News topic du jour:
“United Kingdom-based vegetarians and comparable nonvegetarians have similar all-cause mortality. Differences found for specific causes of death merit further investigation.”
1. Reducing and preventing tendon pain? [12:03]
Hi Robb and Nicki,
Loving the podcast and all your great content!
I have tennis elbow, which the physio said was tendinopathy (after asking me some questions and getting me to do some movements.)
I got it from weight training, and after taking a break for a month or so and then training with my other arm only, it’s still there. As the rest didn’t help, I’ve gone back to weightlifting. I avoid exercises that hurt it, but just moving weights around the gym, from the rack to the station, and general life tasks, seem to aggravate it.
It seems to have spread into my wrist area and upper arm now. And I’m feeling a similar pain deep in my collar bone area (but not the bone itself but the soft tissue (muscle?) part (high upper chest/front trap?).
Even if I was to stop lifting, I think I would still aggravate it, from just general things, like lifting a cup of tea, getting things out of my bag, etc. So I’m not sure I can just avoid triggering it and wait for it to go.
I have some exercises from the physio that I’m doing.
But is there anything else I can try, like supplements, or maybe red light or cryotherapy? Anything really that might help fix it and prevent it from coming back.
I’m male, early 40s, and train with weights 3 or 4 times a week and have done for years.
2. Body Comp and Longevity [18:55]
Hey guys! Love ya lots. I have been following Robb since before my 15 year old twins were born.
One of the many things I love about you both is that you are not afraid to change your views on health and nutrition.
I love learning about both though I find it SO hard to decipher what is “true”. I feel like so much information is contrary.
I am a 41 year old mother of 5. (Ranging from 18-2 years old) I am super committed to my nutrition, sleep, activity, etc.
Having kids in my 20’s was very different than my last one at almost 40.
I have found it much harder to “bounce back” to my pre-pregnancy body. I understand that as I age I won’t have the same muscle tone, skin elasticity, etc though I want to give it my all.
This is my question:
I have heard 2 conflicting ideas:
1) fuel the metabolism
2) caloric restriction
Which is the way to obtain and maintain optimal body composition and best for longevity. Maybe the answer is that one is best to obtain and the other to maintain?
Does this question make sense?
Thank you guys!!
3. Nutrient Density of Chicken Sucks!@#$ [28:25]
So what now? I’m 140 pounds and want to get 1g of protein per pound. Is there still a point to getting protein from chicken if it is low in nutrient density; how does all that work?
Love my LMNT and the holiday stuff rocks!
The Healthy Rebellion Radio is sponsored by our electrolyte company, LMNT.
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Nicki: It’s time to make your health an act of rebellion. We’re tackling personalized nutrition, metabolic flexibility, resilient aging, and answering your diet and lifestyle questions. This is the only show with the bold aim to help one million people liberate themselves from the sick care system. You’re listening to “The Healthy Rebellion” Radio. The contents of this show are for entertainment and educational purposes only. Nothing in this podcast should be considered medical advice. Please consult your licensed and credentialed functional medicine practitioner before embarking on any health, dietary or fitness change. Warning, when Robb gets passionate, he’s been known to use the occasional expletive. If foul language is not your thing, if it gets your britches in a bunch, well there’s always Disney Plus.
Robb: Welcome back, everybody.
Nicki: Hello. Hello. Welcome to episode 132 of “The Healthy Rebellion” Radio. Good day.
Robb: Holy cats. This year is almost over.
Nicki: I can’t believe it. What do we’ve got? Like six weeks left. Not even. Five weeks.
Robb: I… Damn.
Nicki: Four and a half.
Robb: It’s whittling away as we speak.
Nicki: As we stand here. Yes. It’s crazy. Let’s see. We had a really nice visit last week. Our good friend, who you all know and love, Dave Dooley. He’s been on this show a handful of times as a guest. He was also Robb’s co-host on “The Controversial Truth.” For how many years did that run?
Robb: Like four or five years. Yeah.
Nicki: Four years. That was early…
Robb: Early days.
Nicki: Early days. Yeah. Anyway, he came in for a few days and got to spend some good quality time with him, which was awesome. Always a good time. Lots of good combos. I think we shared this before, but if you guys are in need of some holiday Thanksgiving entertainment this weekend…
Robb: That is non-controversial, interesting, and uplifting.
Nicki: Non controversial and would be enjoyable by all in the family and as kid friendly, you could watch Dave Dooley on this documentary that was made about this thing that he discovered a couple of years ago, which is that he is the product of a sperm donor and because of 23 and Me, he has found that he has I think 43 and counting half siblings, and they estimate there might be up to 200. But anyway, ESPN made a documentary about it called “The Great Imposter and Me.” You can watch that on ESPN. We watched it with the girls about a month ago.
Robb: It’s a couple of bucks to rent it. It’s so worth it.
Nicki: It’s a good, great story. Anyway, and you’ll get to see Dave in there. Let’s see. Otherwise, we’re gearing up for Thanksgiving here and I don’t know, I don’t have any other stuff up front. Anything from you?
Robb: Not up front. Not out back.
Nicki: You don’t have a mullet anymore.
Nicki: Did you ever have a mullet?
Robb: Kind of, at a point where I briefly also had a perm. I just went with my naturally curly hair back when I had hair. There’s one photo that exists still. I was just thinking the other day, I have these stashes of photos here and there up in our attic and I’m like, “I need to go through that and destroy all of that stuff because if I die…”
Nicki: Incriminating evidence.
Robb: … And my kids find it, God. Or even worse, if I was just in a vegetative state and then you guys were rifling through it and making fun of me when I couldn’t defend myself. So yes, and at that point I did have a mullet. Yes. But this is when Brian Bosworth was popular and everything and all the kids were trying to emulate him. He was a football player.
Nicki: I was just about to ask, who is Brian Bosworth? I’m dating myself or you’re dating yourself. Yeah. All right.
Robb: Nobody else will date me, so there you go.
Nicki: All right, we will… That is what you call a homophone, two words that sound the same and have different meanings.
Robb: You just got out of homeschooling the kids so bring in all that goodness to our listeners.
Nicki: All right. Let’s move on to our news topic before we derail this conversation any further. What’s our news topic?
Robb: Pretty interesting study, mortality and vegetarians and comparable non-vegetarians in the United Kingdom. The takeaway, so they looked at all cause mortality, and also the varieties of ways that people were dying and looked at food frequency questionnaires for the most part as to whether or not people identified as vegetarian, vegan, or omnivorous. Clearly all the caveats that go into that stuff, although this was on the dietary side, it was more of a qualitative piece. I think that they go really sideways when we’re trying to quantify how much people are eating, whether it’s meat or the total amount of calories or whatever. But whether you are or are not vegan, vegetarian, I guess I could see some people lying about that because, “Oh yeah, I’m totally vegetarian except when I go out and drink, which is also when I smoke.” So there’s confounders with all the stuff.
But anyway, the take away on this thing, United Kingdom based vegetarians and comparable non-vegetarians have similar all cause mortality, differences found in specific causes of death merit further investigation. So the vegetarians and vegans didn’t live any longer than anybody else, which is one of these, we’ve had examples like this again and again and again despite the tired, T. Colin Campbell China study stuff that’s been, how old is that book now? 30 years old?
Nicki: We did that protein debate with Lauren Cordain and T. Colin Campbell back in, I want to say 2006, 2007.
Robb: And it was old then.
Nicki: It was an old book then.
Robb: It was an old book then.
Nicki: I think it must be from the nineties.
Robb: We’ve had examples where the vegetarian folks will hold up the Blue Zones as these people live longer and there have been take downs on that. What’s funny about the Blue Zone stuff, there was a great peer reviewed piece, it wasn’t research per se, but it kind of research, but it really, what it got in and made the case was that these areas where there are these claims of exceptional longevity are places where there are virtually no birth certificates nor death records and people have a tendency to lie quite a lot in those circumstances. And really there’s just no good documentation.
Nicki: No way of knowing.
Robb: No real way of knowing. And then when we look at Seventh Day Adventists, Seventh Day Adventists in United States, and I feel like we were just talking about this last call, but I also do other podcasts, so I never quite remember what the other podcasts are and remember what I’m doing in this one.
Nicki: What you said on what show.
Robb: I can’t even remember what I was just talking about. But the Seventh Day Adventists tend to live longer than average Americans, which isn’t super surprising. Average Americans eat terribly, don’t exercise, don’t have great social connectivity by and large and all the rest of that.
But when you compare Seventh Day Adventists to Mormons, who have, tend to not drink all that much, tend to not smoke, tend to have baked in the cake, kind of a healthy lifestyle as part of their religious community advocates for that physical fitness and everything, you see no advantage Seventh Day Adventist versus Mormons in the United States. You see no benefits of being Seventh Day Adventist and general population within Europe, and this is some older stuff there, but this is just a pretty well done piece of research that got in and looked at a pretty decently large population and looked at these generally non-negotiable endpoints of all cause mortality. You can do some fiddling, died of Covid when their leg was chewed off by a shark or something like that. But you can do some hanky stuff on that, but the person is still dead so we at least get those things.
Nicki: I don’t think they have many shark attacks in the UK.
Robb: Never know. They are an island nation.
Nicki: This is true.
Robb: Maybe they do.
Nicki: I just haven’t heard of very many. And you were just telling me yesterday, I think about Bear Grylls, and he was vegan for a while.
Robb: He was vegan for a while and started getting some health problems. And then there was some scuttle butt that he met Paul Saladino down in Costa Rica. Bear has a place in Costa Rica, and I know Saladino was down there and they got to be pals, but he basically said that he eats two meals a day. It tends to be steak and liver, big, huge helpings of it. He does some honey and he does some fruit and there you go.
Nicki: He feels better than he’s ever felt.
Robb: Somebody in the comments, they said that one of their brothers, the guy said that his brother met Bear at a restaurant and he was there with his kids and the kids are big fans of Bear, and so they’re like, “Hey, we’re sorry to bother you,” that whole thing. But Bear was super accommodating, gracious, and he gave the dude a hug, and Bear’s a pretty big dude. He’s like 6’2″, 6’3″, pretty tall and everything. But this guy said that he felt like hugging an oak tree, just like he was carved out of granite. And this guy is pretty physically fit and does a lot of stuff, but Bear was like this SAS guy and he does lots of calisthenics and lifts some weights and ostensibly eats a pretty good diet, at least for what his needs are and doesn’t carry… It is interesting when you grab somebody and they are particularly fit and you’re just like, “Wow, that person feels a little different.”
Nicki: They don’t feel like the average American.
Robb: Nope. Don’t feel like grabbing a pillow, pillar.
Nicki: A pillar.
Robb: A pillar instead of a pillar.
Robb: We’ll get all kinds of hate mail off that.
Nicki: We will. All right. “The Healthy Rebellion” Radio is sponsored by our salty AF electrolyte company, LMNT. Don’t let muscle cramps, the keto flu or low energy levels get you down this holiday season. Just because the weather’s chilly doesn’t mean you don’t need electrolytes. And electrolytes don’t need to be cold or sweet to be both refreshing and hydrating. They can be enjoyed just as much around a cozy fire as in the gym. LMNT can keep you cozy and hydrated with a mug of hot, salty goodness. As we’ve mentioned, for a limited time, you can grab our new LMNT chocolate medley box, which includes 10 chocolate caramel, 10 mint chocolate, and 10 chocolate salt. That’s available now for all value bundle subscribers.
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Okay. We’ve got three questions for you all this episode. The first one from Joe on reducing and preventing tendon pain. “Hi, Robb and Nicki. Loving the podcast and all your great content. I have tennis elbow, which the physio said was tendinopathy after asking me some questions and getting me to do some movements. I got it from weight training and after taking a break for a month or so and then training with my other arm only, it’s still there. As the rest didn’t help, I’ve gone back to weight lifting. I avoid exercises that hurt it, but just moving weights around the gym from the rack to the station and general life tasks seems to aggravate it. It seems to have spread into my wrist area and upper arm now, and I’m feeling a similar pain deep in my collarbone area, not the bone itself, but the soft tissue or muscle part kind of high in the upper chest slash front trap.
Even if I was to stop lifting, I think I would still aggravate it from just general things like lifting a cup of tea, getting things out of my bag, et cetera, so I’m not sure I can just avoid triggering it and wait for it to go. I have some exercises from the physio that I’m doing, but is there anything else I can try like supplements or maybe red light or cryotherapy, anything really that might help fix it and prevent it from coming back? I’m male, early forties and train with weight three or four times a week and have done so for years. Thanks, Joe.”
Robb: A lot of thoughts on this. One of them is, I remember early in CrossFit, Greg Glassman mentioning that middle aged guys in particular would get in and start doing rope climbs and muscle ups, and that this was early days of CrossFit, and they would end up with this tennis elbow like flexor compartment in the elbow that would just get pissed off. And once it was pissed off, it seemed like it was pissed off forever. People would ice and heat and stretch and this and that. And usually it was like eight months, a year, two years sometimes, and then it just goes away, which is incredibly unhelpful and very anecdotal and there’s probably other things to do within that, but it is worth mentioning that I’ve seen that a lot. I’ve experienced it for sure. That is some stuff to think about. I think that some of the FRC material would be completely appropriate. And what’s interesting is he is mentioning multiple…
Nicki: Yeah, the spreading part was kind of interesting to me. What is going on there? If he’s got an isolated tennis elbow, why would it all of a sudden be spreading?
Robb: The tennis elbow might be because his peck is tight, and so he’s altering the way he’s moving.
Robb: In some way that, so it’s interesting, if you have hip pain, you oftentimes look at the ankle and foot first and start assessing up from that and don’t just look directly at, and it can go vice versa. This is where a full body cars routine, really emphasizing the upper body and the affected limb. There’s some really interesting stretches. We get some programming from Sarah and Grayson at Basis New York and they have some interesting things where you will do a loaded eccentric of external rotation of your forearm and it really stretches it out and internal rotation and you just kind of find these different things. You have to tinker with it a little bit to figure out what things are going to beneficially affect it. And sometimes it kind of pisses it off before it improves it, which is leading into some of the other thoughts that I had.
I think ART, active release technique, is super beneficial for a lot of folks. It can…
Nicki: For soft tissue stuff.
Robb: … For soft tissue stuff. It can hurt like the dickens, but we’ve had great success with that. We’ve recommended it to folks for a long time. The West Side Barbell folks, Charles Pelican, they’ve all recommended ART pretty strongly in the past.
And then finally on that kind of supplement story, and I’ll remember to put this in the show notes, there was a great episode of STEM Talk where the guy was talking about selective pro-resolution modulators. When we get soft tissue damage, there’s an inflammatory, an initial inflammatory response and then that inflammation needs to be resolved and this is where things heal. If we get kind of stuck in that pro-resolution process, then we don’t really heal properly. This guy was recommending a certain amount of fish oil. It wasn’t a huge amount. And he was also recommending like cutting a baby aspirin into quarters and then taking that baby aspirin intermittently because the baby aspirin plus the fish oil is in that omega-3, omega-6 eicosanoid pathway that really regulates this systemic inflammation and so that would definitely be an additional thing that I would drop in.
I’ve been tinkering with a red light therapy device, which I am blanking on the name of it right now. It’s a little portable unit and I’ve had some success with that too. But I would look at, I guess in review, the FRC/KINSTRETCH type stuff.
Nicki: You can also, depending on where you live and what resources you have, you could go see an FRA practitioner, like a functional range assessment, somebody who’s been certified in the assessment so they can actually look and see what is going on and then prescribe you some exercises and stuff. I know you’re seeing a physio and that’s great, but it is different and it is a really unique modality. Just wanted to interject on that.
Robb: FRC, KINSTRETCH, maybe getting an assessment and getting some work going with that, active release technique, the selective pro-resolution modulator, which is basically a little bit of fish oil and aspirin. I’ll put the link in the show notes, but also if you just search for STEM Talk pro-resolvins, you should be able to track that down.
Nicki: And then the only other thing is, because Joe doesn’t mention it, and I’m assuming you’re listening to our show, so I’m assuming you’re eating kind of an ancestral diet, but clearly tightening up any dietary and sleep, anything like that that might be pro-inflammatory in your diet. If you eat on the higher carb of things, if you’re eating a lot of dairy, any of these things that can be pro-inflammatory, you might want to remove them and just see how you do.
Robb: Good call.
Nicki: Okay, next question is from Lindsay on body composition and longevity. “Hey guys, love you lots. I’ve been following Robb since before my 15 year old twins were born. One of the many things I love about you both is that you’re not afraid to change your views on health and nutrition. I love learning about both, though I find it so hard to decipher what is true. I feel like so much information is contrary.
I’m a 41 year old mother of five, ranging from 18 years old to two years old, and I’m super committed to my nutrition, sleep, activity, et cetera. Having kids in my twenties was very different than my last one at almost 40. I found it much harder to bounce back to my pre-pregnancy body. I understand that as I age, I won’t have the same muscle tone, skin elasticity, et cetera, though I want to give it my all. So this is my question. I’ve heard two conflicting ideas. One, fuel the metabolism. Two, caloric restriction. Which is the way to obtain and maintain optimal body composition and best for longevity? Maybe the answer is that one is best to obtain and the other to maintain. Does this question make any sense? Thank you, guys.”
Robb: Actually, a phenomenal question in, that thing of maybe one’s better to obtain versus maintain is really insightful. Maybe next week for the show notes, I need to click over to a Chris Masterjohn piece that he just did, looking at both protein intake and nicotinamide supplementation as cancer promoters versus improving outcomes in cancer treatment. What’s really interesting is that high protein tends to be protective against getting cancer. Once you have cancer, there’s a strong argument to be made that lower protein intake is probably better. And if you think about a neoplasm, this thing that’s growing, if you limit the substrate that it has to grow, it’s probably going to have other problems. And then if you layer in the potential benefits of ketones and how they could improve your resilience to chemo and radiation, different things like that, there’s some interesting stuff. But it is path independent or path dependent. Preventing cancer may be very, very different than treating cancer as to the way that you would tackle nutrient availability and whatnot.
On this thing, at the end of the day, what we’re usually gunning for is wanting a good amount of muscle mass and an acceptable, enjoyable level of body fat. The calorie restriction is clearly a need in this whole thing because if we’re overeating, then we’re just not going to get to the body composition that we want.
This whole fuel the metabolism piece, though, is really, really interesting. I put a link in here to a piece from Chris Kresser where he’s talking about the mid-Victorian diet and what we can learn from their health. There was this period of time in the mid-Victorian era, mainly in the United Kingdom, that is where this studied, although this applied to Europe more broadly, where people started, they were still working very hard. This is pre-antibiotic era, it’s pre-modern medicine for the most part, but people started getting access to much better food than what they had had in the years prior.
We had about this 40 year period where height increased for all these folks, longevity increased for these folks. The average lifespan was up into the mid to late seventies. It was not far off of what we have today with no antibiotics, no surgery, no emergency medicine and all that type of stuff. But also no Lays potato chips, Coca-Cola and Skittles and all the rest of that stuff.
One of the interesting things that they talked about in that is that people were active. I forget the exact numbers, and I need to read the paper again because I was just talking about this the other day and I always forget what the numbers were, but men shoveling coal. It was like 50 tons of cole a day, 25 tons of cole day, stunning amounts of work. And the men…
Nicki: Their bodies felt like oak trees too.
Robb: They probably did. When you think about it, you’re kind of like that guy was not huge, but he was a ropey, sinewey mofo for sure. The average food consumption for men was nearly 5,000 calories a day. It was like 4,700 calories. And for women it was like 3,200 calories. It was a lot of calories because people were active and heating wasn’t spectacular so you relied a lot on body heat for that kind of background thermo regulation in the winter and stuff like that.
I think that there are, she mentioned that there seemed to be these contradictions here. I think these seeming contradictions emerge because the situation matters. Depending on the situation that we’re talking about, that’s what’s going to be the big driver here. We have a 41 year old mom with five kids. That’s a lot. It’s just a lot. I would be shocked if her sleep isn’t still continually fractured, if feeding and watering herself isn’t at least marginally challenging, although I’m sure she runs her ass off throughout the day. It’s probably not an hour and 20 minutes of zone two cardio every day with 45 minutes of strength training in the afternoon. The physical activity is probably very opportunistic and grab baggy.
Where to go with this thing, you could get your hormones checked if you want to, just to establish a baseline and make sure that we don’t have something like an estrogen dominance occurring. You really want to find somebody good to look at this. Functional medicine practitioner, Dr. Gabrielle Lyon, I think has a good network of people that look into this stuff. There are other people in this space that look at this from both an ancestral health model but also kind of a functional medicine perspective. It wouldn’t be the worst thing in the world to just tick that box and kind of see what the hormones look like because we get so much leverage or comparative advantage when our hormonal profile is in a favorable state and it’s working, treading water uphill to mix some metaphors too, if we’re not in a favorable hormonal state. And then from there it’s adequate protein, gram of protein per pound of lean body mass.
Nicki: And actually measure it out because sometimes, I know we’ve talked about this a thousand times, but unless you actually measure out what you’re eating and know for a fact what those quantities look like and you’re eating that every day, you’re most likely under eating on the protein.
Robb: Especially as busy as she likely is. That protein, just by hell or high water, hitting that protein minimum every day, having a sense of whether you do better on some carbs, some fat or a combo. And then whatever you can do to improve your sleep, even if it’s what, we still not infrequently, Sagan will be like, “Can I sleep with you guys?” One of us will usually go rack out with her. She would sleep with one or both of us every single night if she could do it. We have a turkey walking by my office window.
Nicki: Just in time for Thanksgiving.
Robb: Even if that’s something where it’s like maybe pops needs to take the bullet on a day or two a week so you can legit just get super restful sleep, I think that that would be a huge factor in here. A little bit of zone two cardio, some consistent strength training, all those things are going to be big factors.
But I guess again, to recap, I think it’s worthwhile to look into what your hormonal situation is, just good functional medicine screen, if nothing else because you’re 40 and unless you die, you’re going to get a baseline so that we can use that as we motor forward. Make sure that you’re getting that gram protein per pound of lean body mass or per pound of ideal body weight. Be aware of whether you run better on carbs or fat or a combo and try to maybe sit down, do something like the keto gains calculator and figure out what your total macronutrient needs are so that you can work within that calorie window. Make sure to get the strength training and whatnot that you need. But then the sleep piece is going to be probably the magic in this. If we sent you away to camp and your camp was exercise, eat good food, sleep…
Nicki: Lay in the sun.
Robb: Lay in the sun, I think your body comp stuff would just magically resolved because you’re holding down the household with a bunch of heathens there so that’s going to be really demanding and kind of difficult to stay on top of. You got anything else as a mom?
Nicki: I think you nailed it. Good stuff. Okay, our last question this week is from Derek on how the nutrient density of chicken sucks. He says, “So what now? I’m 140 pounds and I want to get one gram of protein per pound, but is there still a point to getting protein from chicken if it is this low in nutrient density? How does all that work? Love my LMNT and the holiday stuff rocks.”
Robb: Don’t fear, Derek. Chicken is low in nutrient density relative to beef and liver and seafood, but it’s still good, and especially when you’re just mixing this into a hopefully varied diet I wouldn’t worry about it too much. Just from that pallet fatigue, burnout perspective, I know it’s heresy in this carnivore centric world where it’s ruminant meat or hit the skids, but we make some chicken soup pretty frequently, at least once a week we do some chicken soup and we’ll do some grilled chicken on the barbecue, and I have to say it’s an enjoyable change up and I know people get all weirded out about omega-3, omega-6 ratios and stuff like that. I’ve done long stretches of time without eating chicken. I’ve done longer stretches of time with it included in, and I’m kind of a canary in the coal mine and I haven’t really noticed that big of a difference with that type of stuff. But I wouldn’t worry about it. Chicken is not as nutrient dense as ruminant meat and whatnot, but it’s still relative to any type of vegetable matter you can eat.
Nicki: Or protein powder.
Nicki: Okay. That was a short one.
Robb: That was a short one.
Nicki: Folks, I hope you all have or had, because this comes out on Friday, a fabulous Thanksgiving. Enjoy your weekend. Get outside if it’s actually kind of cold anywhere. Yep, that’s what I was just going to say. I went out, I sat outside for a little bit with my coffee this morning and it was cold, but the sun was starting, just kind of nice light through the, you have the sun version layer that appears every once in a while, more often than not in the winter.
Robb: It goes away occasionally is a better way of putting it.
Nicki: But the sun was right there kind of shining through this little gap and it was really stunning. So anyway, get outside, enjoy time with your loved ones and we’ll see you next week.
Robb: Take care, everybody.
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