2822: The Truth About Insulin Sensitivity & Muscle Growth

32:13and now this is what I thought I would see, but to see the studies back it up and just how much, it was pretty cool to see that strength training of all the forms of extra, you know, it doesn't burn a ton of, a traditional strength training doesn't burn a ton of calories. You'll burn way more calories doing Zumba or running than you will lifting weights for the same time. But the insulin sensitivity was like, and gaining lean body mass was huge. I remember reading one study with obese individuals who lost no weight. They just gained a little bit of muscle and they saw these huge improvements in insulin sensitivity.

32:45What's happening there? Why is it such a big game changer? Why is it not just burn calories? What is it about building muscle that does this? Yeah, so if you look at those studies, I think it was for every 4 % in lean mass, it was a 4 % decrease in hemoglobin A1C, which is obviously a conventional test they use to detect blood sugar, then 6 % decrease in fasting glucose. but the idea is that muscle is your biggest sink for glucose, right? So 80 % of the glucose that's circulating is going to go into muscle and be stored as glycogen or be utilized, right? So that's step one. And then also muscle is a neuroendocrine organ.

33:24So it's going to also secrete myokines that would assist with not only brain power, right, allowing you to make better decisions, but also just make you feel better in general. Yeah. There was one study I read out of, I want to say it was Australia, where they were looking at the impact of exercise on Alzheimer's. And they were looking at the beta amyloid plaque. Yep. And that strength training was the only intervention they found to halt the progression and might have even looked like it was starting to reverse. And they compared it to other forms of exercise. And my theory is it had to do with the insulin sensitivity because cognitive decline, Alzheimer's, dementia, some researchers would call it type 3 diabetes.

34:08So talk about the brain health benefits of having improved sensitivity to insulin. Yeah, a thousand percent. We just talked about more time above range or let's say glucose variability, less executive functioning. But when you take that out over time, obviously Alzheimer's and or dementia has a metabolic component. And the other thing, other association I'll make is when you have metabolic disease, you have vascular disease. So one of the issues with the brain is highly sensitive to changes in energy, right? Glucose requires a lot of energy, right? I think they're clocking the optic nerve as one of the levels that requires the most oxygen.

34:54So requires a lot of oxygen and energy, glucose, very sensitive. If you look at people who have insulin resistance, you're going to increase your risk of dementia by almost 70%. And then vascular dementia is higher than that. Right. And for me, you know, this is my personal sentiment. But if you look at all these problems that humans have, one component is always going to be blood flow. Right. That's how the body talks. That's how it brings in oxygen. That's how it brings in nutrients. and that's how it takes out toxins you know so dementia is on the rise alzheimer's on the the rise and that pathophysiology is very very very similar the whole point of this talk is like how can i take a look at someone who's sick and try to not do stuff to get to that point right so someone who has dementia i mean that there's nothing worse than losing your mind especially if you're able-bodied so those are very very very um those correlate strongly i always found it interesting when people would debate or question whether or not cognitive decline was a result of metabolic dysfunction.

36:03When we've had studies, we've known this for a long time, that if you put a person with Alzheimer's or dementia on a ketogenic diet, we see improvements in cognitive function. Not that that's a cure, but obviously something's going on there because we're switching energy sources and suddenly their scores move in the opposite direction of where they've been moving for the last 10 years. So to me, that seems like a very obvious, like there's something metabolically going on here. Yeah. And you see how also the, how sensitive the brain is to neuroinflammation, right? Yeah. So when you have impaired glucose, you have impaired fat deposition and that, those, that sugar that's circulating around the brain is going to cause inflammatory products.

36:44And you can even have acute cognitive changes, you know, the sugar's high. Well, I'm curious to ask you about with the rise of GLP ones and like what you found, you know, in your own practice or if you prescribe or, you know, if you've combined that with these glucose monitors and like what kind of data and results you've seen from that. Yeah, I, you know, when something gains popularity, we all win because we everyone starts using, especially if they can make money on it off of it. right? Then we all get all these studies and we see how safe it is and all the other stuff it can do. We use GLP ones and I was using GLP ones for a long time before it kind of got popular.

37:26And so I love them. I think they have profoundly positive effects and I'll tell you the context of how you need to use them, but it does two things. And I talked about those behavioral studies where people were watching what they ate and they had a structured program. So the way I look at GLP ones is it is chemical bootcamp, right? So when you put this in your body, it's going to be really hard. And I'll tell the clients like, it is really hard to eat poorly because you get really sick, right? That's what I've seen in my clinic. Right. And what do I mean? Well, if you have two glasses of wine and a piece of pizza and some ice cream, you're going to have a bad night.

38:04And so it becomes chemical bootcamp, right? So even if I can't be with them there all the whole time and I'll even tell them, I'm like, Hey, you're going to get sick. Not that I want you to get sick but you won't do it again right and so that medication has really really two been two large benefits one it's going to lower appetite and lower gastric emptying so people are going to eat less caloric restriction and then boom it's going to fix insulin sensitivity or let's say enhance insulin sensitivity and so you even see like the fda has now approved it for cardiovascular risk Right. Less hospital admissions, lower cardiovascular events, and then even kidney protection.

38:48So chronic kidney disease they're using. It's FDA approved. And kidney disease is a vascular disease. Right. Those go hand in hand. Are we seeing improvements in insulin sensitivity from GLP-1s independent of the weight loss? like are you like if someone has a cgm using glp1 before they lose weight how do you tease that out

39:11Rhett Langley:you'd see it right away i guess you would use it and you'd see well essentially you also yeah you can see that away right away in the cgm but they have studied the medication they know the mechanism of action right so even before we're again remember they're using this in diabetics before it got popular 20 plus years right so we already know that the it makes the periphery more sensitive to insulin or improves glucose control within the body. So side question, maybe you don't know the answer to this, but I'm now seeing a lot of talk around PDE5 inhibitors like Cialis, not for what you typically would be prescribed for, which is erectile dysfunction, but for longevity.

39:52They're showing now that there's reductions in stroke and heart disease. Do you see any different, when people use a CGM, do you see an improvement in insulin response or blood sugar response? from sal are you asking me for a script of no just subtle way of asking just kidding yeah and and honestly that's how we use it too and you know a lot of guys in the gym use it for yeah performance right they've been doing that since we were all kids whether that helps for performance or not that's what they're using it for so and i can easily relate this to stuff that kills you so the end product of phosphodiesterase inhibitor is nitric oxide right nitric oxide your body makes nitric oxide and you need nitric oxide for auto regulation, which is just a fancy term for the blood vessels, relaxing and squeezing in relation to the amount of oxygen you need.

40:43Right. So yeah, absolutely. Like we're, they're using it on the regular to improve blood flow. And as I told you, like for me, the whole discovery of me becoming this wellness doctor is realizing like I'm a blood flow doctor when organs died is blood flow. And that's what people die of it's cardiovascular heart attack and stroke right you don't die of diabetes it's the same thing with sexual dysfunction right the same vessels in your penis or vagina are the same vessels in your heart and they work the same way yeah and so we see if somebody uses a pd5 inhibitor do we automatically are you seeing immediate like changes in their cgm readings is it or is it showing up in that way or does it take longer yeah the the context that yeah the context for me is more of uh blood flow okay right so it's more of improving blood flow to organs sure right okay yeah it exercises the essentially the vascular system relaxing contracting yeah and also when you have uh metabolic dysfunction the biggest issue is vascular dysfunction right vascular inflammation right that process that cascade of you've heard that that term or i've heard a couple of people say like the difference between a sick person and a healthy person is a teaspoon of sugar in your blood yeah the major insult is insult to the endothelium the inner that glycocalyx that slimy layer of the vessel right and you know even if you look at let's just talk about like sexual dysfunction in men um across the general population it's like 25 percent which i think is still kind of ridiculous right that's one in four yeah when you look at someone with metabolic resistance that jumps to like 50 it's like half so clearly that's a vascular issue clearly heart attack and stroke is a vascular issue right that's the problem so and when you have hyper or diabetes you have high blood pressure right the diabetes is causing the high blood pressure what what percentage of your clients that you're helping uh battle with sexual dysfunction i mean anecdotally like in my opinion it's an epidemic it's a lot i mean probably half of my clinic is sexual dysfunction and this is also this is also jaw-dropping this is this is this is gonna rock your world like the people with metabolic risk or excuse me when you have obesity up to a 13-fold increase in hypogonadism.

43:15And I'm not saying sexual dysfunction is just testosterone. It's blood flow. It's multifactorial. It's all connected. Yeah. If a guy comes to me and he's like, hey, I hate my wife and she insults me and I don't get an erection, I'm not going to say, hey, it's your metabolic health, right? Our brain is our biggest sexual organ. So we're going to impact that a little bit. But I'm going to say like, hey, let's look at some labs. Let's check the physiology. But I think it is an epidemic. Like it is not only on the rise, but it's ridiculous. And the other thing I'll talk about real quick is women. The, and this, this shocked me.

43:51The percentage of women across the population that have sexual dysfunction is 43%.

43:56Rhett Langley:General population. Yeah. So that. How do they measure sexual dysfunction for women? Cause you're not measuring your, you know, erectile. Yeah. Yeah. And that's a good question because yeah, that's a good question because passive pathophysiology is the same. It's still blood flow to the sexual organs. And so desire, dryness, pain, right? Libido, orgasm, right? And one interesting connection I will make from that, the behavioral modification, the look-ahead trial, such a prolific trial that they had these spinoff studies and one of them was women's sexual dysfunction. and so in that trial of the people who had metabolic resistance or had obesity 50 had sexual dysfunction with the modification or the structured program 30 went into remission so again you know that statistic is shocking 43 it's higher with people in women but it's you know we see a man we're like okay i can't get an erection it's obviously a vascular issue right Right.

45:01Rhett Langley:But women struggle with this too. Interesting. How, how are CGMs being used now for behavioral modification? Because CGMs measure your glucose in real time. How do you combine that with, uh, coaching or, you know, behavior to like, what are you looking at and how are you using that as a tool to help somebody? I'd like you to take me through a week one. I just signed up with you. I've got metabolic dysfunction. Yeah. What do you, do you just let me eat what I normally eat and monitor me first do you give me stuff like tell me what a week looks like when we get together yeah well i also you know get an opera out of the out of the clinic too so i have the benefit of taking comprehensive labs so we it's even even more interesting when i can show them the labs and then show them the cgm which is this beat to beat look at their glucose and then give them the context of like hey if you don't do this these are the problems but week one is really just what I want to do is I want to get their baseline.

46:01Right. So do your thing. I'm like, don't, because you know what people do. You guys are in the space, right? You know, and even when you ask that, you know, the 90 % clean bros, right? I eat 90 % clean, right? I'm like, okay, well, let's like test it. And that's also like the biggest takeaway is I get clowned sometimes by clients. I'm like, hey, you should, you should fit. How's your sleep? Oh, sleep hygiene. They're like, yeah, don't even go. I know that. I do it. I'm like, okay, well, let's unpack that. Well, there's eight or nine steps to sleep hygiene. What you find out is they're maybe doing two, 40 % of the time and three, 10 % of the time.

46:36Right. It's the same thing with all of the other lifestyle modifications. They're doing some of it, not all the time. So week one, I'm like, don't change anything. And they still will. Right. I actually have to make it a point to like, listen, if you ever occasionally have a Snickers that have that. I want you to do that thing. You got to be, give me a week. And that's also the problem with other companies that don't have that one-on-one dietician contact or even in my clinic. If someone puts something, just the bias of checking, you're going to be living a lot better than you normally do. Right?

47:12So you're going to be like, oh, I'm good. Just be perfect. Take this thing off and go back to what I'm doing. Yeah. And so that's what I told you. The biggest impact is this stuff is, if I told you, hey, hey, move more, eat less. You're like, cool podcast, bro. But you need to do that over a long period of time. All of these little nuances to add up. Have you gotten to the place where the more you look at the stuff, because I'm sure you get some of this pushback, like I get a plan, my sleep, I got to do all these steps. I got to look at this, that, the other. Have you gotten to the place where you're like, well, I think the world is just designed to make us really unhealthy.

47:49So that's why we have to do all this stuff. because we weren't really supposed to wait though i want to i want to because i know it doesn't end where take me step by because it links to what you're going where you're going right now like okay so the client here's my week and i'm assuming he's got similar advice like how we take someone it's not like do all these things yeah right because i'm sure you've already learned that that doesn't work very well either when you give them the all the answers so so i do this week and you you see all this shit that jumps out at you and we and we look and so what what does it look like do you choose one big rock do you like this is the first lever we're gonna pull like how do you coach me through that after you get my shit labs and shit week that i give you because that's probably what it is for most people right let's be honest yeah well the first thing i do is set expectations and i'll even say this you know i'm giving away all my little secrets but i'll be like look you will know what i'm saying don't believe me well you'll believe it when you see it but you'll know what i'm saying is true when you feel better but i was like this is not going to change in 30 or 60 days.

48:48It may change in 300 or 400 days. And we are going to work through it step by step. Right. And I will give, you know, our slogan at Thrive is called empowering your health. So I'll tell the client, like, here's what I think the biggest levers are. And I'll give them a choice. I'm like, you should start with one of these three, but only start with one at a time. Right. Because I want you to see on the CGM, how, what impact that has or the way you feel, or, you know, your behaviors, you know, and that's also what the app will do is it gives you context. When did you eat? How are you feeling? What did you do?

49:26Who did you talk to? Right. Cause I told you people will automatically associate something. I felt like shit today. It's probably because I had the taco. I was like, well, it's probably the taco and also the stress with your, you know, friend. I don't know. Yeah. Right. You got to bring all that stuff into context. context and what i also call it is your health circle and again i am not immune to this as you say like the the overlords have us all under this distraction and things that are killing us so i'm not immune to that but when i'm feeling bad i go and data check myself and go oh you know i didn't take i didn't uh i was not on my sleep game you know or i changed my diet a little bit or something was off.

50:09And so then the client learns, put these pieces of the puzzle back into place, they start feeling better. How do you discern between what you know is the three biggest levers and then also what you've probably pieced together as the easiest for adherence? So this is something that over decades of coaching people, I sure have the math equation to get this person in the great best shape of their life. But I also know, and I know that this is the biggest lever, but I also know too, that could be a big step for a lot of people. And so sometimes I don't always advise the biggest lever or the best thing.

50:44So how do you like, first of all, give me what those kinds of levers are. And then how do you discern where you go first with a client? Is it always the same? Or is it, do you notice based off of the conversation, like this guy's going to have struggle doing that, pulling this lever? Yeah. For, well, for me, the biggest levers personally that i work with and clients are gotta be they have to be resistance training followed by food right you know and specifically let's just say that you know for me i told you it's we want to make the body resilient yeah right i want to get their body composition better to make them this well-oiled machine and go out in the world and handle toxins whatever that is so we know that that's resistance training and also probably is going to be a caloric deficit which means we got to stick with protein.

51:34I understand that that's going to overwhelm them, but I try to stick to something that's going to build trust. And generally when people start losing weight and they feel maybe they have a little bit of better, better body image so that it puts them in a positive state of mind. You know, the one of the ways the brain works is error correction. So everyone thinks like, okay, cool. Um, you know, dopamine is a reward molecule and it is, and it's all about anticipation, but it's error correction. So if you look at high performers, they're in this range where it's not too hard and not too little, right?

52:08You don't want to make it too hard or too little, just right where you make a mistake, fix it, and the CGM can show you. Yeah. Like, hey, you did great all week. And then Friday, you just, I don't know, you shit the bed and then boom, you feel bad. Correct and get bad. You get dopamine in your brain. So that's how you actually rewrite your brain. It's so cool to hear you answer that in that way, coming from your profession and your angle, because I feel like although we're in similar fields, we come at it at different angles. And those are the first two things that we tell people. And it's, can I get them to the gym once or twice a week, full body, strength training routine?

52:46And can I get them to eat high protein? Yeah. And those two things are such big rocks and levers that it does tend to fix a lot of the other things. And if I can just get them to commit to that, then I could start to build off of that. So to hear you say that from, you know, where you're standing and all that, like, that just shows how many people you've probably helped in your career, because that's what we talk all about all the time. And people kind of mock or, you know, make fun of or scoff at that. That's like what we simplify down to. It's like, man, those are such big rocks that if someone consistently hits high protein intake.

53:22We know that it's going to naturally start to modify their cravings and their calories. And if they just do two full body workouts a week, the amount of muscle and strength that they can build and what that will do metabolically for them, strength-wise for them, and a lot of times it even improves some sleep and energy. So it's cool to hear that, that that's what you distilled it down to. Yeah. And we've got the studies to prove that, right? You know, I'll, just to follow up on that. It's cool that you said that too, because I think that having diagnostics and advanced medicine is great. It's awesome.

53:55You know, I studied in Texas Medical Center, MD Anderson, there's all this stuff, but I think what happens is we scoff at, so we have a bunch of advanced diagnostics and the treatment may still be very coarse, right? So maybe just tell the guy like the, in the bottom of the boat, like, Hey, we need more coal, you know, all right, less cool, less cool. And people look at that and they're like, that's basic, dude. Like, really, that's what's going to change. And it goes back to what I'm saying, that if you did that, and yes, I'm not saying only that, there are nuances, for a long period of time, you would win over time, metabolically, chronic illness, et cetera.

54:33What I find interesting about CGMs is that watching someone's glucose in real time, you can actually diagnose or at least it points you in a lot of different directions, not just food. For example, how many times have you seen someone's CGM spike in the middle of the night and say, oh, you might have sleep apnea. Let's look at your sleep and see if you're snoring or what the deal is. It's interesting. It points to a lot of different things because a lot of things can cause a spike.

55:01Rhett Langley:Yep, and that's the benefit of continuous data because before that. How would you know? Yeah, you wouldn't know of anything that's going on. And go ahead. How do you use this data then to coach someone? Is it questions like, hey, we're noticing this and that. What's going on? What happened at that time? Yeah. I mean, again, the platform that I like to use is let the client figure it out themselves with my guidance. Right. So it always starts with asking like, hey, you know, one, just the thought of them putting the CGM on, they start taking more data points. and you check your own health journey, like without the CGM, you're maybe not thinking about like, oh man, I feel bad.

55:41It must be, you know, again, this, you know, whatever eight in the morning, it's probably a collection of stuff. So with continuous data, we can go back and look at it. The other thing that NutriSense is doing right now is leveraging AI. So they have this Nora, right? That will put this stuff in front of your face. so again we know the best way to win with a client is touch points right you honestly just flood them with interaction and so nora will bring up trends and bring up data even data that's that looks the same across weeks or like when you're putting in inputs it'll show you outputs right so

56:23Rhett Langley:it bridges the gap between your meetings with either the physician or the dietician any supplements that actually make a difference with what you see on the CGM? Like berberine, I hear about berberine all the time. Yeah, berberine is great. There's berberine, there's alpha-lipoic acid. And you'll actually see it? You'll be able to measure it? Yeah, the difference though is that, just remember that all in context, so berberine is not instantaneous. And that's because also bioavailability. So you need to take it over a long period of time. Another one is like myo-inositol. That one's awesome. So it's also used in like PCOS.

57:00So like, you know, that's a great one. But we're just working on basic deficiencies, iron, vitamin D, magnesium, zinc. But yes, I mean, you know, again, it's complex answers complex questions, right? You got to take berberine for a long time. It's hard to just say, hey, I took berberine and then I saw the effects. Got it. What about the GMO product that Z-Biotic makes? Oh, you know, there are - You'd be a great person to ask that. Yeah, so they made a product that this bacteria is modified to convert unused sugar into fiber. Acromantia? Good question. I'm not sure. But I know that they modified the bacteria.

57:39So it's their own patented, whatever. That theoretically should make a difference, right? Because it goes from… A thousand percent. Okay. Okay. Yeah, and I mean…

57:46Rhett Langley:That would be a fun test then. Yeah. It would be cool to give you something. Yeah, yeah. And again, extend the study over time. Right. Like you got to make it almost like a cut out all the other variables, same meals, same timing, but you know, the gut also their nutrients, they do a gut microbiome test. So we're understanding that gut is very complex. It's a great way that food interacts with the world. And when the bacteria are in proper alignment, they can help your glucose. It's interesting. You brought up myo andositol because that's been promoted forever as an anti-anxiety. And I'm wondering now if the anti-anxiety, anxiety effect is from a regulating of blood sugar.

58:28Yeah. Well, and one of the things it does is it helps cellular movement. So like storage to the end of the cell, to the nucleus. So DNA basically enhances mitochondria. It's just like NAD. Anytime you enhance mitochondria, you can have lower inflammation, lower anxiety, better sleep, et cetera.

58:46Rhett Langley:Creatine. Do you recommend, so along those lines, you must recommend creatine quite a bit. Million, billion, thousand percent. It should be part of your daily stack. You even have done studies that show, so data that shows when paired with exercise can improve glucose sensitivity. And then, of course, we know now that we're stacking it for brain effect too, right? You just have to do more. I think brain absorption is a little less. So pump your dose. You brought up the alarming stat with women, the 43%. Anything else? And you're such a data-driven guy. you got all this great all this great analytics that you can go back to anything else that was alarming to you like that you've come across that like surprised you or was like man in the data yeah yeah just um yeah there's another like another one that comes to mind and it's just deals with men it's prostate so as we're aging a lot of people are having prostate issues right and i i mean again even me going up through the medical community it's like just something that old guys had right they just went to pee five times a night and so you see this so now we're also starting to learn that's also a metabolic component so the data is now showing that with insulin resistance and there may it may be a dose response so the worse it is the larger the prostate so it can increase your risk of bph hypertrophy threefold so again if you talk about the impact on a man's life sleep if i'm having to get up five get the five or six times to sleep it's going to destroy everything else right downstream effects yeah so we fix that in the clinic and it's life-changing it's something that people overlook i mean a guy will come in and be like i'm only going to pee once a night changes his life yeah wow not to mention improved blood flow and sexual functions what about um so you hear it now a lot in regards to cancer that um yeah one of the driving forces behind cancer is metabolic dysfunction um are you are you up to date with some of this research i know cancer is very complex but yeah yeah yeah no and that brings up a good point so when you talk about metabolic dysfunction everyone understands glucose but the other flip of that coin is fat deposition right so when you're when this system is impaired you have a tendency to add fat and not just fat it's bad fat ectopic fat visceral fat that's the fat that kills us and so if you look at the risk of someone having high visceral fat it increases cancer risk by 44 and i'm talking about colon cancer pancreas cancer like the stuff that can kill you right um and then the other really important statistic of just having visceral fat is increases your mortality twofold, right?

1:01:36So, so we know there's a connection between metabolic resistance and cancer. And yes, glucose has an effect, but I just want to point out that abnormal fat deposition, which is killing people, right? It's a big, big, makes you big risk factor. When you look at just studies and surveys on people that lose weight and the fail rate is so high, right? Something like 85 % or 90 % getting the weight back type of deal. Do you see greater success rates when people lose weight through using a CGM and a coach versus doing it on their own? What does that look like in comparison? Yeah. I wish I had some cool statistics on that.

1:02:18I can just tell you in reality and you guys are in the same space, right? And what I can point out is those RCTs, those really, really large trials, as I told you, of behavioral modification. What they were given was coaching. So they had behavioral groups, they were taught what macros are, or they were taught, and then they had follow-up. And even the effects of positive, you know, lower depression, lowered anxiety, and how they thought they had a lower perceived stress of sticking to a plan. so that take-home message is like cool you can get a cgm cool you know you have these companies where you can just go like hey i can order my labs it needs context yeah it needs follow-up and even like you know as a physician like i can't do do it all you know so a whole team and that's how we work in my clinic as well yeah yeah no i would have guessed that for sure just from from my experience i think uh behavior change is hard and it takes some time and you need a coach there and then you need some grace and you're going to screw up and then yeah but over time uh far better success rate tell me a little bit more about the the ai that nutrisense is is using i haven't i haven't played with that in a while and so like is it is it giving me like it starts to pick up on my patterns of like saturdays i tend to do these oh wow and does it give you like a notification or something yes yeah positive and negative kind of trends yes it puts it in your face.

1:03:47And the other thing too, is the more inputs, the more outputs, right? So if you're saying, Hey, I went to bed at this time. Hey, my day was stressful. Hey, I worked out. It's going to tell you last week you did this and this is what we saw. And so think about that when I can't sit there and harass you and it's, it's, you know, harassing you to like, think. Yeah. Well, what's so cool about that is one of the things that we talk about a lot in the show is that a lot of what you do with good coaching is really just helping clients connect the dots. Totally. You know, half the time, uh, I mean, and we're all probably all in this room guilty of this at one point in our lives, you know, eating foods that totally didn't agree with us and just thought that your stool was normal.

1:04:32That's just, you have a bad day. It was like, you know, like not going like, no, that's actually because you ate this thing. You felt that way. Also your sleep was, it's like, Like it's just, we're so, it's amazing to me how disconnected we are to how food affects us and how, and just, so a lot of it's connected to us. So now having an AI tool that's monitoring you, that's kind of giving you that feedback loop is incredible because it's like an ongoing coach who's just kind of reminding you like, because then they start to connect it. I'm sure they go like, oh shit, that's the third time that I didn't get to bed at this time.

1:05:04and I also know so one of my favorite things to talk about with uh the glucose monitors that I noticed and it was that uh poor nights of sleep the cravings on the next day yeah what like that was mind-blowing to me and literally just becoming aware of that may help me combat it in the daytime so it's just like if I knew I got up and it was like damn that was a poor night I slept I know what I was in for that day and because I was aware of that it made me it made it easier for me to resist that. It was like, why all of a sudden I'm craving this crappy food? I've been on my diet, but it's like, oh, that's right.

1:05:39I've got that bad night of sleep. I think things like that, people just don't realize how much of what's going on with their sleep and their habits are connected to all these cravings and their moods and all this stuff. And so having an AI tool that is also giving you that feedback, that's rad. Yeah, it's huge. It's just like I talked about, when something happens, you correlate it with something that day or maybe the day before what if it you know complex questions complex what if it was seven days before what if it was 15 days before so aggregating that data really expands like whoa it's very thought-provoking right yeah and even if you know so hey i had a bad night of sleep i know when i have bad night of sleep i have cravings stick to your routine right you're like i am not going to even go over there where the ice cream is or whatever it is is your weakness right How well or how quickly is NutriSense growing?

1:06:33Because they're one of the best at combining kind of coaching with monitoring. Is it a growing field in general? And how's NutriSense doing with it? Yeah, NutriSense is crushing it. I mean, I don't know of another company that utilizes coaching. And so, yeah, there are other CGM companies. But the coaching is where it's at or the one-on-one with dieticians, with experts. and so people want that right i mean i have a bunch of clients that come to me that are fallout from you know hey i got my labs no one helped me right putting it in context so nutrisense is is blowing up in that sense um and so yeah it's really exciting and then the other thing too is when as i said when something gains popularity we get to study it so hopefully the the future forward is continuing to look at this data and then trying to get real world stuff.

1:07:30For example, like they're looking at CGM and changes in arterial flow, which would lend itself to like, Hey, what, what's going to set you up for death, cardiovascular disease, right? Right now, I can't say it's a diagnostic tool, but the more data, the more we can see the whole point of the talk is how do I not end up over there? One, how do I feel better?

1:07:51Rhett Langley:And two, how do I not end up sick or dead? What do you do for NutriSense exactly or with NutriSense? Yeah. So I am, so currently I'm the medical director. Um, and you know, these CGMs are being offered commercially, but if you were to get a CGM back in the day, it would come through me. You might see my name on it. Yeah. I got a lot of phone calls in that day. Hey, Dr. Langley, I need another CGM. I was like, Oh, talk to NutriSense. Um, but yeah, no, I mean, And I work closely with the dietitians and the team at NutriSense. My clinic handles stuff, complicated situations, and much larger conglomerate of stuff, but we work hand-in-hand.

1:08:29My clinic is very much like talking to people at NutriSense. We use the dietitians at NutriSense, et cetera. How did that – I mean, you talked about how that relationship started, and you almost were like a customer first. How did that develop into the relationship you have now with them? Yeah, well, like I said, and Dan's probably going to kill me for telling this story, but you know, Dan and I built a relationship because I was just interested. I wanted to know everything. Hey, let me talk to your dieticians. And at the time I was doing stuff across country, right? So I had all of these medical licenses.

1:09:05And once we built a relationship, he was like, hey, because they're having trouble getting the CGMs out. He's like, hey, I need a doctor who's willing, who's excited. who talks really fast like me and has some medical licenses. And I was like, cool, I need a CEO that talks faster than me. Like, let's go. So that's really it. Like that really started the whole relationship. And a little bit of other truth here. I was more excited. I was like, hey, teach me, let me use this stuff. And, you know, I'll be your medical director. No payment, nothing like that. That's so crazy. so that helped but it did super charge me into like building my own own clinic and learning more now have you guys become friends or just business i mean what's it have you guys i mean imagine you're you're bugging him that much he brought you in you guys probably built somewhat of a relationship yeah yeah we're bros um we're bros he's always trying to get me to hang out and i'm always telling him like dude i have a lot to do but yes yes we'll go to burning man at some point i'm not having a cgm on when we do that okay how are peptides uh um showing up on cgms are you noticing any changes i'm assuming the growth hormone releasing ones you'll probably see an impact and are you seeing anything with like the like the bpcs and the yeah that's a good question um haven't specifically studied it but you know again even with peptides like in my opinion, very safe molecules.

1:10:37The longer you take them, the longer you have to understand what they do. So some of those growth hormones, secretagogues, if you look at some of the studies, I think it's closer to like a week 11, 12. If you're on it, you may have some increase in IGF-1, which we know is going to change glucose a little bit. So that's a good question. I haven't really looked at that yet, but honestly, another tool in the toolbox to show people. what about um uh hormone therapy how is that improved how is that changing or improving so the guy comes in low testosterone doesn't get doesn't rise from improving behaviors you put them on testosterone what do you see typically in their overall health no in their cgms do we notice anything with with improvements well downstream for sure because then they build

1:11:18Rhett Langley:muscle and then you see yeah sorry yeah so so again to me like having normal testosterone lowers cardiovascular risk. Why? We know it's going to burn visceral fat and that's the major killer. Two, it's going to help you add muscle. I've seen one study where it says it may almost add up. Even without working out, you may have a change in like 7 % to 8%. Really massive. That's wild. That's insane, right? I told you every 4 % lowers your hemoglobin A1C like another 4%. So you do see a downstream effect, right? Right. And then again, having metabolic resistance is going to increase your risk of hypogonadism up to nine to 13 fold, which is like ridiculous.

1:12:03Right. So it's an epidemic and there are certain things you would want better sleep, better mood and better body composition, fixture testosterone. Now, I know you haven't had your clinic for decades, but have you noticed even in the short time you have the rise in young men with like…

1:12:25Rhett Langley:Epidemic. Yeah. Epidemic. In fact, I forgot to say this, but so across the general population, let's say it's 24%, but a new study came out last year where they looked at 18 to 34-year-olds and they gestured, and this was a questionnaire, 34%. Which is insane. And also I personally believe that it's underreported, right? Because, you know, you, you're not, you don't really want to tell someone at that age, maybe you have problems. I know it's underreported because we get DMs and messages from young men all the time that haven't even gone and seen their doctor and talked about it. And so there's not, not everybody's reporting it.

1:13:05Where it gets tricky is, and as a good clinician understands, it's not an absolute number, right? You may be low and not having symptoms, low, or you may be normal and having symptoms, right? You have to look at the number and talk to the client. I would imagine that's due to poor health and probably pornography, which is real common now in young men. A thousand percent. Yeah, so it's probably a good combination of the two. Because, I mean, historically, you would not see any sexual dysfunction in that age group. That's like when you don't have any. Yeah, and that's the other thing to point out.

1:13:36It's not all, like I said, it's not all metabolic health. If a guy comes in and says, hey, I'm looking at porn and I'm masturbating like 37 times a day, I'm going to be like, hey, let's unpack that a little bit. That's probably not healthy. That's not too much. Calm down. Jeez. Right? Justin, wait for you. That's some numbers.

1:13:54Rhett Langley:You're all getting Cialis after the show. Well, good deal. Yeah, dude. Well, this will be great, man. Thanks for coming on. I appreciate you coming on. Yeah, thanks for having me. Kind of breaking this down. I think the future of – I think far more people now are becoming aware of the value of coaching. I think that GLP-1s or GLPs have increased the awareness around it because you lose weight, but you also lose muscle. So now your typical doctor is saying you might need to strength train. And so I think that this is all good. I think we're moving in a better direction than we have in a long time.

1:14:29And you add a glucose monitor to that, and you've got this wonderful – We've never had tools like this. As a trainer, it was just me and my client. But if I had a glucose monitor and if I had a GLP-1 working with some of my clients, I think my success rate would have doubled for sure.

1:14:46Rhett Langley:For sure. Yeah. Yeah, and we're going to see that. For sure. We're going to see that. This is the future. Very close. I would just say, if you're going to set up a clinic, you're going to have a program, you've got to have good coaching. I don't care if you're a doctor or whatever you are. Agreed. You've got to spend time with these people. Agreed. Thanks for coming on, man. Yeah. Thanks for having me. Thank you for listening to Mind Pump. If your goal is to build and shape your body, dramatically improve your health and energy, and maximize your overall performance, check out our discounted RGB Super Bundle at mindpumpmedia.com.

1:15:17The RGB Super Bundle includes MAPS Anabolic, MAPS Performance, and MAPS Aesthetic. Nine months of phased expert exercise programming designed by Sal, Adam, and Justin to systematically transform the way your body looks, feels, and performs. With detailed workout blueprints and over 200 videos, the RGB Super Bundle is like having Sal, Adam, and Justin as your own personal trainers, but at a fraction of the price. The RGB Super Bundle has a full 30-day money-back guarantee, and you can get it now plus other valuable free resources at mindpumpmedia.com. If you enjoy this show, please share the love by leaving us a five-star rating and review on iTunes and by introducing Mind Pump to your friends and family.

1:16:04We thank you for your support. And until next time, this is Mind Pump. Hi, I'm Chandler Garcia. As a PCU nurse and global health advocate, I've cared for women and children all over the world, from Costa Rica to Egypt to Kenya and beyond. And no matter where I go or how tough the conditions get, I always wear my figs. These scrubs are lightweight, breathable, and super soft, perfect for long shifts in any environment. They've got pockets in all the right places, the fit is flexible, and they're durable through every admission, surgery, and post-op. But it's not just about the scrubs. Another big part of what I love about figs is when they say they're committed to supporting healthcare workers all over the world, they mean it.

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