Episode 11 – Chris Kresser

In this episode we have a brilliant talk with world-leading functional medicine practitioner Chris Kresser about: - How he would approach functional medicine testing in the UK - The potential problems with strict paleo - The ups and downs of the gut microbiome - His new practitioner training course - His upcoming events in the UK (Oct 31st/Nov 1st) Find his practitioner training course at The Kresser Insitute: http://kresserinstitute.com/ Tickets for his UK events: https://re-findhealth.com/events/

In this episode we talk to Karl Seddon of Elixa probiotic, who has developed a new way of delivering large doses of bacteria to the gut. We talk about: - Why we’re just scratching the surface of what can be achieved with probiotics - Karl’s own experiments with diet, microbiome and cognitive performance - Why the evidence for manipulation of the microbiome isn’t as good as we might think Elixa probiotics: www.elixa-probiotic.com Karl’s work on Free the Animal: http://freetheanimal.com/2015/05/prebiotic-probiotic-mercenaries.html In the episode, I also mention the work of Grace Liu, who runs The Gut Institute: www.thegutinstitute.com Disclaimer: Podcasts do not replace advice from your own qualified medical practitioner who will be familiar with your own individual health concerns.

In Episode 8 of the Eat Better podcast, Chloe and I talk with Dr. Axel Sigurðsson of Doc’s Opinion (www.docsopinion.com) about cholesterol, diet, statins, and heart disease. We cover: -What useful information you can get from a basic cholesterol test -Why focusing on “good” and “bad” cholesterol doesn’t really predict heart disease -What dietary and lifestyle modifications you should make if you have heart disease -The pros and cons of taking statins Notes Early on we discuss the triglyceride:HDL ratio, which you can get by diving your triglyceride level by your HDL level. Both of these can be found on the basic cholesterol test from your GP. Using UK units (mmol/L), a ratio below 0.87 is considered ideal. Click HERE (http://www.docsopinion.com/2014/07/17/triglyceride-hdl-ratio/) for an article where Axel discusses those numbers. We also discuss the pitfalls of using LDL (aka “bad”) cholesterol as a marker of heart disease, even though this is what doctors often use to decide if somebody should be on a statin. Axel has written an article about this HERE (http://www.docsopinion.com/2013/12/15/10-pitfalls-of-using-ldl-cholesterol-to-assess-risk/). Later on we discuss ways to reduce heart disease risk through diet and lifestyle. Because of the need to regulate insulin to minimise heart disease risk, Axel recommends: -A diet rich in fresh vegetables and fish -A diet low in (processed) carbohydrates -Focusing on stress modification We also discuss some of the pitfalls of statins. The evidence behind using them to prevent heart attacks (primary prevention) is pretty thin, and the downsides probably outweigh any potential benefits. HERE (http://www.ncbi.nlm.nih.gov/pubmed/25655639) is a fascinating recent paper which details why statins may (this is largely still theoretical) actually increase the risk of heart disease by interfering with mitochondrial function and vitamin K2 metabolism. There is also increasing evidence to suggest that, particularly as age increases, higher cholesterol levels reduce overall mortality, and are particularly important for things like brain function and reducing dementia risk. The Norwegian HUNT 2 study that I mention can be found HERE (http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3303886/). Though this is just an observational study, they found no increase in risk of death or heart disease with increasing cholesterol levels, and in women especially, those with the highest cholesterol had the lowest risk of death. Head to www.drragnar.com for more information. Disclaimer: Podcasts do not replace medical advice from your own doctor, and any lifestyle or medication changes should be discussed with them.

In episode 7 of the Eat Better Podcast, Chloe and I discuss fish: • Why is fish an important part of the diet? • Where should you get your fish from? • How much should you worry about dioxins and mercury? • What about fish oil supplements? Notes One part of the discussion got lost in the edit: Many trials have shown that adding DHA (and EPA) to the diet (as krill oil, cod liver oil, or fish oil) can both increase HDL and reduce triglycerides. This lowers the Triglyceride/HDL ratio, which is an important potential marker of future heart disease. Fish oil supplements At the end we touch upon fish oil supplements. As with everything, it is best to get your DHA and EPA from whole foods. The benefits of real seafood have consistently been shown to be better than supplementing. Two or three portions of fatty fish per week should be plenty for most people, as we mention in the podcast. If you’re not a regular fish eater or want to boost your DHA intake for various reasons, I personally think that minimally-processed cod liver oil is best. Get the best you can afford, and shop around, as analyses have shown that fish oil supplements are often oxidised (damaged), and don’t get the DHA/EPA you pay for (http://www.ncbi.nlm.nih.gov/pubmed/25604397). Fermented cod liver oil is very popular at the moment, but that process potentially increases the likelihood that the DHA will no longer be in the ideal sn-2 position I mention. It may also make the fats more likely to be rancid and oxidised. However, the Weston A. Price foundation have released an analysis of Green Pasture fermented cod liver oil, which shows no evidence of rancid fats (http://www.westonaprice.org/uncategorized/concerns-about-cod-liver-oil/). On the other side of the argument, here is a release from Nordic Naturals describing their take on fermented fish oils (http://www.bolderbrokers.com/uploads/4/1/3/0/41303351/nn_fermentedclo-2.15.pdf). I won’t weigh in on the debate, but I like my DHA as minimally processed as possible. Therefore I take something like Icelandic Lysi, from a bottle in the fridge (http://www.lysi.com/consumer-products/cod-liver-oil/liquid-cod-liver-oil). No pills or extra manufacturing steps. Finally, there is also some debate about vitamin D to A ratios in cod liver oils, with a risk of relatively large doses of vitamin A, which can inhibit the proper function of vitamin D. Norwegian and Icelandic bottled cod liver oils usually contain 1,000-1,200IU of vitamin D (400-600% of recommended daily allowance) and 2,000-2,500IU of vitamin A (around 100% of recommended daily allowance) per tablespoon, in a 1:2 ratio. This is well within appropriate intakes for most people. However, it is worth checking your own brand. If you are supplementing with any product that includes vitamin D or A (like cod liver oil), it is important to make sure you are getting enough vitamin K2, as the three play important roles together. Get more K2 from: • Grass-fed full-fat dairy (http://drragnar.weebly.com/podcast/eat-better-podcast-episode-1) • Eggs, particularly free-range eggs (and probably fish eggs) • Goose or duck liver • Natto (http://en.wikipedia.org/wiki/Natt%C5%8D)

In episode 6 of the Eat Better podcast, Owen Raybould of Ancestral Health and Nutrition talks about food and mood. In response to previous requests to improve sound quality, we upgraded our microphone system, which completely failed. We apologise sincerely, and will fix this for next time. Hopefully this won’t stop you listening to Owen talking about his work with mental health charities, as well as some tips on how to eat better in the context of depressive illnesses. For some downloads from Owen, go to the website: http://drragnar.weebly.com/podcast Owen and I discuss a review paper on the interaction between genetic mutations that may improve short-term defence against infections, but increase the risk of depressive symptoms in the context of chronic stress. Find it here: http://www.nature.com/mp/journal/v18/n1/full/mp20122a.html Later on I discuss some interesting primate research that highlights the interaction between hyper-palatable foods and stress, and their effect on hormone function, which can later increase the risk of mood problems. Find this paper here: http://www.ncbi.nlm.nih.gov/pubmed/22377541 For more information on Owen’s crowdfunding initiative, go here: http://www.crowdfunder.co.uk/nutrition-for-health Find Owen on Twitter: https://twitter.com/Owen_333 Ancestral Health and Nutrition on Facebook: https://www.facebook.com/groups/ancestralhealthandnutrition/ Owen also discusses the work of Julia Ross, and recommends this talk. She begins to talk about sugar and addiction around minute 28: https://www.youtube.com/watch?v=5LLsVBqrq8c Disclaimer: Podcasts do not replace advice from your own qualified medical practitioner who will be familiar with your own individual health concerns.

Dr. Tommy Wood (www.drragnar.com) and Chloe Archard (www.paleo-britain.co.uk) look at the origins of the Paleo diet, why that’s different from what people on the paleo diet are eating nowadays, and whether that matters. Notes: This discussion revolves around some parts of an article on my blog, which can be found here: http://drragnar.weebly.com/blog/going-back-to-go-forwards It’s interesting to note that the original diet as described by Eaton and Konner differed from what we talk about today: - It was low in saturated fat - It was low in sodium - It was “alkaline” Most people nowadays agree that those are not necessarily important aspects of a healthful diet. However, these are the recommendations largely followed by the scientific trials of the paleo diet that we have seen to date. Despite this, we now know that saturated fat is an important precursor to normal hormonal function, which is underlined by the fact that when we restrict fat in the diet, the body makes extra saturated fat to compensate. Too much salt restriction is also implicated in worse levels of heart disease. The original paleo diet was also often high in carbohydrate, and included pulses. Importantly, I think this shows two things: 1.People are still seeing great results from paleo despite having moved away from the original paleo descriptions of Eaton and Konner, and later Loren Cordain. 2.We have the ability to thrive on a huge spectrum of varied diets, some of which include things traditionally excluded on the modern paleo diet. Later on, we mention an article I wrote about the Horizon Sugar vs Fat programme, which you can find here: http://drragnar.weebly.com/blog/sugar-vs-fat We also discuss a lecture given by Dr. Georgia Ede at the Ancestral Health Symposium in 2012 about the lack of evidence of the necessity of vegetables in the diet: https://www.youtube.com/watch?v=YdRBFiBWQZQ Disclaimer: Podcasts do not replace advice from your own qualified medical practitioner who will be familiar with your own individual health concerns.

Dr. Tommy Wood (www.drragnar.com) and Chloe Archard (www.paleo-britain.co.uk) are joined by Chris Kelly f(www.nourishbalancethrive.com). Chris is a Functional Diagnostic Nutrition practitioner, and professional mountain biker. In the episode, we cover: How he wrecked and fixed his own gut, and how he helps others fix theirs. Why a nutrient-dense diet is the starting point for those struggling with gut issues. How to mitigate the effects that extreme endurance exercise can have on the gut. Why sometimes it's better to get some basic tests rather than hit a wall and keep struggling. Why blue-blockers aren't the answer to all your sleep problems. Below are a list of supplements that Chris uses personally, which he feels most people (particularly if recovering from a gut health problem) could benefit from: Thorne FX AM/PM multivitamin complex Primal Defense Ultra 90 probiotic, alternated with Prescript-Assist and Equilibrium Nordic Naturals Arctic Omega fish oil Alpha Lipoid Acid ("occasionally, 'cos it's pricey") Disclaimer: Podcasts do not replace advice from your own qualified medical practitioner who will be familiar with your own individual health concerns.

Dr. Tommy Wood (www.drragnar.com) is joined by Chet Morjaria (www.strengtheducation.com) to talk about how to approach strength training for better health. See show notes on www.drragnar.com for more information on Chet's work and how to contact him. Disclaimer: Podcasts do not replace advice from your own qualified medical practitioner who will be familiar with your own individual health concerns, and can help guide you when starting to exercise for better health.

Dr. Tommy Wood (www.drragnar.com) and Chloe Archard (www.paleo-britain.co.uk) cover some regular and popular questions about ketogenic diets, and their place in health and disease. Disclaimer: Podcasts do not replace advice from your own qualified medical practitioner who will be familiar with your own individual health concerns.

Dr. Tommy Wood (www.drragnar.com) and Chloe Archard (www.paleo-britain.co.uk) cover some regular and popular questions about dairy, and their place in health and disease. Disclaimer: Podcasts do not replace advice from your own qualified medical practitioner who will be familiar with your own individual health concerns.