Functional Medicine Practitioner Reveals The Sobering Truth About the Coronavirus | Chris Kresser

one of the most sobering statistics that i've seen in this whole epidemic is that people under 65 years of age with pre-existing conditions which are virtually all lifestyle and diet driven conditions are at as high of risk for hospitalization as people who are over 65 with no pre-existing conditions so if you're a 45 year old person with type 2 diabetes you have the same risk of being hospitalized as a 70 year old or a 75 year old that doesn't have any of those pre-existing conditions and that if that's not a wake-up call i don't know what is everybody welcome to health theory today's guest is chris cresser he's a best-selling author and functional medicine practitioner who founded the cresser institute which trains doctors and health coaches in evolutionary health practices he was named one of the top 100 most influential people in health and wellness by greatest.com and he's become known far and wide for his individualized non-dogmatic approach to diet and lifestyle chris welcome to the show my friend tom it's a pleasure thanks for having me dude it's good to have you man i'm excited about this so i've obviously seen a ton of footage um on you and the things you talk about i'm somebody who is really fiendish about health and wellness as it relates to just accomplishing what you want in life so my last company was a nutrition company and when i started the mindset stuff people wanted to know why the protein bar guy was talking about mindset now that i'm full-time mindset people like why am i talking about health but to me they're they're just inextricably connected um how would you define sort of your overarching strategy when it comes to um individualized notions of of getting it right getting it dialed in how do you think about people approaching it yeah great question so i mean it's certainly true that we share a lot in common as human beings you know we're the same species we have the same general anatomy and physiology but it's also true that we have a lot of important differences we have you know different genes different gene expression different lifestyle different goals different health statuses we live in different climates and environments and all of that can affect what an optimal dietary approach is for a given person and not only that that will change over time with each person so for example imagine someone who is a you know high high-level athlete in their late teens and 20s that would require a certain dietary approach but then in their 40s or 50s they're a sedentary office worker you know they're no longer performing at a high level and and so that would be a totally different uh dietary need or situation or somebody who uh develops a chronic illness an autoimmune disease their dietary needs would change versus what they might have been before that illness so i think a lot of the public health messages around diet are oriented around trying to come up with one ideal approach for everybody and i think that's doomed to fail certainly we can extract certain fundamental principles that apply to everybody as a baseline and then using all of those characteristics that i mentioned before to create the ideal uh approach for each individual okay so before we dive into some of the individual stuff which you said some things in the intro like climate um that i actually haven't heard people talk about before so i'll be really interested to dive into that but first let's talk about those fundamental principles so you talk about food quality what what does that mean like how does the average person i'm going to guess you're going to say whole food but i'd love to to really put a fine point on what you mean by food quality and what those general guidelines are so um let's kind of first distinguish between food quantity and food quality so and look to answer this properly i have to actually look a little bit historically at dietary guidelines and what the recommendations have centered around has mostly been quantity quantity of certain macronutrients like carbohydrates or fat you know the low fat guidelines for 50 years 40 years american heart association or quantities of nutrients like how much you know vitamins you should eat or minerals you should eat uh or quantities of specific foods like red meat or dairy products or you know saturated fats or trans fats and the problem with that approach is that it's led to what food philosopher gregory skrinis calls nutritionism which is this kind of myopic focus on the isolated components of food rather than the overall quality of the diet pattern so by overall quality you're right we're speaking of is this a real food is it something that grows in the ground or lives in nature or versus something is in a bag or a box and it's highly processed through the industrial food system is it nutrient dense so nutrient density is a measure of the concentration of nutrients in food relative to its calories or weight and we want to be focusing on foods that are highly nutrient dense that's a measure of quality in addition to you know whether it's a real food or a whole food so if we focus on foods that are high quality they're nutrient dense they're whole foods they're anti-inflammatory then in most cases not all we can talk about the specifics of that that's like 80 or 90 of the battle right there and then the remaining 10 or 20 percent is just tweet the the twisting of the dial to get the optimal approach for each person maybe a little more carbohydrate or a little less carbohydrate or a little more of this food little less of that food excluding those foods including those foods but people tend to focus on that 10 or 20 percent and not enough on the 80 to 90 percent and certainly that's been true of the dietary guidelines it's it is really interesting to me what happens in uh food so food has become a new religion so back at quest we created what dude i cannot tell you there are two times in my life where i created a piece of content that i did not think was controversial i thought people gonna love it and they lost their minds one was when i wrote an article called it's all your fault looking back on that one i get why people were triggered by it i still agree i think i was right but i get why that one's triggering for people and then the other one was that we put out a video that basically was like hey a calorie is not a calorie right it really matters where it comes from and so the nutritional um makeup of a twinkie is very different than the nutritional makeup of a steak or something else or even just match it you know macronutrient to macronutrient a carbohydrate from like a potato or something like that so and people lost their [ __ ] dude it was crazy you want to talk about something i did not think was controversial and people went bananas so go a little bit deeper for me on why do you think people get so dogmatic about this why has this become the new religion what do you think it is about the human psyche that drives people to be so [ __ ] dogmatic about this stuff yeah i like to look at it through the ancestral revolutionary lands as i do with diet and lifestyle factors i think it's evolutionary biology and evolutionary psychology can really help us help shed light on some of these behaviors that that are natural to humans but don't seem that adaptive or helpful at this point in our in our evolutionary history um but humans are essential you know we're tribal animals and um the you know we it had to be that way like in a natural environment we couldn't survive most of us probably very well for very long if we weren't if we didn't have the support of the tribe and so that means we tend to strongly identify with a certain group of people and because that makes us feel safe and if we if we feel like we're apart from that tribe or we're excommunicated from that tribe then we we feel essentially the fear of death and we don't you know consciously go around thinking that way i think it really comes down to like a basic survival instinct um where i'm gonna i'm gonna throw my you know a lot in with this group and therefore everybody else is other and it sets up that that natural conflict um but diet is a is an area that um is pretty universal it applies to everybody you know we eat some of us two times a day some three times a day some more and the public health ramifications of the diet rec you know dietary advice and that is given both by public health officials and now by bloggers authors and doctors and nutritionists and other experts has pretty profound ramifications you know for the health our health not only individually but also as a society so i think it's a big deal i think we're seeing the impacts of poor dietary choices in our country and elsewhere in the industrialized world that are literally threatening to bankrupt our country and as we've seen now with covid 19 that are an issue of life and death you know one of the most sobering statistics that i've seen in this whole epidemic is that people under 65 years of age with pre-existing conditions which are virtually all lifestyle and diet driven conditions are at as high of risk for hospitalization as people who are over 65 with no pre-existing conditions so if you're a 45-year-old person with type 2 diabetes you have the same risk of being hospitalized as a 70 year old or a 75 year old that doesn't have any of those pre-existing conditions and that if that's not a wake-up call i don't know what is yeah no joke how much have you been paying attention to covid19 one of the things that i'm i'm really intrigued to learn more about is the thai they're saying that being obese is like a brutal factor in terms of mortality rate with coca-19 which is scary but i don't understand the mechanism i don't know if you know much about it well yeah i paid close attention to covid19 uh i have seen articles about obesity what's interesting is that in in the studies that i've read that have looked at the existence of pre-existing conditions and their relationship with both hospitalization and and death obesity hasn't been quantified they've looked yes they've looked at diabetes and blood sugar issues they looked at cardiovascular disease they've looked at kid chronic kidney disease they've looked at smoking but they actually haven't characterized obesity as one of those risk factors now we know that many people who are obese not everyone but many people who have who are obese also have either pre-diabetes or diabetes and one of the theories right now this is not proven there's a lot more research that's needed is that one of the pathological or perhaps the main pathological mechanism of covid is that it interferes with oxygen deliverability with hemoglobin's ability to deliver oxygen to the cells and this is one theory why ventilators are not working as well as as they would hope and may even be causing harm uh you know very high percentage of people who are ventilated end up dying and they're on ventilators for a much longer period of time than would typically be expected is that the ventilator can't necessarily move the oxygen around that's the job of hemoglobin and if there's uh something that's causing hypoxia or lack of oxygen then then a ventilator in that situation wouldn't necessarily help um what i heard along those lines something this is what you've heard as well is that basically the ventilator is working at a mechanical level for somebody that has a traditional pneumonia you're just so fatigued you you almost can't do the physical act of breathing anymore and so the ventilator is going to help that it's going to force your lungs to move and for you to breathe but if the problem is at a cellular level and you're just not able to to shuttle the oxygen essentially do the gas exchange right that um it doesn't matter whether you're usually breathing or not and the reason that diabetes is problematic one reason and one's a speculative mechanism here is that uh in in diabetes hemoglobin becomes glycated with sugar it becomes so it's already problematic exactly so the blood sugar levels are high really fast let me interrupt you there i'm super curious so are people that are struggling with diabetes are they already having a problem with oxygen transport yeah i think that's fair to say that that's especially when you see the levels of a1c get higher that that's that's one of the issues with diabetes so you know we can also extend that to say that anything that interferes with oxygen deliverability including anemia which hasn't yet been measured as a contributing risk factor pre-existing condition is important and this of course takes us back to the relevance of a nutrient-dense diet because you know the most common cause of anemia is iron deficiency anemia which affects two billion people around the world two billion people mostly in developing and developing countries but uh here in the u.s it's still a big issue um particularly among people who are malnourished and are undernourished and you know underserved communities and then there are other causes of nutritional anemia too like b12 and folate deficiency a lot of drugs and this is another double whammy effect here a lot of people who have diabetes take metformin and metformin depletes folate and b12 levels which can cause or contribute to a nutritional anemia b12 macrocytic anemia so i don't think we've even begun to get a grasp on all of the different ways that these mechanisms commingle uh and interact with one another so do they haven't quantified obesity yet um they've obviously as you said looked at several different things do you have a rough order of like what are the most terrifying underlying conditions i know smoking is brutal because of the way that it compromises the lungs um is that the worst thing that you could be doing is diabetes the worst thing like what are the the most troubling underlying factors have they sort of rank them different studies have found different results diabetes seems to be at the top of the list in most of the studies that i've seen which was actually surprising you know given that this is a restless severe respiratory illness i think we would have thought that people with you know pre-existing lung conditions would rank at higher risk for for complications but if this is if this um theory about hypoxia cell at a cellular level is true and diabetes impairs oxygen deliverability then that makes sense right it's not just so much about the lungs themselves but about the whole body systemic response to the illness but certainly people with chronic lung disease and and including asthma so some of the younger people who have died um from covid have been people with asthma that were otherwise relatively healthy they didn't necessarily have diabetes or cardiovascular disease or anything else they had and and they didn't even necessarily have you know fully active asthma like people who are immunocompromised so uh that can include people who've undergone you know chemotherapy or cancer treatment um you know immune deficiencies uh prolonged use of corticosteroid drugs like people with autoimmune diseases who've been taking prednisone or something like that for a long time chronic kidney disease which i mentioned is another major risk factor and liver disease even the cdc has said that severe obesity with like people with a bmi over 40 um is a risk factor but i think it's likely that it just you know regular obesity obesity with a bmi less than 40 could be a risk factor too especially if it's showing up with diabetes or pre-diabetes so going back then to b12 b12 something that i hear you talk about a lot i i don't understand its role at all i don't know what it does um give me give me like a brief primer on b12 and why it matters so much yeah so um b12 is a critical nutrient that's involved in the uh in a lot of stuff but uh in this context that you're asking about particularly in the maturation of red blood cells so one way to think about it is like red blood cells go through kind of like a benjamin what was it benjamin button yeah so where he starts out uh old and gets younger over time so red blood cells actually start out uh large and then they get smaller over time like when they're when red cells red blood cells are born you know when they're first produced they're large and they get smaller over time and b12 is part of that process of maturation and if there's not enough b12 in this in the body then the red blood cells don't develop normally they be they stay large and they're shaped like an oval rather than round like healthy blood cells and then that causes the bone marrow to make fewer red blood cells overall and in some cases it causes premature death of the red blood cells so then uh since they carry hemoglobin and hemoglobin what delivers oxygen then you can develop what's called macrocytic anemia macro meaning large large cell anemia which is differentiated from iron deficiency anemia which is microcytic which means small small cell anemia so um b12 is is um mostly present in animal foods true b12 um and so people who are vegetarian or vegan are at higher risk of b12 deficiency if they're not supplementing but even people who eat an omnivorous diet can develop b12 deficiency it's not because they're vegan by choice but they're just malnourished but it's just it's encouraging that we're starting to understand this a little bit better because once you understand the mechanisms better then the the doorway for therapeutics whatever they may be is is much more open than it is when you don't really even know what you're trying to accomplish with the therapeutics well let's talk about some prophylactics so obviously people can supplement b12 what do you think about cardio so i despise cardio i really only do cardio when i'm really trying to get lean but legitimately about seven minutes ago i thought the second this interview was over i am going to a treadmill because if this is around the ability to um lung capacity red blood cells i'm getting oxygen around exactly getting my my cardio on point uh might be truly uh something to really consider i i agree a hundred percent uh i'm i'm with you i don't i don't love cardio i'll do it if it's in the context of something that i enjoy doing like i like to surf i like to ski i'm not doing any obviously either of those right now um i like to ride my bike i think really anything that improves your blood flow right now so even strength training although it's not necessarily increasing lung capacity it's probably increasing blood flow which is a good good thing to do right now of course diet is critical always but it's even more so now especially if you're someone who's at risk for you know higher blood sugar the reality at least from what i am reading and seeing is is that this is you know while the we might reach the peak case a number of cases from this initial wave in the next couple of weeks code's not going anywhere anytime soon and you know i wish that were not true um but it's this is likely going to be with us in some capacity for you know 12 to 18 months and maybe even seasonally for you know until there's an effective vaccine developed so what this means is that it's not just a question of like what do you do tomorrow or in the next couple of weeks to prepare it's what do you do for the next year or two and going forward to reduce your your risk and one of the most important things for sure is to control your blood sugar so if you're someone who's got pre-diabetic or diabetic level blood sugar then you know taking action through diet to lower that blood sugar considerably and get it back into normal range i would think is the probably one of the biggest roi things you could do so that could be a low-carb diet a keto diet um you know protein-sparing modified fast there are a number of dietary approaches that have been proven to be effective for diabetes but it also means strength training getting enough sleep managing your stress uh all of these things are also really important when it comes to lowering blood sugar like just stress alone which is hard to avoid right now raises cortisol and what does cortisol do what what's its main job in the body is to raise blood sugar when it falls too low now um that was an evolutionary mechanism when we would go periods of time without eating and our blood sugar would drop cortisol would be there to keep it stable but that backfires on us now when if most people's blood sugar doesn't ever fall too low and cortisol is just raising it to unhealthy levels so those are you know i think sleep physical activity exercise strength training cardio uh stress management which is even more critical now than ever before and a a diet that specifically a diet that manages blood sugar levels are probably the most important things people can be doing right now great advice so one thing i want to follow up on is one of the things that i um i like most about your approach and the conclusions that you've come to is that it's based on being a clinician um and one thing that i i find drives me crazy about the current state of the different nutritional debates is look studies are important and i i for sure 100 and i'm often very moved moved to action in fact by studies that i read so this is not me downplaying studies this is me saying that there's so much individual variability there's so much complexity that of the study and the way the study is constructed of humans and just nutrition of biology that the idea that you're going to get the full picture for yourself from a single study is it's basically zero so i have to imagine that there are things that you just see like ah [ __ ] this is anecdotal i've had 10 patients but it worked for all 10 i have a theory and i'm just going to roll with that that to me is actually more powerful it's more valuable when it's working in the real world with individual people whose lives have turned around than just the studies what are some things that you see like just on a day-to-day basis maybe you're not even sure why it's working yet but that you see in the trenches with patients um that is interesting and that you're sort of pushing out now to more and more patients yeah uh i i think one thing that i that i'm i mean this isn't like a new thing or anything novel but uh fasting is very interesting to me as a lever by by that i mean all different kinds of fasting so intermittent fasting you know time restricted eating alternate day fasting longer periods of just water fasting you know like or or broth fasting what is sometimes referred to as fat fasting where you know somebody mostly fast but might eat 200 or 400 calories of like coconut oil or something like that so to increase the ketogenic response of the fast in some cases yeah especially if it's mct or coconut oil because mct is ketogenic uh there's a saying in medicine that fasting is a cure for all diseases and if you look in the scientific literature that's really true like there are lots of conditions that will um completely reverse during in a fasted state so when they say that give me the length of fats that they're talking about so are we talking a five-day water only yeah they're usually talking about like you know three to seven day fast and what you can sometimes see in those situations is like pretty severe autoimmune diseases will like almost completely reverse in some cases during that fasted period the symptoms really almost completely go away the problem is that fasting is also the cure for life if you do if you do it for too long right so um i you know but i think that this is a an underexplored area certainly in conventional medicine it's definitely like in my world lots of people are exploring it and lots of people are doing it but i've seen um really powerful and significant changes um in people who are doing intermittent fasting and more extended fasting perhaps as much or more than just about any other intervention so i'm really exploring that a lot more you've probably heard of carnivore diet and like this increasing interest in people who are just eating meat and animal products and nothing else i have a theory that's just a theory it's not confirmed um that the reason so many people feel better this people who have like severe autoimmune diseases are going into remission and stuff like that is that it essentially works in a in a similar way that fasting works on the gut where when you fast there's no new input that's feeding any bacteria in your gut and if you have a lot of pathogenic bacteria and microbes in your gut they're going to start to die because the substrate that they need to survive is no longer there and meat and animal products get digested pretty high up in the small intestine and don't generally reach the large intestine not to the extent that you know fibers and vegetables and plant foods do and so i think a carnivore approach may be kind of mimicking some of the benefits of fasting but allowing people to sustain that for you know perhaps indefinitely why is it that pathogenic um bacteria or fungi or whatever why is it that there aren't pathogenic bugs that are fed through meat uh it's just the case that that uh carbohydrates particularly you know complex carbohydrates that uh are linger are not absorbed high up in the intestine are the primary substrate the thing that most bacteria like and like to metabolize there's something interesting in there and i don't know what it is so this is obviously one of the things that we've explored with my wife um which was when she was really struggling we basically she was eating beef period full stop and that was when she had sort of the biggest leap she hated her life she didn't like eating like that at all it was absolutely miserable for her from an emotional eating standpoint um but it was the only thing that reduced her symptoms walk us through what you see as like the evolutionary landscape and how much it matters meaning like my wife is from a genetic standpoint from the mediterranean i am from uh northern europe so does that is that relevant or are we just talking hominids uh yeah all great questions and you know if we look at the study of human diet you know anthropologically we see lots of evidence that humans have uh for the you know as as far back as we can see have eaten some combination of plant and animal foods now that the exact proportion of plant versus animal foods will vary from population to population sometimes it's skewed more heavily towards animal foods probably most times if if you if you look at it as a percentage of calories and then sometimes it's more heavily skewed towards plant foods and going back to the question you asked early on about climate the percentage of plants versus animals that human populations ate was pretty strongly related to where they were relative to the equator so populations that were closer to the equator tended to have a relatively higher percentage of plant foods that they consumed in their diet versus animal foods and populations that were further from the equator tended to have the opposite so i think that all matters you know climate geography and then um in terms of genes i do think genes probably play some role uh so one example would be lactase persistence so lactase is the enzyme that breaks down lactose which is the sugar and milk and historically as hunter gathers we didn't produce lactase into adulthood we only produced it while we were breastfeeding and as soon as you know after that was finished we didn't keep producing lactase because humans didn't consume milk at that point but about 11 or 12 000 years ago there was a random genetic mutation that allowed uh humans to start digesting you know keep producing lactase into adulthood and digest lactose and that adaptation was selected for meaning it conferred a survival advantage because milk and dairy products were a good source of calories and a good source of hydration especially during times of famine so that mutation spread around the world but it spread unevenly so it was very prevalent in the middle east where it first started and then it became prevalent in certain areas of africa and most particularly northern europe so up to like 95 or 97 of scandinavians for example have lactase persistence this ability to digest lactose into adulthood whereas only about 30 to 33 percent of people worldwide have it so it's actually more common than not for people to not be able to digest lactose around the world if you look at the world globally but for someone with scandinavian heritage it's almost certain that they can digest milk into adulthood so the you know on the genetics there's also other you know there there are um uh other genes like there's one that um may predict our response to starches so um amy1 is a salivary amylase gene that is correlated uh with uh you know people who come from populations that historically had a high starch intake have higher levels of this gene and it may suggest that they might do better with higher starch intake than someone that comes from a population that has a lower intake so those are just two examples there are many more but i think genes do play some role on what determines the optimal individual approach so if somebody like my wife for instance who again is mediterranean so if she's trying to rebuild her um her digestion uh the whole microbiome the microbiome microbiome like the the whole shebang is it just like oh the standard mediterranean diet like that that's exactly what applies or um how do you sort of group people are there a nearly infinite number of groupings or do they sort of fall into five different camps what does that look like yeah i i think although genes do play a role i think people's um like current health status and um existence or non-existence of um you know certain conditions can play a bigger role so let me use an example you know let's say someone has significant gut issues that are caused by sibo which is bacterial overgrowth in the small intestine basically bacteria in the place where it shouldn't be and then that bacteria is fermenting carbohydrates in a small intestine that ferment you know when bacteria metabolize carbohydrates they produce either hydrogen or methane gas maybe hydrogen sulfide as well those gases can kind of wreak havoc in the intestine and it can also that condition can interfere with nutrient absorption it can cause a low-grade inflammation etc so if that condition is present even if genetically speaking that person might thrive on a more mediterranean type of diet they're probably not going to do well eating certain things that are prevalent in that diet like legumes or grains or you know or certain types of carbohydrates that are difficult to digest and break down because of that condition so in other words that condition is sort of interfering with what a normal genetic response might be to a set of foods so what does that experimentation protocol look like so you've got things like the whole30 you know elimination diet how do you get people who are struggling um do you have just sort of a general protocol for people to go through it starts with testing i'm a big believer in tests don't guess so at our clinic we have a whole case review process that includes a lot of different testing so it's a very comprehensive blood panel so much more in depth than what you would typically get at a you know your through your primary care doctor we're looking for blood sugar of course metabolic function we're looking at like comprehensive metabolic panels so that includes like the liver amino transferases ast alt ggt bilirubin we're looking at some of the kidney function markers phosphorus potassium uh creatinine and egfr um of course the blood sugar markers lipid status and then we're looking at all the hormones nutrient status uh immune markers but then we're doing extensive gut testing so we're doing a stool test and that's to look for undetected parasites which are actually more common than most people might believe fungal overgrowth which until recently was sort of pooh-poohed in the conventional medical world but there's now been several studies correlating fungal overgrowth with ibd inflammatory bowel diseases like crohn's and ibs and and then we sometimes will do a urine organic acids panel which looks at some byproducts of of normal metabolic processes and also bacterial metabolism that give us insight into what's happening in the gut and then we might do we also will typically do a test of for the hpa axis looking at stress hormone production like cortisol dhea and depending on the patient we might add a few other tests because that's then what allows us to answer the question that you're asking where do you even start how do you know which diet which approach is going to be best in that case and there's kind of a rough way that i sometimes break it down when i'm talking to patients or when on training other clinicians so there's one group of people which is the majority that the largest group of people whose conditions are primarily diet lifestyle and behavior driven and can be primarily or almost or exclusively addressed just by modifying those factors without ever seeing a doctor so you take the sort of average american who's eating you know too much highly processed and refined food is sedentary is not sleeping enough and is you know overwhelmed with stress you know they might end up with diabetes pre-diabetes obesity irritable bowel syndrome etc but i could have that person just work with our health coach and nutritionist and if they were able to follow the guidance being given and stick with it i would say in many of those cases 80 or more of their symptoms would go away and they would basically be back to normal then you have another uh category of patient which is mostly who i work with just because this is my background of suffering from a complex chronic disease and it's the kind of patient that i attract is patients with complex chronic illness and many of my patients for example are extremely educated about diet they're following not only a you know whole foods diet they're following some very advanced variation of that you know like a ketogenic diet or an autoimmune paleo protocol or low fodmap diet or something like that they're doing they're sleeping or at least they're trying to they're you know they're doing doing everything right and they're still sick and those people will often require functional medicine kind of approach where they get the testing and then they get more advanced treatment and it's harder for them to just do that on their own they're already doing all the right diet and lifestyle behavior things and they're still sick so that's like the the most meaningful distinction in what i see yeah that makes cause that has implications in terms of how do we design public health interventions if most of the people are in that former category then it's not about like more doctors or more medicine it's about more support for people making these critical diet lifestyle behavior changes so this is where like health coaches can i think make a huge impact on the future of health care and on preventing and reversing disease because most disease is diet and lifestyle driven all right so give me the ultimate diet and lifestyle if i want to live amazing i want to feel good longevity high energy what what does my diet my lifestyle and supplementation if that's a component what does that look like well i would say you know all the fundamental principles we've talked about for sure um the you know nutrient dense whole foods anti-inflammatory diet that's tailored for you based on your health status and also your activity levels so for example if you're extremely active doing a lot of highly glycolytic activities like mixed martial arts or crossfit or something like that you're probably going to need more carbohydrates if you're not doing those things and you're trying to lower your blood sugar and deal with you know weight gain or insulin resistance then probably lower carbohydrate intake would work and then we've got you know seven eight hours of sleep a night physical activity again that has to be tailored to you based on what your goals are and what's happening for you stress management and then i would add a few other things that i think are really critical and often overlooked so one is social connection and this is difficult now for us right during covid19 and i think all people are feeling the lack of that of it in a way that they may have never fully realized lack of social connection in study one study was shown to be a greater risk factor for early death than smoking 15 cigarettes a day one of one of the most mind-blowing studies i've ever seen but humans are social animals and when we lack social connection it has very real measurable effects not just on our emotional and psychological well-being but on our physical health um and then another is spending time outdoors which again if you look at it through the ancestral lens that's something that we we lived outdoors 24 7 for most of our evolutionary history and being outdoors it's it relaxes us it reduces stress uh sunlight produces vitamin d it increases nitric oxide which increases blood flow and it it has a regulatory effect on the immune system so there's so many benefits to being outdoors and then lastly cultivating more pleasure so people often raise their eyebrows when i when i say that because they think wait we live in this hedonistic society that's totally devoted to pleasure how can you say that i would disagree with that i think our our society is dedicated to distraction um which is different than pleasure pleasure is a is an experience that's felt in the whole body when you're fully present and aware of what's going on there's the release of endorphins happening during pleasure give me some of the most pleasurable joyful things that you do uh so uh surfing is definitely uh pleasurable massage is great you know touch is one of the things that can do that the most both for me and for everybody else sex dancing you know really kind of fully joyful experiences listening to music brings a lot of pleasure um all of that's important because it produces chemicals that we um need actually to to thrive and live well so that's that's my prescription that's pretty good i dig it um i think you're right i don't think a lot of people talk about joy it's an interesting distinction between distraction and pleasure uh that's very interesting in fact i know you've meditated for a long ass time um yeah where where do you put that in the everyone should try yeah i don't think i would be here if i if i hadn't had that my meditation practice it's just gotten me through so many challenging periods of my life and enabled me to function and thrive in situations where i i think i would have otherwise fallen apart but for me meditation is really about increasing our awareness our ability to observe what's happening internally our sensations our thoughts our feelings and what's happening externally without uh getting being becoming totally reactive to those internal external stimuli so it's it's about cultivating the witness perspective ability being able to witness what's going on and then make a conscious choice about how we're going to respond rather than just a knee-jerk reaction and that's useful in any area of our life whether we're in an intimate relationship and we're having a conversation or an argument with our partner or whether we're in an extremely threatening and even life-threatening situation you know uh or with lots of fear and uncertainty and loss of control as we are with covid19 that ability to stay present take one moment at a time is really critical i think to our survival and and thriving in even in difficult circumstances well said if people want to find out more about you all the things that you teach and offer where should they go chris cresser.com is my main website lots of free ebooks there link to my podcasts and lots of articles and then for my training programs the health coach training program i mentioned and we also have a 12-month functional medicine training program for doctors and other clinicians those are at cresserinstitute.com awesome man dude thank you so much this is fun i love your even keel approach i love that you're not dogmatic i love that your thinking evolves um it's yeah it's incredible thank you so much for spending time with us today yeah thanks for having me on i really appreciate it and enjoy the conversation well hopefully this will be the first of uh many to come in the future i will certainly be keeping an eye on everything that you put out i've loved this so far so thank you man look forward to it thanks take care all right everybody if you haven't already be sure to subscribe and until next time my friends be legendary take care thank you guys so much for watching and being a part of this community if you haven't already be sure to subscribe you're going to get weekly videos on building a growth mindset cultivating grit and unlocking your full potential