How Your Cardiovascular System Improves Metabolic Health w/ Dr. Nathan Jenkins, Anders Varner, Doug Larson, and Travis Mash #783
en
January 29, 2025
TLDR: New RAPID Health Optimization labs analyst Dr. Nathan Jenkins is a tenured professor of exercise science with over 1000 nutrition coaching clients. He combines evidence-based practices, academic expertise in chronic disease prevention, and passion for optimizing body composition and sustainable health habits.

Podcast Summary of Episode #783 Featuring Dr. Nathan Jenkins
In this enlightening episode of the Barbell Shrugged podcast, Dr. Nathan Jenkins, now a labs analyst at RAPID Health Optimization, dives into the intricate relationship between cardiovascular health and metabolic function. Drawing from his extensive background in exercise science and nutrition, Dr. Jenkins highlights the pressing need for understanding cardiovascular health beyond just athletic performance.
Key Themes Discussed
The Connection Between Cardiovascular and Metabolic Health
- Dr. Jenkins emphasizes that cardiovascular health is crucial not just for athletes aiming to improve performance, but it's fundamentally tied to overall longevity and metabolic health.
- He points out a compelling statistic: as fasting blood glucose levels rise above 85 mg/dL, there is a linear increase in cardiovascular mortality risk. Even values considered in the normal range can still elevate risk.
- The connection is further illustrated by the presence of insulin resistance, oxidative stress, and inflammation, which can lead to chronic health issues.
The Importance of Exercise Types for Health Optimization
- The discussion covers various types of workouts and their impact on health:
- Zone 2 Training: Aims at enhancing aerobic capacity while maintaining efficient blood and oxygen flow to muscle tissues.
- VO2 Max Training: Focuses on pushing the cardiovascular system to its limits, akin to training a high-performance vehicle.
- High-Intensity Sprints: Engage the body explosively for brief, intense fitness bursts, enhancing overall metabolic fitness.
Dr. Jenkins suggests that integrating all three types into a balanced workout regimen, tailored to individual goals, brings about the best health outcomes.
Managing and Reversing Metabolic Disorders
- Addressing the question of vascular damage due to inactivity: Dr. Jenkins argues that while reversing damage from atherosclerotic disease through exercise alone is unlikely, a stabilization of plaque and improved vascular health is achievable.
- Essential focus areas for prevention and management of Type 2 diabetes include:
- Exercise: Regular movement is vital to enhance insulin sensitivity and decrease blood glucose levels.
- Nutrition: Simple changes, such as replacing sugary drinks with water or diet sodas, can significantly impact caloric intake.
- Monitoring Blood Glucose: Keeping track of daily blood glucose responses helps in making informed dietary choices.
Key Takeaways for Lifestyle Improvement
- Walk after meals: Engaging in a brisk walk post-meal can significantly reduce blood sugar spikes, enhancing overall cardiovascular health.
- Daily Activity: Strive to integrate physical activity into daily routines. Simple lifestyle changes can dramatically enhance metabolic rate and health outcomes.
- Understanding Health Markers: Dr. Jenkins outlines the importance of monitoring A1C levels, along with fasting blood glucose and postprandial glucose responses to meals, providing a clearer picture of metabolic health.
Conclusion
The podcast paints a comprehensive picture of the significant role the cardiovascular system plays in our metabolic health. Dr. Jenkins’s insights remind listeners that cardiovascular fitness isn't just crucial for improving athletic performance; it's integral to overall health, longevity, and disease prevention.
Recommendations for achieving optimal metabolic health include:
- Regular physical activity tailored to individual needs.
- Nutritional adjustments focusing on whole foods over processed options.
- Proactive health monitoring and adjustments to lifestyle choices based on blood glucose responses.
Listeners are encouraged to adopt a mindset geared towards continuous health improvement through informed choices and active engagement with their health metrics.
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Shrug family this week on barbell shrugged another banger from one of our awesome friends that works with us here inside rapid health optimization dr. Nathan Jenkins he has a PhD in cardiovascular health how relates to metabolic function dysfunction I should say and he does a massive amount of work inside rapid with us on all things kind of the visible side
of things, training, stress, sleep, lifestyle, as well as the hidden side of the analysis on labs, lifestyle, and supplementation, nutrition. So he really is an integral part to our team. And today on barbell struggle, we're talking about cardiovascular health, a little bit of deep dive into the lab side of things, as well as his real specialty. He was a professor at University of Georgia,
Actually really funny because every time you see that you're expecting somebody to say go dogs I know I did which is I actually think I make that terrible joke twice now that I've said it now and in the show but if you enjoy all of this make sure you head over to RTLab.com that is the signature program here inside rabbit health optimization where you can take a deep dive into all things lab lifestyle performance the testing and analysis that we will be doing on you and
If you are very interested and you would like to schedule a call, you can do it all over at orateilab.com. That's A-R-E-T-E-L-A-B.com. Friends, let's get into the show. We're gonna barbell shrug, I'm Anders Warner. Doug Larson, Coach Travis Mash. Nathan Jenkins, Dr. Nathan Jenkins. That's what we're gonna call you today, typically. That sounds good, man. Thanks for having me. We got the PhD on here today. Today, on barbell shrug, we're gonna be talking about cardiovascular health, and specifically kind of starting this thing off,
getting into metabolic health, type 2 diabetes. And one thing that's super interesting about cardiovascular health to me is any time, or I would say like the highest level, what do people always say? I need to work on my cardio and have no idea why they need to work on it.
Outside of it, they think they're gonna like go run better. But that's probably like just scratching the surface on exactly what they need to be understanding cardiovascular health for and the depth that we're gonna be getting into today. And I'd love to start just kind of understanding, as far as like metabolic health type two diabetes, things that we're seeing, population wide, how does cardiovascular health kind of start to scratch the surface on the,
like health optimization side or living a better life on the metabolic health side. Yeah, well, one of the things I'm really fascinated about is
of the connection between metabolic health and cardiovascular health. I spent a long time in my university training, my graduate training, and also as a, back in my academic career, I was a professor for a long time at the University of Georgia, nearly a decade. And one of the, I mean, nobody said go dogs in that when he said that's like, it's like what it was supposed to say, right? Yeah. Yeah, go dogs. That's a sort of disappointing year for us. But we, you know, well, it ended in a disappointing way. It was a good year. But
Yeah, so as far as that connection between metabolic and cardiovascular health, trying to improve your cardio and being more than just like, you know, trying to run better and stuff. Man, it's literally kind of a
It can come to a life and death thing. It is something that absolutely plays into our overall longevity. So for example, I think I heard a recent podcast where Dan was talking about this too and it bears repeating something like around fasting blood glucose concentration of
Once you start to get above like 85 milligrams per deciliter, there's sort of a linear relationship between cardiovascular mortality. So like you might be like a 95, which is in the normal range. Anything under like under 100 is still considered clinically normal.
But there's sort of a quantifiable linear relationship between cardiovascular outcomes and fasting glucose concentrations, just use that as one of many metrics that we could talk about. For example, even within that normal range, there's a, there begins, we begin to see a market elevation in cardiovascular risk. So it's really important, I think, to be thinking about optimizing our
our metabolic health. It's not just glucose, but like insulin and all of the sequelae that come from when these things are out of whack, it gets into oxidative stress and inflammation.
immune system in appropriately activated and all of these things. Gut health, you feel in the blank, and there's a metabolic connection to it. And again, for a long time, that interest for me, because it turns out the thing that actually kills the most people, is a cardiovascular event or disease. And so that's where I go way, way, way back to when I started my training. I was like, well, I am really interested in the cardiovascular system. I'm interested in blood vessels, but what's a really
important problem to focus on as far as like somebody has something to advice that give people going into grad school or whatever. But find something that's really actually important, right? And to me, that seemed like a pretty important problem to spend a lot of time and thought on is that connection between metabolic health and cardiovascular health. So yeah, one of the
Everybody that's been listed in the show for a little while knows that I just want to like a year long journey to running a really fast mile or trying to at least and question in that process. The idea of running and cardiovascular fitness and VO2 max. You can't really help it. You go through a whole year. You're thinking a lot about your cardiovascular system and
I started creating the framework in my brain of like doing the, when, you know, there's kind of like the high intensity sprinting side. There's like a VO2 max training side and then a lot more on the, uh, just call it like zone two side of things. Yeah. Yeah. Break those into three, three main groups and really thinking about the speed and efficiency of how well my body is pumping blood and oxygen to the muscles to be able to use them.
And when I think now about that zone two slow thing, I really think about it more of just like speeding up the intensity that my body is processing blood, like just getting good at practicing moving blood faster.
And when you're looking at like the VO2 max training, that's like trying to get your body to train like a Ferrari. Like if you're gonna, you got to be able to see how long you can push your system to be as efficient as possible. And you start to get really good at it by training that. And then the sprinting side of things kind of being like, how do we just overload the system as quickly as possible? So that we're really like in like a weightlifting terms, like,
building like a one or a two rep max so that everything else from a five to an eight to a 10, 12, something along those lines is just an easier and done at higher percentages of that bigger number. When you think about developing that system, how important is it to be in, or are they equally balanced and training from
high intensity sprints. Do we need people really nerding out on like the podcast that they heard where it's like you have to do three bouts or four bouts of VO2 max for 45 minutes and it has to be in this heart rate. Like how do you kind of coach people in each of those and understanding what's really important for being healthy?
Yeah, but yeah, I think my first thought is it really depends on the goal. And like, Andrew's your goal of getting as fast as you can at the mile is sort of a different goal than being overall health, overall healthy. But I think it's different, but there's a lot of overlap and it's probably more similar than it is different. My view on like, let's talk about metabolic health in the context of exercise.
And you alluded to this in your description. I think that was really cool. Like you got the one engine, the one, so we got these different metabolic engines, right? The different metabolic pathways. You got the loss of creatine pathway, you got the glycolic pathway, you got the oxidative pathway. And they're all sort of different engines that our body uses to produce fuel and
There's, my personal belief for optimal health and this, you know, one of the key words in the name of the company is rapid health optimization is that an optimal exercise protocol will develop the capacity of all of those systems.
to some degree. Now, that's sort of for overall health, absolutely. And so like that sort of baseline sort of like idle, that's not the word, but let's use it for analogy. But going back to the engines thing, sort of like your ability to idle and maybe ramp up to some significant degree, that's your oxidative system, that's that zone too. That's hugely important. That is your foundation, for sure. That's how we train such that like,
A practical application that I like to think about is, why do I do zone two? Why do I include that in my program from a longevity and health standpoint? Well, I don't want to be at my VO2 max, and when I'm so I'm a little over 40 now, and I think I like to think in terms like 20, 30 years down the road.
I don't want to be what should be a zone two stimulus, like getting up out of this desk chair that I'm sitting in and walking across my house to go let my dog out after this call. I don't want that to be a zone four or zone five activity, right? Yeah. So now, a big part of my training now is to do a lot of what's in my zone two capacity and how to maintain the foundation of my metabolic fitness.
And then you get into the higher zones and you get into the intervals with the VO2 max training and the hot top end sprint intervals that the Ferrari like drag race kind of stuff. To a certain degree for health for sure and we absolutely program that for our clients, right? It's every week they're getting some dosage of that.
We sort of go up and down in terms of our emphasis with the different components of our metabolic fitness, depending on the individual's goals. So somebody's got a real competitive goal, like I went around a mile in under six minutes. Then, well, geez, we're going to do a lot of top end stuff each week and a lot of time at that way above threshold. And a lot of it, too, is just adapting.
That's really, you want all of those energy systems to be at a high capacity. Yes, it's primarily in a robot component, but you're doing a whole lot of glycolytic work at that. In an effort like that, it's going to hurt the entire time. You've got to get used to a lot of those trainings between the years as being uncomfortable that entire time too. It's all of it. I love all this stuff.
Yo, I'm curious, if you have some degree of vascular damage from many years of inactivity and for nutrition habits, et cetera, as you begin to implement more and more healthy lifestyle choices and eat better food and getting better shape and more cardio and all the things, are you really reversing any of that? Are you just like slowing down the progression of it from there on out? That's a great question. To prepare your vascular system.
That's a great question, Doug. And there's a lot of sort of debate in the literature on, I'll start specifically with atherosclerotic cardiovascular disease. Something I've followed quite a bit. The evidence, as I understand it, is that with, when we all of us have some degree of atherosclerotic, that's the presence of plaques in your arteries. It is very, very difficult to
promote regression of the plaque. Through exercise alone, there's been a lot of studies on like animal models and looking at human subjects through exercise intervention alone. It does not seem, I'm going to go ahead and say evidence points to it not being all together that likely that you're going to see a lot of plaque regression. It's probably not possible.
But just that's without like any other intervention. There's like a lot. That's purely from exercise. Exercise, yeah. But they can stabilize the plaque progression. And this in the human clinical data on this is from trust where they look directly at the plaque over a period of time, like say, anywhere from six weeks to six months of an intervention.
We could see evidence of stabilization of the plaque. It may not get worse, but including with high intensity interval training, some really cool studies is particularly coming out of Europe using a technique called ibis intravascular ultrasound, where they put an ultrasound probe in the vessel and kind of get this 3D rendering of the vessel. Some really cool stuff from that. But yeah, not a whole lot of evidence of actually regressing the plaque.
But through other maneuvers like nutritional intervention, that typically includes weight loss, maybe some evidence of regression, and then certainly with certain pharmaceutical interventions, statins and so forth. Again, evidence is mixed, not every study shows this, and I'd honestly have to look at it to the very latest.
to see what the current consensus is, but you see certainly in the literature some reports here and there of black regression, probably not complete reversal, not completely like, oh my god, the arteries clean, but significantly favorable clinical outcomes in terms of the black regression, black morphology. Another big thing is plaque stabilization.
uh the plaque and stabilizing even if it does the the amount of plaque in the vessel doesn't change so much uh the plaque can take on a morphology where it's where it'll get like a fibrous cap on the top of it and uh become less prone to rupture and it's the really the rupture of the plaque and the dislodging of like a of a of a blood clot of a thrombus
that typically is the cause of myocardial infarction's most cardiac events. And the vessel can become less prone to that with life style and some pharmaceutical intervention. So that's, before we go on, I want to answer the question with the second part. As far as like exercise or nutrition or any lifestyle modification, I was just talking about a very specific but also really important case of like what happens with the plaque.
All that being said, it's also true that studies have shown significant improvements in vascular health and other peripheral vascular health. A lot of site that's common to look at is for vascular health. It's somewhat of a proxy for the whole body is the brachial artery, the dilaportic capacity of the brachial artery, or also starting to look more and more vessels of the legs. The popliteal artery is a common site to look at. That's important because that's the
the vessel that supplies blood flow to the working muscles during most forms of exercise, like walking, running, cycling, whatever have you. And also the microvascular, small vessels, we have lots of measures that I won't get into for that. By and large, exercise training, nutrition, improving your diet, all that good stuff, reducing oxidative stress, reducing inflammation,
a lot of those indices of both large vessel and small vessel health in the periphery of the body are very amenable to lifestyle changes. And that in the last few minutes has been a condensed version of a course I taught at the University on cardiovascular physiology and pathophysiology.
And I like to compartmentalize it in terms of like the vessels that supply the heart and where you get the atherosclerotic cardiovascular diseases like kind of from truly a life and death situation and also systemic vascular health. It's not always the same answer. It depends on where you look throughout the arterial tree as we like to put it. So yeah, that's a lot. Sorry. So complex answer, but basically we should be doing the things that we know that are good for us because that's going to be good for your cardiovascular system.
Yeah, 100%. So there's the plaque build up piece and then you can have a piece of plaque kind of break off and then it ends up like giving you some type of peripheral vascular issue as it floats down to the smaller arteries of the limbs and legs. And then you have
But you have the coronary artery issues, and then you have brain issues where you could have some type of a stroke, right? It was kind of like the big three areas. If something breaks off, then it's in your trouble. If there's a thrombus, then if it's large enough, at some point, as the arterial tree goes through its various branches, the diameter of the arteries gets smaller and smaller and smaller.
And so you got a blood clot that's floating through and it may go through the large pipe, the conduit artery just fine. And you get into what we call the first order arterials, maybe just fine.
second order, start to squeeze through, and then the third order of arterial, then you're stuck, right? Or, you know, just depending on making that up as I go. But at some point, you're going to get to a pipe that's too small to accommodate that, the chock, the thrombus that's floating through, and then anything downstream of that, anything distal to that, and that is subservient to that vessel's blood supply, we're going to have an infarce is what we call the death of the tissue, or at least a lack of
blood flow supply and deoxygenation of the tissue and worst case of this is the death of that tissue. And if that's in the coronary circulation, that you're, you know, bad news, if it's in this renal circulation, that's a stroke. And if it's in the lower, so this is a big problem in peripheral arterial disease and atherosclerotic disease of the lower body.
You can get an infarct of the cat. This is also very much correlates with metabolic disease, coming back to the original topic of conversation. Type 2 diabetes and peripheral arterial disease really, really track together. You see a lot of
lower limb amputations in the cases of diabetic peripheral arterial disease. So you've got really poor circulation and a lot of oxidative damage to begin with. And then you get the acute event is that infarct of the lower limb and there's really no hope for the tissue to heal. So the best thing that the
The medical care team can do for that patient is to cut it off. I remember my friend was dealing with a lot of that. Like he would get a little blister on his foot. Like, you know, he was a farmer. He had this huge 600 acre farmer, 600 acre farm in the deep Appalachians. He would be driving his tractor all day and they'd come home and he'd just get a blister that would just turn into the, it would just be the grossest
Yeah, it'd be months. I've been trying to deal with it and sometimes it ended up in hospital. It was terrible. Yeah, it's terrible. It's awful. And if they can be painful, they can also be if there's a neuropathy there, they may not even feel it.
So, and then a lot of times, I talked to several, I know in my area, several vascular surgeons, and they'll be like, yeah, this patient didn't even know that they had this wound that was sort of festering and not healing, and then they said one day they'll go in.
It's like, wow, too little, too late. And we got to cut this thing off, man. So it's, yeah, it's really awful stuff. It's really awful. It's always seemed wild to me that type two diabetes seems like this thing where if someone comes to me or just like a regular person is, ah, yeah, my uncle's diabetic. Everyone's like, ah, yeah, bummer, you know, like, but like, it's like, it's almost like it's not that big of a deal. It's like, it's like common enough to be
I was sort of able to put this like, no one thinks it's a good thing, but nobody's like terrified of it. Like if you get cancer, you're fucking terrified of it, but if you get diabetes. I can't see my face when you say it. That's terrified. If you got, if you got some other random disease and someone said, Oh, I've never heard of that. What happens? And they go, Oh, you have to amputate my feet or I might go blind. People go, Holy shit. I got a big deal. But like when someone says they're diabetic, they go, Oh, that's a bummer. It's so normalized that if you just said the symptoms only,
Yeah. People would be like, what do you do? You'd be like, well, if you got to go for a run.
You literally, but you're going to actually control it. You're going to come back from that. You just won't. Yeah, that's actually talk about that. You can't really technically on paper cure it, but it's very manageable. At least I'm very manageable with many interventions. Can we just run through a list of the top things that you actually have control over that you could do to move the needle and control that disease state?
Yeah, well, I'm actually, I actually believe that for a large swath of cases, it is reversible as long as the pain is still able to produce insulin, then it is, it should be largely reversible. And, and there is now like, in the last few years, the American Diabetes Association has sort of come out with the adjusted position stand where it's like,
type 2 diabetes is actually a they define in the setting in which it can be can go into regression or I don't actually have to double check the language. They shy away I think from using the term cure. But again, we can talk about definitions.
If we define a positive diagnosis of type two diabetes is the HPA1C of 6.5, well, it's possible to get your HPA1C below that, right? And then again, you can absolutely, like people, if you're at 7.2 and with lifestyle intervention, which again, going back to Doug's questions, things within your control. Without medication and the insulin, there's the pancreas is still, the beta cells are still producing insulin. Yeah, so yeah, the things in your control.
with a lifestyle stuff, and it's the physical activity and it's the nutrition. Usually it's not usually it's almost always a big problem is again within someone's control is excessive caloric intake typically typified by excessive simple carbohydrate consumption that's causing dysregulation of glucose control.
And so that's what we're doing. First thing is if you're drinking any of your calories in particular, drinking your carbohydrates in the form of simple sugars, well, just replace that with Diet Coke or water. That's a step number one. And that will go a long way to getting your
get a caloric excess under control, getting back towards calorie balance, and also getting that the excessive glycemic load into your body, and more in keeping and matching with what your metabolic output actually is, which is really what we're after. So that's one, and then two, move more. The skeletal muscle contraction is the best way to get glucose out of the circulation, which again, type 2 diabetes,
excessive glucose in any context, diabetes, or predivies, or otherwise, is a problem of more fuel than we need, so increase the need, right, rev up the engine, man. And so it doesn't have to be going back to, I think it was Anders asking about, like, which of the metabolic, my interpretation of it was, which of the metabolic systems do we need to be firing on? Man, it's, zone two will still be a significant glyphosate or glucose
uh, utilizing activity for sure. I mean, a lot of it will be used aerobically, but yeah, if you've got it available, then the muscle will use it. And I think it's actually a blessing. So yeah, exactly. We're supposed to use not to sit there. Yeah. Yeah. So yeah, the sink is the problem is the sinks are full, right? The, uh, the muscle sink is full. Uh, if you're not.
if you're sedentary, and the liver snake is full, so there's just like traffic jam in the circulation. We need to get that out. The best thing to do is just to move, right? And interesting, this will probably be common knowledge to a lot of the listeners of this podcast, but in case not, it turns out it's the exact same transport mechanism between insulin stimulated glucose uptake by the muscle and contraction stimulated.
Glucose uptake, they both involve the same receptor, it's called glute4. You can use insulin to get the glute4 receptor on the cell surface, or you can contract the muscle and get glute4 receptor on the cell surface. There's slightly different initial pathways, but in the side of the cell they converge and it becomes sort of more or less the same mechanism.
And so even in the context of insulin deficiency, you can still get that glucose out of your circulation is the bottom line. So going back to if somebody gets a diagnosis of diabetes, it's like, oh, well, maybe it's no big deal because we can just get on the first line of defenses like metformin. And there's all these second and third line defenses. And ultimately, it's insulin. But still, even that is not looked at the societal level. It's all that big. Oh, you got insulin. You're fine. You got exogenous insulin.
Well, what if you didn't actually need to use, or you could reduce your dose, despite contracting your muscles a little bit, right? And so, yeah, there's a lot within your control when it comes to glucose control. And we're talking in the patient population, regardless of where they are on the disease progression. There's even an advanced stage, there's a lot within your control to mitigate disease, even if it's not reversible at that point.
Yeah. Earlier, you made a comment about something that Dan has said on the show many times about once your glucose is above 85, for every point above 85, I believe the exact number there is you're 6% more likely to become Type 2 diabetic. And so if you're out of 95, you're 60% more likely to be Type 2 diabetic, even though you're not even technically on the type, you're not even on the prediabetic list, which is above 100, which is above 100 rather.
It's very interesting how we kind of have these like these lines in the sand where it's like you're fine over here and then you're like you're not fine over here as opposed to like this spectrum of like you're on your way and you probably should do something while you're on your way and kind of attack the problem much much earlier.
Um, aside from, aside from blood glucose, like are there any other markers where you could like very clearly see that you're, you're on your way to having a bad time with your metabolic health? Of course, there's many, but like what are the top markers and like, what, what are like the numbers that you were paying attention to before you've caught crossed over like the medical line? Oh, yeah. Um, well, dude, that's, it's a great point.
This gets in the difference between like of how a physiologist kind of looks at some things and how clinicians and I don't want to shit on clinicians. Clinicians have to have diagnostic criteria that it becomes like a binary yes, no, right? And that's where like the 100 and up comes from for glucose. And that's where
for like that line between normal and pre-diabetic, right? But the fact is, physiology is not binary like that. A lot of times, I mean, there are some things that can operate in like a threshold phenomenon, but a lot of these variables are absolutely more like, more linear. And that is the nature of the biology here. And it's really interesting that there's this, this connect from a clinical standpoint on that. So anyway, just kind of, that's something I think about all the time. And I appreciate so much how
Dan and you guys in this company thinks on a more linear scale. Let's look at each data point or variable for what it is. Is it something that we need to be paying attention, even if it's in quote unquote the healthy range or not? But yeah, some other metrics, man. The other one that comes to mind is
It's very much related as to A1C because there can be a spurious like fasting glucose reading due to say you didn't get a good sleep that night. Maybe you did have a bigger meal than usual and you got a little bit of residual. A single measurement of fasting glucose is not sufficient to make a big deal about anything.
But the A1C, man, that's the average of three months of overall blood glucose, right? That's due to the fact that it's a permanent modification of your red cells and the lifespan of a red blood cell is about four months. And so it's the way it works out. As far as turnover rates and everything, it's regarded as like a three month sort of average glucose, a reflection of your average
blood glucose over the previous three months. So that's another, man, if that's a good one. So that can circumvent the issue of, well, what if this is an outlier if I just look at my single one off reading? And then some other ones that I would look at are glycemic responses to, and what I mean by that is the blood, the change in blood glucose following either like a standardized meal or just throughout the day. So that gets into
I'm not going to sit here and advocate for continuous glucose monitors for everyone. But if somebody's got concerns about their blood glucose, whether it's a one-off or maybe more than one-off, fasting blood glucose concentration, or A1C is a little higher kind of borderline. You're getting into the 5.5, 5.6, 5.7 range, pushing up on that 6% number. Then maybe just get some strips. Health insurance companies tend to cover them.
or even if not, they're not terribly expensive, but just like the CBS or whatever, just get some blood glucose strips and eat your normal food, eat your normal meal and see what is my glucose response to my normal diet, like my normal breakfast meal, my normal lunch meal. And a good number. I mean, the American, it's the International Diabetes Federation recommends that our post, what we call our postprandial, our
blood glucose concentrations after any meal regardless of what it's composed of should never really exceed about 140.
Um, and if it, which sounds kind of low, uh, because the clinical guidelines go away above that, but, um, or other clinical guidelines as they go, go above that. So if you're, if you're at any point, like, said that two hour mark after, after a meal, that two hour that between, well, I would say between one to two hours, if you're exceeding 140 milligrams per deciliter on a regular basis, uh, in a postprangel state, then, then that could be some signs of, of some problems, specifically insulin resistance of the, of the body's tissues, like the muscle.
Um, and, and liver and so forth. Um, post brain was mostly muscle driven. And yeah, that's a good sign that again, the external is back to the same shit. Like we need to be working out. We need to be moving. We need to be exercising. Right. Um, and also you can also, there's two way, then all the other, just finished the thought, um, reduce the carbohydrate content of that meal is probably in excess of what you need. Um, right. So.
So are you going to ask Doug? No, I was curious. I was going to say just being from the mountains, man, I'm going to make sure I send this to every family member I have. It's so rampant. I've grown up. My mother's always been worried about me because my grandfather had it and eventually took his life. And my grandmother on the other side had it and eventually took her life. But I've never had to even remember it close.
Dude, yeah. Are you remind me, Masha? You in North Carolina, Virginia? North Carolina, yeah. That's what I thought. You live in, is it what part of Asheville area, Brevard? No, no, Asheville is actually a lot nicer. I'm from near Boone. Oh, yeah, yeah, yeah. I'm from the Asheville called West Epson.
Okay, I know, I know a boon. Like, yeah, I love that you live in one of my favorite parts of the entire country. Yeah, it's beautiful. And similar in my family, I born and raised, I don't sound like it, but I'm born and raised in state of Georgia. Oh, yeah. And my, my whole family's very similar story. I mean,
um, car disease and diabetes, quote, on my family, right? And like, it's, and it's always just, I grew up here and it's like, Oh, you're genetics are working against you. I don't know. We should be genetics. Come here. You'll know, right? Like every night. Yeah. Yeah. Gravy on everything. Like, absolutely. We had three days from the garden, but
chicken fried everything. Dude, I saw on Instagram, did you know that you can chicken fry an egg? I saw somebody chicken frying egg with everything and in the inside, the egg, the yolk was still like running. It looks really freaking good. I almost might try it. I almost might try it actually. It's so glad to be to perform versus like, you know, you just, you need to enjoy, you know,
You know, like the whole family. I mean, we were just all like every day and like five thirty, like, not just my immediate, but like my grandfather, grandmother, cousins, aunts, uncles, a single day. Yeah. You're like, it was so good, man. But yeah, like and nobody leaving there feeling good though.
Good. Yeah. Chocolate gravy. If you've ever heard of that, my grandmother. The most delicious stuff in the world. Way up yonder in those mountains kind of thing. Yeah. Bro, I took you right from you and even be able to communicate. My wife, the dug in the end is my wife. What do you even get out of the car? Where I'm from? I was like, hey, let's go walk around. She's like, hell no. I'm not getting out.
I want to see it. I want to come visit. Come visit. I'll take you. Get you. Get your accent back real quick.
I want to jump in on a comment that you made earlier about movement. You understand that you have glute for transporters that are responsive to insulin, but they're also responsive to muscle contraction. They kind of go from the inside of the cell to the cell membrane and pull glucose into the cell. That's a good thing for many reasons.
I think it's very common nowadays for people to fall into the trap of still leading a fairly sedentary life. You're on your laptop all day. Like it's what I do. Most of my work these days is just sitting at my desk on my laptop. And then I go train for an hour. And I feel like I'm a pretty healthy person, even if I was like sedentary most of the day, but I got my one hour workout in, that still doesn't really check the box all the way for like for for movement. There's a text the box in my mind for
exercise, but it doesn't really check the box for movement. There's got to be more movement throughout the day. Um, and so, uh, hey, I want your thoughts on that. And then be for, for people that, um, especially doing damage control on like Thanksgiving dinner and, and things like that, or you're going to a birthday party, you're going to eat a bunch of junk or whatever it is. Like, uh, how do you use movement to kind of mitigate the downside of days where you know you're going to be eating not so well?
Oh, yeah. Great questions. Which one do I want to tackle first, man? Because they're both really good. Let's go. I'll start with the first one, which is essentially like you're working out. So you're checking the box on working out, but basically maybe not getting a lot of other movement in.
Really easily, dude gets jacked, never hits 10,000 steps. Correct. See, I was going to go to steps. Uh, I was going to go to steps. I, man, I've been, that's something I've been experimenting with personally. I mean, we can talk about the science, but also think listeners value like personal anecdotes from, from folks like us. And I'm just going to give mine.
I started paying closer attention because my thought process was, I'm going to go back to the sort of the end of 23. I've always, for the last five, six years, maintained pretty decent body composition. At that point, I was getting pretty damn lean.
10%, 12% body fat, and sustaining that. I would take that. I would love that. Yeah, I know it's good, but I'm also... There wasn't any marker that I said. My glucose, I had to look at it was at the time, but it was fine.
I'm just like, man, I want to do more. Well, I was getting more and more into running. So I started to pay attention to my steps in that way. But just like that daily basal activity, trying to do more of walking my dog, sometimes like the poor guy walking twice a day. I've got a little boy. He was about 18 months at the time. He's coming up on three now. But we play outside as much as we can and try to accumulate steps that way. And so I started monitoring my proxy, my metric for all that was steps.
For me, the more I can get it up to about 20, even including up to and above 20,000 steps in a day, almost universally, the better I feel. Now, that's really anecdotal, right? And that's very nebulous. I don't have a concrete metric for that. But just like if I just rate myself feeling, I'll give you like
Um, feelings of energy, even though I'm burning more energy, but just feelings of like sort of mental energy, brain power, lack of brain fog. Um, all like, all that stuff, like I'm moving closer to like, closer to 10 out of 10 on the scales, almost as a kind of a linear relationship. My basil, like what I tried to maintain about 12 to 15,000 steps in a day. It's been hard because it's fucking cold right now. Um,
But in the spring and summer months when I can and that doesn't that I will say that does include like if I go for a run that it's I'm checking on my watch and I'm not gonna subtract out the some people like oh if you're going for a run that doesn't count well I count those so Anyway, man, I think and I have to think that that is a
Well, I will tie it back to the metabolism thing. If somebody's already checking all the boxes on their nutrition and on their training, frequency, volume, intensity, hitting, getting all the, that dosing, right? But they're still, maybe they want to optimize their glucose.
and it could be any other metric, but that's an easy one that we can then kind of keep with the theme. Stay there tracking like 93, 92, 91, and still want to get back down. Like they've got the Dan Gardner mantra etched in their brain and stressing them out. Well, I want to get back to the 85 because I want to get that 6% every 6% that I can get. I want to get it, right? Well, maybe steps, maybe daily activities as a lever to pull.
And so I'd spent a while since my last checkup was in August. I got another one coming up in May around my birthday. I'll be curious to see. I hope I'm in that like in the 80s, at least, right? And not in the 90s. And I do think that that's, again, the daily activity, the daily steps thing, if you're already checking all the other boxes, then that's a really good one.
And that's an area for improvement or for growth. The other caveat that I want to give at the same time, I don't mean to talk about both sides of my mouth, but this is just from work with a bunch of my nutrition clients over the years.
telling somebody to move more to walk more when they're already fucking maxed out in terms of like all this life commitments and stressors like they've got they got three kids they got a job they're driving their kids everywhere so like for activities and stuff like I guess I got to get my so I'm gonna wake up at 4 a.m. and just make myself miserable and stare at a white cinder block wall on my treadmill in my basement
Let's not work. We got to be realistic here in a way that benefits and drawbacks with all these different maneuvers.
If possible, figuring out how to play things. You know, just kick it with your kids. Like that's like the easiest way to not have like, that's, that's actually the part of the zone two conversation that drives us is how many people really have 45 extra minutes, three to four days a week to just sit on a rowing machine and go slow and go like 120 beats per minute.
No, but like playing with playing with my son is my zone too. Like it can't be absolutely it. I look at my soccer ball. Yeah. Yeah. Yeah. Yeah. And the parents out there, one of the biggest things we've kind of we've joked around I think on some of our weekly group calls at times like about like there's a whole meeting about the alpha dad and all that kind of stuff and that.
Well, you know, you, one of the ultimate half of that. Yeah. And we're, we're cupping the same cloth because I'm totally that way too. But we need a team party. I want to see his. Yeah. There's no, no shirts ever. When other, when other, especially in other Dazza around, right? Oh, yeah. Flex. Sure.
But truly though, like one of the things that I think about using my fitness for is to not sit there. I don't want to be one of these dancers. It's just they're watching.
I want to fucking participate. Like we had our first ever snow in Georgia, like in five years, a couple of weeks ago. And I will say this, all the, all the parents in the neighborhood were actually active. They're playing with it. I would love to see it. Um, but I'm like, and, uh, you know, I'm like right there with all the kids, like going down the down slats, going down the hill and then met an extra neighbor's house and all that kind of stuff. Um, if my son's in the pool in the summer, I'm in there with him and not, I don't want to be sitting there.
Getting my son tan feet, right? I'm in there with it right exactly like it's Parenting like kids are freaking active. They're running everywhere That's a huge opportunity to get some to get some activity in so if you participate participate versus suspectate That's that's an easy choice, right? And then maybe you don't need to stress yourself out about getting on the road or and all that
I think that always comes down to the environment that you are building around yourself to succeed. I just became a farmer like a month ago. Oh, congrats. That sounds pretty awesome. Yes, gangster, man. I was climbing trees with a hatchet last weekend, chopping down stuff so I could build hunting stands. Are you kidding me? The dude just overnight turned into something.
That's awesome. That's all I make it. Totally faking it. But when you are up, moving in wheelbarrowing and like, yeah, the suburbs, you're like, I don't want to do that yard work. When this, when you like design your life that that has to be done, you're going to find 20,000. And you're not even, you don't even think about it. It's just, yeah, you're constantly doing.
things you just have like a it's like a job to do on a daily basis. It's just you chose this life and now every Saturday, Sunday, Friday afternoon, whatever it is, it's like you're hitting 15, 20,000 steps in a fucking afternoon and you don't it's just built into your life.
Yeah, man, my favorite days are in the summer when, so if I had the schedule allows, spring and summer, schedule allows, like I can get wake up in the morning, get across the workout and maybe go for a run and then do yard work all afternoon. And those are my 25,000 step days. And that's the best. And if you want to give up like 60% of your money, you can move to San Diego and you can walk forever.
Yeah, you can do you can do your route. Yeah. Yeah. Yeah. I was just talking with someone about San Diego this morning. I love that city. It's the greatest. That's actually I can't afford it. It's on fire right now. They're right. That's L.A. L.A. I believe both were. Okay.
I knew LA was probably the best. LA is like, oh, it's not good. Yeah, that was really, living in San Diego was actually like a turning point in life where it was like, I have to go do all these things. Like the sun is so perfect there that you just, it's different. And then you just become addicted to it and you can't. And then it disappears for like January and February and North Carolina. And I'm like, where did my happiness go? Yeah, it's really bad. It's really a piece of my life.
Yeah, it's tough even here in Georgia. It's better. It's way better in Georgia than I lived in Maryland and Missouri for a while. It's way better here. Yeah. But still, it's rough. I can't. I'm ready for the spring to come back, man. That vitamin D needs that song. I know it's not bad here because it's like it's like 40 to 60 days of cold before the shirts come off again.
That's, we can wait, we can wait. That's not even- I can handle it. That's not even a quarter, yeah, yeah. Andrew, that takes you from being the guy who goes shirtless, you know, even at 32 degrees. No? Here's where 40 degrees is like to cut off. If you're going from 20 to 40, that's gone off. That's gone off. That goes good. Farf is off. If you're going 60 to 40, you're frozen.
Yeah, completely frozen. I actually had a client that lived in Alaska, and she told me that coming out of the winter, they will, as soon as it hits like 34 degrees, they're all out, sun tanning. They lay out, they're all naked at the beach. They just give me some of that sun, because it's been dark and cold. Yeah, yeah, yeah. Any happiness in a long time, and then all of a sudden it just
there, bro. On Sunday, we got trapped. We just decided to do a day trip to Boone and got stuck in a snow. So we had to spend the night. Can you get back? Oh, my gosh. It was terrible. And when we left following money, when we left, it was nine degrees.
And when we got home, it was 27. That's a big difference. Like 27 felt great. Yeah. Man, let's go lay out of the sun. It's awesome. It's 25 here today or was this morning and all this Georgia people are crying. You can ask the second question about a big meal and what to do with how the movement plays into that. And I actually love that question as well.
Yeah, we're taking down to the end of the show here. We got a few minutes. Give me your high level two minutes. Sure. The best thing you can do, especially if you've had a significant glycemic load in your meal, a lot of.
carbohydrates either healthy or otherwise. And most of the time, I think in this context, we're talking about otherwise, cake, whatever. The best thing you can do is move. So that's a little bit of research we did as part of a much larger body of work. So to give credit where it's due, it's a pretty big field on this, but one of the best ways to manage what we call postprandial glucose excursions or big spikes in blood sugar following a carbohydrate rich meal.
is if you time it ideally between about 15 to 45 minutes after the meal, go for a walk or any kind of movement. But most of the studies just use walking because it's practical. Like that after dinner walk that you do with your family in the evenings when it is nice and not 25 degrees outside like we're talking about, there's some maybe there's some sort of innate biological drive to like event diabetes or something from it. I don't know.
But it turns out, so if the graphs on this stuff is so cool and I wish this is a video podcast, I didn't come prepared to show it, but the way I'm gonna talk with my hands for you guys, because you can see me, like the way the glucose curve after a meal looks, it goes up and up and up and up. And if you time that the walk after to begin about 15 to 20 minutes after the meal, the glucose should literally reverse it and starts going back down.
And that sort of sustained as long as you walk for. And some of the studies we did, we played around with anywhere from 15 to about 50 minutes, and that 50 minute walk in particular was an interesting one where we broke it up into 10 minute bouts, like go for a walk for 10 minutes and then hang on.
We had to just stand there and rest for three minutes just to kind of break it up because 50 minutes of walking for someone type 2 diabetes uninterrupted was kind of daunting But man that almost that really did a nice job of normalizing the glucose response and kept it from Reaching those really dangerous high levels of postprandial glucose And that's really important too because that postprandial glucose spike the magnitude of the spike that how high the glucose gets after meal is very very
What's the word? It's a significant insult, significant toxic dose to the cardiovascular system, to the vascular endothelial cells throughout the body. So that's a great thing to do, man. Just go for a walk after a meal. That's probably more than two minutes. But as long as you train right afterward, you're more or less fine. I think about it all the time. If you think about what a workout drink is oftentimes, it's protein and sugar.
Yeah. Yeah. Yeah. I mean, it's like you're potentially putting sugar in your body during workouts or right before workouts or potentially or after workouts like an intro, intro workout too. Like that's what I like for clients to do is if it's, especially if it's like a strength transition or you're broken up a little bit, drinking a, this is very different than the diabetes conversation, but like that's when you're taking in
carbohydrate while you're using your muscles. So you're actually never allowing the chance for like glycogen, well, even if you do get glycogen stores depleted, you're not getting a reduction in blood glucose, which is problematic for performance. But it's the same biology, absolutely. But like, yeah, in the case of an excess carbohydrate consumption from a big meal, from a birthday cake or whatever it is,
Yeah, you can mitigate that cardiovascular insult that is a massive glucose spike. Sustained biology. We're going to talk about it with shift gears and look at the performance side of things. We're trying to optimize carbohydrate availability for both the workout itself and also starting the repair process post-workout, stimulate muscle protein synthesis.
and all that good stuff. And usually you take that right along with like some whey protein, so that the carbohydrate that glucose is sort of co-delivered, co-transported, it facilitates also the delivery of those amino acids for muscle growth and repair. Yeah, man, it's all this muscle contraction combined with nutrient availability is a great thing, both for performance and for optimization of some of these health parameters too. So that's pretty cool stuff. Where can people find you, my man?
Yeah, I'm on Instagram at Dr. Nathan Jenkins.
Well, that's all one word. And that's pretty much where I hang out. I don't have a TikTok. I got a personal Facebook page, but I don't know. Yes, but that's the best place. I think that it's about the end, right? Post Travis Mash. Don't. Not yet. Not yet. All right. Oh, I'm going to get a new guy in charge. Oh, yeah. Yeah. We'll see you at the home here. OK, so it's machele.com. Read my articles at June. We're here. Well, if you're local, try North Carolina. Go see me rising to our sports.
There we go. Doug with C Larsen. Right on. My Instagram, Doug with C Larsen, Nathan. Appreciate you coming on the show, bro. Man, thanks for having me. Those are all fun. Yeah, we're going to do this again soon. I'm Anders Warner at Anders Warner and we are barbell shrug to barbell underscore shrug to make sure you get over to orateilab.com. You know what that is? That's the place that you could find out more about our signature program, orate inside rabbit health optimization, all of the lab testing, the performance analysis,
everything health optimization and performance optimization inside Rapid Health Optimism. That's a lot of optimizations going on. But hang out. This is what happens Travis when we have new things to talk about on the show. I'm not as like wrapping freestyle. RSA lab.com friends. We'll see you guys next week.
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