141: The Complexities of RED-S in Athletes | Dr. Kyle Gillett

29:13So you're smart with your training. So a lot of people will do things like split their resistance training with their cardio and they'll watch the intensity and pick specific times to be intense. This is where a coach is particularly helpful to have a program that's going to put you with the best chance to succeed before you start. That being said, there's also things other than just nutrient repletion, like localized IGF-1. So without getting too technical, basically there's different hormones that are like systemically helpful for growth, like growth hormone and like IGF-1. And then there's localized IGF-1 too.

29:50So if people have heard of a study, you know, doing five back squats, five sets of them with this weight percentage of your max is going to improve your growth hormone. It's going to double your growth hormone or increase your testosterone by 50%. it's a localized effect that only lasts a couple hours. Oh, interesting.

30:10Nick Bare:Okay. Yeah, so it doesn't actually improve your systemic levels. That's good to know. So, this is also why if you're training complementary muscle groups, you can do two-a-days. For example, you could do a morning run or a bike, and you can do upper body training the same day, and you can go pretty hard on both of them. but the hormonal abnormalities with what i consider the growth agonist hormones or growth hormones that includes endogenous peptides as well for example when people are younger they make more of this peptide called ghk copper peptide and the levels decline pretty sharply as time progresses and things like that also help heal you know people love talking about bpc 157 in the body we make it it's called gastric protective compound 157 gpc 157 and as your gut is less healthy and as you're like deeper into reds you will make less of this as well so you're losing all of these naturally made or endogenous peptides that are going to prevent injuries even before they happen something you said that i just wanted to touch on in terms of glycogen replenishment.

31:23I think

31:24Nick Bare:something that a lot of people don't realize is it takes 24 hours from about 24 hours from the consumption of that carbohydrate to be stored as glycogen because it has to be consumed, digested then assimilated into glycogen. So when people are carving up for an event the traditional model of the night before the race go eat this large bowl of pasta. I mean, that available glucose will help, but it's not going to be stored as glycogen in the muscle and the liver. I think back to that one classic office episode where Michael Scott is consuming the bowl of fettuccine alfredo at the start line. There's only downside, there's no benefit to that.

32:16Nick Bare:So just for people to keep in mind, if you're trying to top off on muscle glycogen, stored carbohydrates, it's going to take about 24 hours from consumption to stored in the muscle in the liver for use. Yes, definitely. I remember running track and field in college and high school and whatnot. And it used to be, we did the classic pasta the night before, and then it kind of fell out of favor and said, well, carb loading is not important. And now we found out that yes, it's important. You just do it over a longer period of time and not so aggressively to cause gut disruption and whatnot. And some of it, some of it depends on the person as well.

32:58So if you're running the 400 and 800, then it's probably not as important, um, as you know, an ultra endurance athlete certainly or even a 5k runner but if you're a um you know the hormonal component is probably more of a factor in someone who is like a middle distance athlete where it's kind of between

33:22Nick Bare:aerobic and anaerobic yeah um talking about injuries and and maybe you're going to get here you know you touched on and we just got done touching on uh injuries in terms of muscles and potentially ligaments. But what about bones? When someone is in this caloric deficit for long periods of time, you'll see athletes who have reds who end up getting fractures, broken bones. What is happening to the bones during this time? This is extremely hotly debated among runners. My friend Nick Norwitz, who is also a physician, I think newly graduated, but a very interesting page. He also kind of does the benevolent clickbait that I sometimes do.

34:15But he's a runner that I think ran marathons and he had an osteoporosis diagnosis, if I remember right. And there is some genetic factors that lead to having thinner or more dense bones. But I know he was at a very light body weight when he did that. So perhaps it's not, I don't think it's as much of a genetic factor. I think that has partly to do with it. But I actually also have the genetics to where I tend to pee out two amino acids called glycine and proline, which can also lead to a higher risk of osteoporosis. But I went and I checked my bone density and it was extremely high. It was a T-score of four for those that know what T-scores and standard deviations were, which is odd because I didn't really lift heavy weights until I was in my mid-20s.

35:03and I did almost exclusively running, but just at a much higher body weight.

35:07Nick Bare:And strength training does help with bone density. It definitely does. But we used to tell people, your bone density is set after you're 20. Your adolescence is done. You're not going to gain bone density. I wish I had done DEXA scans when I was younger, but I didn't. I think that my bone density is definitely better because of the resistance training I started to do. but I think the running also helped too. Because in general, you think the main number one thing that helps with bone density, even more so than vitamin D optimization, et cetera, is actually axial loading, weight-bearing exercise.

35:47And that just means the weight goes from top down through your feet. So walking with a weighted vest is axial loading. Jumping is axial loading. Squats and deadlifts, obviously, but running is also technically axial loading. but just at much sub-maximal force. So the higher the force or the higher the weight, the better it is for your bone density.

36:09Nick Bare:So where do you personally stand in terms of REDD's effect on bone density? I think that it's related to both absolute body weight and the relative change in your body weight over time. So the hormonal components also matter. It does appear that if you replace estrogen, testosterone, growth hormone, and IGF-1, and vitamin D, which is also a steroid hormone. Vitamin D has the same exact cholesterol backbone as other steroid hormones. Replacing those five, which are all commonly deficient in reds, plus limiting the amount of caloric deficit, I think will attenuate or stop almost all of the bone density loss.

36:52Nick Bare:So with a lot of these athletes, I think I heard that more commonly there's women who experience fractures and there's this specific bone that gets injured. I can't remember exactly which one it is. I think it's like the sit bone that fractures most commonly in women, especially female runners. Do you think this has something to do with not just reds but also menstrual cycles, lower iron, and then just the impact on bones over a long period of time. Yeah. If you're a female with REDS and what's called hypothalamic amenorrhea, which is where the brain is not producing enough hormones to send signals to the ovaries to produce hormones, that puts you at extremely high risks of these pathologic fractures or even fractures that can happen without a huge amount of trauma happening.

37:56I'm not sponsored by any like Dexascan place, but people can go to dexafit.com, dexascan.com slash locations, Fitness City spelled with one S. And there's a couple other places of like, you know, national chains of places where you can go get your Dexascan for body composition. That'll also tell you kind of a total body T-score. And then if your total body T-score is not in the positives, you should go get a specific DEXA scan for bone density that looks at like you mentioned the pelvis, the neck of the femur which is the thigh bone and then a lot of them also look at the radius which is a bone in your forearm and then a lot of them also look at the or almost all of them should look at the vertebrae and the spine.

38:45Nick Bare:Okay, that's good to know. So say an athlete is experiencing reds they're in this caloric deficit for extended periods of time how bad can it get and what does that look like what are the symptoms yeah people can kind of jump between the different stages but perhaps a stage that i never got to is the significant psychiatric complications people can have insomnia so bad that they kind of enter a bipolar-like state. Depression is very common as well. And a lot of times this affects people's relationships. I think it's interesting that if you look at professional athletes that are married, have a spouse, then often within a few years of stopping the cycle of their pro-athletics, they split up.

39:41Because you'd think that, at least for certain professions, it would put a lot of strain on your relationship to be going through this cycle of in-season, out-of-season, in-season, out-of-season. For a lot of sports, there's also other factors. For example, if there's boxers, then there's head trauma and concussions, things like that. But that would be kind of a late stage manifestation of REDS. Hopefully it wouldn't get to that because I do think that even if you're training hard, as long as your caloric deficit is not too significant, there are natural ways to address the different abnormalities that lead to this happening to where it can be better.

40:23And even if it's not 100 % better, I know a lot of athletes just like to grit through something and they just finish it and then be done. And that does lead to a little bit more of that dopamine surge during and after. But you can at least make it a lot more tolerable and healthy for your body.

40:41Nick Bare:So I'm assuming one of the solutions to reds. If you're in, say, a big training block or a big cycle, and you're experiencing symptoms of reds where low energy beyond what is expected with increased training load, mood dysfunction, irritability, disrupted sleeping, maybe some loss of performance not as much strength power endurance stamina immune system suppression all these things just start happening once that training block is is done you finish the race or the competition you back to normal life training volume intensity decreases again, you're now on a caloric surplus, those symptoms should go away pretty quickly?

41:46They should. A lot of times they don't. And unfortunately, I see people for this very often that are six months, even 12 months after the REDS phase, if you will. So there seems to be a lag. And part of this is probably because all the different axes haven't been addressed. So I actually have a couple different protocols for REDS. And I'll tell people kind of like the bare bones of it. I won't gatekeep and make you sign up for Gillette Health or whatnot. I'll give people actionable items where possible. But a lot of times you see a lag in how your body recovers after any illness. So after viral illnesses, there's things called post-viral syndromes.

42:26Even after medications, after someone comes off of an SSRI or hair meds like finasteride, there's these post-this syndromes. Even after supplements like ashwagandha or lion's mane. and they don't happen most of the time because most of the time people go back to their normal life and their diet is more consistent. They're not overfeeding their gut. Their gut health gets better. The gut-brain axis gets better. Their relationship gets better, etc. And things improve secondary to those lifestyle things improving. But often supplements and medications can be used for help. The three big things that you can't miss, and this could be during or after REDS, doesn't like sorry during or after the caloric deficit phase and the training phase if you're having these symptoms always consider these three things your sleep your diet especially fat and things that can improve igf1 you mentioned dairy last time i think that um for people who can tolerate it and kind of learn to tolerate it perhaps before they even start their training phase finding out what very high calorie often high fat foods can help high fat leads to better production of things like testosterone if it's not already making up 30 % of your calories.

43:40And then it often leads to better growth hormone and IGF-1 as well. Things like cheese and milk do. And they're also particularly tasty, in my opinion, if you learn to like them. The sleep can be addressed via supplements. It can be addressed via medications. Often I address it via medications just to jumpstart someone's sleep cycle and get that fine-tuned again. and then the last component is, you know, the mind and soul component. You know, where are you at spiritually? Where are you at with your relationships, with your family, with your close friends? How has it affected them? Maybe how, maybe you're affecting them in some way that you're not even realizing and that's kind of a subconscious thing to consider so that there's a lot of interplay in that as well.

44:27So those are the three things, sleep, diet, and then the social, emotional. That's a good call. out um in terms of you know reds it's not just affecting you it's affecting the people in your

44:40Nick Bare:life too and you probably don't even realize it if you're in that state i know i've been there before yep you don't realize the the effect and the impact on your relationships your family the people around you while you're in this decline state of just mental, emotional, physical wellness. A question I have is, what do you think the difference is between REDS and disordered eating? are they similar or is it that reds typically occurs when you don't know you are under consuming under fueling great question i hadn't thought of that because reds is often compared to overtraining syndrome so this would kind of be on the other side of reds and certainly someone with a history of disordered genes probably more likely to get it because they're more likely to want to over restrain their calories.

45:50Is body dysmorphia involved? People may have heard of exercise anorexia where you're still consuming a lot of calories, but you feel like you need to exercise in order to get this disordered body image. So yeah, the number of calories involved can be part of it. I think there's some overlap, but I'm not sure how exactly you would compare the two other than just looking for the history.

46:17Nick Bare:Do you think there's a downside? Maybe not a downside. Let me reposition this question. If someone's tracking their caloric expenditure through a wearable device, like my Garmin watch, for example, It tells me at the end of the day, how many calories I will have expected to burn just based off of me living, breathing, doing everything. And in addition to that, my training. So say my watch is I'm going to burn 6 ,000 calories in a day. That would tell me I need to eat 6 ,000 calories to be at maintenance. Do you think there's validity in that approach? or how would you approach ensuring that you are at maintenance or in a caloric surplus to avoid reds?

47:14Nick Bare:Do you rely on a wearable or do you not? I do use a Garmin watch, but only when I train and not for all training. I think there is validity in that approach and some people can succeed with it. I just don't personally do it. But I do think that looking at things like your HRV and your resting heart rate, That's great data. And I do that. I think that looking at your total body weight, as long as there's not going to be these huge fluid shifts, making sure that that's not changing too quickly, don't put too much stock in any one single weight. So one weighing on a scale should never concern anyone.

47:58And obviously there's a lot of downsides to seeing a weight on a scale too. But for advanced and elite athletes, I think that's one way that they can get around not having to track every single calorie. That being said, in the past, there is this term called intuitive eating. And basically it meant that people should be able to know what they need to eat intuitively. But it has more to do with food intelligence. And the more experience you have with foods and you kind of roughly know the macronutrients and the calories in the food, you intuitively know what to eat. For most beginners, they're not going to know what to eat.

48:40And people who are at risk of reds have the opposite problem of the entire, almost the entire rest of the population in that they're not intuitively eating things that are high enough caloric density. So most of the population eats too many, you know, milkshakes and hamburgers, but people that are having reds, you know, they want to eat healthy. so they have you know too many broccoli brussels sprouts and chicken chicken breast whereas they actually need to be having foods of very high caloric density because it's hard to keep up yeah i'm curious for all the years you've been training practicing medicine

49:21Nick Bare:prioritizing nutrition when have you felt your your best what did your training look like or was your weight or was your diet if you could look back and be like i want to i want to feel this again what did your lifestyle look like yeah it's a great question um i felt i could pick three different times when i started to really care about nutrition a lot was when i was a senior in college that's when i kind of dabbled into cross training i was homeschooled my brothers than I were. And then I ran track in college, but I didn't really care about nutrients or fueling. I just ate. And I did feel significantly better caring slightly more about nutrition then, and also cross-training and sleeping relatively well.

50:13I was definitely less stressed. My final year of residency, before I had my first child, my final year of residency, but before my first child arrived, I felt pretty good and I was making some great gains and successes with training. That was all, and my sleep was much better because I was a senior resident. I wasn't doing 24 hour shifts and whatnot. It wasn't nearly as hard worked. And my diet was pretty good because I cared about my diet more so. I still ate a lot, but I also trained a ton. I did mostly basketball, soccer, volleyball. Lately, I would say I know way more, but the thing that really holds me back is sleep just because I have three kids, five and under.

51:03If not for that, I think that my training would be significantly better. I will say that I'm definitely not as fast as I have been in the past. And I'm probably not as good at basketball or soccer or volleyball, but I'm definitely stronger. So I see the glass half full. Yeah. I mean, there's definitely trade-offs. When would you say that is for you? Because it's probably different for, it's got to be different for strength training versus cardio.

51:33Nick Bare:Oh yeah, completely. I mean, my training has changed so much over the years. And I think what has allowed me to continue improving and also stay healthy is that from the outside looking in, I think a lot of people think that I wake up and I've been running 10 miles a day every day for 10 years. And that's not the case. That is definitely in certain seasons within certain preps. But after I go into a big endurance prep, I go into an off season where I gain weight, my endurance training decreases, my strength training increases, and I feel better. So I look at it two different ways. There's performance goals, and then there's the health goals.

52:26There's definitely a way to manage and balance both

52:30Nick Bare:depending on what your goals are. But right now, for example, being an Ironman prep, performance-wise, this is in the best shape I've ever been in. I'm getting leaner. I'm getting faster. I feel strong. I'm staying healthy. My sleep is definitely not there. I have two young kids as well. It's not where I want it to be. I know I'd feel a whole lot better if I had more sleep. But I don't feel my healthiest right now in terms of mental energy, mental clarity. But I know it's the season that I'm in. This comes with the territory of training for an Ironman triathlon. I experienced the same thing in a marathon prep and an ultra prep.

53:19Nick Bare:I love preparing for these things, but I also know it comes with a cost and a sacrifice. So I'd say when I feel my best, my weight is roughly 205, 210 pounds. I'm running maybe 30, maybe 40 miles a week, 30 to 35 miles a week, strength training three to four days a week and really just enjoying life. Spending a lot of time with my family, not obsessing over the foods that i'm consuming not trying to uh restrain calories or certain certain foods based off of what workouts i have come up next and i think like a lot of people would think that in an ironman prep i'm burning 6 000 calories a day sometimes you can just eat whatever you want but the truth is that when you're eating this much your gut becomes more sensitive.

54:24Nick Bare:Yeah. So you have to be more selective with what you're actually consuming. Easily digestible. It's like being in a bulk kind of for bodybuilding. Yeah, like a good example. I know tonight if I eat sweet potatoes, that will slow down my digestion. That's how aware I am of my food consumption right now. Awesome. As opposed to white rice. If I eat white rice with dinner tonight, I'll be hungry a few hours later to have another big meal before I go to sleep. If I eat sweet potatoes, I'll actually not be as hungry because of the lower glycemic carbs and the fiber added to it. So I have to be more selective with the foods I'm consuming that make me feel good.

55:05What about a regular potato? Because I actually like regular potatoes, but I've never really loved sweet potatoes. And there's obviously a difference between a massive Yukon gold potato that's almost pure starch and the little potatoes have a lot more fiber ratio.

55:21Nick Bare:I can do like red skin potatoes and Yukon gold potatoes pretty well. But my favorite way to consume them is I'll boil them or I'll air fry them and then I'll let them cool. And I actually like to eat them cooled like an apple. You know, they're high in resistant starch. I just find that they digest very easily for me. I'll dip them in some salt and ketchup, just eat it like that. but i'd say that when i feel my best it's it's not an extreme and i'm still enjoying life i'm not as stressed and controlled over the training and the diet all these things but then there's certain times where i want to hit a pr i want to i want to accomplish a goal and that's when i go into a season of more extremes that come with a cost or a sacrifice and most of that being there's a time sacrifices you know obviously but uh more so mental energy sacrifice that comes with it so it doesn't have to do with necessarily resistance training or aerobic work because there's some things like crossfit and high i guess high rocks is still mostly running but there's some sports that are certainly more balanced than iron man prep or bodybuilding show I think for me it's It's a split between strength and endurance.

56:49Nick Bare:And it's not like, hey, I'm running 70 miles a week and then lifting a few times a week. It's bringing that running mileage down to say 30, 35 miles a week and more strength training. And I think even what I'll do post Ironman is keep running, obviously, but add in more cycling. because what I'm finding is with cycling, it doesn't have that impact on the body that running does, especially in my central nervous system. And I can get a really good strength workout out of it as well. You know, like one of the things I found in my, when I was prepping for that bodybuilding show is the last couple of weeks, I could not drop any weight.

57:34Nick Bare:Calories were going down lower and lower and lower and weight would not fall off. and then I finally pulled running out and when I pulled running out my weight over a week dropped 5 pounds because of the inflammation that I was just holding on to from running less venous stasis so I find I feel my best when I'm truly balancing my training and just listening to my body I don't think the way that I'm training right now for an Ironman is any way sustainable for long periods of time and um you know i i watch athletes i'm sure you do as well they're the race junkies online who go from race to race to race to race and in any given year they might have 10 to 15 races on the schedule for me i put one race on the schedule yeah a year but i think when you go from race to race to race to race and you don't let your body recover that's really like when you put yourself at risk of things like reds or potentially even worse you know chronic yeah i agree and you know i do various events that i train through like i did the patriots run which is a rock that you do for nine hours 11 minutes for 9 11 and you have a team of five maddie my wife did it with me and i did get up to a new max heart rate of 199 during that ruck um but uh you know i didn't trained for that i just kind of went and did it and um you know did fine i've done a couple years now and i did the same thing for some you know some small local crossfit competitions i did it i did one at one of the gyms i go to saturday but like you said i'm not training hard for this and i'm not straining my body it's more like a saturday that you just go and have fun but that is very different.

59:31I think that a lot of people, you know, just like you can ego lift, you can ego run. And some people are more of like weakened lawyers and they don't put in the adequate training. And then they don't know how to like modulate their system. Like any, any event that I do, I'm going to try as hard as I possibly can, but I'm going to be smart about it and pace yourself in a way, I guess. Yeah.

1:00:00Nick Bare:What's your opinion on social media's impact on training for the fitness population? And there's obviously a positive element to it. I will never argue that there's not. There's a positive element for sure. You mean like Strava and posting things on Instagram? Yep. Yeah, people are inspired to start working out and to push themselves. But I think there's also can be a downside to social media pressures in comparison with physical training in races and performance. And it puts people into this mindset of having to strive and crush themselves daily. And they're going to become harder and tougher by crushing themselves and not fueling and not sleeping.

1:00:53Nick Bare:and then these are the type of people who are experiencing over training and under recovering and reds what have you seen and kind of maybe even on social but in your practice with individuals that fall into that pattern yeah um the more pressure that someone puts on themselves because regardless if you're posting everything on instagram or strava or whatnot the more pressure you put on yourself to get to a certain thing, you're going to have more mental health and psychosocial outcomes. So you're more at risk of that part of REDS, if that makes sense, which might not even have that much to do with the physical part, has some to do with it.

1:01:39And I think it's just some people are trying to be, they're trying to do it just because they think that's the right thing to do. So I think I actually don't post enough of the different competitions and events I do. I hardly post any on Instagram. I don't do the things on Strava. When I do, there's a lot of interest and people ask me about it because they want someone with empathy. They want someone that's in the trenches. For the same reason why people occasionally will say, well, what do you do personally? They say, Dr. Gillette, what do you do for this? or, you know, when you've had a, have you had a calf strain before?

1:02:20What do you do, et cetera? They like it when I can answer from my perspective and then they kind of develop their perspective from there. So I do think there's a lot of benefit to it. And I am going to try to post more on social media about the different things that I'm doing, but it's just so hard. Like, I don't need that to toughen me up. I have my spiritual life and, you know, trying to strive to be a better Christian and love Jesus and love others. It's just super hard to do, especially like as a public figure, at least in my opinion. And having kids is hard too. So that's where I toughen myself up is getting hard for those things.

1:03:02And then the physical things, it's kind of like a break. I'm happy when I do them.

1:03:07Nick Bare:Yeah. A lot of that comes from just maturing and growing up and getting your priorities in order and wisdom. as a whole. I certainly don't care about as much about like body composition or big muscles or like whatever, how much I bench as I did even five, 10 years ago. Yeah, I completely agree with that. It all used to be, fitness was vanity metrics and now it's more so performance metrics, which I feel now is even shifting and evolving towards health and wellness metrics. that's one thing that CrossFit does really well they have this big continuum where you have pathology on this side and then lack of pathology or health and fitness is over here but it's just one smooth spectrum I like that so for a hard pivot another thing that I know we were talking about previously that we want to talk about on you know on this episode during this conversation but I'm actually really interested in is light therapy so a few years ago I bought a red light panel got really into it fell off just stopped using it didn't think much of it about two weeks ago started doing research on red light therapy again I bought a panel we have one of the full body panels in our closet I am hooked I don't know what the difference is now compared to back then.

1:04:47Nick Bare:When I had my previous panel, it was before having kids. Steph and I were getting a whole lot more sleep. Life just looked a little bit differently. But now I do red light therapy for 15 minutes every single morning when I wake up. I can feel myself literally waking up within those 15 minutes. Throughout the day, my mood, my energy, is much better. I'm not drifting towards that caffeine as frequently as I was. I don't have the slumps and dips. Maybe there's a correlation, maybe not, maybe it's just coincidence. And in the evening, I do the red light therapy for 10 minutes before going to sleep.

1:05:31Nick Bare:And I fall asleep faster than ever before. So red light therapy, light therapy, is it legitimate or is it overhyped? Yeah, so the short version, it's legit, but more study is needed. I'm also experimenting with red light therapy for a couple of years. I've had a panel, it's not a full body panel, but it's a big panel and it has a wide array of spectrums. So there's red light and there's infrared or quote unquote near infrared, which is usually a higher number. For example, I think in the 800 nanometer range is often infrared. Yeah, this panel that I have has both. 670, I believe, is like deep red.

1:06:08So a lot of them will have a red, a deep red, and then a couple different near-infrared or IR wavelengths. And those actually have better evidence for things like neuropathy. But I know I sent you an article that was a meta-analysis of six of the best randomized placebo-controlled trials, which is generally what you want in medicine is you want repeatability because you can find an RCT for almost everything now, which is crazy. It's great that there's that many studies being posted. But these large sample numbers kind of help parse out the bias. So the sample size is over 200 people, and it did appear to decrease pain and help people feel better and perhaps help them move better biomechanically earlier on in injury and for recovery, especially with muscle strains.

1:06:58It appears to be particularly good. And I think that it's also going to help bring in some of the fluid into the area to actually help it recover. The limitation is it didn't look particularly good for getting people back to full activity faster, which, you know, for quality of life doesn't really matter. But it might be slightly overrated from a pro athlete perspective. If someone's saying, I need to go back to playing, you know, bowl all out basketball or volleyball. Like if I was a volleyball player and I wanted to get my shoulder back to 100%. I've been doing red light therapy, actually a couple different types of red light therapy devices that I've purchased and also hydrogen water, which is a different topic.

1:07:41And I don't think it has helped my shoulder at all. So when I go back, I'm going to do some PRP and peptides. And then I'm going to see if that helps more than the red light therapy and hydrogen water I've been trying.

1:07:55Nick Bare:I have done PRP before for a quad strain. And I will say that made a huge difference. Yeah. A huge difference. Quick side note, hydrogen water. Yeah. Yes or no? You know, that's why I'm trying it is I'm open-minded. You know, I tried that, the Echo Flask hydrogen water. I know there's differences and they all say that they're better than the other one, of course. I also tried the hydrogen prebiotic. and I just didn't feel fantastic on it. And I did a gut health test and it said I had like hydrogen dominant SIBO as well. So I don't know if that's from the hydrogen prebiotic. Were you experiencing symptoms of SIBO?

1:08:38No, I wasn't.

1:08:42But I've been kind of underwhelmed. There's a lot of confounding variables in my life right now, but I'm still going to continue to try hydrogen water. I don't think it's harmful and it's kind of cool. although it does make Maddie, my wife, cringe a lot I would rate it maybe like a 1 or 2 on a scale of 10 whereas I'd rate photobiomodulation I think it's called PBM it's just light therapy, I would rate light therapy maybe a 6 or a 7 with the potential to get up to an 8 or a 9 with more study

1:09:16Nick Bare:On that scale, do you rate that effectiveness for For recovery or for what kind of outcomes? For recovery, presumably hydrogen water might have some of the same effects as bicarb in terms of performance enhancement because of its pH buffering and affecting the bicarbonate system, which is basically, not to go into too much science, but there's like three different forms of bicarbonate and hydrogen ions have to do with one of them. But theoretically, I understand it. and there's actually some small studies that show a little bit of benefit compared to regular water but I don't think that it's significantly performance enhancing enough to where it's probably not worth it to do for the average person Do you like using red light therapy both the red and the infrared near infrared for anything outside of recovery.

1:10:21Nick Bare:I personally am using it, in my opinion, for regulating circadian rhythm. My awake and sleep cycle. I feel like I'm getting a lot out of it for those outcomes. Yeah. Actually, I did some Monday. I did something called photodynamic therapy, which is a combination of red and blue wavelengths. Blue because it helps target bacteria in the skin. Just because my skin has been very oily recently. I came off of a hair med called Dutasteride and my skin is always more oily when I do that. And for this podcast and this vibrant longevity conference, I didn't want my face to be too oily or have breakouts.

1:11:02And blue light and red light therapy have some evidence to help with that. That's why a lot of times after you go to your med spa, like Gillette Aesthetics spa to get your salt facial, which is what we do. I just got salt exfoliation and then that red and blue light therapy. And it might have some collagen restoration benefits as well. In the past, I've had what's called a laser therapy done where they take off the outer layer of skin to help with like fine lines, wrinkles, acne scars. And then after that, I have patients, including myself, also do that light therapy. So for aesthetics, I would rate it as a nine, maybe even a 10 because there's almost no downside to it.

1:11:43the downside to the panel that we use is it's one that actually works well so it's super strong so even if i close my eyes tight all the way and put the complete blackout goggles and even an extra thing over it i still feel like it's pretty bright on my eyes is that the red or blue the combination of red and blue light but there's a setting for red light only there's a setting for red and amber there's a whole bunch of different settings but this panel is just so strong it's almost always too bright for my eyes, even with multiple layers of blackout goggles, which generally is the case for really strong light therapies.

1:12:22Nick Bare:When would you recommend, say someone wanted to start experimenting with light therapy, what protocol would you give someone to use a red light panel, but then also when to limit blue light exposure and when to incorporate blue light exposure. So blue light coming from our devices, our phones, our TVs, our screens, stuff like that. Yeah, so blue light is fine in the morning. The last hour or two of the evening, I would eliminate all blue, including kind of full spectrum white light that contains blue. People can go to their iPhone and click the night mode and that eliminates most of the blue spectrum light.

1:13:05And there's a similar setting for most tablets and maybe even TVs. I'm not sure. So that's the first thing to do is eliminate blue light later on. There is benefit to infrared light and most of the lights that are here, like these indoor lights, some people say there's a deficiency of infrared light because we used to get it because we're outside all the time. So I think infrared light is fine in the morning and the evening. It's particularly important for those with neuropathy because again, I think most of the studies on neuropathy did include those wavelengths of near infrared light. Whereas for, you know, if there's somebody that doesn't have neuropathy, just a wide spectrum, multiple bands, we don't exactly know which ones are best.

1:13:53I've talked to the owners of many of the companies. I don't have a horse in the race. I've been offered these huge affiliate codes because, you know, people have to make money and right i'm uh i've done enough health and fitness podcasts that people say we'll offer you this percentage it looks really good for selling all these but at the end of the day i just don't know if that's true and i've went through i don't i don't use like directly grok or chat gpt but i use consensus or hippocratic um and there's open evidence and there's a bunch of these different kind of like thinking or reasoning model AIs that help you find the last, like the latest studies.

1:14:35And people can still go through Google Scholar too, but that's going to save them a lot of time if they use something like Consensus. Is Consensus an app?

1:14:42Nick Bare:Yeah, it's an app. So it's consensus.app. And you can plug it into your chat GP too as well. Yeah, it's super cool. But anyways, you can find, you can look for all the studies, you can talk to all the experts. I've spoken with many of them. And right now, I would just say I don't know, but I'm very interested to see kind of what ends up looking like the best in the future. Where do you think light therapy is going? Do you think it's just going to stay where it's at or is it going to become more popular? I think it's going to become extremely popular. Especially with, like, it makes sense to me.

1:15:17You know, we're in this, that's why, you know, the sunlight is a pillar of health. because the indoor lights and environments that we're in is not natural. That's why we have saunas and cold plunges is because we're in temperature control environments all the time. And I think that light therapy will kind of be the equivalent of what's happened with contrast therapy.

1:15:42Nick Bare:Yeah, sometimes in the morning when I'm standing butt naked in front of my full red light panel, I'm almost like disgusted with myself because I'm thinking we have gotten to a point where we have to stand in front of a light that mimics the effects of the sun because we can't find enough time to be out in the sun. This is pathetic. It is sad. But here we are. Yeah. And you know, depending on where you live, you can go get that low solar angle light. But yeah, it is kind of sad. When I was in residency, I used to longboard, which is like a type of skateboard to the hospital. Like, you know, it'd either be in the evening if I was doing the night shift or super early in the morning.

1:16:27And I would go outside and I always joke that people would just tell me to go touch some grass, but I'm always pretty chill. But, you know, I would literally go touch the grass and the birds would be chirping and the wind would be like, I'd feel the wind and it was usually very cold, not you know uh freezing and i got such a great rush from that people would always think i'm on adderall or xanax or both which i was not um but where were you living at this point this was in springfield missouri okay but yeah whenever i could as long as it was not like actually snowing or pouring rain i would ride my board to the hospital i mean there's nothing like a

1:17:13Nick Bare:a cold I should say cool crispy fall spring morning growing up in Pennsylvania and when we lived in Nashville the fall the spring just like crispy and you go outside the sun is rising there's some like dew on the grass you can smell like the the season then nature just really can like energize you. Yeah. That's one great thing about having a dog, more excuses to go outside early in the morning, late at night. Yeah, that's true. That's true. Okay. Well, I'm, I'm so far sold on, uh, light therapy, red light therapy specifically. And, uh, one of the things I've been doing in the evening, cause I, I'm really trying to build my, my sleep hygiene sleep routine to optimize and improve my sleep at night one of my my goals post iron man that i i tried to incorporate during the prep and i've realized it's just unrealistic i'm going to get eight hours of sleep at night wow that is the goal post iron man eight hours sleep at night i'm going to prioritize it i'm going to sleep in till 6 a.m if our children allow us to.

1:18:38Nick Bare:Right now I'm still waking up 4, 4, 15 a.m. to knock out my run before the kids wake up. But in the evening I do my red light panel. I stay off my phone. I put my blue light blocking glasses on. I lay in the bed. I put my compression boots on. Normatec hyper ice compression boots. I just try to bring myself to a

1:19:05Nick Bare:parasympathetic state and I read and I just pull my Bible out and I read for 30 minutes. And a lot of times I don't even make it to 30 minutes. I fall asleep with the compression boots on, Bible in hand, Steph has to wake me up. But like that routine has really improved my, uh, just like fall asleep cycle in the evening, as opposed to what it used to be of being on my phone until literally I put it down, turned over, and now wear a sleep mask over my eyes. That helps too. I like that. So there's a lot of things I'm building into my nighttime routine to try to improve my sleep. Yeah, that's great.

1:19:44Nighttime routines are tough, especially, you know, we have church small group Wednesday night that usually goes pretty late. And then my run club, which is like the track workout that I do is 30 minutes away at 530 in the morning. So that's a quick turnover. And then everything just kind of gets thrown off a little bit there.

1:20:02Nick Bare:How many hours do you think you're getting a night of sleep? It depends. Anywhere from five and a half to seven and a half. But most good nights, I really do try to emphasize seven and a half. What I found is because I've been in this sleep routine for so many years of waking up at 4, 4.15 a.m., even when I try to sleep until six, my body's up and ready to go. So I know it's going to take a long time to break that cycle. Yeah. And it becomes harder as you get older too. We're the same age. So it's only going to get more difficult. So that's one reason why I like being the early bedtime. Oh, I love early bedtime.

1:20:43That's great. Sorry, my bedtime is early. I got to go.

1:20:46Nick Bare:No, I love it. Last time I was in bed, the kids fell asleep early. I was in bed by 8.30. fell asleep in the bed with my compression boots on bible on chest blue light glasses on by like 8 50 yeah and staff woke me up like 30 minutes later saying hey you get it go to sleep okay next thing i wanted to talk about uh i know you said it was going to be brief but you brought up this this new study linking high mileage running in colon cancer and from what I understand online, it's gaining some traction right now, but I believe you might have some different opinions on what is being shared online. Correct me if I'm wrong.

1:21:36Yeah. So the study itself is a good study. So they took runners that had done at least two ultra marathons or I believe at least five or six marathons. So people who had put in some serious mileage and then they screened them for colon cancer and a surprisingly high percentage, I think somewhere between 10 and 20 % did have colon cancer and they were between 30 and 50. Now the recommendation for first colon cancer screening did just go from 50 to 45. So all those people between 45 and 50 probably should have been screened in some way. There's many ways that you can screen it. But the theory is that you have less of that parasympathetic rest and digest input to your gut and that and then also, you know, all the junk that you're taking when you run, which, you know, a lot of runners consume a lot of energy drinks, etc.

1:22:28Maybe all these different things will lead to an increased risk of colon cancer. But I think it's more likely a correlation because for whatever reason, a lot of runners have significant history of gut issues like inflammatory bowel diseases or, you know, they've had a SIBO diagnosis, etc. From running specifically, you think? I don't think it's from running. I think that people who tend to seek out running also tend to have those things in common. For example, the other thing that a lot of runners share in common and swimmers as well is actually alcoholism. So they're significantly more likely to binge drink and have that dopaminergic response from alcohol, which there is some causatory links.

1:23:13But I think that it's, I could see the parasympathetic thing being a little bit of a link, but I think it's mostly correlation. And if people improve their diets and consume less processed foods and address their gut health early on, try to avoid antibiotics, et cetera. You know, ultra marathon runners and people who are in a lot of marathons are a certain mental type. In fact, usually, even if they didn't have a different body habitus or whatnot, you can kind of recognize them. And those same people will seek out, you know, going on a trek in Nepal and getting terrible dysentery in the Amazon or something like that.

1:23:51So I think a lot of the other factors that they tend to have lead to the increased risk of colon cancer. My takeaway is the same as the takeaway in the study is if you have blood on the stool or any GI symptom, if you're 30 plus, 35 plus, don't wait to 45 to get screened for colon cancer. Do it earlier. I've recently had my first screening, which fortunately was clear, but I also know people who have been screened before the age of 45 and found pretty early stage precancers and colon cancers.

1:24:21Nick Bare:With colon cancer, is that easily treatable? It depends on the stage. So early stage is often so, but it can come back and it can also metastasize. So it can be difficult. So you think these studies were more so correlation as opposed to causation? I think there's a lot of things that the people in the selected group did. So the exclusion criteria was Lynch syndrome and hereditary polyposis, which is like different hereditary colon cancer syndrome. So I think that there's probably some variables like the type of things that those runners tend to seek out also lead to increased risk. but I do think that runners should be because of the study I think it's reasonable to be more cognizant if you've had gut symptoms and I think if you have any gut symptom especially blood on the stool then my reflexive thing would be screen for colon cancer there's no reason not to it seems like a lot of endurance athletes have gut issues is there a reason behind that you know is it the the inflammation that the the exercise is causing itself or is the amount of just food that endurance athletes have to consume to keep up with energy demands outside of training and during training like what are your thoughts around that yeah both those contribute and like i mentioned the longer you are training.

1:26:03So, you know, if someone's an endurance triathlete for their entire career, that is a lot of training hours. During those training hours, your sympathetic fight or flight system is active and your parasympathetic rest and digest system is less active. So, I think that does lead to more gut pathologies. And then those individuals, maybe they're having to do more courses of antibiotics because of environmental exposures or whatnot. And that also is going to lead to more gut issues. And then those individuals are also, like I mentioned, with alcohol, maybe there's other things that they're taking.

1:26:43I know a lot of endurance athletes in the past used to smoke cigarettes or use tobacco products, and that's certainly going to affect your risk as well. They don't do that much as much anymore. But if you take a study of runners in their 40s, 50s, and 60s, you're going to see a pretty high like lifetime use of those products.

1:27:05Nick Bare:Yeah, I just feel like there's a lot of endurance athletes who experience stomach issues. And I've always been curious why or what was causing some of that. yeah I think all those things are significant inputs I think that once you do have your first like gut episode whatever it is whether it's IBS diarrhea symptoms whether it's constipation you think about it a lot more which actually improves your biofeedback which I think is a good thing some people don't have a great biofeedback with their gut and they just kind of ignore it but when there's no bathroom close you can't ignore your biofeedback oh yeah i have gone to the bathroom on runs in many different places in my life some i am proud of many i am not which is wild because i haven't had uh i've had those issues in probably the last two years yeah but there was there was a phase and it was it wasn't when i first started running but it was when I first started training seriously for endurance that I'd be on the middle of a run.

1:28:18Nick Bare:I'd have to go to the bathroom out of nowhere. And now I haven't had those issues for probably two years. Yeah. And you know, there's a couple of ways that you can look at this. One issue you mentioned is that they have to consume more calories. So you literally just need more digestive enzymes and you need to be better at digesting the bulk of fat and carbohydrate and protein that's in your gut. And your gut is often full and is trying to work as you're running. So that can be difficult and lead to a lot of symptoms as well. And then secondary to that, there's a lot of microbiome changes that you see that is not necessarily unique to runners, but is unique to athletes.

1:29:03There are certain bacteria like acromantia that tend to be very high if you exercise a lot. Whenever I test mine in a stool, it's always sky high and it's almost always low in people who are metabolically unhealthy. So having that as a protective mechanism, it can take time to develop that ecological niche. Just like if you have a fish tank, it can take a while to kind of like make the environment of the fish tank perfect for that species of fish.

1:29:30Nick Bare:It makes sense. For someone who, earlier you mentioned you have just naturally a large appetite. For some of these people, athletes especially, who naturally don't have just a crazy appetite or they're training a lot and they have trouble keeping up with the amount of calories they have to consume, is there anything that people can take such as digestive enzymes to stimulate hunger and to ensure that they can consume as many calories, as much food as they need to, to fuel the energy demands? Yeah, there's a lot of things, even without taking digestive enzymes that help. Digestive enzymes can be reasonable and there's specific types of digestive enzymes that can help.

1:30:18But one of my favorite tips is from Diana and she's one of our sports and performance dietitians at Gillette Health. and one to ten minutes before your meal, you can take something called bitters like apple cider vinegar, lemon water, even ginger, anything that's bitter on your tongue and you leave it there just enough to get that bitter sensation and that will stimulate the natural flow of digestive enzymes from your own body even before you start to eat. Also, if you smell or taste something you particularly like, that will also help start the flow of digestive enzymes. and then if you take literally longer to eat something then that will also help.

1:31:00Sometimes if you're inhaling a bar as you go then it can't take as long. I'm a fast eater. Yeah. I'm a super slow eater. I think we talked about this before but being a fast eater it can be more difficult to acclimate to that to make sure you digest it and a lot of fast eaters do use digestive enzymes or the bitters before the meals things like that to help.

1:31:26Nick Bare:would you consider like pickled ginger a bitter you know like the ginger you get with sushi as long as it gives you that it's just enough it's not super bitter but it should be bitter enough to give you that sensation where it makes you want to make a face yeah that ginger like sushi restaurant does that to me and I can go crush you know nigiri yeah crush nigiri but I'm the person who's eating the ginger multiple plates of it throughout the entire meal. I love that ginger. When I get back from crushing sushi and nigiri, and I keep it very clean. It's not like these hand rolls with all the spicy mayo on it.

1:32:10Nick Bare:But two hours after a massive meal, that type of meal, I'll come home and I'm starving again. And I'm wondering if that ginger is helping aid in digestion during that meal. Yeah. It could also be the glucose and insulin shift. which often leads to that too. And then it could also be MSG depending on what's in it. That's what, like bodybuilders used to use MSG for bulking. For what reason? To upregulate appetite and then sodium in general is going to slow gut transit. So MSG will upregulate appetite but sodium will slow down the digestion. Yeah. And then, you know, an hour after, I actually posted this on my Instagram.

1:32:52I did a donut eating competition with a continuous glucose monitor on. I got up to 213 and then I crashed to 50. Oh, wow. And I did it one hour after eating, I think like eight or nine donuts. I did a high rocks workout and I felt great. I took a video of myself. I was literally sugar high when my sugar was up. And then an hour and a half later, I kind of felt hungry, sweaty. I felt like I had to lay down. I was cramping up, felt terrible. because my insulin spikes so fast, my glucose crashed despite having, you know, however many thousand calories of donuts.

1:33:29Nick Bare:But that insulin spike will aid short-term in athletic performance? Yeah. So, you know, donuts are high in fat, so not the exact same as sodium slowing. And you don't want your insulin spiking as you exercise. Exercise is an insulin mimetic. They both actually push carbohydrate into your cells similarly. But I think donuts could be a reasonable thing to eat the night before doing a workout. I felt terrible that I could barely finish the workout. I was cramping so badly. But I did it for, I guess I did it for the social media and I did it for my own interest because I've also heard people, influencer doctors say, your glucose should never go above 180 or your glucose should never grow above 200 or it means you're really unhealthy.

1:34:19But I think that that one time that my glucose went to 213, it was not terrible for my health. And my next two days, the glucose was perfectly normal. I felt great. I was completely back to normal. So from time to time, something like that, or even a couple of times a year drinking some alcohol, I mean, it's very trendy to avoid it completely 100 % now. I think things like that can be worked into a healthy diet.

1:34:49Nick Bare:On the topic of alcohol, what is happening? Do you consume alcohol occasionally? Yeah, I do. In the last year, probably only three or four times, partly because you have a young child and I'm not going to drink by myself. And if I do, I want to do it at 10 a.m. as ridiculous as that sounds. I don't want to consume alcohol late in the day because it's just going to destroy my sleep. So it is very rare. But I think that it's safe to say there's no physical benefit, but there is a significant social benefit whether people like it or not. I think it's kind of falling out of favor, which is great. But I think that people can consume small amounts of alcohol infrequently and still have optimal health.

1:35:42So I do, and I enjoy it when I do. I don't feel guilty. If you feel guilty when you drink, even if it's just a tiny bit once a year,

1:35:50Nick Bare:then don't do it. Yeah, we rarely drink at this point in our lives anymore. And if we do, it's one drink. It's like one glass of wine. It's a crazy night if it's two glasses of wine, you know, or it's like a four-hour dinner out with friends. It's like, all right, we'll get the second glass of wine. but it's just it's so rare now at this point that for me it's if there's no net positive i'm like why even why even do it but i do love the social aspect of it like if we're having a group of friends over for dinner and we're cooking some good food and we're just relaxing you know crack open a good bottle of wine and have a good wine what is what is happening in the body when you consume alcohol?

1:36:38Nick Bare:What creates those downstream negative effects that we're trying to avoid? So alcohol is ethanol, of course. And ethanol converts to acetylaldehyde via alcohol dehydrogenase. And then acetylaldehyde is metabolized via acetylaldehyde dehydrogenase. So people who get flushed from alcohol, usually it's from that acetylaldehyde metabolite. And there's a lot of different things in your microbiome or even probiotics that can help metabolize it. I'll actually send you my alcohol attenuation stack that I take even though I probably don't need to because I hardly ever drink. But even with one drink, you take this?

1:37:18With one, I don't. But I also rarely drink one drink. If I'm going to drink, I'm probably going to have two or three or four. And I'll probably start in the morning, maybe trying to smoke something on the Traeger or whatnot. And it's a social benefit like you mentioned. but there's things that you could take before and after. DHM is another one that helps with metabolism. I also take NAC, which is a amino acid that helps replete glutathione and often glutathione itself. A lot of times I prescribe subcutaneous glutathione injections or even NAD plus injections to take the next morning for a nice energy boost if people kind of feel under the weather.

1:37:58And some people just come in and get IV of glutathione or NAD plus, but those are prescriptions. Glutathione is a tripeptide. but I'll kind of post the full stack sometimes I also take something called LDN which is low dose naltrexone that I've talked about a lot that does the opposite thing of dairy protein and gluten it kind of helps push the gut forward and helps give it more normal motility because alcohol is going to slow the gut motility a lot of it's actually absorbed pretty quickly but it's going to slow the rest of the motility of the gut and then some people get that dopaminergic spike from alcohol and then they kind of get the crash after almost like a mild version of what happens when someone takes an ADHD medicine, a little bit of extra energy and adrenaline, and then almost kind of a pseudo-depression phase after.

1:38:42You can also get with alcohol. And then because it's also GABAergic, you think about Xanax, Ambien, Gabapentin, alcohol, these things increase GABA signaling. Then you kind of have that GABA withdrawal. So alcoholics in the hospital, we'll put them on protocols called AWAS or CWA. But basically it's just measuring how much desensitivity they've had from the GABA standpoint. and we give them things like Xanax or Valium to help bind that GABA receptor. So there's a lot of things that you can do, but L-theanine is a good thing to kind of balance that out. LDN also helps that side of things. But yeah, I'll post the full protocol.

1:39:22Nick Bare:So consuming alcohol has a lot of downstream negative effects almost immediately on the body. That's why I say there's zero physical benefit. It used to be like the heart association said some alcohol can be heart healthy, maybe for males, but doesn't really appear to be the case. Yeah, I've even found, especially when I'm in a big training block, one drink with dinner will affect my sleep and performance. And right now I feel so good in this training block because my diet, my sleep, my recovery protocols are so dialed in. And when you feel that good, you don't want to do anything that's going to take away from that.

1:40:04Yeah. People are scared of antibiotics and they should be. They should just be used for things that are not going to get better otherwise. But alcohol is kind of a mild antibiotic in your gut as well. It's going to lead to a lot of gut microbiome shifts that are going to lead to downsides even multiple days after. You see a lot of males of college age developing things like Crohn's disease or inflammatory bowel disease. And often you see antibiotic use, alcohol use, and poor sleep as a lot of the kind of sparks. Of course, there's a lot of genetic causes. And with any autoimmune disease, there's the fuel to the fire.

1:40:46And then there's the tender, which is the kind of genetics that is the preexisting environment. And there's a spark that actually starts it all up.

1:40:56Nick Bare:Yeah, Steph and I were actually talking about this this past week. she grew up in Michigan I grew up in Pennsylvania and just the environment that we grew up in going to college was just this natural progression from high school to the next chapter of life before you get a full-time job and college wasn't taken in all honesty very serious in the environment I grew up in it was considered like here's four years of just truly having fun and partying and all these things. And one of the things we've talked about a lot recently is as we're raising our children, you know, Charlie's three, Nico's one.

1:41:37Nick Bare:So we have some time before they go to school is just instilling in them core values and, you know, our faith and following Jesus and living in a way that he would in hopes that in our goal, our mission is that by the time they get to college age, whether they decided to go to college and university or not, that we don't have to tell them, hey, when you go to school next year, this is what you should and should not do. But they go, if they go to university and college, they're going for an education. They're going to learn. They're going to get better. They're not going to make these poor decisions.

1:42:21Nick Bare:and you know just like the way that we are trying to lead and raise our children is that they can make those decisions on their own based on the core values that are true to them in their life and i just look back to you know how i was prepared to go to that next chapter of life with uh with not those tools or mindset and it's a huge opportunity as parents you know leading and raising children um the complete side tangent based off of where we started with the alcohol conversation but it just had me thinking um you know it's it's a drink it's consuming this beverage but has such negative not only short term but potentially life-altering consequences yeah very true um as i mentioned my brothers and i were homeschooled all the way through so i actually almost went to a six-year med school program and I would have been done when I was 21 because I finished the high school classes early with my older brother that we did all the school together but I wasn't culturally mature enough so yeah I definitely wasn't into like that type of things in hindsight I was probably a very uncool homeschooler and I remember I ended up joining in a fraternity, one of my fraternity brothers told me when I was in one of my last couple years of college before I went to KU Med, he said something like, well, you've changed.

1:43:51I feel like you're just being a fake person because you're trying to be cooler than you are or something like that. And he knew me pretty well, so I didn't take it negatively, but I thought to myself, I think I've literally just changed and been okay with growing as a person through college. I think it helps me do podcasts and relate to people who are homeschooled from Kansas or whatnot. But that's the other thing that Maddie and I have talked about with Ozzie and Archer and Goldie Grace is that we want them to be able to be lifelong learners and be able to change as a person and not be stuck into whatever personhood that society or the average person thinks that they might be stuck in.

1:44:41So when you got to college, so you didn't drink when you got to college?

1:44:47Nick Bare:No. Did you make that decision based off of the values that your parents taught you or based off of just lack of exposure prior to that life transition? It's a good question. I would say everybody's kind of in a micro environment of culture and the one that my family was in was not really, it was kind of in the category of nobody drank. So I just figured I wouldn't. I would almost say it's like more part of my faith than anything back then, but now not so much. I don't think it really has much to do with being a Christian. Some Christians are okay microdosing nicotine or taking CBD or there's all these different things that some Christians are okay with.

1:45:39And I think that comes down to your personal relationship with Jesus and what your convictions are. And I'm just worried about mine. I'm not worried about other people's. But at least at that point in time, I think I just kind of considered it. That's part of my walk of faith.

1:45:55Nick Bare:That's what we're trying to really instill in our children

1:46:02Nick Bare:is not necessarily trying to teach our children what is right or what is wrong, but truly knowing the Lord and having a relationship with Christ. And we believe that if we can teach our kids to have a relationship with Christ, they will make the right decisions on their own based off what they know is right or wrong, not what we are telling them. I love that. Again, Charlie's only three and Nico's only one, but really just starting to plant the seeds in preparation for raising them prior to sending them off because I recognize how fast that goes. Most brain development occurs before age seven anyway.

1:46:43So it's kind of crazy to think with Ozzy, who's five, almost a third of the time that I've had with him before he goes off is gone. That's pretty crazy. At my church, they have a sign and they fill up beads of how much time is left with your child. And they show newborn, kindergarten, sixth grade. That's sad. Freshman and then done.

1:47:04Nick Bare:Yeah, it's crazy. I've recently had that realization of just how fast it goes. And everyone tells you it goes fast, but it actually scared me. you know realizing i'm having full conversations with my daughter about real stuff now and before i know it she's gonna be running off playing with friends and and moving away i don't want to wish these years away i actually want to slow these times down i'll be very present uh which is one of the reasons my whole view and perspective around around training and sport and, you know, striving and running myself into the ground physically for a race to rob me mentally from time with my kids.

1:47:54I'm like, this doesn't make any sense. So it's been a, it's challenged me.

1:48:01Nick Bare:It's made me grow and realize, okay, I'm seeing what's important now and what's really not. yeah there's definitely a level of growing as a person and being an example and you know you're talking about being an example to your kids for their walk of faith but exercise is obviously the same thing so and that's different for everyone so you know if some people say I don't like my parents were a good example or not a good example my parents at least knew that exercise was important. Maybe it wasn't extremely consistent, but it's that way in all areas of life. Yeah, I agree. Well, Dr. Gillette, this was another good one.

1:48:45As always, I appreciate you,

1:48:48Nick Bare:everything you're doing for the community and the health and wellness and performance and optimization space. My family obviously works very closely with you and we appreciate you. So thanks for coming on the show again. Thank you.