can actually do this. I guess for our long history, and I guess for the history of the people that are alive, the people listening to this right now, we always know innately, ‘I'm different to that person’.  But then, when we go to recommendations. And when we go to how we go about our life, whether it be the job that we're sitting in, it's like, ‘You have to do this job in this way’ or ‘You can't do that great. We'll get someone else to do this job this way’. Like you must do this job this way. You must, ‘Oh, you're going to get fit? Great? You go to this gym, and you do this boot camp. Everyone goes to this boot camp because that's what is going to be great for everyone because the latest science says this’.  And when it comes to food, it's like ‘You should definitely do this because this is what the average of everyone should do’. And so we know that everyone's different. But then when we go to actually doing the thing, we apply the average or we apply what we think is appropriate thinking that everybody else is the same. So we have this disconnect between knowledge and action.  And so why we need to? I guess what we know now is that the timing of your food, the timing of your exercise, the type of exercise or foods that you're consuming, the type of work that you're doing, the types of interactions that you're having, if you don't get that right, it creates disease. If you align your body with its environment, then your body goes into a healing and recovery state, and you get healthier. But if you misalign, and that can just be getting up at the wrong time, and we see this with shift workers all the time—the longer that they do shift work, the more likely they are to die prematurely.  And this is when you get a misalignment with the body and the environment. But the really incredible thing is now, it's not just that we all should avoid shift work, it's rather that some people are going to be better suited to it than others. And when it comes to every other domain of life, there's going to be something that is great for one person. Like a big Gatorade is going to be the best thing ever for a runner during their race for it’s in the mean of best thing ever, and I'm not attached to Gatorade as a brand.  But let's say that you have some sort of electrolyte fluid as a drink. And that's going to be fantastic for a marathon runner 30K's in versus a person who's been sitting on the couch for the last six years and has a significant waist circumference and diabetes.  Lisa: Disaster. Dr Cam: That drink is diabolical.  And so, when we start thinking about personalisation, we start thinking about, well, ‘What's going to help this person align and perform’? Because if you misalign, it creates disease. So that's another motivation.  And then I guess, as I started, we now have the understanding of how people are different, what people need to do about it, and we've got some really wonderful results on if we apply that to these individuals, they're going to get a great result for themselves. It's now the time that we can act on this innate knowledge that we've always had but do it in a very intelligent way. Lisa: And do it in a very structured way. A great example of this is that the whole fitness industry was really run by people with a certain type of genetic combinations. And so we trained, and I belong in that group, and you belong in that particular group. We train people we like to train and how we see benefits. We see benefits from the way that we train—high-intensity workouts and getting up early and training. Well, that suits you and me, right, Dr Cam? Because we're very close on the epigenetics wheel, if you like, have similar genetic makeup. So that works for us. Whereas it doesn't work for someone on the other side, so who's more that of the endomorph type of body.  So I've used this example before, but my husband, I used to make him get up at five or six in the morning and do a CrossFit workout when he's what they call a Diplomat. And now in that terms, which means he has a different set of genetics, basically, that is not suited to getting up at that time and doing that type of workout.  Both are wrong for him. From a chronobiological perspective, he should be in bed because his testosterone, his hormones are doing their thing at that time in the morning. So that was a problem.  Number two, I had him doing a type of exercise that was wrong for his body type. His ATP doesn't replace as quickly, and his cells are doing back-to-back sets just seem to map on a stress reaction. So his cortisol would be up, and then it would be up for the rest of the day. And what have I done to my poor husband? I've made him actually put on weight and not get further and feel like crap all day. So whereas for me, that same class, that same set of exercises, that same time of the day, perfect, and I'm good to go, and I'm really rearing to go. So that just gives you a little bit of an example.  So today, let's look at chronobiology because this is all about at the timings of when to do what. So can you explain what the science of chronobiology is, Dr Cam, and how it applies in this situation? Dr Cam: Yes, absolutely. So chronobiology is how our biology interacts with time. And we know about this because we all get older—that's a chronobiological effect, is that we get older. But what's really interesting as well is that within because of the sun, and it's showing its face every day or so. It comes along at about 6 am and then leaves at about 6 pm whatever it might be. Because we've been living on this planet with this big stimulant from the sky, essentially our bodies have got adapted to things happening in a rhythm.  And so, it's just like we wake up, and then we go to bed, we wake up and then, that's a daily rhythm. We have a menstrual cycle. We have ovulation. We go through the menstrual period, and that happens on a 30-day cycle. We then have our early life. We have our middle age, and we have our later life. That's another cycle.  Even a yearly cycle as well, we have  the circannual cycle. And so, we have seasons. So winter, it gets colder, and our body does different things. And so, essentially, now that we understand that we got these different patterns of time that are occurring, our body is constantly responding to cues from the outside.  And so where this work first came about was they started looking at shift workers instead of wondering why all of these people were getting so much more cardiovascular disease, diabetes. And they found that if you're waking up at night, and you're getting lots of light, and you're getting food at night as well—all of those things, tell your body, ‘Hey, you should be awake’. And so it wakes the body up.  But you've got this momentum of a cycle that's coming from generations of being exposed to the sun and sleeping at night, and all of our physiological systems are actually setting up for us to sleep at night and rest and recover and do a whole lot of things that definitely don't require doing heavy work or digesting food as much. And so we get this disruption. We get things happening and things being signalled to the body that shouldn't be signalled at that time, which creates irregularity in the hormones that flow through our body. Our cortisol, our melatonin, our testosterone levels, our adrenal levels—all of those things get shifted out of whack when we give ourselves an artificial time input. So we want to—essentially, the first and foremost, the first thing that we gauge what time it is is what amount of light we have.  Lisa: How much light, yes. Dr Cam: Yes, and then when we get—when the sun comes up in the morning, it sets off this cascade of wakefulness. It takes us from dead asleep to awake in a very short period of time. There's a big hormonal shift that occurs to make that happen, and it maps into sunlight. And so, as we go through the day, we have this homeostatic drive of ‘The longer that I'm awake, the more I want to go to sleep’. That's a natural thing that we have. The more that you run, the more that you want to stop is another way of thinking about this one. So we have this—as the day goes on, you get more tired.  And we then also have these rhythmical changes. Essentially, it's not the homeostatic drive for tiredness, but the circadian drive of tiredness, and you'll have peaks in your day, or maybe in the afternoon, you're firing. Other people are really, really tired that they wake back up at night. Some people are really energised in the morning. We have all of these different things that are happening throughout the day as well. So to simplify all of this, our body is designed to rouse with early morning light or rears with light. We then are meant to—essentially, our body is searching for the rhythm that suits our body.  And what's really interesting, if you take light away from somebody—and I know I'm jumping all over the place, but I will bring this all together. So if you take light away from somebody. A great guy did an experiment on this way back in the day. He sat in a cave for a couple of months and with no changes in light at all, just exactly the same ambient light the whole time. And what happened was, his rhythm went to 24 and a half hours for a daily period. So what happens is, if we were to not have any sunlight input, we would run on a 24 and a half-hour cycle. And the was out of sync by a few days after a couple of months.  Lisa: After a couple of months. Dr Cam: He actually—and he thought it was only a month that passed, it was two months that passed. His time really—oh no he thought it was three months that passed. It was only a couple months because time really slowed down. And so what we know is that inside our body, we have a rhythm.  Lisa: Yes.  Dr Cam: But that gets reset every day with the sunlight. And so, and it actually keeps us on track with the hormones that have been flowing as a result of that sunlight. So sunlight is one time giver. And if we disrupt that, it creates lots of disease in that shift work. Not only does your waist circumference get bigger the more shift work you do, all of the risks—cancer, diabetes, heart disease—increases the longer you do shift work.  Lisa: Wow. Wow. Dr Cam: And what we see is if you disrupt a body for three days with bright light at night, they start looking like they get diabetes. Their insulin resistance changes.  Lisa: Instantly? Dr Cam: Within a few days, you can start disrupting these cycles of hormones, which makes your body say, ‘Well, there's something wrong with this environment. Why am I awake at a time where I shouldn't be? Well, there must be something wrong. Therefore, I'm going to start conserving. I'm going to start going into a stressed state so that I can escape and protect myself’, and diabetes is just the ultimate protection—starvation protection that makes you gain weight very easily. And so, after a few days, four days, you can actually start seeing some changes in metabolism if you're out of sync with your sleep alone, then four days to correct it. So you can actually get back on track very quickly.  Now, light isn't the only time giver, there is also heat that you have in your body. Food is also a time giver. Exercise is also a time giver. And so if you eat regularly at the same time each day, your body will start falling into a rhythm of ‘I expect food’, and this is what happens when you change your diet. Some people go from six meals a day to two. Let's say they're doing some fasting or something like that. They'll be really, really hungry at the times that they were eating when they're doing six meals a day for about a week.  Then what happens is each cell in our body has its own timekeeper as well. The master clock is coming from the sunlight, and then each tissue in our body has its own timekeeper. And so our gut takes about a week to correct itself, and then it starts getting on track with the new routine, and so then, it starts setting up for the new routine. Therefore food, it gives time to the body, it actually gives the schedule. And along with that food intake comes insulin release, hormone release, all of those types of things.  But then the really important thing we need to consider is if you don't stimulate the body at the right time to get the right hormonal outflow, you start going into disease. And so, if you're eating food at the wrong time, you're stimulating these hormones just as if you were not sleeping at the right time. If you're exercising at the wrong time. Let’s some bodies are really, really well adept at tolerating stress in the morning. If you exercise, that's a stress.  Lisa: Yep. Dr Cam: You give your body that ‘Stress is coming now’. And if you do that regularly, your body's gonna say, ‘Okay, stress is coming now’. It prepares itself, and it deals with it quite well. But then if you take a night owl, and you give them that same stress in the morning, it gives them the time of stress in the morning, but their body is not set up for stress at that time of day. And so they start trying to compensate later through weight gains, like ‘I spent all of this energy at the time that I didn't want to. I wasn't set up for it, so I'm going to have to conserve my energy because something's wrong’.  Lisa: That’s what I was doing to the husband. Dr Cam: Yes, absolutely. So what you see in a practical sense—and I'll just say one more thing as well, that the mind is also on a clock of its own. And essentially, if you're exercising at the wrong time, you set up the wrong kinds of hormones, and you can actually create complete status in your health. As in it doesn't get any better even though you're working really, really hard or can sometimes take you backwards.  And we're seeing this with some diabetes now is really high-intensity exercise in the morning, in some studies is indicating worsened blood sugar levels at the end of the day because everybody goes into survival of ‘Oh, this environment is really stressful’. So where you position things in your day… Lisa: It’s crucial. Dr Cam: ...sets a rhythm. But if that rhythm doesn't align with what your body needs in order to be in its best health, then it creates disease. And that disease, obviously, tracks down pathways of compensation and stress, and you end up with a body that has been getting up eating five meals per day, has been doing the early morning exercise, just like your husband.  Lisa: Yes. They’re getting nothing out of it. Dr Cam: And because they’re putting stress out in the morning, they're giving them too much insulin response throughout the day because their bodies just not designed to get five hits of it throughout the day. Some bodies are, some bodies are. Lisa: Yes. Dr Cam: After 12 weeks, they've gained a kilo and got a bad knee. And they're wondering, ‘What the hell is going on’? Lisa: And they've been a super disciplined person getting up. And I mean, just to give you a couple of examples of the set of my life because I like to put things into stories. Dr Cam: Yes, please. Lisa: So that people actually get the science. Six months ago I went through this terrible time with my dad, who was unfortunately dying and passed away in July. In the 16 days that we were in the hospital battling for his life, I was round the clock with him. Now my blood sugar levels went through the roof. So afterwards, I was showing like diabetic levels of blood sugars—fasting blood sugars because I was so out of whack and so stressed alongside of it. And it took me a good two to three months for me to get my body back into rhythm. So that was just 16 days of sleep deprivation, being up all night, hardly any food, in this case, was actually sharp throwing my blood sugar's up through the roof and the stress hormones that were coming out. So that's a really extreme example. And obviously, that was for a specific purpose.  And I've seen this also with ultramarathons that I've done, that I've been going for days on end. You would think that a person who was exercising 24/7, around the clock, sort of thing for not seven, but let’s say two, three days, that they would lose massive amounts of weight, and so on. And I would actually put on weight when I did ultramarathon. So I typically lose it initially, and then I would have all this weight gain. And then I would have this response. And within a month, I would be usually heavier than when I started, which was really frustrating.  Dr Cam: Yes. Lisa: So this stuff matters, and this stuff is really, really important. And I've done podcast episodes already on circadian rhythms in regards to light and why we need to block out blue light at night time because, again, that's giving us a signal to stay awake and stopping our melatonin production.  And the example there with the cortisol, right? We want cortisol. We want these stress hormones at the right times of the day. So there is also a genetic component to this. And this is where, what we do at ph360, and what we find out in the programme that we run is looking at your specific genes in relation to circadian rhythms. Can you explain a little bit? So why is it for my husband that if he gets up at 5 am and does that, that's not good for him? Whereas for my body type, that's not so bad? Dr Cam: Yes, sure. So when we're talking about this, there is a genetic component, and I guess what we're going to be talking about today and what we've kind of alluded to is that there's also an epigenetic component. And so when we talk about chronotypes, and whether someone's an early bird, a night owl, or an intermediate type, or somewhere in between because there's a full continuum of where people are. This is based on not just their wants to wake up, not just that ‘I can wake up’, I'd prefer to sleep in’, or ‘I'd prefer to wake up early’. It's not necessarily that. It's actually as to when a body can tolerate stress and how that stress should be placed on them.  And in our body, at all times, there is a system of stress and then recovery, and it's that balance that we're trying to fluctuate through with our rhythms throughout the day. That's actually what the rhythms protect is that stress-to-recovery balance. So waking and then sleeping and then eat and then rest or, move, eat, rest, all of those types of things.  So, we have individuals that as they're developing in the womb, they get a heightened sensitivity to testosterone, they have a greater development of their adrenal system and their response to adrenaline, and that's due to embryological epigenetic factors. And to make that simple is that there's different tissues that are developing in the womb, obviously, that make up our body. Depending on the genes that you have and in the environment in the womb, you will give more dominance to certain tissues. And this particular person, they called the Activator in our ph360 circle. The Activators have, they develop the tissues more dominantly that are related to the muscle, the skeleton, the testosterone, and the reproductive glands, adrenal glands, kidneys. And so as they develop throughout their life, these hormones and these tissues have more dominance than the other tissues.  And so, I'll give another example just to give a comparison in a second. So if you've got a body that's more sensitive to testosterone, it also has a slightly stronger adrenal system. And Lisa is a perfect example of that, and I'm not too far from that.  Lisa: Yes.  Dr Cam: And essentially, what this body does really well is that it responds to that adrenal system very powerfully. And first thing in the morning is when your adrenal system is the strongest. This is when you get the biggest glucocorticoid release that's your cortisol and your adrenalines. And essentially, it's to say, ‘Hey, you were dead asleep, and now you need to be awake’.  And because they've got tissues that are also ready for that, they even take that energy. And if they use their adrenal system at that time, it matches their strength. This is what they've grown to be strong in. And so it matches their strength to be really great at this. And so, when they use it, it aligns with what their body is looking for. And then they ride that energy all the way through to the end of the day. And this is because we've put the right body into the right environment at the right time.  However, a Diplomat, which is the opposite side of the circle, and what we see with embryological development is, on a circle, opposite sides, you'll see opposite effects. And so, instead of it being the adrenal system and the testosterone system that's really sensitive within the body, the other body, we actually see their digestive system and their neuro system being more developed and more sensitive.  And so what's happening in digestion in the morning is that it's, essentially, it's regulating where all the fluid is going to go in the body.  It's finishing off these really important digestive processes, clearing out the digestion, making sure that the gut is rested and ready for new meals. And it's doing that right up until 7am.  And so this body is having to focus all of its energy on its digestive system because that's the really important system for this body. And if you then stress this body, what happens is it goes, ‘Well, I was trying to put water into the right place, I was trying to get my digestion on track, and I'm running all of a sudden’? Lisa: You’re just taking what. Yes. Dr Cam: ‘Like this does not match at all. I don't need adrenaline right now. This is bad news’. And so what happens is the body then goes into compensation. It says, ‘Oh, God. Well, I'm gonna have to make up for this later. I've spent all of this fluid of sweat. I've used all of this energy’. And so this body goes, ‘Well, I didn't get time to put my fluid away, so where is it? Okay, I'm going to retain fluid now’, because, and this is exactly what happened in that body. Lisa: You’ve put on weight. Dr Cam: You have enough cortisol at the wrong time.  Lisa: Yes.  Dr Cam: They make that retaining fluid. And this is exactly what's happening—they get the adrenal burst in the morning, but if they then run with that with some morning exercise, it becomes too much for their system. They can't then do those digestive processes. Their gut goes off, which influences their serotonin production, which makes them less happy.  Lisa: Wow. Dr Cam: What's really interesting with this kind of crowd is that the things that we'll see is an individual wakes up, like I said before, we'll get up, and they'll do their exercise. And what they'll notice is they start getting this bit of weight around the middle. Lisa: Around the middle. Dr Cam: And they'll also start accumulating fluid. They'll get a halo effect from exercise of two to three hours because their stress levels actually stay a lot higher for a lot longer because they shouldn't be stressed at that time. So they get this, and stress hormones make you feel alive, and they make you feel awake. And so, for the first three hours of the day, you're going, ‘Yes, I'm an early bird. This is awesome’, and then come lunch, it crashes really, really hard. And you also become more diabetic in the afternoon, for lack of a better term, more insulin resistance. Lisa: Insulin resistance  Dr Cam: Yes. And so, this individual has been working their guts out literally, and all they've got is more fluid retention, tightness in the afternoon, weight gain around the middle, which is the thing that they're doing exercise for. Lisa: They’re stuck. Dr Cam: And if they just shift that exercise later in the day when their body is ready for movement because this body likes to conserve energy in the morning, make sure everything is sorted in their body, and then they can move in the stress and all that sort of stuff in the afternoon. And if they do that, there's no cortisol rise to the same extent. They have much lower cortisol all day, which means they don't deposit fat around their stomach.  Lisa: Because cortisol is a real effect on… Dr Cam: Huge one. And this particular body, absolutely, because it's the opposite of the Activator, the Diplomat is, they don't like their cortisol so high. They like things to be cruisy and peaceful and steady as opposed to high-intensity and… Exactly. And so, whenever you put this body into this thing at the wrong time, you end up with this adverse effect. And you start questioning yourself, it's like, ‘What the hell could I be doing better? I'm waking up, I'm getting my food in…’ Lisa: ‘I’m useless’. Dr Cam: ‘...I’m doing the things I’m supposed to do, and then I'm crashing in the afternoon’. And all of a sudden, now they're having three or four coffees, which is just another stimulant of cortisol.  Lisa: Yes. Dr Cam: And then they worsen the effect. And so we see for this person, if they just sleep in, they actually start losing weight faster than if they exercise. And this is… Lisa: So counterintuitive. Dr Cam: So counterintuitive. But when you think that whether you put muscle or fat tissue on, it’s actually—not to do with your food or your exercise, it's got to do with the hormones that those foods and exercise stimulate.  Lisa: Yes. Dr Cam: You don't grow muscle from protein alone. Because we'll see people in hospital who are malnourished, and we're feeding them lots of protein and they just burn then they lose weight. What we're trying to do is we need to modify the hormones. And if we get the right rhythm to our day—cortisol is acting, testosterone is acting at the right time, growth hormone is acting at the right time—if we were able to match our day with our hormone release that's relevant to us, then our body is able to—anytime that it gets some protein, is able to put it to work rather than burn it off in stress.  Lisa: Wow. Dr Cam: And the same thing with exercise. If you do exercise stress at the right time, you stimulate the right growth hormones, which like in ultramarathon running, and I use this example all the time, it's just so appropriate right now. If you run for three days, are your muscles bigger by the end of the three days? Lisa: Hell, no Dr Cam: Exactly. They’re broken down. Exercise is a stress, and it just stimulates your body to say, ‘You need to be stronger here’. So this is where—whenever you're thinking about exercise and food, you've got to be thinking about ‘What hormones am I modulating here? And what hormones do I need right now’? And that's the information that we can have. Just two very simple examples that we provided before. Lisa: Yes, and this is why this information in the programme that we do is so powerful because it gives you that specific information along with a ton of other things about what time to do things and when, in optimising your whole daily rhythms. But it isn't just about exercises, it is also about the food timing. So let's look at a little bit into the food timings and then also the whole neurotransmitter side of things. Dr Cam: Yes. Lisa: Like when am I going to get the best out of my brain? All that type of stuff as well. So from a food perspective.  Dr Cam: Yes. Lisa: So you and I are Crusader. I'm a Crusader-Activator on the cusp there, means four to six meals a day is ideal for us or regular food. My mum's a Guardian. Opposite end of the wheel, again. Dr Cam: Yes. Lisa: Two to three meals a day, ideal. That doesn't mean that you and I can't do intermittent fasting. That doesn't, by the way. We can still do that and get the benefits of autophagy and stuff, but it's a shorter fast from what I worked on. Dr Cam: That's exactly right.  Lisa: Yes Dr Cam: Yes. And that's the perfect—I was actually going to use those two examples for that, Lisa. Spot on. So we've got Activators and Diplomats, which we’ve spoken about. Then, we got the Crusaders and the Guardians. So Crusaders are, essentially, Lisa’s a really good example, I’m a good example.  Generally slight like a soccer player—taller, leaner, slender. And one of the features of their body is that they're very neurally-driven. So as opposed to adrenaline and testosterone, as opposed to digestive, the Crusaders are very neurally-driven. Everything is about mental focus, mental drive, and creation of hormones that allow you to keep driving forward. And you see these types of people in triathlons and marathons and anything that requires that long-term high-intensity focus.  Now, with this body, not prone at all to obesity. You have to really, really really push with bad habits to get this body to a level of obesity versus the Guardian. Naturally, this is your strongest, thickest jointed, biggest muscled, and also, they have the greatest capacity to store fat. So anyone that you see at powerlifting or in shot put or in those power sports, like the world's strongest men. Oprah is a good example of a Guardian. This is a body that's just more substantial.  And so what's really interesting about these two bodies is that—and I guess the most relevant one, we can start with the Guardian because it's kind of interesting. And then we'll come back to the Crusader, which is more—the most appropriate for general healthy guidelines than any other one. Lisa: So we run the show as far as… Dr Cam: We have the other types.  Lisa: ...we have told everybody how to do it all wrong. Dr Cam: Well, and what's really interesting is that our bodies—because we're unlikely to be obese just with the way our body is made up. That's not good or bad. We die from other things, by the way. We may not die from diabetes.But we might get... Lisa: What can else haunt us? Dr Cam: Exactly. Yes. There’s Parkinson's or something not so pleasant like that. So essentially, when we're feeding a Guardian, they've got a body, they walk past a bakery, and they smell it, and they gain weight.  Lisa: Yes. Dr Cam: They have this ability of just accumulating mass at all times. But they have these hormones in their body, and they're more sensitive to prolactin, and they produce more insulin. And these hormones are growth hormones. They make you grow. And so, they have an abundance of these things going on. They have a slightly slower thyroid, which means that they are able to conserve weight very easily. And what's really interesting, psychologically, they're being driven to care for people. So they have the most ability to conserve energy and the most ability to nurture. So you have these big, strong protective individuals.  Now what's really interesting with the timing of food, they’re recommended to have two meals per day, breakfast and lunch and then a very, very light, if not, non-existent dinner. Now, the reason that we do that, particularly with Guardians who are feeling like they wanting to—because this is the body that's most prone to excess weight gain as well. They'll be healthy and obese, but they can also really extend out past that unhealthy obese as well.  And so, what happens overnight is your prolactin and your growth hormones, even insulin release, all of these things are greatest overnight. And the reason for that is when we're sleeping, it’s the best time for our recovery. And so all of these hormones that are associated with growth are the response to the day of spending energy. ‘I spend all this energy. I burn. I then have to recover’.  Now, what's really interesting about the Guardians is that they have like a supercharged ability to grow overnight. And both protein and carbohydrates stimulate growth in different ways, and it's modulated through—insulin is a really great growth factor. It's one of the hormones that are involved. Essentially, if Guardians have a really big protein-carbohydrate meal at night, they get all of these growth factors at a time that they're about to have their biggest growth of the day.  Lisa: Growth anyway. Yes. Dr Cam: And this is a body that all they do is grow really well. They actually have a different rhythm that's not as catabolic, or doesn't break down as easily. In fact, it's quite anabolic by nature, it grows very easily. When they get stressed, they grow. And so what we want to do is to help this person rather than top up their blood sugar levels, rather than give them protein to feel full, it's actually—these individuals don't get that hungry that often if they're eating the right types of foods.  Essentially, what we see is if we can remove the proteins, carbohydrates, and even the fats at night and have a very light dinner and on sort of that time-restricted feeding, I say, is the way that you can think about it, but it's an early window for the day. What we do is we drop those growth hormones and the growth factors, I should say. We allow their digestive system to do a whole lot more recovery overnight. They'll wake up the next day feeling so much lighter. But we also haven't triggered off their key growth factors, which they already have plenty of anyway.And so all of a sudden, now, instead of growing excess overnight, they're able to start just recovering other systems and processes in their body.  And particularly when you're getting the breakfast and getting the lunch, you're creating stability in their system, then you're just taking away their growth stimulus at night, and they can start losing weight. And what's really fascinating about this, the studies that have shown this is if you can take people with diabetes, you give them six meals per day of 1400 calories, or you give them two meals per day of 1400 calories—breakfast and lunch. And what you see is a one-kilo weight loss for the six meals per day and a five-kilo weight loss for the two meals a day. Lisa: Massive on the same amount of calories. Dr Cam: Exactly the same macros, exactly the same calories, it's just that we're changing when it's coming into the body. Lisa: So these people shouldn't be doing a morning intermittent fast. They should be doing a stop at six o'clock eating type thing. Dr Cam: Even five. Lisa: Even five. Dr Cam: But really, it's about two meals. And if those two meals can be earlier, that's going to be better. And with lunch, is a time when we really tolerate foods very well. There’s a lot of systems that are really supporting us. That's actually a time when the meal can be most substantial as well. And so, this is what's really important if we're thinking about, let's say, reversing diabetes, for example. If we give someone six meals per day, it almost prevents us from doing that.  Lisa: Wow, so you just can't fix it as you’re just getting it a spot. Dr Cam: And it is why there are so many issues with so many, the dietary protocols out there because so many of that predicated on three meals and two snacks for this body. However, for the Crusaders… Lisa: For us. Dr Cam: ...which is the opposite function, they are much more likely to lose weight than gain weight. Obviously, in your exception, it's different when you're running ultramarathons.  Lisa: Yes. Dr Cam: But we're more likely to wither and lose muscle, as opposed to the Guardian that's more likely to accumulate and gain. And so what food has to do for a Crusader is provide energy so that they don't break down. Because food is that important for recovery, and we will... Lisa: And we’re catabolic by nature. Dr Cam: Exactly. Food is designed to provide growth to a body that would otherwise be breaking down. And so when we see the need for regular three meals and two snacks throughout the day, and dinner can actually be relatively substantial because overnight, you want this body to take advantage of the recovery. Because if they don't get enough growth, then their immune system doesn't come on, and they start getting sick, and they start breaking down. Whereas the strength of the immune system in The Guardian is so much greater because that's the time that they really ramp up their growth.  So we have this newly-driven body that we're not trying to protect it from diabetes and insulin problems because they don't often have them, particularly insulin resistance, and they have a faster thyroid function so their metabolism is burning hotter. They have all of this mental energy that is burning as well, and that requires more carbohydrates. So essentially, we provide regular meals with carbohydrates to this body, and their brain starts operating really, really well, that decreases their stress. And it's the decrease in stress that allows muscle growth, that allows our waist to reduce. And so, by having more regular food, we actually end up with better body composition for this person. But if we have more regular food for the Guardian, we actually end up with worse. Lisa: You need to know. Dr Cam: Whereas if you put two meals per day into the Crusader, now, all of a sudden—because they've run out of fuel because their metabolism turns it over really quickly, they have to dip into their stress hormones to stay energised. So they have to use more cortisol and adrenaline. And what do those hormones do? They break muscle down, and they put fat around your waist.  And so we have this environment for a Crusader, if they're having two meals, they're having to stress and push to stay awake. And now all of a sudden—oh, and to stay alert and on. And now, we're going to have the effects of what those hormones do, which is in that body, they’re with the muscle, and they gain body, and they gain fat around their waist.  Lisa: Wow. So they can—that’s the exact opposite. So Crusaders can be overweight, but that's usually they hold it in the middle of the body around the waist, which is the most dangerous fat—that visceral fat. And with the Guardian—so this is why like some people when they get stressed lose weight, and some people when they get stressed put on weight. And this was always like, ‘Huh? How does that work? Because I thought cortisol always put on fat’. And it does for the Crusader as well, but it puts it on around the middle, and that's because the cortisol has gone up, and you haven't had enough food.  Okay, what about—this is just because I'm off on a tangent again—but autophagy? We all hear about inhibiting mTOR, which is one of the growth pathways. And I'm always like, ‘Okay, I'm an activated Crusader’. I'm on the cusp there. So do I do intermittent fasting or not? I feel like if I'm looking for autophagy and wanting to knock off senescent cells and all of that sort of thing, how do I do that without triggering my body to go into a stress situation? Dr Cam: Great question. And so, this is what it comes down to then, we spoke about the rhythms at the start of the day—like the daily rhythm, the monthly rhythm, the yearly rhythms. Essentially, when we're looking at the rhythms of the different bodies, a Crusader has quite a quick turnover rhythm. So whereas the Guardian has a much longer slower turnover rhythm. And so, what I mean by that is if a Crusader does a day or two of intermittent fasting, their metabolism goes, ‘Whoa’, like really hits them because they're always on the edge of their fuel supply. And so the fast hits them a lot faster, but they're their nervous system, which is the thing that's driving stress In their body, that will be impacted quite significantly if they go without food for a period of time. It'll start driving muscle loss and demineralisation to keep the body alert.  And so, for a Crusader, it might be the one day per week that you do that thing just to give yourself a bit of a top up. For example—or to give yourself that effect of autophagy. Whereas for a Guardian, they have this ability to accumulate, and their rhythms are much slower. They can actually go for extended periods of time in that intermittent fasting. It's actually quite beneficial for them because they are more likely to build up toxins, and they're more likely to conserve over time. That state of a semi-fasted life is actually appropriate for them because their body, generally, their rhythms are slower and steadier, and they aren't affected by a lack of caloric intake or a lower caloric intake as much. Lisa: So for us to do extended fasts as Crusader types, are we putting ourselves at risk then? If so, how do we get rid of that? Because autophagy, just for those listening who don't know what the hell autophagy is, it’s basically recycling when a body goes up, there's not enough food supply around, there's not enough nutrients because their body is sensing the nutrients that's available in our blood, and this can be low protein or low caloric intake. And then it starts to recycle old parts of cells or knock off cells that are damaged and not doing the job properly. And this is a process that we want to have, but as Crusaders, we don't want to tip ourselves into the stressed out state, where we’re actually too catabolic.  So, because there's lots of things going around about fasting and the benefits of fasting. And, again, it is appropriate for one type more than another type or at certain periods of time. So how would you optimise it for a Crusader versus a Guardian? Dr Cam: Yes. Okay, that's good call. So essentially—probably, the thing to state here is that it's not just food that creates this level of stress or rest and recovery. If you were—let's say, for example, that you're up in some sort of retreat, where they're doing meditations a lot of the day, where you're walking in nature, where it's just very, very gentle surrounds, and there's virtually no stress on your nervous system, and you're able to completely dial out, this is as a Crusader, then you're going to be able to tolerate a much lower food intake for a longer period of time because there's less requirement that's being placed on. You have food.  But if you're in the middle of a busy week and you start fasting, your brains will go in ‘Well, I still want to get stuff done.’ And so your brain is going, ‘Let's do this’. And so in order to do that, you have to create stress hormone responses to keep your brain alive and to break muscle down, turn it into glucose that you can use in your brain for fuel.  Lisa: Oh, we don’t want that. Dr Cam: So it definitely depends on the environment that you're in as to how long you could do this. But generally, what we say is, if a Crusader is going to be doing some sort of intermittent fasting or something like that, just doing a day per week, and on a day where you can control the amount of stuff that is going on so you're not too narrowly stressed, it's really, really good way of going. Making sure you're meditating, deep breathing throughout the day, doing some gentle exercise, some stretching, just to really calm your nervous system. You're not having to do really big meetings and really stressful thinking sessions because you want to dial down the thing that's taking all of your energy. And for a Crusader,  it's their brain.  Lisa: Yes.  Dr Cam: And so if that's being used lots, then the body will commit its reserves to looking after the brain. So you have to turn that off in order to do a fast without affecting yourself too much.  Lisa: Wow. Dr Cam: Because if prolonged, you'll start continually breaking down muscle tissue to fuel your brain, and that's not good. And you release a whole lot of calcium from your bones to provide energy in your mitochondria. Lisa: Wow. Dr Cam: In your little, your muscle tissue within your muscle fibres as well. You need calcium to make muscles contract and do their thing. And if you're stressed and not consuming, you'll release more of that, which is not a good thing either.  Lisa: ...osteoporosis.  Dr Cam: So this is where you will essentially know...Yes, osteoporosis is a big risk for Crusaders. So you will essentially know that if you're doing a semi-fast and you're starting to have the feeling, if you're a Crusader out there, you're having to push to have your energy. When you're using your energy and flow, it should be just this flow of energy that feels good to use when you're doing mental tasks and things like that. If you've fasted for too long, it'll now be this push. It's like, ‘I have to get myself up to do this work’. And that requires... Lisa: You repel.  Dr Cam: Yes, yes. So if you're starting to get less motivated, and you're getting to the end of a job, and you're just exhausted, I would say you're fasted too long because your body overextending itself. The thing about Crusaders is their bodies are quite sensitive. You'll be able to pick up on those cues a couple of days in just to see what's going on.  Lisa: That’s really important for people to understand. That again, it's not a one-size-fits-all when you hear everybody talking about intermittent fasting or doing these things on autophagy and inhibiting mTOR and all those sort of things. It's not a one-size-fits-all approach once again. It really needs to be...and just talking about the Guardians to like what we've been saying, sounds all negative. They tend to hold—and I know like my mum complains bitterly when I give her this tiny little meal at nighttime that's full of veggies, and she doesn't get a big steak like I'm eating. And that’s a pain for her at times.  However, her body—to see the advantages of being a Guardian. Like back in the caveman days, she would have survived—I would have been long gone if there was a lack of food supply. She would have carried on and survived. Her immune system is incredibly strong. She's very resilient. She was in a wheelchair for 18 months, and she still had massively strong muscles. She's not catabolic in that, but she has a struggle with her weight. And now we've seem to have cracked the code on it. Because we're doing the meals at the right times most of the time and doing it appropriate for her body, we've had this huge weight loss over a very long period of time.  Dr Cam: Yes. Lisa: And that's the way to do it. That's what you want. You want to sort of do that in a controlled manner. And so there are good—and she's never going to get osteoporosis. Her bones aren't going to break. Mine? Quite likely. Dr Cam: Yes. Lisa: There's likely to have Alzheimer's even given whose particular situation. So those are some of the benefits just for those listening out there who resonate with that body type. Not to think it's all negative. And we've got an ‘Oh, gosh’, and we have an ‘Oh, good’ some things. Dr Cam: And to add to that, survival wise, we would have these individuals who are much stronger than everybody else who has a focus on looking after everybody else. The reason that their body is built the way it is is when we go through famine as a community, their body goes into conservation, they start growing, or essentially, they start growing, or they start slowing down their metabolism so that they can provide food for everybody else. There's this internal ‘I must provide’. And so, their body actually assist with that, and it slows down its metabolism, enables it to gain more or at least stop the weight loss. And this is why, for this body, you can actually extend the fast because they have this incredible resilience.  What's interesting about this body is that when you, any kind of stress—mental stress and things like that—if they experience stress, they'll say, ‘Ah, my community mustn't be safe. If I'm stressed, I'm the most resilient and I'm the strongest. So everybody else must be almost dying. So I'm going to start slowing my metabolism down straight away’. And as a result, they're going to take advantage of those hormones that help you grow, like the insulin resistance, the lower thyroid function. They're going to take advantage of those to be stronger for the community.  Lisa: Wow. Dr Cam: And this is a really important piece for any of your Kiwi listeners, particularly Modi and Modi populations.  Lisa: Yes. They’re dominant Guardian. Dr Cam: They stick out and generally have got this incredible capacity for protection. They're very family-oriented, it's all about protection of the family. And that thing comes from the same thing that makes them big and strong. It also makes them much more tolerant of prolonged fast because their body is designed to be a faster.  What's really interesting is their body was meant to accumulate during great times. And then when the fast came along, they just ate. And as they fast, they get healthier. Like their blood sugar start normalising, whereas the Crusader or the Sensor, that the leanest of the bodies, when they fast, they start breaking down and heading towards disease because they just lack that ability to grow and that ability to accumulate. So the mTOR pathways, which is all about growth, they're actually very protective for Crusaders and senses. And so we don't want to spend too long without them versus a Guardian, Connectors. Some Connectors and Diplomats, they have probably an excess of growth. And so, for them, that pathway is going to be more relevant to modulate or at least you'll be able to influence it for longer with greater effect.  Lisa: And this is why we see in the Polynesian community more diabetes, more cardiovascular disease, more—and then they also have a tendency to like those particular types of foods even more. So when you see with Sensors—it’s another one that we haven't gotten to, but that’s a real ectomorph body—and Crusaders have a tendency to actually want more vegetables and things, and they can actually do with more cooked, slow-cooked meats, and things like that.  Dr Cam: Yes. Lisa: But they have a tendency to like those sort of heavier, fattier, more sugar-rich foods when that's actually the worst thing for them. And that's why we're seeing, unfortunately, so much diabetes, so many metabolic disorders, and so on. Dr Cam: Yes, well, those foods provide a lot of safety. By having so many calories, it's like, well, ‘If I've got enough weight on, my family is now protected’. And so there's this biological drive to eat foods that are very caloric so that you can have more mass because more mass equals more protection for my family. But if you just go and lift really, really heavy weights, your body feels heavier, your body gets the sense that it's more stable and stronger, and that can actually replace. It's a really interesting one that requirement. Lisa: Ah, is that right? Dr Cam: That requirement to feel it. Yes. So there's a feeling of groundedness you get from those very heavy weights, and we also know that it actually creates a bit more growth hormone, a bit more recovery overnight, but it will direct it with the right nutrients and the right exercise to muscle growth rather than fat.  Lisa: So that's why the Diplomat and the Guardian body types, these stronger, heavier body types are really good at heavy weight lifting. And even though—because I have this argument with some of the clients that we have—women who are Guardians or Diplomats, ‘I don't want to do heavy weights. I don't want to put on more muscle mass’. But that it's—again, that’s counterintuitive. So they ended up doing lots of cardio-based stuff, which has its benefits as well, but it doesn't have the quickest response as, say, heavyweight sessions will do.  Dr Cam: Yes. Lisa: Is that right. Dr Cam: That's exactly right. Yeah. And there's a number of things that need to go on, but essentially, this bo

Every day, we spend an average of 20,000 breaths with 11,000 litres of air, primarily made with subconscious effort. If you want better health, changing your breathing technique probably isn’t the first option that comes to mind. We don’t even think about it; we don’t pay attention to how we do it. But it turns out that how you breathe has far-reaching effects on many aspects of human health. Discovering what it means to breathe correctly is crucial for greater wellness. In this episode, author and journalist, James Nestor, joins us in seeking to unlock a person’s full breathing potential. He discusses the myriad of health benefits controlled respiration can provide. You’ll also learn how industrialisation made it harder to breathe correctly and how various exercises can improve your respiration. Listen to this episode to discover simple methods to maximise the benefits of each breath you take.   Get Customised Guidance for Your Genetic Make-Up For our epigenetics health program all about optimising your fitness, lifestyle, nutrition and mind performance to your particular genes, go to  https://www.lisatamati.com/page/epigenetics-and-health-coaching/. You can also join our free live webinar on epigenetics.   Online Coaching for Runners Go to www.runninghotcoaching.com for our online run training coaching.   Consult with Me If you would like to work with me one to one on anything from your mindset, to head injuries, to biohacking your health, to optimal performance or executive coaching, please book a consultation here: https://shop.lisatamati.com/collections/consultations.   Order My Books My latest book Relentless chronicles the inspiring journey about how my mother and I defied the odds after an aneurysm left my mum Isobel with massive brain damage at age 74. The medical professionals told me there was absolutely no hope of any quality of life again, but I used every mindset tool, years of research and incredible tenacity to prove them wrong and bring my mother back to full health within 3 years. Get your copy here: http://relentlessbook.lisatamati.com/ For my other two best-selling books Running Hot and Running to Extremes chronicling my ultrarunning adventures and expeditions all around the world, go to https://shop.lisatamati.com/collections/books.   My Jewellery Collection For my gorgeous and inspiring sports jewellery collection ‘Fierce’, go to https://shop.lisatamati.com/collections/lisa-tamati-bespoke-jewellery-collection.   Here are three reasons why you should listen to the full episode: Discover how carbon dioxide is necessary for getting enough oxygen in your body. Learn how soft foods and bottle feeding during childhood can impact your health as an adult. Understand how oral exercises and breathing practices can significantly improve your wellbeing.   Resources DEEP: Freediving, Renegade Science, and What the Ocean Tells Us About Ourselves by James Nestor Breath: The New Science of a Lost Art by James Nestor Wim Hof Method James Nestor’s website   Episode Highlights [04:03] How James Got into Breathing  James is a journalist who once covered a world freediving championship in Greece. Despite being a swimmer and bodysurfer himself, he was astounded by participants who can dive 300 to 400 feet in a single breath. Upon returning to San Francisco, James decided to write a book about freediving. His research exposed him to the art of breathing and its importance to wellbeing. He learned that improper breathing is damaging to the body. [10:29] The Physiology of Breathing Contrary to widespread knowledge, it’s possible to have too much oxygen and not enough carbon dioxide in the body. However, it is essential to have a balance between these two. Many standard breathing methods deplete carbon dioxide levels, leading to lower oxygen saturation and more unsatisfactory performance. A study found that by holding their breath comfortably for 25 seconds, 85% of the athletes will not have a breathing dysfunction. Instead of compensating, learning proper breathing techniques can increase your bodily tolerance for carbon dioxide. Listen to the full episode to learn more about the process of breathing! [19:57] Basic Breathing Techniques Most people breathe faster than the optimal rate without realising that many of their health problems come from their breathing rate. The point of breathing exercises is to acclimate your body to breathe through the nose without thinking about it. Slower breaths while maintaining the same volume of air can increase efficiency by 35%. Transitioning to slower breathing will temporarily reduce performance, but you will eventually see improvements as your body acclimates. [27:11] Nasal Breathing Listen to the full episode for James’ points on running and breathing! Nasal breathing leads up to 20% more oxygen absorption compared to mouth breathing, all else being equal. Nitric oxide is a potent vasodilator that increases blood circulation. Nasal breathing increases nitric oxide concentrations six times more than mouth breathing. Breathing through the nose is more effective in defending your body against viruses than any other form of breathing. [38:36] Why Aren’t Breathing Interventions More Popular? There’s not a lot of money that can come from breathing interventions. Hence, the development of this alternative practice isn’t promoted widely. That said, James believes that alternative medicine isn’t always the answer. Conventional Western medicine is still crucial for many health interventions. [41:38] How Modern Diets Changed the Way We Breathe In antiquity, people always had perfectly straight teeth and larger mouths. The introduction of industrialised food removed the need for a larger jaw. Evolution drove the shrinking of the human jaw, so more people have crooked teeth or impacted wisdom teeth. Smaller oral cavities also made breathing more difficult, and the incidence of upper airway resistance syndrome rose. [44:24] Childhood Feeding Improper oral posture can root from habitually breathing through the mouth. When we were younger, chewing was essential. The introduction of baby food prevented infants from performing the right chewing exercises. Breastfeeding changes the face structure and promotes more efficient breathing. Children need to eat hard foods to develop a proper jaw and airway. [48:20] Oral Exercises Even adults can see improvements in their breathing efficiency by doing basic oral exercises. After a year of oral exercises, James was able to improve his airway size by around 15% to 20%. Palate expanders are an option for people who need them. However, oropharyngeal exercises and myofunctional therapy are easier and more effective methods for improving your breathing. [54:33] Relaxation through Breathing Slow, focused breathing activates the parasympathetic nervous system, leading to greater relaxation. Doing breathing exercises several times a day will immensely help you cope better with stress. Listen to the full episode to learn more about how slow light breathing diaphragmatically stimulates the parasympathetic nervous system and the vagus nerve. [59:14] Hormetic Stress The quickest way to reduce stress is to breathe. It is all about working your respiratory system and working out your stress. James suggests starting with the foundations of nasal breathing, slow breathing and awareness. Similar to exercising at the gym, breathing exercises promote hormetic stress. At moderate amounts, hormetic stress is beneficial to human health. Listen to the full episode to learn more about the Wim Hof Breathing Method!   7 Powerful Quotes from this Episode ‘By mastering this sort of breathing, we can not only dive deep, but we can heat ourselves up, heal ourselves, and do so many other things’. ‘Scientific papers were published about this 115 years ago, showing very clearly that you need a balance of carbon dioxide and oxygen to operate effectively and efficiently. When we breathe too much, we can offload too much CO2, which actually makes it harder for us to bring oxygen throughout the body’. ‘That slower breath with that pressure allows us to gain 20% more oxygen breathing through our nose than equivalent breaths through our mouth.” ‘I think our bodies are the most powerful pharmacists on the planet and that’s been shown, so why not try to focus on your body and health a little bit’? ‘By having a smaller mouth, you have less room to breathe. And this is one of the main reasons so many of us struggle to breathe’. ‘Start slow, start low. See what your body can naturally do. If after six months, you’re like, ‘I’m still not, this isn’t working’, go see someone and take it from there’.  ‘I talked to dozens and dozens of people who have fundamentally transformed themselves through nothing more than breathing. I want to mention it again. I’m not promising this is going to work for everyone, for everything, but it needs to be considered as a foundation to health’.   About James James Nestor is a journalist and bestselling author. He has contributed to many newspapers and publications such as The New York Times and Scientific American. His first book, DEEP: Freediving, Renegade Science, and What the Ocean Tells Us about Ourselves, took inspiration from his journalistic coverage of a world freediving championship.  James also authored Breath: The New Science of a Lost Art where he combines thousand-year histories with modern research to shed light on proper breathing. His investigations have revolutionised the conventional understanding of breathing and have helped many people live healthier lives. His other projects include speaking engagements for institutions, radio and television shows, and collaborations for scientific research and communication.  Learn more about James Nestor and his work on diving and breathing by visiting his website.   Enjoyed this Podcast? If you did, be sure to subscribe and share it with your friends! Post a review and share it! If you enjoyed tuning in, then leave us a review. You can also share this with your family and friends so they can include more amino acids in protein in their diet. Have any questions? You can contact me through email (support@lisatamati.com) or find me on Facebook, Twitter, Instagram and YouTube. For more episode updates, visit my website. You may also tune in on Apple Podcasts. To pushing the limits, Lisa   Full Transcript Of The Podcast! Welcome to Pushing the Limits, the show that helps you reach your full potential with your host, Lisa Tamati. Brought to you by lisatamati.com. Lisa Tamati: Well, hi, everyone. Welcome back to Pushing the Limits in this new year. I hope you're enjoying yourself. You've had a good break over the holidays, and I have a fantastic guest today. Wow, this guy is insane. So his name is James Nestor, and he is an author, New York Times best selling author, Wall Street Journal best selling author, London Times New York Times bestselling author of a book called Breathe. So it's all about breathing. You might think, how the hell do you write a book on breathing. But I tell you, this is going to be a really exciting interview, and you're going to learn so much that you wish you'd been taught years ago. He's also the author of Deep, another best selling book that he did on freediving. And he's a filmmaker and science writer for many of the science magazines. Now in this book Breathe. He explores the million year long history of how the human species has lost the ability to breathe properly. And why we're suffering from a laundry list of maladies from snoring to sleep apnea to asthma to autoimmune diseases and allergies. And in this, on this journey in this book, which was absolutely fascinating. He travels the world and spends a decade in the attempt to figure out what went wrong and how do—we fix it. And, you know, the links that the sky week two—for his research has just absolutely next level. I really enjoyed doing this interview with James. He's an incredible person. And just so very, very interesting. So I hope you enjoy the show. Before we head over to speak with James in San Francisco, just like to remind you to do a rating and review if you came for the show. This is a labour of love. And it really really helps the show get out there if you can give us a rating and review, either on iTunes or wherever you're listening to this podcast. Or if you can't work it out, just send me an email with it. And we'll gladly receive those as well. And if you want to reach out to me if you've got any ideas for podcasts, or people that you would like to see on here, or if you have a question, health question, if you want help with health journey, health optimisation, epigenetics, run coaching, that's our day job. That's what we do for a living. And that's what we are passionate about. And that's what we love. So if you're having trouble with a tricky health issue, if you wanting high-performance, if you're wanting to do that next ultramarathon or first run your first five-kilometer race, whatever the case may be, please reach out to us, lisa@lisatamati.com. And you can find all our programs also on that website, as well as this podcast and lots of other goodies. So I hope you enjoy this interview with James Nestor. Over to the show now and thanks for listening. Lisa: Well, hi everyone and welcome back to Pushing the Limits. It's fantastic to have you with me and I am jumping out of my skin for excitement today because I have someone that I've been just so looking forward to interviewing. An amazing author, James Nestor, who is going to be sharing his research and his book, which is really a game-changer. Breathe is the name of the book. And James is coming to us all the way from San Francisco today. So welcome to the show, James. Fabulous to have you. James Nestor: Thank you for having me. Lisa: So James, can you just give us a bit of a background into your—who you are in your background? And how the heck did you end up writing a book about breathing? And why do we need to know about it? James: So I'm a journalist, and I write for science magazines and outdoor magazines. I've been doing that for years and years and years. And I think the real jumping off point for me was when I was sent out to go to Greece to write about the world freediving championship. And even though I've spent my life near the ocean, I'm a surfer. I'm a swimmer and body surfer, all that, I had never really spent too much time under the ocean. And I had never seen anyone freedive before because the water is very cloudy here on the West Coast. There's not a lot of places to do this. So I remember going out in this boat, it was the first day of the competition and just watching these people take a single breath and go down 300, 400 feet on a single dive there. And come back four minutes later and—just it was like they we're answering emails just like. Okay, next up, back for lunch. It was what the hell is going on here? I had understood that this was absolutely impossible. And yet here these people vary sizes, various forms - big, tall, large, small, all that - that had mastered this thing. And I got to be friends with a few of them who took me into this other side of freediving outside of the competitive freediving, which I just thought was pretty insane. And they allowed me to understand free diving as this meditation. And of course, breathing is at the core of this meditation. And by mastering the sort of breathing we can not only dive deep, but we can heat ourselves up, heal ourselves and do so many other things. Lisa: Wow, so that was the jumping off point in, for those interested. Yeah, I've taken an interest in freediving too. And my gosh, what they do is pretty next level, insane. I don't think I'm crazy enough to really have a go at it. To be fair, but absolute admiration for what they do and how they do it, in—the everything that they have to overcome. But okay, so if we just jump in now, the into—how does we know? What can we learn from these free divers and other traditional breathing techniques? And why is it important for the everyday person to be understanding how the breath works in the physiology, which we'll get into which I found absolutely mind blowing and thought, why is nobody told me this? And why did—why does, why should someone listening to this actually be interested? James: So the free divers told me that the only way to hold your breath is to master this art of breathing. And it was also something interesting to see all of these different people. And they all had these enormous chest, they had expanded their lung capacity. Some people double the average adult lung capacity by forcing. Well, they were not born this way. So it made me think about how malleable the body is depending on what inputs we give to it. And so I got back to San Francisco, and I wrote another book that featured freedivers. But in the back of my mind, that book was called Deep. And it looks at the human connection from the very surface to the very bottom of the deepest sea, magnetoreception echolocation all that. But as I was researching that book, and writing, I just kept finding more and more information about breathing, about how so many of us in the West, including in the medical world view breathing as just this binary thing. As long as we were breathing, we're healthy, and we're alive. When you're not breathing, that's bad, your dad or you have a serious problem. But that is such the wrong way of looking at this. It's like saying, as long as you are eating, you're getting food, you're getting nutrients. But it's what you eat. That's so important. And it's how you breathe. That's so important. So I was lucky enough to then meet a bunch of leading experts in this field who have been studying this stuff for decades, even publishing in these weird scientific journals. No one's been reading their stuff. I thought, why the hell hasn't anyone told me this? Like, I'm middle aged, I've been mouth breathing, through most of my life. I've been whenever I was working out or surfing, I'm just thinking I'm getting more oxygen in. And this is so damaging to the body, and no one was talking about it.    So this book took me so long, because I couldn't understand why some researchers on one side were saying how you breathe has no effect on your asthma, has no effect on your body, on your brain. And this other side was saying they're 100% wrong. Here's all the data. So it was going through all that and weeding through all that that took me a while. But I think at the end, I finally found the truth behind all of this. Lisa: He certainly did. And the book is such a deep deep dive like you know, and I've been talking to some friends about you know, reading this book and, and everything. How can you have a whole book on breathing? And I'm like, you have no idea. You could probably write 10 books on breathing and it's so powerful. And as an athlete I've, you know, I was just saying to you prior to the recording, I've spent my entire life as an asthmatic since I was two years old. I have a very small lung capacity. I have a low VO2 max, despite that I decided to become an endurance athlete. Go figure that one out, got some mental issues, obviously. But I'd spent my entire athletic career breathing in my mouth in places like Death Valley, in the Sahara, in the Himalayas, and altitude, and you know, freezing cold temperatures. And all of the problems that that brought and so this book has been a life-changing thing for me personally. Unfortunately, I'm no longer a competitive athlete bagger. You know, like I didn't get the memo back then. But now training hundreds of athletes. Wow, I can start to influence them and change them and are already started to adopt some of the information into the programs that we're using. So super powerful information, and in really important. So, okay, now let's go into a little bit—the physiology of breath because we sort of think if I take deep breaths, and breathe often in faster, if I'm running, then I'm going along. I'm getting as much oxygen as my body can get. Why is that completely upside down? James: That is upside down. And it's so counterintuitive. It took me months to get my head around this, even though we've known these scientific papers were published on this 115 years ago, showing very clearly that you need a balance of carbon dioxide and oxygen to operate effectively and efficiently. And when we breathe too much, we can offload too much CO2, which actually makes it harder for us to bring oxygen throughout the body. If you don't believe me right now, you can breathe 20 or 30, heavy breaths. You might feel some tingling in your fingers or some lightness in your head. This is not from an increase of oxygen to these areas, but a decrease of circulation. Lisa: Wow. James: Because you need a balance of CO2, for circulation, for vasodilation. This is—it is integral to providing blood and nutrients to our body. And for some reason, as Westerners we just think more is better, more is always more. That is not the way of the proper way of thinking about this when you talk about breathing, you want to breathe as closely in line with your metabolic needs as possible. Why would you? It's like being in a car. Why would you be revving the motor? Everywhere you're going, I had a stop sign just revving the motor. When you were over breathing. That's exactly what you're doing. You're causing a bunch of wear and tear on your heart on your vascular system. And you're sending stress in those—to your mind. People like you are very strong willed and we'll fight through it right you'll just keep going you're in pain, I don't care. I'm gonna finish this race. I'm gonna make it happen. Compensation is different than health. Oh, and and so this is why so many professional athletes, they'll be really good for a few years. The minute they stopped, diabetes, chronic health problems. Our body.. Lisa: Thyroid, diabetes, metabolic problems. Yeah, like no hell, you've spent your life being a disciplined athlete. I'm struggling with hypothyroid, for example, and high blood sugars. And I'm lean and I'm, you know, it's like what the heck. Like, wow. And I hope through the breathing in some of the other stuff that I'm doing that I can remove some of the damage because you're because it is so counterintuitive. So that carbon dioxide there was a real mind bender for me, because I've always understood carbon dioxide as a negative thing. You know, we want to breathe it out. We want to get it out of the system. That's the end result of you know, what do you call it the electron chain in the ATP production, and we're producing this carbon dioxide, we're gonna give it out. And that's not the case, isn't it? It's a controller of the acidity in the blood is something that we want to train, our chemoreceptors need to be trained in order to be able to tolerate more carbon dioxide. So this just dive into the winds a little bit on the actual physiology that I've just touched on the air so that we can actually get to the bottom of this carbon dioxide, your mind bender, really. James: So when we take breath in, it enters into our lungs and the bronchioles, to these little air sacs, the alveoli, and from there it goes through various layers and enters into red blood cells. The vast majority of oxygen enters into red blood. So there's some free floating but not much. So in those red blood cells or something like 270 million hemoglobin, and so then it enters into this hemoglobin. And it's, you know, it's funny, why would when we're working out, why would we get more oxygen in one area than another? So CO2 is the signaling molecule. So where oxygen is going to detach is an areas where there is CO2, and oxygen isn't going to attach otherwise. So you need this healthy balance of CO2, we have 100 times more CO2 in our bodies than we do oxygen.  Lisa: Wow. James: Okay, so this is this very carefully controlled system that needs to be in balance, and our bodies are so wonderful at keeping us alive. So when we become imbalanced, all these other things happen. If we become too acidic, we'll learn to breathe more, right? We’ll trigger that if we become too alkaline, our kidneys will release bicarbonate. So all of this is incredible and so important. Compensation, different than health. We can compensate for a very long time. Imagine you can live maybe 40 years eating garbage crap food eating Fritos. That doesn't mean you're healthy. No offense to Fritos. Delicious, absolutely delicious. But, you know, it doesn't mean you're healthy. So… Lisa: Yeah. James: ...the reason why you have to understand this balance of CO2 and oxygen is because you can't just understand CO2 as a waste product. It's still considered this a medical school. Yeah, you don't need it. But people who study this know that is—it's absolutely essential to have that balance, you don't want too much. But you don't want too little. You want your body to be able to operate at peak efficiency without having to go through all those compensations, right? To keep you there.   Lisa: Exactly. So when we breathe in, we.. When I say, we don't hold our breath, and I'm holding my breath for a long time, as long as I can. And then that's horrible urgency that comes up and you start to—your diaphragm starts to make that sort of hiccup thing. And this is actually the chemoreceptors in the brain, which is the area that is what I understand, correct me if I'm wrong, that is measuring the CO2 levels more than anything in the blood, not the oxygen levels. And it's so, the CO2 going up, and then the body's going “Oop, time to breathe,” and it makes you do that, you know, hiccup thing in order to make you breathe. And when I'm doing my breathing exercises that I've learned from you, I let that reflex go for a while while I'm training my body and to be able to accept more carbon dioxide. And that will help me be a better athlete with a bit of a EO2 mix hopefully, and make me faster and so on. But it's the CO2, that's actually pushing the oxygen into the cells as well, isn't it? And that was another, a mind bender as well. James: It's an exchange. So you can think about those red blood cells as this cruise ship, right? So and they're full of oxygen. And they cruise to areas where there are other passengers that want to get on this is CO2, and they exchange. The CO2 hops on as oxygen hops off. And this is just how it works. So that need to breathe, you're 100% right. A lot of people think, gonna exhale, hold my breath. “Oh, I don't have enough oxygen, I need to breathe.” No, that is dictated by rising carbon dioxide levels. And so many of us are so sensitised to CO2, that we can't hold our breath more than 10 seconds without going. But they've done a study with athletes. And they found that to very comfortably hold your breath, over 25 seconds, 89% of those athletes will not have any breathing dysfunction. So this is a great practice to do. And this is why this is used in so many different breathing techniques for so long. The ancient Chinese were doing breath holds. Pranayama ancient Hindus were doing breath holds for thousands of years—is to exhale softly. And to hold your breath calmly. You don't want to be struggling and feeling your diaphragm moving. Just calmly, when you feel a little teaspoon of discomfort. You breathe and you calculate how long that is. Don't look at this as a competition. I know that there's a lot of people out here. No, you can compete later. So what you want to do is to get your CO2 tolerance higher, because by having a higher amount of CO2, which is really a normal amount of CO2, your body can operate better. You will have more circulation. Oxygen will detach more easily. And when you're doing endurance sports, this is what you want. You don't want to use energy for things you don't have to use energy for. You want to be burning clean and tight. And that's what this allows you to do. Lisa: This is about efficiency isn't and maybe you're saying that the average person is breathing 12 to 18 times a minute, on average. And ideally, we should be around the five and a half or six times a minute would be ideal. “So breathe light to breathe right” was one of the catchphrases that stuck in my head. And that's my trigger for all over breathing again. And so it's actually slowing down our breathing rate and not increasing the volume so much as diaphragmatic breathing. So using the deep, lower lobes of our lungs to actually get the breath end and doing it a lot slower. And why are we all you know, doing it 12 to 18 times a minute and overbreathing? Which is yeah. It is... James: Sometimes a lot more than that. I mean, I've talked to clinicians who see people breathing 25, 30 times a minute just and they've been doing this for decades, and their bodies are just destroyed. So it's, these things become a habit after a while and our body gets used to that cycle of compensation. And we start acknowledging this is normal. We started thinking having migraines is normal, having cold toes and cold fingers all the time is normal, being exhausted all the time is normal. None of this is normal. And especially if you look at modern populations of what's considered normal now, I mean, what 15% of Americans have diabetes, 25% have sleep apnea, 10% have autoimmune like, what is going on here? And that this is just accepted that, “Oh, just you know, I've my diabetes...” Lisa: Aging. James: ...my drugs. So anyway, I'm getting off track here. You when this becomes a habit, again, compensation different than health. And a wonderful practice to try is to breathe in at a rate of about five to six seconds, and breathe out at around that same rate. I put in the book 5.5 yet, but then people have been writing me, saying, 'I'm a half a second off'. Oh, my God. So now I'm saying anything in that range. And if that's too difficult for you, slow it down, go three seconds in three seconds out. It's perfect. This is not a competition. This is about acclimating your body. So we can't breed this way all the time, that's going to be impossible. But whenever you become aware of your breath, that you're breathing too much, you can bring your breath back by breathing this way and recondition it. And the point of all these exercises is not to think about them. You want to do them often enough, that you're always breathing through your notes that you're always breathing lightly and slowly. And that range of diaphragmatic movement, especially for athletes, I cannot tell you how essential this is, when you're breathing too much. Okay, here's what's happening, you're breathing up into your chest, which is extremely inefficient. There's more blood further down in your lungs, so can participate much more, much better in gas exchange. But you're also doing something else. You're taking air into your mouth, your throat, your bronchi, bronchioles, none of which participate in gas exchange yet do you bring it in? You go? I'm using maybe 50% of that breath. If you slow down with the same volume, six laters a minute, to about six or seven breaths, right? Per minute, your efficiency goes up 35%. 35%. And if you're not gonna make a difference, you're running for five hour days. You're crazy. If you look at Kipchoge, check out how he's breathing, you know, an hour and a half, extremely light. He's completely in control, you can hardly see his chest. And he is in the zone. Sanya Richards-Ross was the top female sprinter in the world for 10 years, check out how she's breathing through the nose in control, destroying everyone else and all of our competitors. So it takes us a while, which is why people don't, you're going to see a decrease in performance when you switch. Okay, guaranteed that it's gonna to go down. If you stick with it, it's gonna go up. I don't want to say that it's true for everyone. But I would say 95% and the breathing experts, the elite trainers I've worked with have told me 100% of the people they've converted, their performance goes up and the recovery is cut by half. Lisa: Wow. And then I mean, who the hell doesn't want that as an athlete, you're fighting for 1%. So when we're talking, no such mess of possible changes that don't rely on your genetics and don't rely on you know, things that you can't control anyway. And like, for me, transitioning has been hard. I'll be honest, because I was completely congested all the time. And that's why I'd heard that nasal breathing because that’s the next thing we'll discuss that nasal breathing was very, very important for a number of reasons. I didn't really understand why. But I was like, well, I can't breathe through my nose is just blocked the whole time. And I don't have a show on hell of doing that. So well. Well, I'll carry on doing my breathing. And then when I learn how to decongest my nose and sometimes it will take me two or three breaths. And the first time the first couple of weeks when I was doing it, my nose was running and I wasn't getting anywhere and I'm like, this is not working. But I pushed through that phase. And now I can run for like a team case at a fairly good pace, completely nasal breathing, if I do the warm up phase properly, if I go out the door and just try and do it straight out, the gate won't work, I need to do the walking, holding my breath, and get that cleared first, and then I can get into my training. And then I can hold it in the first 10 minutes, I'm still finding it a little bit like I want to breathe with my mouth, but that instinct is there. But I'm slowly training myself into that system. And saying, I can actually, you know, I can actually run for a good hour just through my nose without any problems. And I've also not done the high-intensity. So I backed off the super high-intensity, because I know I'm automatically going to open my mouth when it gets to that. So while I'm in this transition phase, I'm not doing anything beyond that sort of aerobic capacity level. And I think I need this just to adapt. So these are huge types of people listening out there, if you are congested, and you think, well, this is all well and good guys, but there's no way in hell that I'm going to be able to breathe through my nose. Think again, there is, it's just a matter of being taught how to do it. And that's a pretty simple couple of exercises that were, you know, that's in the book. It can really, really help us if you persevere through it. And then I expect to see improvements and my VO2 max and all the rest of it. Now, let's talk a little bit about the reason why it has to be nasal breathing. And so it's not just about breathing slowly. We've talked about breathing slowly, we've talked about diaphragmatic breathing. We've talked about CO2 and the role that we don't want our CO2 levels too low in the body. Let's talk now about the whole. Where was I going James? Help me out. I've just hit a.. James: You wanted to talk about breathing, you want to talk about fitness, you want to talk about nasal breathing. Lisa: I hit a moment. So nasal. So we want to understand the physiology of the nose and why the nose is what we want to be breathing with rather than our mouth. James: So I want to mention a few things. A few more things about running. This may seem overkill, but just a couple of points. So what I've heard from various instructors, Patrick McKeown is a world renowned breathing therapist, top got Brian Mackenzie the same thing. Never work out harder than you can breathe correctly. So if you're entering the zone, your mouth is open, slow it down and build your base and work up from there. Sometimes it took Dr John Douillard took him six months to fully acclimate. But once you get there, you are going to find a power in yourself that you did not know existed. And this has been proven time and time again. When Carl Style was working with the Yale running team and the US Olympic running team. He said that these people suffered way more sicknesses, respiratory problems, asthma, COPD than anyone else. And he said, “They push through it because they're competitors. They're gonna push through it.” A complete mess. So there has to be a slight shift and thinking of like, you have to accept your performance is going to go down for a little bit. Right now's a good time to do that. We're still in a pandemic. So you know, once things open up, you'll be kicking everyone's ass. And that's not a bad thing. But just know that this is a wave. This is a process. So the reason why you want to be doing this, we'll get to nasal breathing now is I will bring on my guest. He's been waiting over here patiently. Steve, for the people who aren't watching this, I'm holding up a cross section of a human skull. You can see the nose right here. When you breathe through the nose, you're forcing air through this labyrinth. It's so similar to a seashell. It's called the nasal concha. So seashells have their shells this way to keep invaders out to keep pathogens out. Right? Our noses serve the exact same function. This is our first line of defence. So when we breathe through our nose, we're heating air which is important in cold climates where humidifying it, which is very important in dry climates. We're pressurizing it, we're conditioning it, we're removing particulate which is important, if you live in a city or basically anywhere else now. We're helping to fight more viruses. So there will be a smaller viral load breathing through the nose. And we condition this air so by the time it enters our lungs, it is properly conditioned to be more easily absorbed. When you're breathing through your mouth. You can consider the lungs as an external organ. Yeah, because they're just exposed to everything in your environment. So not only that, not only is this the most effective filter we have is it forces us to breathe more slowly. This is a self-regulating device. Yeah. How long did it take me to take that breath took a while? How long does this take? Yeah, nothing. So that's slower breath with that pressure allows us to gain 20% more oxygen breathing through our nose than equivalent breaths through our mouth. Again, if you think this is gonna make no difference to, you you're absolutely crazy. And this is simple science. You know, this isn't controversial stuff. Lisa: No, this is simple science, but not well, knowing until your book came out and became a worldwide best selling book. Thank goodness because this stuff needs to be out there. And I'm called silly because I'm deep in the waves and in researching all the time. And by hacking and the latest longevity, and the goodness knows what I'm just always into the latest and greatest. And I'm constantly surprised at how you know that some fantastic information never sees the light of day, because of the systems that are in place, or traditions and laws and stuff. And it's like, wow, we have to get this information out there. And this is one of those times when I'm thinking thank goodness, someone has put this into a book that's readable for people to understand the science without having to do such a deep dive themselves. And I think that that's really important. And that nasal, you know, nasal breathing. Also, it does another thing that I found really, really interesting was all about the nitric oxide. Can you explain what nitric oxide is and what it does in the body and why the nose is so important in that regard? James: Nitric oxide is this amazing molecule that our bodies produce that plays a central role in vasodilation. Having more nitric oxide will decrease your chances of having a stroke, will decrease your chances of having a heart attack. It will increase circulation to your brain. I mean, I can go on and on here. It's no coincidence that the drugs Sildenafil also known as viagra, guess what it does, it releases nitric oxide in your body. That's how it cleans. Yeah, we get six times. One study showed that we get six times more nitric oxide breathing through our nose than we do through our mouth. And if we hum we get 15 times more nitric oxide. So this has an incredible effect on the body and especially now there are 11 clinical trials right now where they're giving patients with COVID. Guess what? Nitric oxide. And apparently, according to Nobel Laureate, Louis Ignarro, oh, it's working wonderfully well in these. Studies are going to be out soon. I heard something. My brother in law's an ER doctor, my father in law's a pulmonologist. So we talk all about this stuff. And the vast majority of the people suffering the worst symptoms of COVID are people with chronic inflammation. And as an opposite, very observational study. There are also mouth breathers. Yeah. And this was known 100 years ago, they were saying 75 to 80% of the people with tuberculosis are mouth breathers, chronic mouth breather. So there's been no official study on this just this is just observational stuff. Don't go write me about this, that your nasal breathing got COVID. It can happen. Lisa: Can happen still, we're not saying that.  James: It's to me, but we know that can happen. But we also know something else. That breathing through the nose will help you defend your bodies so much more effectively, against viruses. And this is what Louis Ignarro again, he won a Nobel Prize. So listen to that guy, if you're not gonna listen... Lisa: Yes and I've actually I've heard Dr Ignarro speak a number of times, and I'm hoping I can get him on my podcast to actually just to talk a whole session on nitric oxide and what he discovered, because he he won a prize for discovering this, this gas if you like in the body, because nobody really understood what it was or how it operated. And it is being used for Viagra. And the reason it works for that is that it expands and dilates the blood vessels, but that's what's actually doing it and all parts of our body. And therefore when we're doing this nasal breathing, and we're getting more of that nitric oxide and I mean, a lot of the athletic supplements that you can get now in your corner supplement store are about, you know, drinking beetroot juice or whatever increases your nitric oxide. So this is another way to get at an info for you athletes out there. You want better performance, you know, a lot of my athletes are on beetroot juice and things like that. Just nasal breathing is another way of doing that. You know, so that's a really big piece of the puzzle, I think. James: And those don't work. They certainly work but the key was so much of this just like with a key with oxygen. You don't like, go and get a bunch of oxygen for five minutes, then walk away so I'll fix them. You want to constantly be producing this stuff. So beet juice, you know what we'll work for a short amount of time. But to me, it seems like a much better idea to use something that we're naturally gifted with to use our nose. And to constantly be having a body that can constantly produce a healthy healthy level of nitric oxide. I drink beet juice. I'm a big fan of that, the nitrates and other vegetables can help release more nitric oxide. Great stuff, right? But nasal how often can you be drinking beet juice, you don't want to be drinking that 10 times sugar in it. Lisa: No. There's a lot of sugar in it. James: There’s a lot of sugar in it and you know, occasionally is great, but there's other ways of doing this. And you know, I think our bodies are the most powerful pharmacists on the planet and that's been shown so why not try to focus on your body and health a little bit? Well last thing I want to mention that I just find, is so frustrating here in the US is all this talk of COVID all this talk of you know wear a mask, which I'm a believer in that stay at home. I'm a believer in that. Zero talk about not eating four double cheeseburgers a day.  Lisa: Hey, mean. James: Ola, like getting your health and breathing through your nose. like where's that conversation? Getting vitamin D, getting vitamin C. And so anyway, we've seen what the government's you guys have a much more progressive government, let me tell you, we're so jealous of it. But now we have the whole... Lisa: We’ll be a medical society, though there's nothing. It's not that late. But yeah, and I've had a number of episodes, I've just done a five part series on vitamin C, and intravenous vitamin C, and cancer, and sepsis. And, you know, the whole gamut in the problems there. In this, every single doctor has said to me too, when it comes to COVID, why aren't we building up our immune system so that we don't get people in our ICU on ventilators? You know, so that we don't get to that point, or we have less people and, you know, that just seems like a no brainer to me, but we're still promoting eating crap and drinking crap. And, you know, and not taking into account. It's, yes, I mean, the vaccines and all that, but how about we just take a little bit of self-responsibility we might not have as bad if we do get it. You know, like I've got a mum. I've just written a book called Relentless that my listeners know about and it was about rehabilitating my mum back from an aneurysm four and a half years ago, where she hit massive aneurysm. Hardly any higher function, I was told, like, should never do anything. Again, I spent four and a half years rehabilitating her and she's completely normal. Again, she's driving the car, she's walking, jogging, everything's fine. And this is why I've ended up doing what I do, because I'm very passionate, because none. And I mean, none of this was offered in the standard medical system that we were in. They were great at the surgeries, they were great in the crisis. But when it came to rehabilitation, there was just nothing there, and so I discovered all of these things. And one of the passions I have is just staying one step ahead of here and giving her the next thing now she's 79 years old, I want to keep her healthy. So when COVID threatened us, you know, I've, you know, got over there in the corner, my hyperbaric oxygen chamber, my ozone over the air, and, you know, you name it. I've got it so that if it does come, we prepared as prepared as we can be. And that is a good approach, I think prevention, rather than waiting for the disaster, and then trying to pick up the pieces at the end of the day. You know? James: Yeah, and I just want to be clear, and I know that you're saying the same thing here. There's, doctors in my family that practice Western medicine who've helped people, when I get a car accident, last thing I want is acupuncture. I want to go to the ER and have somebody say, “Sir, I break a bone. I'm not doing pranayama breath work, I'm going to go and get a cast.” But about rehabilitation. This is 100% true, because it costs a lot of money. There's no way a system can support full rehabilitation. And one thing that I've heard from almost every expert in the field, whether it's a professor at a university, or an MD, or a nutritionist, or whatever is they believe, this isn't my view. This is their view. I want to be objective here but they believe that there's a reason people aren't talking about breathing again. It's, there's no money in it. There's a money. Oh, why the US government isn't saying “Don't go to McDonald's today.” That's going to shut the economy down. So the good news about this is people who are interested want to take control of their health. There are now other means of getting information from people who have studied this stuff, people who are into scientific references, who are looking at science in a real objective way. And so I view this thing, hopefully, this is going to be a lesson we can all learn then that we can acknowledge how incredible the human body is, how we become susceptible to illness, and how to better defend ourselves in the future. Lisa: I'm just so on board with all of that. And I think it's our right and this is a problem we do. You know, we love Western medicine, they do some brilliant things. I love naturopathic medicine, I love alternative, complementary, whatever you integrate, or whatever you want to call it.   We've all got deficits, and we've all got blind spots, and every single piece of this. And it's about bringing the whole lot together, and not letting money rule the world. I think is, if we can ever get to that point, that would be fantastic because it is at the moment. And there's a lot of things that are being hindered, like things, simple things like breath work, like stress reduction, like intravenous vitamin C's, like things that don't, nobody can make money at, or hyperbaric oxygen is not going to make millions for anybody. So it's not getting out there, that information is not getting out there. And it needs to be out there. We got I reckon we could talk for days, the job's because we were obviously on the same track. But I wanted to touch on a couple of areas. One was the whole skeletal muscle record of our ancestors and our facial, you know, our whole facial development and why that's part of the problem and the food problem, the mushy food that we eat today. And then remind me to talk briefly about the immune system and all this inveigled the vagus nerve and stuff. So let's start with though, with the skeletal record, and the difference between our ancestors and how we are today. James: So early on in my research, I started hearing these stories about how humans used to have perfectly straight teeth and I don't know if you're like me. I had extractions, braces, headgear, you name it, every single person I knew had the same thing. It was never if it was just went this is what how it was done. At wisdom teeth removed. If you think about how weird that is, you're like, why are we removing teeth? From our mouths? Why are teeth so crooked? Where if you look at any other animal in the wild, they all have perfectly straight teeth. And what I learned was that all of our ancestors, before industrialisation, before farming, any hunter-gatherer all had perfectly straight teeth. So I went to a museum and looked at hundreds of skulls, and they all stared back at me, these perfectly straight teeth. Completely freaked me out. They had these very broad jaws, wide nasal apertures forward, growing powerful faces. So if you have a face that grows this way, and you have a mouth that's wide enough for your teeth, you have a wider airway. Having a smaller mouth, you have less room to breathe. And this is one of the main reasons so many of us struggle to breathe, we have upper airway resistance syndrome, sleep apnea, snoring, and so many other respiratory issues is because there's less room in there. And what happened is this came on, in a blink of an eye with industrialised food in a single generation. People went from having perfectly straight teeth, wider nasal apertures, to having crooked teeth and smaller mouths and a different facial profile. And this has been documented time and time again. Yet I had learned in school, which for me, it was zillion years ago that this was evolution-meant progress we're getting we're always getting younger, you're getting taller, we're getting better, look around the day and ask yourself if that's true, it's complete garbage. And then I went back and looked at the real definition of what evolution means. All it means is change and you can change for the better, or for the worse. And humans, as far as our breathing concern is concerned, are changing very much for the worse. Lisa: Wow. And so we're, I mean, I'm saying I grew up have had so many extractions and teeth completely crooked and a tiny little mouth and all of those sort of problems that you're describing. So what was it that their ancestors did differently? So it was just the food being not we not chewing as much was that basically? Yes, like that's that was a real chain game changer for us when the industrialisation happened and we got mushy food. James: There were many inputs, chewing is the main one. So when you live in an extremely polluted environment, sometimes your nose can get plugged, right? You start breathing through your mouth, that can create respiratory problems, but if you breathe through your mouth long enough, your face grows that way actually changes the skeletal picture of your face. So that's another input improper oral posture is what that is called, but it's for when you're younger chewing is so essential and it starts with breastfeeding. There were no Gerbers food. I don't know if you have that out there, but there were no, like, soft foods. Just a few 100 years ago. So if you think about it, so now we're eating the soft processed foods right out of the gates. We're going, we're being fed on a bottle, soft processes. All of our mouths are too small and too crooked. So this chewing stress starts at birth. They've done various studies looking at kids who were bottle fed versus those who are breastfed. When you're breastfed, your face pulls out your mouth, gets wider because it takes a lot of stress to do. Two hours a day, like every day, every two hours, you're doing it. And literally, and I've talked to parents who had twins, I just talked to a lady yesterday who bottle fed one did love not want to be breast fed breast fed the other. They look totally different. One has crooked teeth, one has autoimmune problems. One has swollen tonsils, the other doesn’t. So that is anecdotal. But there's been studies in the 1930s they did tons of studies into this. So I'm a dude, I'm not going to sit here and tell everyone they breastfed people for that is not my point yet. But some people just can't. But I think it's important to acknowledge that the physics of how this works. And after that, if you have bottle fed a kid that's fine. But they need to start eating hard foods baby led weaning, this is what needs to happen to develop that proper jaw to develop that proper airway. And even if you don't do that, if you then go to soft foods, and your kid is two to three years old, and it's snoring or sleep apnea, which is so common now it's so tragic, because that leads to neurological disorders, ADHD, again. This isn't crazy New Agey. This was at Stanford, there's 50 years of research on this from the top institution here. So there are direct links between those things, but luckily we have technologies now that can help restore to the mouth to the way it was supposed to have been before industrialisation. They actually widened the mouth of these small little kids, and open their airways, and it drastically improves their health. Lisa: Today so it's palatal expanders that you you tried out and actually isn't even as an adult was you developed I remember it was at eight coins worth of new bone in your in your face and in a year or something crazy so we can still so if you've missed about if you've not received your kids or your you didn't get that yourself or whatever, it's not all over there is things that you can start doing even starting just to chew now like that to eat some carrots and whatever you know, whatever hard foods you can find to actually use those that powerful joy in order to make it stronger. It's just like every other muscle in the body isn't it? And when we're mouth breathing to our remember you saying or the muscles here get lax and flattered and just like any other muscle that we're not training, if we're if we're going to mouth open all night and we're you know, then we're causing those muscles to be lax and over time that that leads into sleep apnea and things as well can do. So yeah, so this is something that we can practically get a hold on now even if it's a bit late for you and I think. James: Yeah, I talked to my mum I was bottle fed after like six months my mum was like six months is a long time when I was growing up bottle fed soft foods industrialized crap my off intel I was you know 25 and it discovered these things called vegetables. But you know, so so this isn't pointing the finger at anyone we were sold this story by our governments that said you shouldn't eat mostly refined grains, eat your Cheerios, eat your bread, or crema wheat eat your oatmeal like that this is eat your sugar, that's good. Eat your chocolate milk, you know, so we have knowledge now we know the folly of our ways. But the one thing that was inspiring to me this is easier to do, when you've got a developing kid quickly growing it, you can set the foundation and their face will grow around like their faces grow different. It's just, it's beautiful to see how the body forms to its inputs. So I, you know, youth was several decades ago for me, for far too long. I was a child of the 70s and 80s. Right? Yeah, we thought I thought once you're in middle age, you're completely screwed. What can you do, but that is just a convenient excuse for people to say, “Oh, it's genetics. Oh, I inherited this.”  Like genes turn on but they can also be turned off and so I wanted to see what how I could improve my airway health in a year and so I took a CAT scan, and I did proper oral posture, you're 100% right when, when you're just eating soft, mushy food in your mouth is open. All of those tissues can grow really flabby just like anywhere else on your body. But if you exercise them if you exercise the jaw, the strongest muscle in the body, you know, for its size, the tongue, extremely powerful muscle, you exercise these things, they get tone like anything else. And this can help open your airways. So this is just an anecdote, this was my experience, it'll probably be different for other people. But I did a number of these things. And a year later to the week, I took another CAT scan, and the results were analysed by the Mayo Clinic, which is one of the top hospitals here. And they found that I increased my airway size about 15 to 20%. In some areas, and I can't tell you just as a personal story, it has absolutely transformed my life because I can breathe so much more easily through my nose. At night. I am silent. I didn't snore before but I was knowing that my wife would always tell me, totally silent now. And of course I am because I have a larger airway, things are more toned air can enter more easily. Lisa: Is it easy to find palace expanders are these like any a couple of dentists in the world doing this sort of stuff? James: Not everyone needs palatal expansion. I've gotten so many hundreds of emails of people, you know how we are, it's like, what's the latest thing, oh, there's a new pill, there's a new device. Oh, I get it, that's gonna solve all my problems. So they can really help people who need it just like surgical interventions. For people who have severe problems in their nose are a huge help. They're transformative. What I found is a lot of people don't need that. And what I firmly believe is start slow, start low, see what your body can naturally do. If after six months, you're like, ‘I'm still not this isn't working,’ go see someone you know, and take it from there. But palatal expansion absolutely works for people who really need it, but you would be amazed by just doing something called oral-pharyngeal exercises. There was a study out in chest, which is one of the top medical journals, you know, they found this significantly cut down on snoring, not lightly, significantly. And all it is, is exercising the tongue, roof of the mouth, proper oral posture, just working out this area. Toning it, of course, that's gonna help you if this is flabby and hasn't been to.. Lisa: The gym for your mouth. James: That's what it is. And I view that world, there's a whole separate school called myofunctional therapy that is helping people do this, which is so beneficial. They focus mostly on kids, but they also work with adults. And this is what they do. They are the instructors, the gym instructors, for your mouth and for your airwaves. And I strongly recommend people looking that up, there's a bunch of instructionals for free on YouTube, you can go that route as well. Lisa: Oh, brilliant, we'll link to some of those on your website. And, you know, I get people those resources. It's just, it's just amazing and fascinating stuff. And who would have thought this conversation would go so deep and wide, I wanted to just finish up then with talking about the immune system and stress reduction and vagus nerves and all of us area too, because, you know, me included in this and most people are dealing with, you know, massive levels of stress, and breathing can I've, since I've read your book, and I was really, you know, quite aware of how to bring my stress levels down and movements and the importance of you know, yoga and all those sorts of things. I've had that piece of the puzzle sort of dialed in, if you like, but the breathing exercises and actually calming the nervous system down within minutes. Now I can fall asleep in seconds. And you know, what seconds is a bit exaggerated but minutes, and I can I can take myself from being in this emotionally, my god and i tend to be like that because I'm like, you know, busy, busy, busy. And then go, “Hey, I'm spinning out of control. I've lost control of my breath. And I hear myself and I pick myself up on it now.”  And I go and do two minutes of breathing exercises. That's you know if that's all I can afford to do, and I can switch into parasympathetic now, that's been gold. Can you just explain why the heck does doing this slow light breathing diaphragmatically stimulate the parasympathetic nervous system and the vagus nerve from what's actually going on there? James: Sure. So what people can do now is take a hand and you can place it on your heart. And you can breathe into rate of about three seconds and try to breathe out to about six to eight seconds, just whatever's comfortable. Now, breathe in again. 123 and exhale. And as you're exhaling out very softly, you're going to feel your heart rate, get lower and lower. And lower. So when you are exhaling, you're stimulating that parasympathetic side of your nervous system, our breath can actually hack our nervous system function. And by exhaling more, and taking these long and fluid breaths, you can trigger all of those wonderful things that happen when you're parasympathetic. You reduce inflammation very quickly. You send signals to your brain to calm down. You actually change how your brain is operating the connectivity before the between the prefrontal cortex and the emotional centers of the brain changes when you slow your breathing.  So throughout the day, if you want to remain balanced, you take those soft and easy light, low breaths, to account of whatever's comfortable, three, four, even up to six, and six out. But if at some times you feel “My stress levels are starting to increase. I'm feeling my mind slip. I'm making rash decisions.” Start extending the exhale. An exercise I like to do is inhale to about four, exhale to six, you don't have to do it that long. Inhale, two, three, exhale to five, whatever's comfortable, as long as that exhale is longer, you're gonna feel your body slowing down. And if you don't believe me, all you need to do is get your heart rate variability, monitor your pulse oximeter and take a look at what happens after 30 seconds of slow, focused breathing. And you will see this transformation occur in your body, if that can happen in a couple minutes, what's going to happen to you after a couple of hours of taking control of your breathing, or a couple of days, or a couple of months.  I'll tell you what's going to happen. I talked to dozens and dozens of people who have fundamentally transformed themselves through nothing more than breathing. I want to mention again, I'm not promising this is going to work for everyone for everything. But it needs to be considered as a foundation to health. Lisa: And you need to stick at it for a little bit. And you know, I do my HIV monitoring every morning before I get out of bed and do my breath holding exercises and look at my boat score from Patrick McKeown. And you know, all that sort of stuff. Before I even put my feet on the floor, and I yeah, I can control my heart rate to a degree just through my birth weight. So I know this works. And I know that when I do a longer exhale from that, and compared to the inhale, immediately, I just feel a bit more calmer, and a bit more in control. And it's reminding myself and this is the trick because we, when we're in the middle of work, and we've got meetings and phones are going and emails are coming at us, and it's like the “Lions are chasing me.” And it's been trying to remember to breathe in. Bring yourself down and calm yourself down. And just take that couple of minutes many times a day, you know, depending on how stressful Your life is. And in doing that on a regular basis, over time will have massive implications. Because we're talking here, your digestion. You digest food better if you're in a parasympathetic state versus a sympathetic, your immune system. Again, coming back to COVID in that conversation, you're going to be improved, you know, your hormone balance. Yeah, just to fix everything, the way your, the brain waves, all of these things are going to be affected by your stress levels. And what is th

Self Care Ideas That Most Corporate Professionals Haven't Considered You can't go very far when you're running on empty, no matter how hard you push. And that's why we've come up with this fun episode for you — consider it a virtual "filling station." All you need to do for now is hit the brake, find clarity, and refill your tank with self care ideas that use your natural talents. Just like operating from your unique strengths, practicing self care makes a world of difference. Self care is not self-ish, because it results in giving your world the best of you [very punny, right?]. No matter your role in your team, your strengths can guide you in choosing the tasks that replenish you so that you can contribute your best - and achieve goals with less effort. Our host Lisa Cummings is joined once again by TyAnn Osborn, and together they will guide you towards the things that could re-energize you. As you'll find out, filling up on self care ideas doesn’t have to be limited to studying mindfulness, meditation, and massage. Surprisingly, self care can feel really practical in the workplace, despite the typical connotation, which seems to live outside of the office. There are many self care ideas that come right out of your natural talents - ways you can approach your work to re-energize you while you simultaneously get things done. Here’s their conversation: Lisa: You're listening to Lead Through Strengths, where you'll learn to apply your greatest strengths at work. I'm your host, Lisa Cummings, and you know, I'm always telling you, it's hard to find something more energizing than using your natural talents every day at work.  Well, something that's just about as energizing is when I get to hang out with my other host here in the room, TyAnn Osborn.  TyAnn: Hi! Lisa: Today, we're talking about... We don't know yet what we're talking about, because we're doing a spin-the-wheel, where it tells us what we're talking about for the day. So let's spin.  TyAnn: Okay.  Lisa: Ooh, this one is talking about self care ideas...  TyAnn: Self care.  Lisa: When you run empty. TyAnn: Well...  Lisa: No, you should just start this Ty, because you've talked about when the cup is empty, you have nothing to give. We definitely need some self care ideas up in here. How These Self Care Ideas Can Help You Avoid Burnout TyAnn: That's it. So I think this is a really important topic right now. And, you know, we're all facing different struggles, no matter what it is. Depending on when you listen, there can be any number of things happening. Maybe you've got a personal health struggle, maybe you're facing job troubles, potential job loss. Maybe you've got some family stuff going on, kids stuff going on. I don't know, maybe there was a global pandemic. There's all kinds of things happening in the world right now, and something is probably happening in your life.  And here's the deal. You know, we have a lot of demands and pulls on our time and our energy. And often, we're trying to give so much to other people. If you're a manager, a people manager, you know, you're really trying to show up and be the best for your team. If you've got kids you're trying to give. If you're a volunteer, you're trying to give. But the truth is, you can't give from an empty cup. And so this is really where we've got to build self care ideas in our own life so that we can have our own replenishment - things that help us so that we can help give to other people. Because, believe me, if you're just gonna keep pouring, nothing's gonna come out.  Lisa: That's a good point. It's kind of like, if you use your cup metaphor, I'm going to drink, there's nothing there. I'm trying to take a sip, there's nothing there.  TyAnn: Yeah, you're still slurping on that straw, like (slurps)... Nothing happening.  Lisa: And I, I see this with a lot of clients where we want to be it all. We want to give it all. We want to do it all.  TyAnn: Yeah.  Lisa: I have very high expectations of myself that I never meet. I see customers who have high expectations of themselves that they never meet, and they feel crushing expectations from other people around them, so that same family member, teammate, boss, all of those situations, and they are like, "Everyone wants a piece of me, and I've got nothing." TyAnn: Yeah, "I've got nothing to give." And believe me, that is the number one recipe for burnout right there. Because, you know, we're people and a lot of us are strong in terms of achievement, and being able to really, you know, move forward. That's why we're successful in our careers. And we've kind of gotten to these points. But believe me, there's only so far you can push this before you will just hit a wall.  And often, you and I've talked about this before, oftentimes your body will tell you you've hit a wall before your brain will intellectually let you believe it. And, you know, I heard this one time on Oprah, she said, the universe speaks to you. And first, it'll be a whisper. And if you don't listen, then it'll start tapping a little louder. And finally, you know, if you keep not listening, it'll smack you upside the head. So I think it's really important to generate  self care ideas, and create a practice.  And we can talk about, "What does that look like from a strengths perspective?" Lisa: Yeah. When I think about self care ideas, I think about fitness. I think about fuel in the body, like what you're eating and drinking. I think about, "Am I consciously trying to direct my work to allow energizing things?" TyAnn: Yeah. Lisa: I also think about hobbies. Am I doing things in life that fill my cup back up?  TyAnn: Yeah. Different Energizers For Different Folks — Scrap The Judgment Lisa: There are a lot of things I think people can list if you ask, "What things energize you?" TyAnn: Yes.  Lisa: But then how many do you allow yourself to do, and how do you know the payoff, like, “Okay, if I allow myself to sleep 9 hours a night, which my body thinks it wants…”  TyAnn: Yeah. Lisa: We can have self care ideas, but we might not give ourselves permission to try them. It feels self-indulgent. TyAnn: So true. Lisa: ...I think, "I don't have time for that. I have too much to do." But I think I also would like to drive to a gym and go do yoga in the morning and then, start work around noon, and...  TyAnn: Play with your dogs and the drums and take a nap.  Lisa: Yeah, I have songs to write. I have drums to play. I have dogs to take care of. I have a husband to hang out with. I have a lot to do. And that takes up a whole workday all by itself. These are beautiful self care ideas, yet I need to bring home the bacon too. TyAnn: Right?! Did you time for work? Lisa: Who's got time for that?  TyAnn: Yeah. So how do you fit these self care ideas into your day? And how does this feel like not just one more thing I have to do? And then where can I get the biggest bang for my buck?  Lisa: Yeah. Good point. You can have self care ideas, but they can also feel burdensome because they take up time. So what's the first step? I mean, and we're doing this related to strengths.  TyAnn: So what are all the answers to this mystery?  So a few things. I will just offer a personal bias. I think this word "self care" is used a lot now. It's thrown around. And sometimes when I hear it, it feels a little soft. Or it's all about like taking long hot bubble baths or something. And I think that feels a little squishy to me. So how about we just say, things that replenish you? Whatever that is for you.  Lisa: The magic wand, we are now turning "self care ideas" into "things that replenish you." Very simple. That definitely makes it less squishy. TyAnn: Yeah. And I also think we can take away judgment on that, because something that makes you feel good might not make me feel good. So it's very personal to you.  Lisa: Well, I think that we have one of those because I think that you're making fun of bubble baths, but that you actually do like them. And you like to read in the bath.  TyAnn: I do.  Lisa: Meanwhile, when we built our house, we built a bathless house because we don't take baths.  TyAnn: Hey, interesting trend in real estate, right? Lisa: Is it?. I didn't realize that. TyAnn: As someone who just went through that process, now you go in, it's kind of polarizing. Bath person. No bath person. Some people have the big freestanding bathtub, it's a whole spa. Other people are like, "No, that's big waste." So it is a good metaphor for this topic.  Lisa: It totally is. TyAnn: Because one person's replenishment is another person’s waste of space. So that's something that I do for myself and actually recommend for my clients as well. It’s just...take out a white sheet of paper. I'm a big believer in like analog tools, or get a whiteboard, and then just list out stuff you like.  And here's what's interesting. Sometimes that can be paralyzing to clients, like, “Oh, my God, where do I even start?” So just take away all of the judgment. It can be little things like, "I like chocolate ice cream." That can't be my entire self care regimen, by the way, or I'd gain 50 pounds. But, you know, just start listing without judging the list. Creation and editing are two very different processes. Separate them so we can start listing out things. Start with the creation of a list. Write all of the things that replenish you. If that feels too limiting, just write things that you like - activities you enjoy. Lisa: Don't judge it while it's landing on the page. TyAnn: No judgment. As Planet Fitness says "this is a no judgement zone," (even though they misspelled judgment). So... Lisa: They did? TyAnn: Some judgment...  Lisa: You’re judging the judgment spelling, that is.  TyAnn: I know, judgment, right? Slightly judgy. So I would just say, try that, or I get clients stuck on... "I can only list work things that I'm excited about..." Lisa: Ha ha. I hear your Maximizer talent coming out. Maybe we can do categories for their self care ideas. Tyann: Yeah.  Lisa: Let's come up with some categories. You could list work things that you like,  TyAnn: Could be...  Lisa: Work people that you like. TyAnn: (laughs) That's a big one.  Lisa: Because people are like, “You replenish me. When I'm around you, my energy goes up.”  TyAnn: But there are some people who don't replenish us. So they wouldn't go on the list.  Lisa: Right? Ha ha. Okay. So we've got work...tasks or responsibilities. We've got people.  TyAnn: Maybe workplaces.  Lisa: Ooh, like physical places? TyAnn: Yes. Or maybe if you get to travel somewhere that's fun. Or maybe traveling for you to some location you dread that maybe you have to go once a quarter. And that's really a de-energizer for you. So don't put that on your list.  Lisa: And you might know, "Hey, I'll make another list of things I need to get my energy up because I know it's going to be drained more...when these things happen." TyAnn: So this is the “things that bring me energy” list. So work stuff... and get as granular as you can in terms of work tasks. So I don't recommend putting things on there like, the XYZ project, because that's way too big. So get very granular about what specifically about that project did you like? Did you like interacting with the project team members, because it was just that awesome team where you really felt like you clicked with everyone? Or was it because you got to be out front? That would be me. You know it to be out on stage or I get to be the one making the presentation. Or maybe you're that spreadsheet jockey and you came up with just a brilliant thing that you pushed a button and all these magic happened, and it was the coolest thing ever. That would not be me. But for someone that could be.  Lisa: You can also see trends after the list is complete...if you make yourself stick with the list-making when it gets tough for a minute. Then you can see bigger trends. Like one that I know for me I've figured out is, I like making things, but I like making a class. I like making an audio file. I like making a song up. I like making all sorts of different types of making. Some are very tech-focused. Some are super creative, but I couldn't see that trend until I listed a bunch of the details.  That's when you get self care ideas that you never expected. They don't come out on the first pass. TyAnn: That’s great! I love that. So then you can go back and say what is it about these things that are similar? It's a creative process.  Embracing What’s 'Weird' And Improving On What’s 'Standard' Are Self Care Steps Too TyAnn: Yeah. And this is for people who are like, "Oh, I can't list that, because that...that doesn't count. Or, I don't want anyone to know that I secretly like to….[insert whatever crazy hobby it is]. I was working with a group of chemical engineers. And this one gentleman, he stood up, and he said, “I like Dutch oven cooking.” And I thought, what a brave thing to say in front of a room of other chemical engineers. And I'm like, “You go! Dutch oven cooking! What a specific niche thing to do.” It's a brilliant self care idea, but he never would have called it that. Lisa: Yeah. It makes me think of "things you do to decompress" as another category for the list of self care ideas. Tyann: I didn't even know that was a hobby. And I like to cook too. And whatever it is, it doesn't matter. It's all about what rejuvenates you. Lisa: Back to your analog self care idea list: I facilitate an activity like this. I'll put the timer on two minutes, and I'll say, “Don't let the pen stop... keep going as a stream of consciousness thing." What did I like doing when I was 9? What am I doing when I lose track of time? What activities are fun? Who is fun to be around? What am I good at? What comes easily to me? What makes me feel alive? What am I saying when I crack myself up? What topics to I love to learn about? What makes me different from the average person? If you just can't think of an answer, keep the pen going and move to another angle." What you brought up for me is my follow-on, that I'll often have people do, which is: Keep this out for a week, because you need to grab the little moments that you didn't even know, “Oh, I got a little spark out of that idea and it reminded me of a whole new set of self care ideas.”  And one of them that I think is really cool is: What makes you weird? And if I just ask you that, like, how many things could you list? Well, I might be able to add more than a normal person. But the little things like, what has anyone ever commented on? Because they'll come up. They'll pop in your head later.  TyAnn: Right.  Lisa: Okay, a weird thing about me is I eat canned things, because I like to eat vegetables and I like to be efficient. And I don't like spending a lot of time on my food. But I do want quality food in me. So somewhere in the middle, I found a jar of beets that I eat for my snack or my lunch. That's weird. I just stick my fork in the jar of beets and I eat it. Isn't that bizarre?  TyAnn: Lisa eats green beans out of the can as well.  Lisa: I will. Green beans are doable... but.. some of them are too squishy, like canned asparagus and spinach. Those are a no-go… Green beans, corn, beets — all workable for moments of vegetable efficiency. But that is very weird. But if you start looking at it like, what energizes me? The energizing part isn't the beets. It's finding new efficiencies. Finding ways to break a rule, like that rule makes me think about how I don't have to cook because other people do. I remember a moment when I got feedback at my house that I was not running the dishwasher as often as it should be because we were running out of forks. And so my answer was *not* to wash dishes more frequently or run the dishwasher more frequently. It was to buy more forks. And I got a real kick out of that. It was my special way of being efficient and effective. So these weird things about you can generate surprising self care ideas. TyAnn: I love that.  Lisa: When you see “Oh, I love coming up with something that is a solution to a problem that is not normal, that no one else would think of.” And I'll get a jazz out of that that will give me an hour-long high.  TyAnn: Yeah.  Lisa: So being able to write down those things, like the moments where you got a boost or you got a kick out of yourself.  TyAnn: This is so great. So you've said a couple of things that I think are brilliant.  Life is made up of all these little moments that are punctuated by the big thing. But 99% of life is...just we go through life, right? So that's where we can look. And so much of what you said is like a Maximizer coming out, which by the way, I'm that as well. But two examples for you in the food realm. So we started getting those home boxes that come with the food and the recipe. The box comes in, you have the recipe and you put it all together. Usually it's my job to put the ingredients together. Occasionally, my husband will put it together but he takes the recipe and goes exactly step by step and it comes out and, you know, it's fine. I'm different. I take the recipe and use it as a launchpad. It's like a starting point because I'm often thinking, "Hmm, you know, what would make this better?Just a little bit of shallot, a little bit of garlic, you know, a dash of cinnamon..."  And then I’ll present it to him, he's like, “This is not the recipe.” I'm like, “I know. It's better. It's better.” That's like a hallmark of Maximizers: "I’m gonna make this better!" Lisa: And it makes you really excited. TyAnn: Oh, huge, huge jazz out of it. 'Cause I sort of have this image of myself back at the test kitchen of whatever company being all like, “I made it better,” even though that's not my job and I would never do that. Anyway, in my head, it's pretty exciting. So, and a long time ago, back when the interwebs were still very new, I had this website, and one of the things I did was reviews of restaurants and products. This is really crazy to think about now. But do you remember flight — I know, we'll get back there one day — and in the in-flight magazine, how there were always those lists of like, top 10 steak houses in the United States.... Well, I took that as a challenge. And so I decided to go visit all of them, and then do reviews on them and see if I really thought they were the top 10 steak houses.  So then I had a whole thing on. Lisa: And you had this whole energy...  TyAnn: I do!  Lisa: ...about it.  TyAnn: And I'm 100% sure no one ever read that. But it didn't matter. I wasn't doing it for the audience, I was doing it as, like, a quality kind of thing.  Lisa: Hmmm. What's your take...you're making me think of...on the topic of self care ideas...how fulfilled we feel as humans and how alive we feel as humans, because I think there's a difference between being alive and feeling alive, like feeling alive for what you're doing. And that so much of it can come from striving and having a goal and that there's something around it even if it's something like, “I have this thing, I'm going to visit these 10…places." TyAnn: Whatever… Lisa: Whatever that thing is, so even making one of those lists...instead of it being an inventory of things you've found yourself get a charge out of it, could be like, “Oh, that sounds fun. I'm actually going to go do that.” TyAnn: You know, there was research that was done about, and this was really done on couples and families. And something that was particularly bonding was something they came up with and called it a quest. But it works for individuals too, that whenever you have a quest, something that you're doing together, and it doesn't have to be like, “We're gonna go visit every continent,” even though that could be fun, but that might be a little unattainable for a lot of people, it could just be, “We're gonna go check out all of the state parks in a 30-mile radius from our house.”  Lisa: Yes! TyAnn: Or we're gonna find a public fishing hole near where we live. I mean, it doesn't, it literally doesn't matter what it is. It's just something that's a common goal for you.  Bringing Strengths Into Self Care By Focusing On Things That Energize You Lisa: I like that as a very actionable thing that you could do with this, where you're like, "How can I do self care? Can I bring my strengths into it?" And by the way, you can look at them and say, "What would light these up?" And that can be part of your list making. But also, if you do things that feel easy to you and energizing to you, they probably are in alignment with your strengths naturally. TyAnn: That's a clue to strengths, too.  Lisa: Yeah! TyAnn: Usually your strengths are things that bring you energy and you feel naturally attracted to. So it doesn't matter if it's, "You know what, I'm going to try a seasonal fruit or vegetable this month. This is going to be the month of asparagus, and I'm going to go try that.” Whatever. Or, "We're going to try a new place." You know, you often hear this, "We're going to try something new." Because if you put yourself out there a little bit, but it's a new adventure of some sort, it kind of satisfies a lot of this neat thing. And that's what really gets a lot of cool juices flowing for you. Doing the same thing over and over tends not to stroke that same area for you.  Lisa: Yeah. And I like how you do the... If you're going to come up with a quest as one of the action items like, what could your quest be? And could you have a quest that would be a workplace quest or a family quest? And then could you do one that would feel really enlivening to one of your strengths? And then even if you wanted to have a work or family conversation around it, how could this quest be really fun for this family?  TyAnn: Yeah.  Lisa: Or how could this quest, this big aspirational goal that the team is heading toward, which… How could you find a way that one of your strengths comes alive through it? It would be a really cool conversation.  TyAnn: Absolutely. Lisa: I don't know if this is the same video you were talking about with research? Jane McGonigal was a researcher and she was recovering from a concussion. She started a quest to get better. There's a TED talk where she describes what she did to power up. She called it Super Better. And it was how she gamified getting better. She was also a gamer and she figured out a way to get super better, but bits at a time. And this quest notion, whether or not she used those words. TyAnn: I love that.  Lisa: ...it was baked into it. And it gives you a way to get there. Instead of feeling like, I think when people are bad at self care, when we're doing ourselves wrong, it's because I'm like, “Well, I'm, I haven't worked out this week, so I'm going to eat tater tots for breakfast.”  TyAnn: We like tater tots in our house as well. Gotta say. Tater tots loving family. And then someone might say, well, and if I had tater tots for breakfast, I might as well just go all in and have cake for lunch. And... Lisa: Oh, and I put ice cream on my list of self care ideas. So we have that and then you're all downhill.  TyAnn: But it's an interesting kind of this concept too. So you know, a lot of people have workout on their list because they think that's what should be on the list. So I would say stop shooting on yourself. What brings you energy is what brings you energy. No one's creating this, by the way.  And so if you feel like a natural attraction to you would like to get more activity in your life, that doesn't have to mean I have to go to the gym for an hour and a half, and get on some torturous piece of equipment that I don't want to be on, that makes me feel icky... Or, I have to go to a Body Pump class where I'm embarrassed and don't know how to do it. That's not what that means.  Lisa: Yeah, I think that thing, like remembering, there's a notion, maybe it's one that other people have put out there for you. Or maybe it's something you've made up about what that word means. Workout is a good example of one that's loaded. TyAnn: Yeah, a lot of baggage, Lisa: I think quick shout out to the book, Eat, Move, Sleep. That’s a really good one for self care ideas. TyAnn: Absolutely.  Lisa: …asking yourself, how are you on your eating and moving and sleeping? But okay, like if you said, “Okay, I want to move.”  TyAnn: Right.  Lisa: What kind of moving is fun for me? Maybe for one person, it's taking a walk with a friend,  and you got to have the social connection while you were power walking. For the next person, it’s going to a group exercise class.  Like I had... I went and hooked up my Xbox again, for the Kinect, to dance to Fergie. I mean, it's silly, but that's a fun workout for me. So why don’t I do it? TyAnn: That counts. That counts.  Lisa: And then you go, “Oh, well. Well, I do. Why don't I hook that back up? TyAnn: Right!  Lisa: Why do I have that unplugged? TyAnn: So if you want to be Dance Dance Revolution, man, knock yourself out!  Lisa: I love Dance Dance Revolution.  TyAnn: Or if you just want to crank up the music, or take a walk, or if you want to try some, you know, whatever new class is out there... Lisa: Take a whole new class! Whatever sounds fun for you. TyAnn: ...there’s something. So I think it really is trying to get away again from, if you write something down because you feel you should, I would say take another look at that, because that's not bringing you energy. And this is supposed to be a self care list about things that are exciting to you and bring you energy.  So if you feel like you should call your mom every day and spend an hour on the phone with her, but that doesn't bring you energy, don't put that on your list. Don’t put that on your list. Or even working out. If that doesn't sound so great to you, think about, “What does sound great to me? Hanging out with my friend sounds great. So maybe, I get an accountability partner at the gym. Then, that can be where I go to see my friends, I've kind of paired something I'm a little more iffy at with something I'm excited about. So together, I'm sort of killing two birds with one stone in a way that still feels awesome."  Lisa: Yeah.  TyAnn: So I think that's part of that self care. So I would just say, get back to that creative space. Think about those things which bring you energy. Try to get down to those micro-segments. I like organizing, that brings me energy. And so if I'm feeling a little out of sorts,  Lisa: Labeler.  TyAnn: If I'm feeling a little out of sorts, I might just literally pull open my desk drawer and just get it sorted out.  Lisa: Oh, this is the perfect closing to this.  Self Care Need Not Be Hard Or Inconvenient — Grow On Micro Habits Lisa: On the best self care ideas: My favorite TyAnn concept of the universe is “stop making things so hard.”  I make life hard because I think of all of these things I should be doing or want to do or that would feel great. But then they feel too gratuitous. It just feels like too much time. I don't have that much time for these eight hours of things I would prefer to do during the day.  TyAnn: It's too much.  Lisa: So the opening one drawer, and organizing one little space...  TyAnn: Right.  Lisa: The reading one page of a book, not even one chapter, but I like reading, I read one page.  TyAnn: Yoohoo, ‘crushing it! I’m winning. Lisa: If you’ve read Atomic Habits, have you checked out that?  TyAnn: Yes. Yeah.  Lisa: It's like, I will put my workout shoes next to my bed, and I will put my workout shoes on and then maybe...I will do 10 push-ups, and that's your only expectation for yourself — 10 push-ups, just something that is...  TyAnn: ...that you can crush, you can win... Lisa: ...very small and doable.  TyAnn: Micro-habits.  Lisa: ...and let it grow.  TyAnn: And you're like, I want to eat more vegetables. Great, I ate one asparagus. Winning! (laughs) Right? As opposed to, “Well, now I have to become a vegan.”  ...which seems like a big thing.  Lisa: That is so funny as a closing thought too because I have some like vegan experimenting things that… TyAnn: Vegan-curious? Lisa: Yeah! Say I’m plant-curious. If you're listening, hey, Becky Hammond from Isogo Strong!  TyAnn: We love Becky!  Lisa: Becky's a vegetarian. I was talking about well, you know, if I were to do it, I would just go vegan because I don't eat dairy so I would just like, that's the big battle with going vegan to me anyway, is I can't eat dairy anyhow. So I got past the vegetarian vegan thing. But I don't know about that. And I started giving all of these reasons: "This gets in my way...this makes it a precarious approach...and this makes it inconvenient. And she's like, “Just have one more plant-based meal per day." I said, “Oh, hello!” I hadn't thought of that. TyAnn: Something doable. Lisa: Stop making everything all or none. Stop making everything have a mutually exclusive this or that.  TyAnn: Stop making it so hard. Stop making it so hard. Lisa: And with that, I think it is…the perfect ending. So you've been listening to Lead Through Strength. As you think about not making it so hard and bringing your strengths into your self care practice, walk away with your list. Log those moments over the next month, maybe just a week or a few days. But catch the moments that were fun to you. Come let us know on social what they were for you because it is fun to hear the energizing moments for other people.  TyAnn: Absolutely. We'll talk about all of the self care ideas. Lisa: We will. Because the variety is so much fun when you learn one person's trash is another person's treasure - in hobbies and in tasks at work. So with that, let us know which ones you're starting to implement. We would love to hear how you took five more minutes for your self care so that you can fill your cup because we don't want you out of water. With that, we'll see you next time. Bye for now. Resources: Self Care Ideas To Help You Fuel Up Your Strengths And Fire Up Your Life Vital to self care is staying at your top form and performing better at work by knowing what keeps your strengths honored and insulted. Visit Lisa’s insightful episode about finding energizing tasks at work to discover what situations (or cultures) can either drain or motivate you based on your strengths. But simply knowing what honors and insults your strengths or talents cannot complete a self care process. Lisa’s Strengths Blind Spots episode serves as a great reminder to “feed our talents the same way we feed our body." Spend time developing and nurturing them instead of squashing them down so they can best serve your performance and, ultimately, that of the team. Finally, check out this episode on Wellbeing: Bravely Build a Fit Body and Mind Through Strengths with Lisa and Matt Swenson. You’ll learn to create healthy strengths habits around the 5 essential elements of wellbeing: career, social, financial, physical, and community. Life-changing self care ideas!

How Can I Turn Conflicts Around When My Manager Hates Me? Certain situations can highlight the stark differences within a team, especially when your strengths seem opposite of others' strengths. For example, you might think “my manager hates me” when they seem to value other team members' ideas and blow off yours. To conform or to stay true to your natural talents becomes a tough choice to make.  When you’re the manager, it takes some skill to build a balance between honoring your team members' strengths and honoring yours, especially where you think the business priorities and values are at stake. And when you manage a team with a very different set of top 5 or top 10 strengths, how exactly do you do it? Welcome to this episode, the first in a series with TyAnn Osborn, who role-plays and reflects with our host Lisa Cummings on the difficult scenarios where team members may have conflicting strengths. How do they handle the situation and turn conflicts around? Here’s the transcript of the episode. Lisa: You're listening to Lead Through Strengths, where you'll learn to apply your greatest strengths at work. I'm your host, Lisa Cummings, and you know, I'm always telling you, it's hard to find something more energizing than using your natural talents every day at work. Well, something that's just about as energizing is when I get to hang out with the other host here in the room, TyAnn Osborn. TyAnn: Hi! Lisa: Today, we're going to talk about a topic that we haven't decided yet, because I am going to use this spin-the-wheel thingy thingy, to tell us. *Spins the wheel* TyAnn: I like the sounds. Lisa: Oh, it says: ‘You don't like a teammate.’ When Someone On The Team Drives You Crazy Lisa: So today, we're going to talk about what you could do with your strengths when you don't like one of your teammates. Has this ever happened to you, Ty?  TyAnn: No, I've always loved everyone that I worked with... No...[hint of sarcasm] Lisa: But I bet one of your clients has had this situation since you've never had it, 'wink-wink...'  TyAnn: Of course, there's always someone that - for some reason - rubs you the wrong way. You just, you know, they're not your love language. And I work with clients all the time who have... there's always seems to be someone on the team who they just can't seem to get along with. Has this ever happened to you too?  Lisa: Definitely. I mean, it's funny because I feel like a big thing about me is that I love people. And I love most people.  TyAnn: Right. Me too! Lisa: But there are people that I don't jive with as well.  TyAnn: Yeah.  Lisa: And it takes some extra effort to understand where they're coming from, or really feel like, ‘Oh, I fully get them,’ or something like that. TyAnn: Which, you know, that's interesting when you're an individual contributor, when you feel that way, because you're like, ‘yeah, maybe that's just him’, you know. But when you're a manager, and you think, ‘Oh, I'm supposed to like everybody on the team’, or, ‘I need to not show favoritism but, eh, I kind of don't like that person. What do I do?’ It's kind of like being a parent; you're not supposed to not like one of your kids. So...  Lisa: Or not have a favorite.  TyAnn: Or not have a favorite. So, what do you do? Lisa: Okay, so let’s do a scenario? Let's do it like, you’re a manager. It will allow us to see the perspective of the manager thinking, "Ugh, that person is high maintenance on the team." And it will allow us to explore the flip side where a team member is thinking, "Ugh, my manager hates me. What should I do?" TyAnn: Yep.  Lisa: You happen to have done CliftonStrengths as a team.  TyAnn: Because you're a great manager. Lisa: 'Cause you're awesome. And there is a person on your team that you appreciate as a human, but as a performer, they feel very high-maintenance to you, they drive you kind of crazy. Let's pick some talent themes that might be seemingly opposite each other so we can make it a real scenario.  TyAnn: Okay. Lisa: Does one pop up for you as one that is least likely to be paired with another?  TyAnn: I see Deliberative being perceived as a problem child, especially when a lot of other people on the team might be more, say Activator, or something that's very forward in motion. Either Achiever, Activator, something like that. So maybe you've got a team that's like, ‘Oh, we're always ready to go!’ And there's one person who seems like they never can just get on the bus. And they're always the one dragging their heels. Lisa: Yeah. Oh, we should do this on both directions.  TyAnn: Okay. Lisa: Let's take Achiever-Activator.  TyAnn: Okay.  Lisa: And then let's take Deliberative. Say these are the two different people. And we can start with the manager, having Achiever-Activator, wanting stuff to get done quickly, and wanting to make decisions quickly. And the person who wants to take a little more time is the team member who reports to you, and then we’re gonna swap it.  TyAnn: Okay. Okay, I've got a real life example on that.  Lisa: Awesome. Okay. TyAnn: Absolutely.  Lisa: So you're my manager.  TyAnn: Okay.  Lisa: You're Achiever-Activator [role play begins you can also watch the video version to get the subtleties]. TyAnn: Woohoo! Let's get going, man, come on! Lisa: And I'm saying, "Well, bad news. I'm going to miss that deadline that you gave me." TyAnn: Lisa, what's going on? I gave you the deadline. Come on! Chop, chop!  Lisa: Well, the thing is, I *could* get it done, but I can't get it done *properly* right now, because we don't have all of the information. I've been trying to work with this other department. They've been dragging their heels. I’m waiting for them. If I do it now, I might just be giving you completely incorrect information because I'm seeing three or four ways this could all go wrong if I blaze ahead today, and it feels like I'm just gonna be wasting time…. TyAnn: Lisa, all I hear is excuses. I have stuff to get done too. We owe the marketing department this information. They're waiting on us to get this stuff into print. We're behind already and you know what, you're never going to have 100% confidence in what you do. So just give me something.  Lisa: Uhum...[hangs head]. Okay, now that we've come out of our characters from our roleplay, I would say, you were kind of playing like the in-between our manager where you were trying to give the people listening to the podcast, like a little bit of a glimpse of inside your head, but also be somewhat mature, like, in how you...  TyAnn: Right, right.  Lisa: ...because you're balancing the two - and that the inside voice and the outside voice are really different.  TyAnn: That’s true. My Team Member Frustrates Me: How Can I Moderate My Message To The Person? Lisa: Can you explain what was going on fully inside voice? Unfiltered. TyAnn: Yeah.  Lisa: ...and then how, if you wanted to maturely talk to me, and still keep me engaged...how that might look?  Tyann: I think that's a good point because hopefully, as you progress in your career, you just don't say the first thing that pops into your head. I always say, there's the reason why there's a little space between your head and your mouth. Yeah, have a little filter in there. But inside your head, it's very normal be like, "Oh, my God, you are so frustrating! I gave you the deadline. Arrgh, why didn't you say something sooner? You, you always do this. And all I'm hearing is excuses. Now you're throwing this other department under the bus. I cannot count on you. The rest of the team - we're getting it done. And we have to deal with the same things." So typically, what I see when I see this combination of strengths is a lot of frustration. That is usually the emotion that I see a lot, it’s frustration. Whoever has the action, it's like, "Oh, I'm just really angry with you." And whoever's on the receiving side, well, we can debrief how you feel. But usually it's a lot of frustration on that side, too. So that's kind of what's happening inside.  And then on the outside, but I'm trying to be a good manager, and I'm trying not to just say, "Oh my God, you're such an idiot, and I hate you." 'Cause I would never say that to someone. But I'm trying to say, "You know, of course, we're never going to have 100% confidence in what we do, because that's not real life. So we have to get to a point where we may feel 80% confident, and how do we do that? And too, you can't always have an excuse for why things aren't happening. You have to take ownership of something, too." So that's what I was trying to moderate in the message. So you could feel some of that?  Lisa: For sure. And I put you on the spot and I know this person is thinking, "I know my manager hates me, but I still don't want to deliver shoddy work." TyAnn: Right.  Lisa: It's easier when you have time to think out the words for the feedback. It's simpler to give the vibe that, "I've been thinking about how I'm going to coach you and how we can improve this over time." What we've been doing is the in-the-moment heated feeling, "Oh, we just missed a really important deadline. You didn’t tell me. I am so upset." Tyann: Right. And now my butt's in the sling because of you.  Lisa: Yeah. And I hear things from managers, like, "Everybody else can do it. You're the only one…" And then you don't want to give that as feedback... TyAnn: Right. Or you start hearing that relationship language like "always," and "never," which we say, you know, anytime you start hearing, "always," "never," that should be a clue. But when you definitely start feeling...  Lisa: Alarm bells. TyAnn: Yeah, alarm bells should go off. But when you start feeling inside, like, "Oh, my God, you're always the problem. You're the problem employee. Everyone else can get it done on time, how come you can't?" And that's when you start hearing things like, you know, "Lisa's got to go." Lisa: Right. The employee also feels the My Manager Hates Me alarm bells. TyAnn: Absolutely. From the manager, perspective they're already thinking of firing the person. I always call it "my employee’s broken, I want a new one" syndrome. And, you know, that might be an answer. But I don't want that to be the first answer. To me, I want that to be the last answer. And I would like to try and see, "Can this marriage be saved before we go to it's broken?" Lisa: Yeah.  TyAnn: Because it takes a lot of effort to get another employee.  Lisa: Oh, yeah. And I have something valuable to offer you with the Deliberative talents when they're dialed in well.  TyAnn: Right. Yes. Absolutely. Lisa: I might sit in the seat... Okay, here's what I would say, like, what would be in my head if I were this team member? I would be thinking, "Yeah, other people get it done on time. And all of my teammates, ‘always’, ‘never’... all, all my teammates, give crappy work. I'm on a team where no one cares about quality, all they care about is speed. We do so many things three or four or five times because we were refused to do it right the first time because we won't take an extra minute to get the information from the other department, or fix that relationship that's creating the block that won't let us get the information. My manager hates me and hates my style. "And anytime I bring up the ‘what ifs’ or ‘this might go wrong’, people treat me like I’m the negative Nellie so I just shut down and don't say anything. But it doesn't mean I want to give you bad work." TyAnn: Mm hmm. So yeah, so you're surrounded by people that you think are...yeah... Lisa: Half-assing it.  TyAnn: Half-assing it. And I like to say why half-ass when you can whole-ass? [smiles] Because you're right - then you're pretty probably seeing a bunch of rework that has to happen. When if we just put in the correct effort to begin with, you know, that wouldn't happen. But meanwhile, you've shut down.  Lisa: I've shut down.  TyAnn: ...because you've been shut down.  Lisa: Yes. And I might be thinking, leading through Deliberative, seeing all of the activity that is resulting in, in my opinion, bad quality work out there, now I'm thinking, "Oh, look, the whole team is running around like chickens with their head cut off. Looks totally foolish. I'm the only one actually putting reasoning behind what we're doing. I'm the only one who's thinking I'm the only one who is bringing some rigor to this process. How is it that my manager hates me when I'm the voice of quality and avoiding a crisis that we're bound to experience if we don't pump the brakes?" TyAnn: Right. Lisa: And no one's valuing it. And then I'm thinking, "Well, clearly, I'm not a good fit for the job, or the company or the team, or maybe my manager. But if the whole team I perceive it like that…" TyAnn: Yeah.  Lisa: And maybe they are like that. Or maybe they've just conformed to your behavior, because as a manager, you've been so strong in your speed. TyAnn: Right. Lisa: At least you're clear. So that I'm grateful for. You know, opposites.  My Manager Hates Me: Do I Conform And Please, Or Do I Look For Another Team? TyAnn: So you said two things that were really interesting. In this scenario, you talked about this, you were waiting on something from another team, so you were the only person who brought up even an interaction with another team. So to me that says you were thinking a little more systematically and holistically. So maybe these other guys should have been interacting with this other team, and they haven't been, so there's something going on there that should be paid attention to.  But you also said something about maybe the rest of the team, they actually know things should be being done differently too, but here's what you find in a team. People want to please the manager. Because why? Because we are self-serving creatures. We do self-preservation activities, because that's what help... helps keep us alive. And at work, that's what helps keep us employed and...  Lisa: You’re writing my performance review!  TyAnn: You’re writing my review, you're helping me keep this job, you're helping me get paid more. And so it's not that there's a diabolical plot, it's just we are human beings, and we are doing these behaviors because if that's what you want for me, that's what I'm going to deliver. Even if I know there's something else that's possibly better.  Lisa: Oh, it could even be especially if. What if I think I need you to think I'm a good performer? Because if I want to change roles, because this one isn't a good fit for me, I need you to...  TyAnn: ...to support me.  Lisa: Yeah, I need your support to move into another team. And when the next manager asks how I am as a performer...  TyAnn: Right.  Lisa: ...I want you to just say how amazing I am, not that I was your highest maintenance team member, right? TyAnn: So even if I thought you would be good for another role, they're going to say, what was Lisa's performance on your team? And I'm going to have to say Lisa was the worst performer. Who's going to want to take my lowest performer? That's going to be a much harder sell.  Lisa: Yeah.  TyAnn: And so you end up with kind of these, I always call them like aberrant behaviors. And again, not because people are diabolical, or someone sitting around trying to figure out, you know, the worst way to do things. It's just...it's self-preservation in action. And so if we don't make a conscious effort to really stop and think about things, this is what happens unintentionally. So at the end of the day, you have good ideas, probably that aren't being heard. People are running off half-cocked. And you know, there's a bunch of rework - probably not very high quality. You know, ultimately, it's just not the best product and not the best environment, or certainly not as good as it could be something. That's what we tend to see.  Lisa: Now even though this could be a perfectly good place to end this example, let's make sure that we've flipped the scenario. Because I think it's a good example for people to experience when the same situation exists, but the themes are flipped around, because it can just change the whole scene of how the team culture looks. You actually said you have a real example of this. So...  TyAnn: Yeah.  Lisa: Is that, is that a shareable example if it's anonymized?  Leverage Communication To Resolve StrengthsFinder Talent Theme Conflicts TyAnn: Absolutely. So I had this happen. And it doesn't often happen this way. But it did. And I thought it was a good story. I was working with a news crew, so the people you see on TV to put out the news. And the manager was very high Deliberative.  Lisa: Okay. Nice. TyAnn: And the news people as you can imagine, very high action-oriented. I mean, and it was a newsroom. It was very much "we have to get this on the air right now." I mean, it was very high-pressured. And so Deliberative, you know, doesn't like high pressure, needs time to think, really wants to make sure that all the facts are correct, I would hate to put something out and have it be wrong. So the manager was feeling like, "I am working with a bunch of people who don't care about quality, are willing to be excessively risky with the reputation of our brand, because we might have to put a retraction out on the air. And that we're just going to be putting stuff out there that's half-baked, and I work with a bunch of people who I can't trust." Meanwhile, the reporters are saying, “Our manager is a wet blanket. Every time we take him a really cool idea, his first reaction is ‘no’, or he asks me 17,000 questions that I haven't fully thought through, I don't have the answers to. So he makes me feel stupid, or he makes me feel like, by the time I get through all of his questions, you know what, the moments passed, like, it doesn't even matter anymore. Or he'll never get back to me at all.”  And so there was this just huge conflict between them with none of them feeling valued on the team. But you know, the funny thing is, I wasn't called in because there…to do a remediation or a problem. I was called in, because they were all high performers. That was a really interesting one to step into.  Lisa: Wow. What you're bringing up for me is this idea that it really doesn't matter what the themes are, or what the job is, because you can take any of your top CliftonStrengths talent themes, and they could be applied to serve any role. Because it's easy to get caught up in this thing, where we're like, "On this team, this group of them feels bad and this group of them feels right, or for this manager, this, this serves me, and these are not serving me. But the reality is that our natural talents are (if we allow them to be) our easy buttons to performance." TyAnn: Yeah.  Lisa: It's this concept of, well, maybe it's gone wild. You know, strengths gone wild. So if they could be honed in a little bit, both things that you were just bringing up in that scenario, are valuable to the organization. TyAnn: Right. Lisa: It's just all of them can't be on blast...  TyAnn: ...All the time. Right. So, Lisa, you often talk about keys on a keyboard, and when we play them together, and they're harmonious, we've got some good chords going. It sounds awesome, right? And so you're right, it's not that there's good strengths and bad strengths, or that, you know, these things are naturally in conflict. It's just kind of finding that right level, because I don't think anyone would say, "Yeah, we're just gonna slap junk on the TV. And if it's not, right, well, who cares?" I mean, no one's gonna say that, right? And no one's gonna say, "Well, we're going to chase down every possible lead until we get a 100%, you know, confidence in this. And meanwhile, it's just gonna be black on TV until we feel like we're 100% confident." Because that's not realistic, either. So ideally, it would be great to feel like, we can work with the pace that we need to and put out really quality content that I feel good about. And in the event of an escape, you know, or a quality issue, we have a good process in place to catch that and to do whatever we need to to make a quick correction.  Lisa: Yeah.  TyAnn: And so what I got him to do was, actually, to codify his thinking process. I said, "What are the top three questions you usually ask when someone comes to you with a new idea?’ And he said, ‘Well, I just wish people had thought through things a little bit better. So I wish they would think about this, this and this." And I said, "Great, let's capture that. Let's get that out to the team so that they can do that thinking and you don't have to." And that's it. That's easy. And I said, "How long would it take you to get back to the team then when they come to you with ideas? What...what would feel good and realistic?" And he said, "I could get back to people within 24 hours." So okay, so we went back to the team said, "Is that a commitment that's workable for you?" So we had both sides in a satisfied position. I wouldn't even say it's a compromise because it didn't feel like anyone was giving something up. It just felt more like communication. And so that together, we're better. And it was like a light bulb went on in terms of, now It didn't feel like I was just doing things the hard way, like it didn't feel like a struggle every day. It felt like people were almost looking for that next opportunity so that they can test the stuff out. Find Out Where One Is Coming From And Assume Positive Intent Lisa: Love it. So when you think about action items to give listeners, lets see what they can do with this. Maybe a person is thinking, "my manager hates me, so what are my next steps?" Or a manager is thinking, "Jim wears me out, so how can I give him a chance to show up at peak performance?" It's too bad that this becomes a recurring theme at the office. It's the same frustration over and over again, it's just that they haven't figured out how to talk about it yet. Often they'll bring in Ty to say, “Can you help us communicate better because we haven't been facing the tough conversation with each other - now it's messing things up." Tyann: Right. Lisa: I love that there's the facilitated process that could happen. And by the way, you can bring Ty into your organization to do this, if you need help. Sometimes it just still feels awkward for you to do it because you can't be neutral like a 3rd party. TyAnn: I'm always happy to come in and facilitate awkward conversation [all smiles].  Lisa: You are the number one awkward conversation facilitator.  TyAnn: I could totally do that. But you can start this on your own as well.  Lisa: Yeah. I think if I were to leave any parting words for the person who's trying to do it on their own first before they blow up to the team, or before they verbalize the feedback to someone else, it would be, really get clear. “Is it because my personal preferences are different from the business priority?” It's personal preference, business priority, which is which? Are they not the same? And if they're not, that can be okay. You just have to get clear with yourself to go, “Ah. I get it - this is why it wraps my gut up in a knot.” This is what I would rather it be like, but it's not like that, because it's real life. TyAnn: Right. Lisa: So I need to proceed like this. And then as I proceed like this with the business preference, because it's my job, it's what they're paying me for, then can I see some positive intent coming from that other person? Like, what are they actually aiming for here? Even though it's making me upset or making me feel frustrated, what are they trying to do that has good intent? Because nearly always, (sure, not always, there are nefarious characters out there somewhere), but nearly always people have good intent.  TyAnn: Yep, absolutely. That's one of my favorite things, is assume positive intent. Because believe me, your life will be much better when you do. It's amazing how many people that I run into don't or do think someone's out there trying to get them. Believe me, the vast majority of people go to work, and they want to do a good job. So let's assume positive intent. And I think that's just when you feel yourself getting... getting anxious, or you see that team member and you can just feel yourself getting triggered, or that thing happens again, and you feel it in yourself, that's a really good moment to think, "What is it specifically that is triggering me about this?" And again, it doesn't have to be they are an awful human being, it's just something in them is different than how you would react in that situation. So I think, stop. Think about what it is. Think about the good thing that they bring. And then again, what problem are we trying to solve? What's our ultimate goal? And how can we both get there together?  Lisa: What a perfect way to end this one.  TyAnn: Yeah.  Lisa: So next time that comes up for you, be thinking of the other person, what's the positive intent? Where are they coming from that is good and how could that, if you know CliftonStrengths talent theme language, then what are they trying to accomplish? And since you already have the talent themes in a list (or the StrengthsFinder 2.0 book), you might get some ideas about where they're coming from.  Tyann: Right. Lisa: Because sometimes you do feel a little baffled...  TyAnn: Yeah.  Lisa: ...at the beginning, like why do they act like this, or why do they think like this, or why do they approach work like this? Or why does my manager hate me like this? Just going to someone else's CliftonStrengths report and going, ‘Oh, they think this way, aha. This makes sense now.’  TyAnn: Reading the reports is a really good place to start.  Lisa: It's great for helping you understand the other person.  Alright, with that, you've been listening to Lead Through Strengths, where you've been learning to apply your greatest strengths, to make your work stronger, and now also looking at other people's strengths and trying to notice those so that the whole team can get better together. Thanks, Ty. TyAnn: Thanks, Lisa. Hate Is Unproductive — Understand More With These Additional Resources Whether you’re a manager or a team member, you can stop any tendency to hold a theme bias against others’ so-called “bad strengths." Listen to our conversation on that for more. Of course, most teams don't have true hate, but when a team member thinks that a leader dislikes them, their engagement and performance can take a quick nose dive. With the premise that conflicts arise in any widely diverse work environment, Lisa and Lead Through Strengths Facilitator Strother Gaines exchange views and tips in another episode on how to Ignite Better Team Collaboration Through Strengths. All this highlights the importance of energizing tasks at work. What can fuel or discourage best performance lies in how much CliftonStrengths talent themes are allowed and supported within the team — a challenge for some teams but highly doable.

Lisa is the founder of the Colin Garrett National Awareness Campaign to combat veteran suicide through his racing. Lisa Is passionate about suicide prevention and shares her story about her grandfather who lost his battle with suicide and how her grandmother almost lost hers battle as well. She has lost several friends to suicide and understands how devastating It is to many generations of families.She is a huge mental health advocate and Is passionate about racing to combat veteran suicide.Lisa Is offering a 10% coupon code for her services at her website . Use code WILDRIDEFor more on how to contact Lisa please refer to the podcast guide at www.awildridecalledlife.com/podcast-guide--- This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app

Lisa is the founder of the Colin Garrett National Awareness Campaign to combat veteran suicide through his racing. Lisa Is passionate about suicide prevention and shares her story about her grandfather who lost his battle with suicide and how her grandmother almost lost hers battle as well. She has lost several friends to suicide and understands how devastating It is to many generations of families. She is a huge mental health advocate and Is passionate about racing to combat veteran suicide. Lisa Is offering a 10% coupon code for her services at her website . Use code WILDRIDE For more on how to contact Lisa please refer to the podcast guide at www.awildridecalledlife.com/podcast-guide --- This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app

Ascorbic acid or vitamin C is a known antioxidant. Clinicians have conducted numerous studies to discover its role and effectiveness on life-threatening diseases such as sepsis, acute respiratory distress syndrome (ARDS), cancer and COVID-19. Dr Alpha 'Berry' Fowler joins us in this episode to share his work on vitamin C and its role in improving the survival of critically ill patients. He also talks about ongoing trials on vitamin C and its possible benefits on COVID patients. If you want to know more about the research backing up the success of vitamin C in disease treatment, then this episode is for you.   Here are three reasons why you should listen to the full episode: Learn the mechanism of sepsis in lung disease. Discover the role of vitamin C in treating patients with sepsis and ARDS. Find out more about past and ongoing trials on vitamin C.   Resources Learn about Dr Fowler's Phase 1 safety trial of IV vitamin C in patients with severe sepsis. Explanation lecture of the CITRIS-ALI study by Dr Fowler JAMA publication on CITRIS-ALI Article on the sequential organ failure assessment (SOFA) scores and mortality of patients involved in the CITRIS-ALI trials Dr Paul Marik's protocol for sepsis using vitamin C and steroids   Episode Highlights [04:02] How Dr Fowler's Research on Bacterial Sepsis Began Dr Fowler started working on mouse models to investigate sepsis. A solution made from mouse pellets was injected into ten mice, five of which received a treatment of vitamin C. The septic mice in the control group all died while those treated with vitamin C were crawling around, drinking water and eating. Dr Fowler then started using animal models to determine how vitamin C treats sepsis. [09:05] How Sepsis Damages the Lungs In sepsis, the lung barrier is injured. The progression of sepsis traps activated neutrophils in the capillary space of the lungs. Activated neutrophils release their DNA and enzymes, damaging the capillaries. Plasma then fills the air spaces, causing the patient to drown in their fluid. [09:34] The Role of Vitamin C in a Septic Lung In vitamin C-treated mice, the lung’s barrier function is preserved. Vitamin C stops neutrophils from disgorging their DNA into the extracellular space. Free DNA has become a marker to predict mortality. Blood reanalysis showed vitamin C lowered free DNA circulation as a result. Vitamin C completely inhibits the expression and appearance of inflammatory proteins. [16:15] Phase 1 Safety Trial Outcomes In a randomised, blinded trial, 24 patients were enrolled to determine the safety of vitamin C. Organ failure score was tracked in all patients. The higher the score, the higher the incidence of mortality. Patients treated with vitamin C saw a dramatic and significant reduction in their organ failure score. Vitamin C also improved their chance of survival. Intermittent infusion of vitamin C every 6 hours could get the plasma level up to 3000 times the normal level. [25:47] Phase 2 Proof-of-Concept Trial Outcomes Patients enrolled in the study had septic ARDS. The vitamin C treatment resulted in no adverse event. After 96 hours, 19 of 83 placebo patients died while only 4 of 84 patients with vitamin C died. Upon follow-up after 28 days, 46% of placebo patients died while only 30% of treatment patients died. This was the first blinded trial to show vitamin C’s impact on the mortality of patients with ARDS. [28:17] Explaining the Inconsistency of the SOFA Score Jean-Louis Vincent created the SOFA score. Jean-Louis Vincent sent a letter to the editors of Dr Fowler's work that the data was incorrectly analysed. Reanalysis showed the patients who died had the top SOFA score. Vitamin C significantly impacted organ failure scores. Vitamin C treatment resulted in a significant number of ICU-free days, improved mortality and more hospital-free days at day 60. [36:05] Is There Another Trial Underway? The NIH tasked the Prevention and Early Treatment of Acute Lung Injury (PETAL) Network to turn towards COVID treatment.  Dr Fowler started a trial on vitamin C as a treatment for patients with early COVID pneumonia, and the results are dramatic. There is another trial for sepsis and vitamin C planned by the PETAL Network involving 1000 patients across 69 medical centres. [39:48] Why Larger Doses of Vitamin C Are Not Administered The primary concern for higher doses of vitamin C is the formation of renal stones. A safety trial is first recommended before vitamin C treatment for COVID pneumonia can begin.    7 Powerful Quotes from This Episode ‘The cage that the mice got the sepsis and the vitamin C, they were all crawling around, drinking water and eating. And I knew at that point that we had stumbled on something pretty significant’. ‘One of the first things we found was that the lungs of the treated mice that were septic, they weren’t injured’. ‘Most people understand sepsis as being a bacterial infection, but they don't understand that it's actually taking all the organs and causing oxidative damage to multiple organs, not just the lungs’. ‘We had kind of a basic grasp on the immune system and how vitamin C could alter the septic immune response and how vitamin C could protect the lung’. ‘Vitamin C was actually improving the possibility of survival’. ‘The amount of vitamin C that you administer is critical. Dose matters’. ‘You’re going to save not only thousands and eventually more — hundreds and thousands of lives. You’re going to reduce hospital bills enormously’.   About Dr Fowler In his 35 years of service at VCU, Alpha A. ‘Berry’ Fowler, M.D., Professor of Medicine and Director, VCU Johnson Center for Critical Care and Pulmonary Research, has had a profound influence at VCU and beyond. Considering his robust grant support and over 300 publications and abstracts in clinical areas including adult respiratory distress syndrome (ARDS) and sepsis, he might well be lauded for that alone.  Likewise, with over 16 years as Pulmonary Disease and Critical Care Medicine (PDCCM) Division Chair, with numerous ‘Top Doc’ awards and other honours, his pursuit of excellence in clinical care, impacting thousands of patients and their families, might well be the highlight of most careers.  To learn more about Dr Fowler’s research on vitamin C, you may contact him at 804-828-9071 or send a message to alpha.fowler@vcuhealth.org.    Enjoyed This Podcast? If you did, be sure to subscribe and share it with your friends! Post a review and share it! If you enjoyed tuning in, then leave us a review. You can also share this with your friends so that they can learn more about vitamin C. Have any questions? You can contact me through email (support@lisatamati.com) or find me on Facebook, Twitter, Instagram and YouTube. For more episode updates, visit my website. You may also tune in on Apple Podcasts. If you would like to work with Lisa one to one on anything from your mindset, to head injuries,  to biohacking your health, to optimal performance or executive coaching, please book a consultation with Lisa here: https://shop.lisatamati.com/collections/consultations Lisa's latest book Relentless chronicles the inspiring journey about how a mother and daughter defied the odds after an aneurysm left Lisa’s mum Isobel with massive brain damage at age 74 and the medical professionals told her there was absolutely no hope of any quality of life again. Lisa used every mindset tool, years of research and incredible tenacity to prove them wrong and to bring her mother back to full health within 3 years. Get your copy here: http://relentlessbook.lisatamati.com/ For Lisa’s other two best-selling books Running Hot and Running to Extremes chronicling her ultrarunning adventures and expeditions all around the world, go to https://shop.lisatamati.com/collections/books. Go to www.runninghotcoaching.com for Lisa and Neil’s online run training coaching. For their epigenetics health program all about optimising your fitness, lifestyle, nutrition and mind performance to your particular genes, go to  https://www.lisatamati.com/page/epigenetics-and-health-coaching/. For Lisa’s gorgeous and inspiring sports jewellery collection ‘Fierce’, go to https://shop.lisatamati.com/collections/lisa-tamati-bespoke-jewellery-collection. To pushing the limits, Lisa   Welcome to Pushing the Limits, the show that helps you reach your full potential with your host Lisa Tamati, brought to you by lisatamati.com. Lisa Tamati: Hi everyone and welcome to Pushing the Limits. This week I have an exciting interview with intensive care medicine doctor, Dr Berry Fowler, who is an intensivist from the Virginia Commonwealth University. The director of the VCU unit via 35 years of service at the VCU Johnson Center for Critical Care and Pulmonary Research. And he's also the author of a number of studies around vitamin C. So today we're continuing that conversation that we've been having in the last few weeks around the importance of vitamin C. Last week, we had Professor Margreet Vissers on, from Otago University, talking about—who worked with vitamin C in cancer. She's been studying this for 20 years. And Dr Berry Fowler has been studying vitamin C in regards to sepsis and pneumonia and how to use it in COVID. And he's been researching in this area with vitamin C for over 15 years. So some really amazing insights into this incredible vitamin and how it can help with all of these things. So please don't miss this episode. If you enjoy the content, please share it with your family and friends. You know, there’s some important messages that we're wanting to get out in this vitamin C thing that I've been doing, because I lost my father recently and this would have been a major player and I was desperate to get him help with intravenous vitamin C, and I was unable to until way too late. And so I'm desperately wanting to get out the information about this research about the clinical studies that have been done, the research that's been done, to share this really important information.  As always, I really appreciate a rating or review for the show. If you can do that, that'd be so so appreciated. And if you've got any questions, please email me at support@lisa tamati.com, if you want to discuss anything that was brought up in these topics, in this podcast. I'm also doing some one on one consultations. I have a limited number of spaces available for people who are wanting to work with me one on one. If you are facing difficulties in areas from whether it be around some of your health aspects like head injuries, obviously I've spent five years researching head injuries. I have a lot of knowledge around vitamin C. I have a lot of knowledge around biohacking, around epigenetics trained as an epigenetics coach, gene testing, and so on. And I work with a very small number of people who are needing help with these areas. As well as of course run coaching and mindset in high performance. So if you're wanting to get some one on one support with me, please reach out to me it's lisa@lisatamati.com. And I can send you the information there. Right over to the show now with Dr Barry fellow who is sitting in Virginia in the USA. Well welcome everybody to Pushing the Limits. This week. I have a very special interview continuing our series around intravenous vitamin C or vitamin C in general. I have Dr Barry Fowler with me, who is sitting in Virginia and Dr Fowler has agreed to come and have a little chat today about his work in this area. Dr Fowler, I've done a wonderful extra introduction. So we won't go into all your amazing credentials and your achievements, of which there have been many. But Dr Fowler, can you just give us a little bit of background? You are the director of the VCU Virginia University over in the States. Can you tell us a little bit about your work and your background? Dr Berry Fowler: Okay, well, I am professor of medicine in the Division of Pulmonary Disease and Critical Care Medicine and I'm one of the ancient doctors in the division, just turning 71 last week. I trained at the Medical College of Georgia in the US, then went to the Medical College of Virginia in the US, then went to the University of Colorado for pulmonary and critical care disease training, and then came back and joined the faculty at Virginia Commonwealth University which used to be the Medical College of Virginia, it's now VCU, in 1982 and I've been here ever since. Lisa: Wow. Dr Berry: I rose slowly through the ranks. I led the pulmonary division for a number of years, for approximately 17 years, and then stepped aside in 2016. And all during this time, at least for 13 years now, we've had this interest in vitamin C. And it's interesting how our interest in vitamin C developed. It first started at a very molecular level where we were studying cardiac ischemia, but some of the heart attendings. And then slowly began to get back to what we have been doing for years which was bacterial sepsis. And we had some molecular reasons that drove us towards vitamin C. And so first thing we did was we created an animal model of sepsis. And let me explain that. It was pretty straightforward to create. We had 30 gram mice and we went to the mouse cage and collected mouse pellets. Then took them to the laboratory and sonicated them really hard until it became a solution. Lisa:  So this is the fecal matter. Yes. Dr Berry: And we would take that solution and centrifuge it really hard so that all the solid matter went to the bottom of the tube and we just took off the liquid from the top, which contained multiple different kinds of organisms. Lisa:  So all the bacteria. Yes. Dr Berry: Yes. And so we took that, put it in the refrigerator overnight and then came in the next morning. And we had 10 mice. We had 5 control mice and then 5 treatment mice. So all the mice first were injected into their peritoneal space, you mentioned that earlier, with a tenth of an mL of this solution containing all this bacteria. And so all 10 mice. And then in the mice that were going to receive the vitamin C, we injected a tenth of an mL, which was 200 micrograms per gram of bodyweight of the mice and then closed off the light. By that point, it was about 4:00 in the afternoon. And just let the mice sit in the laboratory where we had left them and I always get to work at 6:00 in the morning and I was thinking, ‘Holy cow, I got to see what's going on.’ And so I went into the lab where we had the mice and the cage that was the control mice that were septic. They were all dead. In the cage that the mice got the sepsis and the vitamin C, they were all crawling around drinking water and eating. Lisa:  Wow. Dr Berry: And I knew at that point that we had stumbled on something pretty significant. This take us back to around 2010. Maybe 2009. My laboratory has had this intense interest in sepsis ever since I finished my training at the University of Colorado. And so what we decided is that we would begin to use the treatment animals and some control animals to determine exactly how vitamin C was working. Lisa:  To look at the molecular, the mechanism of action. Why is this happening? Why are they surviving better? Dr Berry: So what we did was—in these studies, we were always comparing the control mice to the treated mice. And one of the first things we found was that the lungs of the treated mice that were septic, they weren't injured. Lisa:  Wow. Dr Berry: And we have a number of ways to determine the way a lung is injured. One of the things that happens in sepsis, and this might have been what you and I were talking about earlier, is the lungs barrier function, which is the ability to keep the blood in the blood and keep the air in the air. Lisa:  Yes. Dr Berry: It gets injured. And so the bloodstream floods into the airspaces of the lung. Lisa: And fills it. Dr Berry: Yes. And one of the things we discovered was lung barrier function was preserved and the vitamin C treated septic mice. Lisa: Wow. So you're perceiving that it’s stopping the plasma and the neutrophils getting into the alveolar space. Dr Berry: Exactly.  Lisa: And the NET— of one of your lectures, you talk about neutrophil extracellular traps (NET). Is that a part of the barrier function?  Dr: Berry: Very nice. When are you starting medical school? Lisa: Thank you, Dr Fowler. Dr Berry: So what happens as sepsis progresses is that there are a bunch of molecules that live in the capillaries of the lung that begin to get expressed. And what they do is they trap neutrophils that are activated in the capillary space of the lung. And one of the things that happens in a highly activated neutrophil is they disgorge their DNA and all of the enzyme systems inside a neutrophil begin to damage the capillaries. And then what happens as the capillaries get injured, the plasma from the lung, just a vein from the bloodstream, just flows into the lungs. Lisa: So you’re basically lost—it's like your skin barrier, if you like, between the ear and your insides is disintegrating. Dr Berry: Well, one injury from sepsis is like drowning. Lisa: Wow, so you fill it with your own fluid. Dr Berry: The airspaces of the lung fill up with your own plasma. Lisa: So when you have, cause sepsis—I don't think most people are not aware of the progression of sepsis to acute respiratory distress syndrome. That this is a sort of a linear progression that happens, isn't it? That you actually get lung—because most people understand sepsis as being a bacterial infection but they don't understand that it's actually taking all the organs and causing oxidative damage to multiple organs, not just the lungs, but particularly the lungs. And so this is a very important finding that what you've had here because this means that if you can stop the vitamin C, if the vitamin C can stop the neutrophils from disgorging their own DNA into the extracellular space, which is then, that's in a marker, isn't it? That cell-free DNA, when you take a plasma drawn and you see that cell-free DNA floating around at a certain level, that's a predictor of mortality, isn't it? Dr Berry: Listen, you've done some fabulous reading. But let me just tell you, it's been known for several years that in septic individuals, one of the unfortunate things that will predict mortality is how high the cell-free DNA arises in the circulation. And I don't want to jump too far here, but I will tell you and the vitamin C trial that we reported one year ago this month, that when we reanalyzed the blood from those individuals, we found that vitamin C dramatically lowered the cell-free DNA in the treated patients. Lisa: Wow. That was in the CITRIS-ALI study? Dr Berry: Exactly. Lisa: Oh, okay. That's a new finding from that study because, yes, we will go through that progression of how you got to do that study. So let's bookmark that for a moment and backtrack because that is a very important finding for that study. So let’s backtrack a little bit. So we are talking about vitamin C being able to protect the lungs if we put it very simply and protect the barrier function of the lungs, stop the neutrophils from disgorging the DNA and causing these traps, which is a predictor of mortality. What are other things is vitamin C doing? And why is a septic patient, without fail, going to be very low in vitamin C? So you’re using that for Vitamin C. Dr Berry: I'll get to that in a minute. But what we demonstrated in a huge number of murine mouse studies is that the septic lung in a control animal, the septic lung began to express many inflammatory proteins. And that's just your endogenous immune system trying to protect itself. But we showed in the next cage, in the septic mice that we had treated with Vitamin C, that the expression and the appearance of those inflammatory proteins was totally inhibited completely.  Lisa: Wow. Dr Berry: Yes. The idea of leaping from preclinical animal studies into humans was that we had kind of a basic grasp on the immune system and how Vitamin C could alter the septic immune response and how Vitamin C could protect the lung. Well, protecting the lung in terms of septic critical illness is very, very important. Lisa: Absolutely. And so then you went to a phase one safety trial, which was really to look at some basic markers. Is this going to be damaging for people if they get vitamin C and look at hypertension? And is it going to affect the kidneys and so on. I think some of those safety mechanisms. Can you tell us a little bit about that phase one safety trial and then the outcomes of that trial? Dr Berry: Well, I can tell you, I had this really close colleague. His office sat right next to mine. He's a molecular biologist, basic scientist. And after we'd done all these murine studies, one day he walked in, he looked at me, said, ‘Fowler, this needs to go into the hospital. We've developed all this data. You've got to make it happen to get it into the hospital’. We designed this little safety trial, enrolled 24 patients. The safety trial was randomized and it was blinded. And so half the trial was just controlled sepsis. The other half was septic patients treated with Vitamin C and we had no idea who the hell was giving vitamin C to people who were critically ill. Lisa: Yes. Dr Berry: And we found it had no impact. But one of the things we were shocked at, and we were just trying to define, was vitamin C safe?  Lisa: Yes. Dr Berry: One of the things we tracked was what is called an Organ Failure Score. And we found that all of the patients treated with Vitamin C, their Organ Failure Score reduced dramatically and significantly. Lisa: Wow. Dr Berry: And the way Organ Failure Scores, basically you're counting numbers. A higher number is a higher incidence of mortality. Lower numbers are improved and that vitamin C was actually improving the possibility of survival. Lisa: So this is like, in my father's case, is the sepsis progressed and I was unable to get him Vitamin C as we discussed earlier, Dr Fowler, early enough for him to get to survive. But as I watched his sepsis progress, more and more organs started to fail. So his liver started to fail. His kidneys started to fail. His heart started to fail. And so this is the Organ Failure Score. If this person's Organ Failure Score is going up, that is a very strong predictor of mortality. Dr Berry: Yes. Lisa: Okay, so this was reduced with the people who received the Vitamin C in the small trial. Dr Berry: So what we did, we took the data, we combined it with our preclinical data, and applied to the National Heart Lung and Blood Institute. They had just published an announcement where they were asking for anybody who could think of some clever trial. And we said, ‘Well’. And so we submitted an application. What the NIH wanted, they wanted the proposal for a phase two, proof of concept trial. Lisa: Right. Dr Berry: And so what we proposed was a trial that had seven medical centers. I have friends in seven medical centers around the US. And with this application in and that was I guess you guys don't remember Hurricane Sandy. Lisa: Yes, I do. Dr Berry: Hurricane Sandy was just—it killed the Atlantic Coast of the US. And the National Heart Lung and Blood Institute happens to sit on the Atlantic Coast in Washington, D.C. And it was a year and a half before we found out that we had received the highest priority score because of the application that we had submitted. And the NIH gave us 3.2 million dollars to do a multicenter, randomized, double blind, placebo-controlled trial, proposing to administer 50 milligrams per kilogram of intravenous Vitamin C every six hours for ninety six hours. Patients were continuously receiving vitamin C. Lisa: Can you explain why that continuous topping up that level is important every six hours? Dr Berry: That's a great question. So from the safety trial that we had performed, we analyzed the plasma Vitamin C levels that we had achieved by infusing. So basically someone your size, for example, would probably get maybe 3 1/2 grams intravenously every six hours for ninety six hours. And what we showed was, we could get the plasma level up to basically three thousand times the normal plasma level. So from a normal diet, human plasma levels of vitamin C are about 70 to 80 micromolar. When you give the protocol that we had settled with, we got the Vitamin C levels up to five millimolar. Lisa: Wow. Dr Berry: Yes. And so that's what we were shooting for in this NIH trial. And that's what we did. We charged into it, the trial. What we had proposed again, was the Organ Failure Score as well as the two biomarkers. We also proposed in the secondary outcomes, days on mechanical ventilation. Lisa: Yes, which is hugely important. Dr Berry: And what we were studying specifically, was patients who were septic, who had gone on to develop acute lung injury called Acute Respiratory Distress Syndrome, ARDS. And so when a patient was septic, like your father, we would become a fly on the wall and visit the patient every day until a lung injury developed. And that's when they would get randomized. Lisa: This was a critical—from my analysis of the data, that was a critical thing in the phase. So you had to wait until I basically had developed ARDS before you were able to put them. So this wasn't really a sepsis trial, but more of an ARDS trial. So the progression of the sickness comes into play here, doesn't it? If you’ve gone through day one, like in the phase... Dr Berry: In the safety trial... Lisa: Yes. Dr Berry: The second aseptic individual walked in the door, that's when they got random. Lisa: Which is a much better, more effective with the timing. Dr Berry: We had a couple of patients who got Vitamin C in the emergency room. Lisa: Yes, wow.  Dr Berry: You know you have to get informed consent. You have to get the pharmacy on board and get the patient enthused. Lisa: I wish I'd had you tending to my father. We could have had that from the moment he got to the emergency. That would have been, I think we would have had a different outcome. But so this was a key point that you had to wait until I had developed ARDS. So in this CITRIS-ALI trial, so here you have, I think it was 47 patients in the control and 47 in the intervention group, was it right? Dr Berry: 83. And 84 in the Vitamin C treatment. Lisa: Oh, 83. I'm sorry. Sorry. So 167. One of the big questions I had in my— why was mortality not one of the primary objectives of the study? Dr Berry: That has been the most frequent question. When we answered the NIH, they had put out a program called, UM1, and we applied to the UM1 program and they were not interested in mortality as a primary outcome. Part of it was this. There had been hundreds of sepsis trials and nobody had ever shown any impact on a treatment for sepsis. And so NIH didn't want to get burned again so they said that they wanted a physiological outcome. That was the Organ Failure Score. And they wanted a biochemical outcome. Those were the biomarkers. Lisa: It's the C-reactive protein, procalcitonin and thrombomodulin. And yes. So the reasoning was that we don't want to shoot for the stars here and automatically hope for a decrease in mortality and a decrease of days in hospital. We're going to go for something else just to see if this has legs, so to speak, if this treatment is possible, possibly going to work. And that's why they went for the safer scores, rather than the mortality. Looking back, do you think... Dr Berry: By the way, we haven't talked about this yet, but SOFA stand for Sequential Organ Failure Assessment Score. Lisa: Thank you. Yes, it's amazing the jargon that you pick up and then forget that you haven't explained yourself. So what actually was the outcome? This was a seven multicenter trial. You did a double blinded. This was incredibly important because I know Dr Paul Marik had also done a study with intravenous Vitamin C, thiamine, and hydrocortisone. And one of the criticisms that was thrown at him was that it wasn’t a double blind, randomized controlled trial, so it didn't have any meaning, which is absolutely tragic. So this was—what was the outcomes of this phase two trial? Dr Berry: So we enrolled 170 patients. One of the placebo patients we had to take out because that patient did not have septic ARDS. They had Acute Eosinophilic Pneumonia. That's something else to discuss later. And then in the Vitamin C arm, we had two patients with Acute Leukemia who had no coagulation in their bloodstream and they were hemorrhaging into their lung and that was not sepsis. So as I mentioned, we had 83 in the control placebo and 84 in the vitamin C-treated group. First of all, we saw no, and I emphasize capital N-O, adverse events. There was not a single adverse event.  Lisa: Exactly. Dr Berry: All right. And so what we showed was in 96 hours, placebo patients in the trial, 19 of 83 died within 96 hours. Lisa: Wow. Dr Berry: In the Vitamin C group, 4 of 84 patients died. And if you look at the statistics and the analysis of that, the difference is P=0.0007. We then followed the patients out because in sepsis trials, there's always this demand to see what is happening to a patient at 28 days. Lisa: Yes. Dr Berry: And what we showed was 46% of placebo patients died and only 30% of the Vitamin C treated septic patients with ARDS died. Lisa: Wow, that's a huge result in my mind. Dr Berry: And that was the first trial. I'm not slapping myself on the back, but I will just tell you, that was the first trial to ever show in a blinded fashion, an impact on ARDS.  Lisa: Yes. On mortality of ARDS. Dr Berry: Yes. Lisa: And this was extremely sick people. Now, unfortunately, the SOFA scores didn't show any difference and the C-reactive protein markers didn't show any difference. Dr Berry: So let me explain. Lisa: Is it because... Yes, is it because of the mortality. Dr Berry: So we thought publishing the results of the trial in probably one of the most important journals on the planet, JAMA, which as it turns out, is a very, very conservative journal. And they had their ideas about what we could and we couldn't say. So we published, and this is very important for you to listen to and all of your listeners, we published that there was no difference in the SOFA scores at 96 hours. And immediately, letters to the editor started coming in and one of the most important letters to the editor was the person who created the SOFA score. His name is Jean-Louis Vincent in Brussels, Belgium. He told us that we had analyzed the data incorrectly and that what we were reporting was a survivorship bias. Lisa: What does that mean? Dr Berry: And what he said we needed to do, and he provided five publications where he had important statisticians tell him that analyzing the data, like we reported, as a worst rank, best rank scenario, that we had to reanalyze it so that the patients who died, what we were reporting was the SOFA scores on the people who had survived. Lisa: Not the ones who died. Dr Berry: We had not considered the SOFA score on the patients who died. Lisa: And because they died so quickly. Dr Berry: So what we did was we went back and the people who died along the way, those 19 patients, they got the top SOFA score. The patients who survived and left the unit, they got a low SOFA score. And so when we reanalyzed the data, according to the way these letters that had come in from Dr Vincent and two or three other colleagues, it turns out that Vitamin C significantly impacted the Organ Failure Score. Lisa: Wow.  Dr Berry: And then we—here's the important thing, we reported that February 25th of 2020. So you can go to JAMA, you can look it up and you can see our response to the SOFA score reanalysis. Lisa: Because this was a key factor in my father's case. They threw the CITRIS-ALI trial at me and the original data from JAMA, which said negative result, which when I analyzed... Dr Berry: That lets you know that the doctors were not reading JAMA. Lisa: Exactly. And they weren't on the up to date and they did not look at secondary outcomes and they did not look at the parameters of the score and I was not able to present the case. They had just read it briefly. Dr Berry: Let me go on. We had a strong trend to ventilator-free days and the people who got the Vitamin C, but it just missed statistical significance. Lisa: Yes. Dr Berry: But we had a strong significance for the people who got Vitamin C in Intensive Care Unit-free days. Lisa: Which is huge. Dr Berry: So the people who got Vitamin C had a significantly higher number of ICU-free days. There was an improved mortality. The other thing is patients who got Vitamin C had significantly more hospital-free days at day 60. Lisa: Wow. So they were actually out of the system altogether. Do you think—now this is controversial, I'm playing devil's advocate here. But do you think the fact that it costs so much for someone to be in ICU when they have sepsis—I think in America it's something like, to the order of 60,000 dollars US a day—and the medications that they are typically on are costing around 20,000 dollars a day, do you think that if you come along with Vitamin C and you start dropping the mortality rate, you start dropping the days? Is that part of the resistance to accept and acknowledge these findings, that the pharmaceutical companies are going to lose out on profit? Dr Berry: Oh no no no. No, no, no. At VCU, Virginia Commonwealth University—that Anitra knows well—the average care cost per day is about 46,000 per day because that accounts for medical care, nursing care, radiology, all laboratory data, respiratory care, caring for the ventilator. All of that is somewhere in the neighborhood of about 45 to 50,000 dollars per day. And so, if you have a treatment, first of all, that gets people out of the ICU earlier and keeps them out of the hospital, think about the impact on the cost of care. Lisa: Yes, it’d be huge. Dr Berry: But here's the other thing. There's not going to be any drug company out there who would argue with that. They are all trying to do the best they can with their different antibiotics, but the common antibiotics that are administered in an ICU when patients are septic levofloxacin, meropenem, vancomycin. Just one day of meropenem is 1500 per day. Lisa: Exactly. It's a lot of money.  Dr Berry: Yes.  Lisa: So you don't think that... Dr Berry: And listen to this. That's the cost of the drug. That's not the cost of pharmacy preparing the drug, cost of nursing administering the drug and so on and so on and so on.  Lisa: Okay, so all right. So if you can work this problem out and if you can get this in all ICUs around the world, we're going to save not only thousands and eventually more hundreds of thousands of lives, you're going to reduce the hospital bills enormously. So this is incredibly important work. And you've proven—so the statisticians proved in that phase two trial that the way that you are measuring it was incorrect because a lot of people, as you said, 19 died in those first four days in the control group and only four, so that skewed—if you like—the statistics to initially look like we hadn't had a win here. Now, that's been rescinded and you've managed to get JAMA to publish it in a different light, that the SOFA score was impacted. What has been the effect now? Have you got another trial underway or have you got one in sight? Because this work’s too important, obviously, not to be taken further into a phase three. Dr Berry: All right, so you are in New Zealand where there's not much COVID.  Lisa: No. Dr Berry: We are in the United States, where it's a pandemic, where we are close to 220,000 people who have died from the virus. We are at 50,000 new cases per day. Lisa: Oh my God. It's so...  Dr Berry: And there are somewhere in the neighborhood of 1,800 to 2,000 patients dying per day of COVID. And so because of that, the network that I'm part of, that unfortunately—I'm going to have to jump off and listen to it, because it's been going on since 2:00, the annual meeting of the Prevention and Early Treatment of Acute Lung Injury Network, abbreviated P-E-T-A-L, the PETAL Network. The PETAL Network was tasked by the NIH to turn sharply towards COVID treatments. Lisa: Yes. That makes sense. Dr Berry: And so we were thinking, ‘Well, maybe vitamin C to treat patients with early COVID pneumonia’. And so what we did was we started a trial. We have studied 20 patients now and that trial is complete, where patients who develop COVID infection and develop early COVID pneumonia, so it's just at the start of an oxygen requirement, are treated with Vitamin C and the results have been pretty dramatic. We are in the midst of writing that up. But again, it's a—open label trial. It's not blinded. Everybody in the world knows that an open label trial does not have the power like we did with CITRIS-ALI. Lisa: Yes. Dr Berry: And so what is happening at a world level is that all of the health organizations around the world have come to bear to try to design treatments for COVID pneumonia. Lisa: Yes. Dr Berry: And that is ongoing right now. And there are like 9 or 10 major networks in, across the world. Probably, I'm not sure if New Zealand is included in that, but Europe, the US, possibly Australia. I don't know if they commit to participating in what is called the network of networks formation. Lisa: Yes. Dr Berry: So right now, the next trial for patients with sepsis that's not COVID is going to be conducted by the PETAL Network where we will be probably next April, starting a trial with a thousand patients. Lisa: Wow.  Dr Berry: Using vitamin C conducted by the PETAL Network. Lisa: Gotcha. Dr Berry: And the PETAL Network has 69 medical centers. So doing a trial that would get a thousand patients can be done within a year. Lisa: Wow. So this is exciting stuff because this is hopefully you'll be able to reproduce and show a strong correlation between intravenous vitamin C and I'd like to see the decrease in the mortality rate. That would be a key factor. Some centers are already using vitamin C because as you mentioned before, there were no adverse reactions. And this is like in all of the studies that I've seen there has never— this is a low risk intervention and my argument when fighting for my father was that, ‘He's dying. There is no other options. Why can't I throw the bus in? Why can't I put intravenous Vitamin C’? And they were like, ‘You still have to go through all the ethics committees’. I had to sign off from every single doctor and every single nurse in the ICU unit of which there are many. Dr Berry: Well, let me make another statement. So Paul Marik, who was using 1.5 grams of Vitamin C, 200 milligrams of thiamine and 50 milligrams of hydrocortisone, administered every six hours. That meant that the patients were only getting 7 grams. Lisa: Very small amount. Dr Berry: In the CITRIS-ALI, I mean, some patients got 16 to 18 or 20 grams. Lisa: Yes. Dr Berry: According to body weights, 50 milligrams per kilogram. In the aftermath of that article that you mentioned that Marik published, there have been efforts to repeat that trial. The vitamins trial came out in January, using that and it failed. Then another trial, the ACTS trial using the Marik protocol failed. And then a trial that I just participated in called the VICTAS trial completely failed. And so the Marik protocol is not an effective treatment for sepsis. And well, look. As I think Anitra Carr mentioned to me a couple of years back, the amount of vitamin C that you administer is critical. Lisa: Absolutely. Dr Berry: So dose matters. And the adult, again, of your size, you probably weigh 120 pounds or something would probably get somewhere in the neighborhood of about 12 and a half to 13 grams, spread out over a 24-hour period. And then you would get it for four days. Lisa: Yes. And that is still a relatively low dose. Dr Berry: It is. Lisa: When I'm doing intravenous vitamin C with my mum, I did it with my dad prior and unfortunately, months prior to his aneurysm. Too little, too late. We were getting 30 grams. We get 30 grams a week. When I take my mum and niece today for an intravenous Vitamin C is a prophylactic as I try to keep her, as a 79 year old healthy, 30 grams. So why—I had this question certainly with Dr Marik’s protocol. It seemed to me to be very low, although the six hourly is obviously a very important point as well. Why not do the bigger dosages? Like in Japan, I know they did a study with up to a hundred grams of Vitamin C in a burns case, a burns trial, where they had some markers of sepsis there. Why are you not trying higher levels? Dr Berry: Let me come in here quick? Because I'm going to have to jump off in about 8 minutes. But listen to this. The major concern for those high doses of vitamin C, and if you talk to the oncologists who have been using it for years, they will give, like you said, they will give massive doses. And I'm talking massive, like in somebody with pancreatic cancer, they will get 60 to 80 grams intravenously, Monday, Wednesday and Friday for seven weeks. Lisa: Yes. Dr Berry: But the major concern, in somebody who's septic, who's hypotensive, in shock, that you're giving vitamin C, one of the major concerns is that it causes a significant rise in oxalate crystals formatiion in the kidneys. Now, I will mention here in the CITRIS trial, we had no evidence of renal stone formation. Lisa: No. And I mean, that was one of the arguments that the doctors had at me, ‘You could have damaged his kidneys’. And I said, ‘Well, the last time I looked, being dead damages your kidneys too’. To me, that wasn't even a consideration. And he had—after the very first vitamin C, and for my dad, his kidney function went from 27 percent to 33 percent. He's actually improved his kidney function overnight. And I know that's just one anecdotal case, but kidney stones are not going to kill you either. So surely that's not the most important consideration here when you've got a septic patient who is on death's doorstep. Dr Berry: With vitamin C struggling in the United States after the CITRIS trial, the Federal Food and Drug Administration, they always have to be concerned about adverse events. And we have put together a trial randomized and double blind using Vitamin C in patients with COVID-pneumonia. That's about to start. Lisa: Wonderful. Dr Berry: And we had, I unfortunately let my IND, Investigational New Drug lapse after CITRIS. And so I've had to claw our way back into the good graces of the FDA. And one of their major, major, major complaints was, ‘You're going to be forming renal stones’. And we're using the same protocol that we used in CITRIS. So FDA got their nephrologists involved and finally gave us the IND. But for us to begin treatment of COVID pneumonia, they have demanded that we first do a small safety trial to show that we are not causing any renal stone formation. We can get that done. We currently have somewhere in the neighborhood of 60 to 70 COVID patients in the MCV hospitals right now. Lisa: Wow. Well, Dr Fowler, look, I know I'd love to spend another five hours with you discussing all this because I think it's incredibly important, both for COVID and for the sepsis and for pneumonia and for obviously, for cancer. I just want to thank you for your dedication to this. I mean, you could be in retirement and sunning yourself somewhere, relaxing, but, you know... Dr Berry: That's right. Lisa: You know that this work is critically important. And I heard one of your lectures is the equivalent of two 747 planes going down every day filled with people. Dr Berry: Every day in the United States. Lisa: In the United States alone. Dr Berry: That’s just in the U.S. Lisa: Yes. And these people, thousands of families being destroyed with losing loved ones. I'm one of those, unfortunately, sitting here all the way in New Zealand. And so this work is incredibly important. So please keep going. And I'm desperate to hear what comes from this COVID clinical trials and the other sepsis trials, obviously. So thank you so much for your work, Dr Fowler, and I really appreciate you. Dr Berry: It's been wonderful meeting you and speaking with you, and your and your audience. And when you have Anitra on a couple of weeks, give her my regards. Lisa: I will definitely do that, Dr Fowler. That's been awesome. Thank you, Dr Fowler. And all the very best there in Virginia. Dr Berry: Take care. Bye. That’s it this week for Pushing the Limits. Be sure to rate, review and share with your friends, and head over and visit Lisa and her team at lisatamati.com.  

Welcome to the Ol' Bee Gal Q&A brought to you by KeepingBackyardBees.com Please submit your questions by following this link.    Here are the questions addressed in this episode. Lionel What can I do with black/brown propolis infused comb?   Stephanie Are there temperature limits when using oxalic acid?   Ken If I buy a nucleus with short frames, how can I move the bees into a regular deep framed hive.   Mary Ann What time of day is best to rob the hive?   Joseph What is the best time to consolidate hives?   Mike I’m storing old comb and they are now covered in fungus.  What can I do to prevent this in the future?   Kent What’s the best way to get rid of hive beetles?   Doug If you’re not supposed to heat honey to high temperatures, what happens to the quality when you put it in a cup of tea?   Lisa Is it too late to treat my hive for mites?      

Oakland entrepreneur Jessica Gray Schipp shares her life's journey of coping with multiple food allergies and her book #AllergicToEverything, a cookbook and guide for people living with multiple food allergies.Transcript:Lisa:Method to the Madness is next. You're listening to Method to the Madness, a biweekly public affairs show on KALX Berkeley, celebrating Bay Area innovators. I'm your host, Lisa Kiefer, and today I'm speaking with Jessica Gray Schipp. She's the author of a new cookbook and guide for people suffering from multiple food allergies.Welcome to the program, Jessica.Jessica:Thank you.Lisa:You just wrote this book called Allergic to Everything, which is an incredible guide and a cookbook for people with allergies. Are you allergic to everything?Jessica:I'm allergic to several things. It's called #Allergic to Everything and I am allergic to wheat, gluten, corn, soy, oats, eggs, shellfish, and possibly sesame.Lisa:You've been through a lot.Jessica:Yes.Lisa:This has taken decades to put this together. How did you figure out what to do first? Tell us your life's journey.Jessica:Well, I knew I was lowered to shellfish when I was a little kid. I was about six and I had an anaphylactic reaction and that was really scary, so I kind of grew up conscious of what it was like to have that happen. And then when I was in my, I would say like mid-twenties, I started getting a lot of hives and odd reactions that I didn't know what it was.Lisa:And this is out east?Jessica:And this is on the East Coast, yeah. And I was just going to literally every type of doctor that I could think of. My mom's a nurse practitioner, so she was sending me to like specialists and using her network and my body just slowly got worse and worse and worse. And then I ended up in Bloomington, Indiana with a friend from grad school and I arrived on her doorstep and I essentially looked like I was just dead. I had sties, I had hives everywhere and I didn't even know kind of how sick I was because I was so used to living that way.But she forced me to a doctor and they were basically like-Lisa:That was the first time you'd seen a doctor about it?Jessica:No, I had been seeing specialists but nobody identified it as food allergies and they didn't really know. So they just kept throwing me on steroids and different medications. And finally at that point in Bloomington, I was just in a place of I'm either dying of cancer or I have food allergies and I have to see what I can do. So I moved back home at that point and I did an elimination diet using all of these different tests I had gotten done with the food stuff because I was basically everything I reacted to. And I think that's also because my system was so hyperactive because it was so irritated all the time that it was triggering responses to more than what I really-Lisa:What does that mean? Elimination Diet? Because you talk about that and you also talk about the symptom tracker that you put together, which is also in the book.Jessica:Well I would say the elimination diet, I didn't start doing it with a symptom tracker. The one that's in the book is kind of a design that I came up with from trial and error and my experiences and what worked for me. I initially used something called a health minder, which I had found on Amazon and it was awesome, but it didn't quite track everything I wanted it to, so I've kind of made my own model.But in terms of the elimination diet, I did that without tracking initially. You basically, a lot of people start with removing the top eight food allergens.Lisa:And what are those?Jessica:Those are wheat, eggs, milk, fish, shellfish, nuts and peanuts.Lisa:Not corn?Jessica:No, corn's not one of the top eight, but I guarantee you this is my philosophy actually because we're shoving it in so much of the food.Lisa:Exactly.Jessica:I'm almost positive that when they revamped that topic eight, that that's going to end up on there [crosstalk]Lisa:I grew up in the Midwest and one of the things I noticed was the simultaneous rise of obesity and GMO corn farming.Jessica:No kidding. No kidding.Lisa:Even though no one is pinpointing that.Jessica:Yeah, and it's cheap.Lisa:Why do you think that's been left off the top?Jessica:I think that just not... I don't know. I think there's not a lot of money in research right now for food allergies. There aren't even really very reliable tests that have been developed. Everything does a lot of false positives. So it's really weird, which going back to the elimination diet, that's really the best way to determine what's triggering things.Lisa:It's very time consuming though, isn't it?Jessica:It's very time consuming. Yeah. Yeah. The process of writing the book took about six years, but the process of getting through the elimination phase and starting to learn about foods probably took like three months but a good year of getting used to it because at first I was just eating a piece of cheese or string cheese, just really basic foods like seed crackers, just nuts, like very plain stuff. And then after I got comfortable with that, I was able to expand and start trying to figure out how to cook the foods that I really missed because there's a lot to be missed when you have to take so much out.Lisa:So when you say "cook the foods you missed," coming up with recipes that would taste somewhat like them because you're not using the ingredients and that they've done in this book.Jessica:Yes. Yeah, so it's really a book of kind of comfort food and super holiday friendly and things just like muffins and breads and pizza and pasta sauce and tacos and it's super kid friendly too, I would say. I think I just had this desire to go back to the foods that I had grown up with-Lisa:Comfort food.Jessica:And figure out... Yeah, exactly, and figure out how to go from there.Lisa:Backing up a little bit, you were in Indiana, you went to this doctor, you started the elimination diet and then?Jessica:And then it was a long process of kind of realizing that I had to start tracking certain things when I would have reactions because you're supposed to add one food back in at a time and then kind of wash yourself for up to basically three days, give or take. Because reactions can happen in many different ways. They can be on your skin, they can be in your digestive system, they can be instant or they can show up in three days. It's kind of a bizarre, bizarre world.Lisa:And the other thing is if you're social at all and you go out to eat at people's homes or in restaurants.Jessica:Yeah, don't trust anybody because nobody knows what they're talking about. And I love my friends and they are, some of them are really amazing and truly have an understanding and have memorized stuff and there are certain people that I really trust. But then there are other people who I know they intend well but they don't know that the shredded cheese that they're using happens to have corn starch on it to prohibit mold. And cornstarch really, really gets to me instantly. I get hives, which I hate. I hate when my symptoms show up on my body.Lisa:Well, in a way that's good because then you know pretty quickly something's wrong.Jessica:Right, that's true.Lisa:In the midst of this discovery. Where were you shopping?Jessica:I was in the Midwest at first and basically I went home pretty quickly after that. I went back to right outside of Washington, DC, in Arlington and I moved back in with my mom, which was hard because I had just gotten my master's and I thought I was going to go into the world rather than a retreat. But yeah, so I went home and my mom has always been very health conscious, so she... There's a little place called Mom's Organic Market and I think it's an Alexandria technically, but it's a great little like health food type of store. And I kind of stuck to stuff like that. And Trader Joe's for just basics, which I still love Trader Joe's today because they just offer so much of high quality stuff at amazing prices.My mom trained me in the organic produce selection and I kind of did like a little work trade. So I did their grocery shopping and did some cooking. And in exchange I got to kind of take some time. I had asthma as a kid. My mom kind of suspected that I had some corn allergies as a kid too because she kind of thought that I would get like fussy when I ate things with corn syrup in it. So there were periods where she suspected it, but nothing was identified until I was 27 when all of this kind of came together.Lisa:How did you get out here?Jessica:I eventually started looking for jobs and I'd kind of always dreamed of California and I found an AmeriCorps position working in East Oakland at a school and the whole idea was kind of like teaching creativity and putting creativity back into the classroom, which my undergrad was an art education so it was a really good fit and they give you a stipend to help you move across. So I ended up driving my little Honda Civic out here and it was pretty beautiful and incredible. And then I ended up, I thought I was coming to California and I was going to be this picturesque mountains and everything. And then I wound up like right in the middle of another city and it was kind of like what?Lisa:You mean like East Oakland?Jessica:Yeah. Being here has been the most incredible part of this journey. The food culture here is phenomenal. Really, you just have access to everythingLisa:People don't realize that unless they've lived elsewhere.Jessica:Yes.Lisa:Because if you're in the Midwest, you have to carve out time to find organic food.Jessica:Yes. Or those little co-ops. The co-ops are like the way to go.Lisa:The co-ops, they're usually near universities.Jessica:Totally. Yeah.Lisa:It's not easy.Jessica:No, no.Lisa:To find good food.Jessica:That's, yeah, 100% I agree with that. Yeah, and I guess that's been the blessing of being here is just that a whole... Like Berkeley Bowl and just a whole new world happened for me and I moved in with a bunch of foodies and learned a lot from them. And so all of these different things kind of came together.Lisa:And how did your allergies, did it improve here or...Jessica:Yeah. Yeah, it's been actually a drastic difference. I think the climate is better for me in some ways. So I think my skin in general has been a lot less irritated, but, but I think my quality of life has been better since moving out here. And I'm not sure exactly why.Lisa:If you're just tuning in, you're listening to Method to the Madness, a biweekly public affairs show on KALX Berkeley, celebrating Bay Area innovators. Today I'm speaking with Oakland based entrepreneur, Jessica Gray Schipp, the author of a book called Allergic to Everything for people suffering from multiple food allergies.So tell me when you decided to write this book.Jessica:I didn't really specifically decide to write it at first, I just started writing down the recipes that were working for me and I had a little notebook. I've always, you can see my journal here, I always have a journal. And so I just kind of started writing down what was working and I had some friends over for dinner and my friend Phil had asked me like, "What is that recipe? How did you do that? I can't even tell it's allergen free," which was kind of this real goal of mine was to trick the people into thinking the food had all their allergens.But yeah, and he looked at the notebook and he was just like, "Jess, you should publish this." And I hadn't considered that and I didn't think of it that way. And then I kind of ran with it.Lisa:And then when you say "ran with it," what are the steps that you took?Jessica:Well, it was more of a jog because I was teaching full time. So I started in the summers when I had my summers off. The first summer I basically typed up this notebook and wound up with about, or I guess it took me two summers to do that, but I wound up with about 115 recipes that I developed. And then more recently, so in August, I actually left my teaching job to do this full time and try to give it a real stab. And I sat down and wrote the guide, which I didn't realize was going to be so lengthy but-Lisa:It's comprehensive. I really enjoyed that.Jessica:Thank you for saying that.Lisa:Well yeah, you...Jessica:Thank you for saying that.Lisa:Not only recipes but you list resources for people, you get into household cleaning substances, that you can make on your own. I was surprised how comprehensive. It's over 200 pages.Jessica:Thank you. Yeah-Lisa:And also what to put in a pantry.Jessica:Right? Like your staples and where to get them and how to do it and you can do it affordably and you can also spend a lot of money on this stuff. There's a million ways to do it. Yeah, and it was fascinating to kind of go in because I think before moving out to California, I hadn't started to consider what was in the products I was using on my skin, for example. I was using really sensitive simple lotions and stuff like that. But for hair-Lisa:But even laundry detergent.Jessica:Or laundry detergent, exactly.Lisa:And people use these softeners and they always smell.Jessica:And they're full of chemicals and it's gross stuff and it irritates sensitive skin even if you don't have allergens. So just kind of all of that stuff has gone into it. And then just simple things like reading ingredient labels.Lisa:Just today I read an article that the USDA, they just announced now that instead of saying whether something has GMO ingredients, genetically modified, now they are opting for bio-engineered or BE on products. Some people think it's to avoid the labeled GMO because that's kind of a bad thing.Jessica:It has a stigma.Lisa:But it also allows companies to choose between the option of either writing out the warning saying, "This contains bio engineered food," include a just a BE label or this code that you have to swipe, which they assume most consumers will not do. It seems like it's a constant battle to get the true ingredients listed because...Jessica:Well, I want to comment on what you were just saying about the labeling of food. I think that that's one of the most frustrating things because you can slap all natural on it and it means absolutely nothing. They allow a lot of loopholes in this kind of stuff, which is why it's so important no matter what to flip the package over and actually read the ingredients.Lisa:Some of these ingredients, you look at them and you don't even know how to say them.Jessica:Well, and that's my rule. I have a 10 ingredient or less rule and you need to be able to pronounce all of them. The chemicals, it just, it's really unreal.Lisa:And this is mostly processed food.Jessica:It's mostly processed food, yeah, that has that.Lisa:So people who are shopping the middle aisles are going to see more of that.Jessica:Correct. Yeah. I'm a big a perimeter shopper now. I go into the middles for my brown rice pasta or some crackers.Lisa:Or olive oils.Jessica:Or olive oil, yeah, definitely loved my olive oil. I've been leaning into avocado oil too. That's-Lisa:And you talk about coconut being a good alternative to corn oils and things like that.Jessica:Yes. I think one of the interesting things was too with my skin, how irritated it was at the beginning of this journey. I started just trying to figure out natural things I could use to moisturize because normal lotion wasn't working. So coconut oil was something that was really, I was just like slathering it on. And it was really, really healing for me, which was interesting because a lot of doctors had told me to try these lotions with oats, which I hadn't realized at first that I was allergic too.There are also gluten free versions, but oats just in general give me a scarf rash. And so it was really weird and it was like making me more and more irritated. So then I started going backwards and doing just really simple like olive oil on my skin and it was amazing.Lisa:The difference.Jessica:And anti-inflammatory and yeah.Lisa:So tell me the difference between allergy and a simple intolerance.Jessica:It shows up differently in symptoms. Some things are more severe and tolerance is like your body and your system just can't handle it.Lisa:Is that worse than an allergy?Jessica:Yeah, because you're hurting yourself and you might not necessarily be aware. Like, if you continue, let's say you're a celiac and you're eating gluten, that can lead to huge complications where your digestive system just stops functioning on its own. There's all these thresholds. But I find all of those areas, like I go into it in the book but at the same time I find, I don't like all of the little narrow paths that they put with this. Like if a food doesn't work for you, I think it's good to stay away from it and find an alternative.Because people talk about food sensitivities and food intolerance and food allergy and what is the difference? And it's confusing but I think with intolerance is really your body won't tolerate it and you just have all these weird symptoms and you're used to living with them. So you go with it and you don't realize what's on the other side when you...Lisa:So it affects your mental health as well.Jessica:Yeah. Oh definitely. I think so hugely.Lisa:In your book, you lay out in a really nice way the daily symptom tracker also sort of a guide for the elimination diets. So this book is something somebody can actually start writing in right away.Jessica:Right.Lisa:Is that your copyrighted food tracker?Jessica:Yes.Lisa:It's not available yet?Jessica:No.Lisa:To the public. How did you finance publishing book? How are you doing it?Jessica:I took everything I had saved up from my teaching salary, which was challenging, and my Grandma Donna passed away a couple years ago and left me a little bit of money and I was going to use it for a business or an investment on a house and I decided to put it into this book because I just really believe in it. So I've put about $25,000 into getting to-Lisa:Of your own personal money.Jessica:Yeah, of my own money, into it now. And to finish the project, I decided to go onto Kickstarter and so the project is live now and it's live through June 17th at 11:11 PM.Lisa:And what are you trying to raise on Kickstarter?Jessica:$33,000.Lisa:And that'll take you to where you need to...Jessica:And that'll take me to where I need to be and to do it properly, to get the editing done and the printing, to mail out the rewards. Shipping is phenomenal when it comes to Kickstarter, which was a really interesting to learn.Lisa:What do you mean?Jessica:I would say about a third of that amount of money is what it costs to actually send the rewards to the backers. It adds up. And if you can do media mail for books, which is great, but if you add in-Lisa:What are your rewards for backers?Jessica:Currently we have the book. I have a dinner party option, so that's kind of low end, high end, and then in the middle there are gift sets so you can do like an apron gift set. I'm really, really big into aprons. I'm in love with them. I started sewing my own and then I just actually added a new reward, which I'm really excited about, which is a grocery tote but also a cooler. So it's kind of like bring it to the grocery store or to the picnic because I know you're carrying all your own food if you're allergic. And I'm trying to keep it really, really simple because it's really about the book at the root of it.Lisa:And how do people find out about a Kickstarter campaign?Jessica:I have a URL that is forwarding right now straight to the Kickstarter so people can go to hashtag, the word hashtag, and the word allergic together, hashtagallergic.com.Lisa:Not the symbol, the word?Jessica:No the word. Yeah, so hashtag written out, allergic written.com and it'll take you right there. But also if you're on Kickstarter you can just type in the word allergic or allergies and it should come right up.Lisa:And you also have a website?Jessica:Yes.Lisa:What is the link to that?Jessica:The website is allergictoeverything.life and on the website, this has been kind of a new experiment and I'm still playing around with it. At first it was a platform to share what was going on with the Kickstarter, but I've been working on starting a blog and sharing some recipes through there. So I don't have a huge collection, but it's something I'm going to keep growing so people can go on there for food, food tips, and I have all my favorite resources. I have recipes for my food allergy purse.Lisa:Do you ever list restaurants that might accommodate allergies in the Bay Area?Jessica:No, but that's something that I am really interested in doing actually. And I think that we live in such a friendly place for that. A couple of days ago, a woman from Toronto who has, that's kind of her mission in the food allergy world. She reviews places you can eat and she does profiles of people. So she did a profile of me and she really wanted to get into the places that you know you can eat and that are friendly. And I think that that's so important and I think we're really lucky on the West Coast to have such-Lisa:We are, but you made a point earlier that it was a good one. Even your friends, let's say someone decides they're going to have you over and you're allergic to allium, which is onions, garlic and all this stuff.Jessica:Right?Lisa:And they say, "There's nothing, I swear to you, there's nothing in this." And yet they use a canned broth.Jessica:Correct.Lisa:In a soup or a sauce, which is full of allium.Jessica:And probably maltodextrin.Lisa:And it doesn't say it on the label. It says "natural ingredients."Jessica:Right. That's the most unfair.Lisa:And so you can't get mad at people, but there needs to be a raising of awareness and that's something that you've done in this book.Jessica:Yeah. And I think that's my biggest motivation for all of this is... Well, it's really to make people's lives easier, learning how to navigate all these little intricacies, but awareness is so important because people just don't know and it's not their fault. It's just a matter of education and...Lisa:I just noticed there's more and more food allergies and I can't help but think that it's our air, it's our water, it's our soil. I don't know if anyone is looking at the root causes of this.Jessica:Yeah, I don't think many people are. I think there's a lot of people burying the root causes.Lisa:You don't mention it in your book either. But depending on where you come from, what you're exposed to.Jessica:One of the things that I think about a lot with that, which gets me a little crazy if I think about it too much, but is the fact that, so I'm able to eat meat, right? And let's say I want to eat a steak, but they're feeding that cow corn, which I'm allergic to.Lisa:GMO corn probably.Jessica:Yeah. So how does it affect me with the end product? And that's just something that is mind boggling and...Lisa:It is, but out here you can actually seek out a butcher that that gets meat from local people who they know what they're feeding the animals. But that's not true in most places.Jessica:Right, and most of the population doesn't have that luxury. And if they do, maybe they can't afford it. There's a lot of barriers to it, but I think it's a really systemic problem that needs to be looked at from the ground up. But when we keep coming up with these new, what did you say it was going to be, BE, on the package?Lisa:Yes, bio engineering.Jessica:And the natural ingredients.Lisa:It's deflecting.Jessica:It's deflecting. It's like the whole sugar thing in the 70s or whenever that whole epidemic started, but it's really incredible the lengths that companies go through to bury the truth from people and to just keep people uneducated.Lisa:Even sugar, it's not so easy in some places to find something made from natural sugar. It's either going to be genetically modified sugar beets or corn.Jessica:Yeah, and sugar is super inflammatory too, so it kind of all comes out the same in your system. But corn syrup, I really, I just really hate that stuff. I just feel like it's toxic and it's in everything.Lisa:What were your biggest challenges along the way or maybe surprises along the way as well in this whole process of getting this book out?Jessica:Well, I'm in the midst of the challenges right now. It's been really hard to connect with the community that I'm trying to connect with because there's a lot of barriers. So-Lisa:What are they?Jessica:I'm part of a lot of groups online for example with like food allergy communities. But I'm not allowed to post my project because it's seen as fundraising or an endorsement of a fundraising project. And same thing with every single organization that I've reached out to and I'm sending thirties of emails a day trying to get people to help me put this out there.So that's been the greatest challenge and the greatest barrier really. This isn't even about profit, it's just about getting it into the hands of people who need it, the hands of people who are struggling or just foodies who want to cook. Because really the book is... Anybody can use it. It's not, you by no means have to be allergic to appreciated.So connecting with people has been challenging and I feel like I've really had to prove myself in ways that have just been shocking to me. I didn't think I would have to beg food allergy people to see me as an authentic person just trying to put a resource out there.Lisa:Any positive surprises or challenges?Jessica:A lot of positive surprises. I've been just in awe of the support of family and friends and I had an amazing launch day, which was just incredible. But just-Lisa:When was your launch date?Jessica:I launched on May 15th during Food Allergy Awareness Week. So the campaign will be a total of 33 days. It ends on June 17th.Lisa:Let's talk about what you're going to do if you do make it. And if you don't make it.Jessica:To make the goal, I need a 1000 people to put $20 into the project. I think it's really feasible. And if the project succeeds, the plan is then I want the rewards to get out to people and the book itself to get out to people by December. So I will just jump right into the editing phase and illustration and then getting the book printed and shipped out.So I've been working with editors and plotting around that. I think it should take about between four and six months. I've given myself a lot of given myself enough padding, I think to make that happen. I really believe in this book and I'm not really focused on what's going to happen if it doesn't work because it's going to work. So on June 17th, I will know and I'm just kind of trusting that the next thing, yeah, will come and it will happen.Lisa:And so then you're going to be busy touring with this book.Jessica:Then I'm going to be really busy. Yeah, if it hasn't been busy enough, Kickstarter has been an adventure. It's a lot of work.Lisa:Let's say you get the book out and you're onto the next thing. Do you know what that's going to be?Jessica:Well I already have a another book in mind that is going to be like #Allergic to Everything Light because I think this book has a lot of comfort, delicious recipes. And I think that my cooking has shifted over time. So I kind of want to put just my newer, lighter. Yeah, just a little bit healthier. Initially, the things that I missed were breads and things with sugar in it and things like that. But no matter what, I've always been a teacher and I'll always be a teacher. So however I can teach, that's what I'll be doing.I was teaching for about five years, everything from yearbook to coaching robotics actually here at Berkeley. I was with high school most recently. And I think something that I think about in the future is teaching on the college level. I've kind of snaked my way up through all the grades and I found a really sweet spot in high school. But I think there's a really sweet spot in young adulthood when you're studying what you want and learning how you can manipulate the world and leave it a better place.Lisa:Do you feel like you've reached your comfort zone of allergies? You have your allergies under control?Jessica:I think I have my allergies under control. I don't always have temptation under control because it's a tempting world when everybody you live with is eating pizza. It's not always that easy not to eat it. Certain things I noticed trigger me and I'm still looking at them, like sesame for example. I kind of think that sesame oil causes me issues, but then I don't always think so. So I don't know. I think it's kind of an ongoing process.Yeah, and something to revisit too because a lot of people end up removing things and their system kind of gets this little break and then they're able to reincorporate them, which I've tried that. I haven't found that to be successful for myself, but I think it's possible for a lot of people, so yeah, I think it's a lifelong.Lisa:In your research, do you think that the human body will evolve to accept these bio engineered or GMO products ultimately?Jessica:I feel like we're evolving to reject them. If you look at just the ratio of wheat in things and the ratio of corn in things and that with the number of people affected by these things and the rate of the increase of allergens being diagnosed, especially in kids, it's outrageous. I don't think that we're helping ourselves. I think we're hiding a lot of things behind big bureaucratic systems.The way that the book is written is to be able to be used by anybody who's dealing with any of the top eight allergens. And this question has come up a lot by people looking at the project, wondering if their child's allergic to dairy and nuts, will they still be able to eat? And the answer is yes because every recipe is going to be flexible and your allergen will be able to be substituted within that. And I would say only 30% of the book probably contains those two items.So even without the flexibility of the recipes, there's still a ton of resources for everybody, but it is friendly to to all top eight allergens. And part of the reason that I wanted to do that is because I know that nobody's journey is the same and nobody's allergens look exactly the same and mine aren't all the top eight, but the top eight are responsible for 90% of the food allergic reactions. So I wanted to try to include as many people as I could.I think the things that made me fall in love with food, I think the food is all about our memories and about our experiences and little things go a long way and food attaches us to memories. And that's how we make memories with each other. And there's just a real sense of comfort in it, whether it was my grandmother taking the time to slice the grapes for the fruit salad and just shows love.Friendsgiving is how I started celebrating Thanksgiving when I came out here and just bringing people together. And I think that food really connects us with each other and with ourselves. And it's a big reflection on how we're taking care of ourselves and I think it's important and I think this book is important. I hope that people will consider supporting the project regardless of whether or not you have food allergies. Because I can practically guarantee, you know somebody who has food allergies and they deserve this resource.Lisa:Well, thank you, Jessica.Jessica:Thank you.Lisa:You've been listening to Method to the Madness, a biweekly public affairs show on KALX Berkeley, celebrating Bay Area innovators. You can find all of our podcasts on iTunes University. We'll be back in two weeks at this same time. 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This week i have Lisa Phillips on the show. Lisa Is a two time Australian open singles champion who has taken a step back in her bowls in recent years but is well and truly on her way back. I asked Lisa all the listener questions that were put up on Facebook which there was plenty of good ones!

This Episode’s Focus on Strengths In this episode, Lisa has a fun conversation with Melissa Dinwiddie. Melissa is a multi-talented, creative person who lights up your day with her voice and enthusiasm! She helps her clients to use their strengths to get their mojo back when they feel like their innovation gene has left the building. You’ll find lots of ideas to spark your creative mojo in this episode. Plus, you’ll hear about her “Passion Pluralite” life, as she calls it, so listen in. You’ll walk away with a newly formed opinion of what’s possible for a multi-passionate person. It’s inspiring to see someone who wouldn’t settle for “one thing” or one activity driving her entire career path. As she’s working with her clients, Melissa always keeps in mind her Top 5 Talent Themes from the Clifton StrengthsFinder: Connectedness, Achiever, Input, Futuristic, and Positivity. You’ll hear why this combination of Talents makes Melissa one of the most knowledgeable, multi-talented, creative people you will ever meet.   What You’ll Learn Find your unique you. Melissa Dinwiddie is a multi-talented woman who has many different interests. She knows a lot about a lot of things. She always took for granted that she had so many interests, until she had a conversation with a client that led to a life-altering Ah Ha moment. In that moment, she realized that she had a unique gift, and that her Connectedness and Positivity Strengths made her a natural at consulting and collaborating with others. This led to her career working with clients to improve their creativity – which leads to innovation, increased profitability, and achievement. Use your Strengths. Connectedness and Positivity also enable her to look for meaning and connection all around her. She is always using that information to figure out how she can help her clients. Always say “Yes, and…” Improv class, which is one of Melissa’s newer hobbies, taught her to always say “Yes, and…” instead of “Yes, but…” because when you say it, you keep thing going and growing. This approach generates more new ideas, and allows for more creativity. Saying “but” is really just another way of saying no. It shuts down creativity. It leaves your team with more potential conflict and stifled creativity. Adding many ideas to the big mosh-pit brings forth more possibilities, and will empower your team members. When people are scared that they’re gonna be cut down, they become afraid to speak up (and you might be missing the best idea yet). Understand your Strengths…to overcome them. This might sound counter-intuitive, yet Melissa gives a great example when speaking about her Achiever Talent Theme. In the past, her need to achieve kept her stuck in self-perfection. By understanding how the Achiever Strength has the possibility to (counter intuitively) limit her ability to finish projects, she has developed self-compassion. She now considers herself to be a “recovering perfectionist”. So, if you tend to be a perfectionist at work, remember, everything doesn’t always have to be perfect; sometimes it just needs to get done. Give yourself a break! Lisa adds that the Achiever Talent Theme in its pure form is all about completing tasks and getting to the finish line. She hypothesizes that Melissa’s other StrengthsFinder Talents may be playing into her perfectionist tendencies too. While her Achiever wants to get things done, her Input will want to keep sponging up learning and insights that broaden her view of the project. Speaking of opening up possibilities, her Futuristic Talent will keep her in constant “what-if” mode. The fascination and vision of what can be can also keep you in rework mode. And her Connectedness Talent could have event played into her perfectionist tendencies because she sees connections and wants to share them with other people. Imagine when she’s creating courses and wants to keep tinkering so that every person with every perspective can get what they need. Ahhh, feeding your talents can be so energizing. And, sometimes, they can derail your progress if you’re not keeping an eye on the outcomes you set out to achieve. Schedule sandbox time every day. Our modern lives are super-busy, and often jam-packed with activities and projects every single day (even the weekends). Melissa suggests you spend 15 minutes every day relaxing, like you used to do as a kid. Play in the sandbox, doodle on paper, or go for a walk – whatever floats your boat. She’s proven that just that short amount of downtime can rejuvenate your creativity, and you will have a much easier time coming up with new ideas or finishing projects you’ve neglected. So schedule a short break time every day, and see what happens. Finding your “true passion” takes practice. People often ask career coaches and StrengthsFinder consultants how they can find their “true passions”. Melissa has an answer for them: Go out and try different things. She cites the example of learning to dance, another recent hobby. It took her 3 – 4 years of different types of dancing to figure out that she loves salsa and Argentine tango. In the work environment, you may be in a role you don’t love. Maybe you even hate your job. Look at the tasks your perform, and pay attention to what you actually do enjoy. Then find ways to get more of them added to your job responsibilities. If you stick with it, you’ll end up happier, more successful, and your business will be more profitable. Remember, knowing your Strengths and understanding them can have a huge impact on your personal and professional lives. So go out there and create.   Resources of the Episode To connect with Melissa and grab some creativity resources, check out her website. You can also connect with her on Instagram, Twitter, and Facebook. Ready to live a full-color life? Melissa’s Live Creative Now podcast is filled with practical tips and inspiration on creativity and creative productivity. Feeding your creative hungers is one of the fastest ways to happiness, joy, and self-fulfillment. Not only will you feel more alive, it’s how you will change the world!   Subscribe To subscribe and review, here are your links for listening in iTunes and Stitcher Radio. You can also stream any episode right from the website. Subscribing is a great way to never miss an episode. Let the app notify you each week when the latest episode gets published.   StrengthsFinder Mini-Course For Managers If you’re a people-manager and you want to sharpen your strengths based support, come join our monthly mini-course. We don’t charge for this because we want to help you keep the StrengthsFinder momentum going. Teams who receive strengths feedback have 8.9% greater profitability. Yowza! Sounds like a great reason to join. Source:  Asplund, J., & Blacksmith, N. “Strengthening Your Company’s Performance.” Gallup Business Journal.   Go Live Your Talents Remember, using your strengths every day at work makes you a stronger performer. Go claim your talents and share them with the world! Read the full conversation: Lisa: Today, this show is all about using your natural talents to unleash your creative side at work. Your guest is so super interesting. She's actually dedicated her career to instigating creativity around the world. She works with teams to help them get their Mojo back when they feel like their innovation gene has left the building. She might even change your mind today about how very important play is at work. And speaking of play on the literal side, your guest plays the Ukulele and even brings that into her work world. So get ready. You're about to see how your creative expression can help you offer your value to the world. So Melissa Dinwiddie, welcome to the show. Melissa: Wow. Thanks Lisa. That was like the greatest intro ever. Lisa: It could have only been better if I had primed you for it so that you could have your Ukulele ready to play a little tune. Right. So, okay. You know, this show, it's all about exploring strengths from every angle. We're getting a unique angle of creativity today and we're bringing in strengths to that. So when you mentioned to me that when you first considered your top five StrengthsFinder talents that the one called Input was interesting to you because at first you didn't see that as something special and you. So tell us more about how that went down for you. In your mind, how did you open yourself up to the idea that it could actually be a superpower that you were overlooking? Melissa: I was doing a trade with a woman who was, at the time, my yoga teacher and she's also a life coach and so she was trading coaching. She was giving me some coaching and I was creating a website for her. It was maybe the third time that she had asked me about how to do something inside of a WordPress website, upload an image or create a new page or something, and I was showing her. And then she said, well, what if I want to do, you know, x, Y, z? And I said, oh, well there's three different plugins that I know of for that. And she looked at me and she said, how do you know all this stuff? And I said, I don’t know, I just, I made my own website a number of times so I know this stuff. And she's like, I think you don't appreciate how that, you knowing all this stuff, like that's not normal, that's normal in a really cool, really cool way. Melissa: Like you could, you could do consulting and you know, Blah Blah Blah. And it, it was that moment that made me realize, wow, this is something that's unusual about me in a good way. And it made me flash back to a moment, years earlier, this would have been back in the late 90’s, mid 90’s when I had started doing calligraphy, which became a huge passion of mine and that ultimately turned into a career. But at this point I was still a relatively new calligrapher and I was at a workshop and it was one of the first workshops I had been to with this calligraphy guild that I had joined. And somebody asked about a tool called an automatic pen. Well, what is an automatic pen and how is that different from, you know, this other kind of pen? Well, I, when I got into calligraphy, I had taken, like I'd ordered all the, there were two big stores that had, at the time, this was really before the Internet took off, so they had these paper catalogs. So of course I had ordered these paper catalogs and that was my bedtime reading. I would go to bed and pour through these catalogs and read all the details about every single tool and every single book. And so I just knew all this stuff. And so here I was, I'd been doing calligraphy for, you know, less than a year or something, and I was spouting off “well and automatic pen is its way and it works in this way and the way it's different from quick pan is blah blah”. And I remember the people looking at me like, are you an alien? Like they just didn't know you've been, I've been doing calligraphy for eight years and you just started, eight months ago, how do you know all this stuff? Melissa: And I, didn't realize that that was, I didn't have a word for it. I was just who I was. So I didn't realize that it was unique or unusual or a particular strength. And it just was this quirky thing about me that I didn't even realize was quirky. So yeah, that, was probably of my StrengthsFinder strengths. That was probably the first one that I went, oh yeah, that I can totally see as a strength because the things that I'm passionate about, I dive in and I learn everything that I can about them because that's what I do and then it nothing makes me happier than sharing that knowledge with other people, so it's a natural for consulting. Lisa: So cool. I love when I have clients with Input. It is so much fun to hear because they love going deep and gathering all the information and learning about a topic and then really directing it to what they're into, whether it's a hobby or work and then sharing it and it becomes such a collaboration strength too because you can add so much value because you realize, oh, not everyone does that. I mean, if I know if I got into calligraphy, I would flip through and look at the pretty pens and that's about it. I didn't know anything about any specs. Melissa: Right, right. Yeah, it, it definitely comes in really handy. The other one, I'm number five for me is Positivity and that one I recognized right away and people are always telling me, Oh my God, you have so much energy and you're such a cheerleader, you know, and that's just my personality. I hadn't really thought of that as a particular strength either, but I see it like I use that every day and the work that I do with clients and the groups that I lead that, that I am always essentially cheering people on. I mean not with like pompoms or something, but you know, I always have a positive spin on things and that it's not pollyannaish. It's just, it's just how I am. I think actually that's quite related to my top strength of Connectedness, which I mean I read that and when that's a strength, what? Lisa: That one always surprises people. They go, Huh, I would never think of that one. Melissa: Never would have thought of it. But I think that really ties in with my Positivity that this sort of outlook of always finding meaning and connection and you know, there's always this sense that everyone and everything is connected and I'm not like a religious person, but I'm it definitely infuses kind of everything I do Lisa: Well, knowing a little bit more about you and how you bring play into your work and how you’re an improviser, that's a high Positivity. It just makes complete sense because there's a fun-loving elements of it. It's finding the good times and things like if you're going to be here on the planet, go have a good time while you're at it, why not? And that tends to be one of the outlooks of people with high Positivity. So when I saw that and then knew that you were into play and Improv, I thought, oh well, it's just so perfect. Melissa: Yeah. And of course the sort of core piece of Improv is to say “yes, and”. Lisa: Yes, please say more about that. How that has shown up at work for you? Because most of the corporate people I work with are completely unfamiliar with Improv. Maybe you can talk about how that looks for people in a meeting or how that looks for people in either supporting each other's ideas versus squashing it if they gave it a “yeah, but.” Melissa: That got really clear for me when I think it was like my first Improv class, I've been doing improv for about three years now and although I've been improvising, interestingly enough, I've been drawn to improvisational creative forms for a really long time. For example, I got into salsa dancing and Argentine tango and those are purely improvisational dance forms. They are based on a vocabulary of movement and each social dance has its own vocabulary of movement, but within that vocabulary it is 100 percent improv and then when I got into music, the music that I was drawn to was jazz, which is an enormous umbrella that covers so many different styles of music within it, but the one thing that is a consistent among all of them is that there have improvisational elements, so it's really not that big of a surprise that I would end up doing improv. Melissa: Now I can connect that all together. My very first improv class, there was an exercise where a group of us were sitting up on the little stage area. We were supposed to pretend that we were in a meeting creating, we're talking about creating some, I don't know, some random object that we made up on the spot and about how to market it, I think. And so the first part of the exercise was that whenever anybody says something, let's, you know, let's throw a big party with confetti and invite the whole town or you know, whatever it was we were supposed to respond with, “yes, but,” and then add something. Right. So we did that for a while and then we stopped, and we replayed the same scene essentially. But this time whenever somebody gave an idea, the response was to be “yes, and”, and what was so interesting was when we did the “yes but” or “well, but” it would turn into just squashing, squashing just that: No, no, no, no, no. And it stopped everything where when the exercise was “yes, and” it became this like crazy mashup and it just kept growing and growing and growing and growing. And when you bring that “yes, and” to say a meeting where you're generating ideas or something and if you can respond to somebody else from that space of “yes, and” it opens up so many possibilities, you know, there's time later where you can refine things and cut things out and look at the, you know, the reality of our budget is limited to x or whatever. But to generate ideas, you have to be in that space of “yes, and”, and people don't like to put an idea out there if they know that there's a chance that it's going to be cut down. Right. Nobody likes that. That feels terrible. So that's a really important place to bring that Improv scale of “Yes, and”. Lisa: I love the example too, of how you used it and actually had the contrast of the “yes, but” or the “well, but” with the “yes, and in the same situation because right, it just stops all the momentum and turns everything. And it's kind of like the eeyore moment. Melissa: Totally. Yeah. And “yes, but” is really another way of saying “no” Lisa: it true. Another thing that you're getting me thinking about reflecting on a work day and how you can have these breakthroughs and also sparked me to think about something you mentioned about your Achiever talent, how when now when you look back on a work day, you can kind of see that when you're fueled up, it's because you've achieved something and felt productive and that you feel frustrated when you're not. What does that process look like for you? And just exploring them and seeing how they show up. Melissa: That one for me, in some ways it feels like as a liability as much as a strength only because, my history is being way too much of a perfectionist. I mean, I am now a card carrying him perfectionist, which means a recovering perfectionist. It's the same thing, which means basically that I treat myself with self-compassion. I was so stuck in perfectionism. I mean my Achiever strength was, you know, so blown out of proportion, there was no balance to it. There was nothing, nothing connected with the Achiever that you know, just sort of say it's okay. You get to be a human being, you get to be human. What ended up happening was, I mean, I call myself an artist. I had a career, a business. I still have a business and our business primarily making Jewish marriage contract. It's basically a side business these days. It used to be my main business and for about a decade while I was making my living from my art, I didn't create anything for myself purely for play, except once a year I would go on a retreat with my calligraphy guild and then I would do some things for myself, but the whole rest of the year, all the other 360 days of the year, the only art I ever created was to other people's specifications and partly or a big chunk of that was because I was so trapped in perfectionist paralysis that anything that I would create, I would think, well that's not good enough. That's crap. And so it became so painful to try to do anything that I just didn't do it. But I was in such denial about it that I told myself, you know, I bought into the story, I created this story that it was because I just didn't have time and it wasn't until February 1st 2011 when I was actually interviewing an artist for my first online course that I created called the thriving artists project and this particular artist mentors other artists who want to have fine art, you know, professional fine art gallery, exhibiting art careers. Melissa: And they get stuck in resistance as anybody else on the planet. Surprisingly enough. And so this artist that I was interviewing would tell her mentees, if you can't put 15 minutes a day into your art, you're making an excuse. And she was just talking about what she told her mentees. But in that moment, I was so nailed. She was, she was talking to me. She didn't realize she was talking to me, but she was saying to me, and by the time I got off that phone call first I got very defensive inside. But then I realized, oh my God, she is right. For the past decade I have been making an excuse because of fear, and so that day, and it was February 1st 2011, I committed to putting 15 minutes a day into making time for the joy of creative sandbox time that you talk about. Lisa: Is that your creative sandbox time? Melissa: Absolutely. That is. I didn't have that terminology at that point, but yeah, that's, that's my creative sandbox time. That is my playtime where in fact, in order to get myself into that head space where I could put even just 15 minutes into making art, I had to set up a bunch of sorts of ground rules for myself and it started off with maybe four or five. You know, it's all about the process. It's not the product let go of the outcome. When you get to the place where, you know, it's not done yet, it needs something, but you're not sure what and you're afraid to try anything because you might ruin it. One of my rules was go ahead and ruin it. And over a period of a two or three years that expanded into 10 rules for the creative sandbox. It's now what I call my creative sandbox manifesto. Melissa: And the sandbox image was because I realized at one point that I wasn't taking time to do art. I'd started making some art, but the art that I was making, I stopped after a while, a couple of weeks into it or something, I just wasn't getting to my art table anymore and I couldn't figure out why because I wanted so badly to get back to making art. And one day I was looking at the table and I realized, oh my God, the art that I'm making right now has nothing different from when I'm working for a client. So it feels like work to me. It was very meticulous. It was very design-y. There was nothing improvisational about, there was nothing playful about it. It was the opposite of play. And I realized it was like this light bulb went off over my head and that's when I thought I need to play. Melissa: I need to be like my little four-year-old nephew playing in a sandbox, making messes, thinking, oh, what would happen if I poured water on this? What would happen if I did this? That's the headspace that I needed to be in. And so that's, what I develop those, those rules to help me get into that headspace. Lisa: It's so cool. And the boy, I mean, you know that in the corporate world this is such a thing for people because you have this push-pull and your mind whether or not someone's specific talent is Achiever. People have a drive to get stuff done is push for the next thing, but then you know you need white space. You have to explicitly sometimes not manage yourself to a goal or you burn yourself out. And there's this internal fight thing and you even sparked for me a thought that takes it beyond the moment to moment push-pull, but even the overall career stress that people put themselves under when they think of finding their passion or finding their calling. Lisa: And I, think I remember you talking about callings as an elusive thing and that it's normal to resist them and refuse the call, that sort of thing. And I'd love to hear… you just got me sparked on that idea to what's your take on work as a calling and what do you do for those people who are beating themselves up over the fact that they feel like they don't have one? Melissa: Oh my God. So that makes me think about a conversation that I had a number of years ago with a woman in my synagogue and I was talking about this stuff was pretty new to me then I was like, wow, I'm discovering this new direction for my life or I'm helping people get connected to their creative side, which for most of us has been, you know, got quashed down pretty early, including me. Melissa: I mean a lot of people get quashed down at age five or six or something was like age 13 when I stopped making art. But for most of us that that gets really squashed and you know, so I was finding my passion again and our passion number 17 or whatever. So I figured out that I have a lot of them and this woman said, well, what do you do if you don't, if you don't have a passion. And I was stumped. I did not know how to answer her question. And it was only later when I was reading an article by somebody who I think she calls herself like the passion mentor or something, I can't remember, but she was writing about how, you know, passions, we have this idea that you're going to have this Eureka moment. You're going to open a door and boom. Melissa: Yeah, that's my passion, I found it. And the reality is, even though I spent, I can't tell you how many times I've told the story of various passions I've had in my life: dance, calligraphy, getting back to social dancing, writing, improv, music. So many different passions. And the story has always been, oh, you know, then I discovered this and that became my next passion. But that's not really what happened. Really, what happened was with dance, I was too scared to try dancing as a little kid. I had some movement classes when I was like four. And then I had friends who were in ballet, but I had this image of the mean ballet teacher with the big stick who would like hit you if you don't do things right or. So I never took any dance classes. And then in I think my freshman year in high school, some friends of mine, we got together, and we took a class at a community center. Melissa: We thought it was going to be, you know, mtv kind of how to dance to Madonna's material girl or something, you know, like the music video kind of dance. And it was actually, it was a modern dance class, which I didn't realize was much more classical style. And we were like, wow, this is lame. So I didn't, you know, I ended that class and forgot about it. So finally, you know, years later after, you know, first thinking about dance, I took a class at this local dance school and that's the moment where I went, oh my God, I want to do this every day. But it was, you know, three or four years of, tipping my toe into different kinds of dance before I discovered that dance school and Bingo had my Eureka moment. Every passionate I've ever had has been like that. Melissa: You have some kind of interest in something enough to try it. And you know, maybe the first time it doesn't do anything for you. But for some reason you go back to it at some point again and maybe the next time you find something new in that and eventually you know, you try it a little more and then it starts to develop a little more meaning for you. And then you dive in a little bit deeper and it's the sort of back and forth thing and it happens, you know, much more organically. It's much more like, you know, there are people out there in the world who feel like they had this instant, you know, love at first sight moment with their spouse or their partner. Right? But most people, it didn't actually happen that way with me, my husband, it took me two and a half years to see him as a contender and, he's like best match I could ever imagine for myself. Melissa: And that's what it's like with, with our passions for activities or pursuits. Lisa: What a good metaphor because it is like, I mean I can see the relationship metaphor so strongly that you meet somebody and then you think, hey, I actually enjoyed my time there, or I feel better when that person enters the room. Then when they leave the room and then you think, well, I'm going to hang out with that person some more, and it's the same with responsibilities and tasks in the work that you do. You can say, oh, that things kind of neat. I've never done it. I'm going to hang out with that thing a little bit more. And then you start exploring all the offshoots of it and it's so much like that at work and people for whatever reason, feel like there should be the Eureka moment you talked about and not the process of experimenting and going, okay, that thing's cool. I'm going to follow that path and all of the arms and legs that it has, and then you find that one thing that's super awesome and really fuels you up and I don't know why it's like that, but it does make me sad because a lot of people beat themselves up because they haven't found “the calling” or “the passion” and I know you use that term passion, plural light and looking at the plural like we have. We love a lot of things. Yeah, you have a lot of hobbies. You have a lot of interests, so let yourself feel that way about your work as well and go explore them. Maybe we can end with that exploration combined with how you explore your creative energy through your doodles because I think that's so fascinating and people will dig finding their own version of what you do with your doodling. Will you share about that? Melissa: Oh yeah, absolutely. Yeah. So what I know about myself is that if I don't get a little bit, at least a little bit of time in the creative sandbox every day, my day doesn't go as well. It just, it makes me happy. It feeds me, it nourishes me. I also know that, uh, the thing I do first is the thing that gets done. So if I want to make sure that I get something into my day, it works best if I get it in first thing. I was not making, not making time for my creative play and realized I have to do it like before I even get out of bed. So I figured out, well, you know, I can bring a sketchbook and a pen, have it on my bedside table and then I can draw first thing in the morning. And so I set a timer for 15 or 20 minutes and I doodle first thing in the morning and I intentionally call it doodling because I want to be in that space of Improv. Melissa: That space of being in the creative sandbox like a four-year-old playing in the sand so that it's all about exploration and following my curiosity and not about trying to make something perfect or even good. And so it's just been an incredible self-growth experience to do this for the past, well, it's really since the start of the year, so it's been three months that I've been doing this. Every day I spend, you know, 15 or 20 minutes usually with a pen and some paper and a sketchbook, just doodling. It's like a spiritual, a spiritual practice because you learn so much about yourself. You know? Just today, there was a page where I had started something and I got really frustrated with it weeks back because I could see that it was going to require all this meticulous work that I just didn't want to invest in. It was going to drive me straight into that perfectionist place, which I don't like. I don't want to be in. And I came back to it today and thought, oh well I don't have to look at it that way I could come at it from a creative sandbox mindset and not worry about if these lines are perfectly rounded or whatever. And I was able to come back to that piece that I had totally rejected and really enjoy it and learn something and kind of expand my ability to break down those perfectionist walls from this one little doodle. So I highly recommended it. And it doesn't have to be pen and paper. I mean, you could do it with sound, you could do it with movement. You can do it with, you know, they're just so many ways that you can express yourself in, the equivalent of a doodle. Lisa: And I even do my white space. It's not quite my creative sandbox, but just my white space to clear my brain. My office is at home and in the woods and I take walks with the dogs and I just insert them in the middle of the day to give myself that moment. To not be distracted, to not be listening to shows. To not be learning, to not be in a meeting and it clears, it clears the space in a different way. And I'm the uber efficient. I mean I get so caught up that I'll listen to podcasts while I'm in the shower just because I want every moment to be so productive. And so it's that moment where I go, no, I'm just breathing, I'm listening to the wind listening to the birds and just let it rest for a minute. And then I get all these strokes of brilliance in that time and the sandbox time and the white space time. Lisa: I hope for everyone reading that this gives you some inspiration to bring that creativity back into your work day. To try yes, and if that's not something that's been part of your vocabulary, that you give that, some, just give that some air go, try that. It's easy to implement at work. Just show up and say “yes, and”, and your next set of meetings and don't squash an idea even if the squash comes to your mind, let it ride, let it ride and do that later. And let the ideas and the big breakthroughs happen. So thank you everyone for reading this Lead Through Strengths today. Melissa, this has been great. The readers are going to want to check you out. You have a show to tell them about, tell us how they can find you and your doodle delicious life. Melissa: Oh sure. Well, my website is Melissadinwitty.com.com, but that's hard to spell so you can also get to the exact same place livingacreativelife.com and my podcast is livecreativenow, which you can find there are. You can go to live creativenow.com, which will take you there as well. Lisa: Thank you. And we'll put all of that in the show notes so you guys can find it super easily and we'll get you her twitter and Instagram and Facebook links as well. So guys, remember using your strengths makes you a stronger performer at work. If you're always focused on fixing your weaknesses, always stuck in that perfectionist zone she's been talking about today then you're choosing the path of most resistance and you can choose instead to claim your talents and share them with the world.

This week, Dan and Jack enter a world of their own creation (filled mostly with action figures) to watch Season 20's Lisa the Drama Queen. Lisa and her new BFF Juliette create the fantasy world of "Equalia" to get away from their problems in a loose parody of Peter Jackson's "Heavenly Creatures." Sure, why not? Is there potential romantic tension between Juliette and Lisa? Is there potential romantic tension between Dan and Jack? And does anyone else remember Krod Mandoon and the Flaming Sword of Fire? Plus, the joys of Crazy Town, the new Mozart, and the best animated mugs. NEXT WEEK: Season 20's Sex, Pies, and Idiot Scrapeswww.weepodcast.com