Episode #165: Skinny People Just Don’t Get It

In this podcast, skinny people just don't get it. When to use magnesium oil how much carbohydrate do you absorb in your mouth? A frank discussion on bowel movements, cramps from muscle fatigue, how to train fat legs and cankles, what to eat on a rest day, how to use chia seeds, keeping joints healthy during endurance training and racing to prepare for a race versus just training to prepare for a race Foreign. Hey folks, Ben Greenfield here and I gotta tell you I am pretty excited. In just four days I shove out for Kona Hawaii, where I will be going to race the Ironman World Championships down in the hot lava fields of the Big Island. And that actually has a little bit of a relation to this podcast because it means that next week there will be no podcast from BenGreenfieldFitness.com now what there will be are some pretty cool updates every Single day from BenGreenfieldFitness.com I'm going to be doing a project for the week of Ironman Hawaii called the Kona Diaries. And each day what I will be doing are video episodes that kind of walk you through what goes in to racing a race like the Ironman World Championships, what I do when I get up in the morning and prepare for the race, what type of things I'm eating, what type of things involve signing up for registering, getting your transition bags ready, just all the little tips and tricks that I do in the week leading up to an Ironman event. You'll get to see me packing at my house, what type of foods I travel with, what type of things I bring when I'm traveling to big triathletes. And whether you're a triathlete or you're just somebody who's trying to get fit and stay healthy, I guarantee that over the next week@BenGreenfieldFitness.com starting on October 2nd, you're going to be able to pick up a ton of video tips. And related to that is this week's Twitter hashtag game. The way that we're doing the Twitter hashtag event this week is that I will answer in those videos any questions that you send through to me via Twitter. You just need to ask your question with the hashtag conaquestion konaquestion and be sure to address that tweet to Engreenfield. And if you do so, I will answer any questions you have about healthy travel tips, racing triathlons and traveling to race triathlons, things to do before an Ironman, et cetera. So I will put in the Show Notes for this podcast podcast number 165 exactly how you need to phrase that tweet for me to be able to answer it in the Kona Diary videos that I will be doing for the entire week next week from BenGreenfieldFitness.com that being said, we've got a few quick special announcements and then we'll move into this week's Listener Q and A, followed by an interview with a bariatric surgeon who has just written a new book entitled Skinny People Just Don't Get It. We're going to be talking about appetite cravings, weight gain, and much more.

Special Announcements.

So I have a quick technical announcement about the free Ben Greenfield Fitness Android app. There have been some updates made to that app. For those of you who are having trouble with the podcast feeds appearing on your Android app, you will probably need to delete the app from your Android and then reinstall it from the store. There is a link to the free Ben Greenfield Fitness Android app over@BenGreenfieldFitness.com as well as a link to the free iPhone app. And my basic goal in designing those apps was to give you a central place on your phone where you could have the podcast automatically delivered. All the new posts, all the new videos handy Dandy Ask Ben Question button on the phone app, and pretty much anything you need to access the information that I'm putting out for you right there in the actual app itself. So there is a link to the app over@BenGreenfieldFitness.com but you may need to up your Android app. The Podcast Awards are still taking nominations, so if you like this podcast, please head over to podcastawards.com and nominate the Ben Greenfield Fitness show in the Health and Fitness category. And for the URL that it asks you for, you can just put BenGreenfieldFitness.com and then finally remember that if you haven't yet signed up for the triathlon in Jamaica, my wife and I are going down there. A few other athletes are going to be coming along with us. We're going to be partying, racing and having lots of fun down in Jamaica. There is a 50% discount code that you can use when you register over@triathlonjamaica.com and I will put that discount code in the show notes for this episode. Episode number 165 over@BenGreenfieldFitness.com it's coming up super soon. It's in about a month and a half, but still time to grab a ticket. Super cheap flights out of Miami, Philadelphia and New York and head down there. All right, folks, let's go ahead and move into this week's Listener Q and.

A.

Listener Q and A.

Hey, Ben, this is Craig from Birmingham. And first off, congratulations on your recent win. That was quite a performance in that almost back to back half. Ironman's there. Secondly, I am really a believer in magnesium for recovery. Now, I'm doing, as you mentioned, 10 sprays of magnesium on each on your arms and your legs. My question is, I've ordered the compression gear you Talked about from 110% and kind of the order that you do those, because the magnesium says spray it, leave it on for 20 minutes and rinse it off. And then the compression gear, I'm thinking you want to use that right away and just wondered what your routine was about that. Thanks, Ben. I appreciate all you do.

Okay, cool. Well, for those of you scratching your head about this, blitz 110% and topical magnesium and this and that. Here's the skinny on what's going on with this. I use topical magnesium, which is like a magnesium that you spray onto your skin. And the reason I do that is because magnesium competes for calcium on a receptor side of your muscles. And calcium leakage is what actually causes a lot of muscle soreness and can also cause muscle cramping and muscle tightness. And when you use this topical magnesium before a workout, it can decrease your propensity to cramp or to experience muscular fatigue. And when you use it after, it can decrease post workout soreness and also improve a lot of the blood flow to the muscles. So I did an entire podcast interview on topical magnesium and its benefits with Dr. Mark Serkis. And if you went to BenGreenfieldFitness.com magnesium you could listen to that. But basically you're supposed to spray this magnesium on, as Craig said, after you've showered and kind of dried the skin. But then the instructions are to rinse it about 10 minutes later. The only reason that the bottle tells you to rinse is because the magnesium salts can kind of cake on the surface of your skin. And it makes almost this kind of like white, cakey, dust like appearance to the surface of your skin. But it's only for aesthetic reasons. There's no other reason that you would need to actually wipe the magnesium off. So that being said, the way that I do things is after I've finished a workout and showered and dried off the skin, I spray anywhere from about 10 to 20 sprays of this topical magnesium on my arms and my legs. And I don't worry about wiping it off or anything. I rub it all in. And then if I'm going to wear these compression garments that Craig talked about, this blitz 110% compression garment, I simply put that on over the skin after I rub the magnesium. So I'll pull my compression shorts on. The reason I use the ones that Craig mentioned is because when you buy this compression gear, they also send you these little freezer packs that are basically like frozen ice packs that you whip out of your freezer. And there's special compartments inside the shorts that you put that ice into. So if you're sore after a workout and you don't want to say, take an ice bath, you just throw these little packs in and it cools down the muscle after your workout. And you leave Those in for 15, 20 minutes and then put them back into the freezer. I actually did a video about the compression garments and why I use the ones that I do. And you can find that if you go to BenGreenfieldFitness.com and do a search for compression shorts. But those are the ones I use and that's how I actually time them with the magnesium, spray the magnesium on, rub it in, and then pull the shorts on over that. And that's perfect recovery, vastly reducing your post workout soreness and stiffness and kind of setting you up if you want to get a good workout the next day. This isn't just stuff that like elite athletes or pro athletes do. Pretty much anybody that you know, say, runs one day and wants to have a good workout the next day, do this and you'll bounce back a lot more quickly. That kind of one, two combo of magnesium and compression shorts with the ice packs put into them. So great question. And if you have more questions or comments or feedback about that question, you can leave it on the show notes for this episode, episode number 165. BenGreenfieldFitness.com we have a question now from Jeff.

Hey Ben. This is Jeff in Tampa. I have a question for the podcast. Is there any physiological difference in having a gel melt and kind of absorb in your mouth rather than swallowing it? And is that a good option for people that have some gastric upset with gels and shot blocks and the like? Thanks a lot, Ben. Appreciate you and have a great day.

Bye. Well, for any of you that took high school biology or college physiology or anything of that nature, you know that carbohydrate digestion begins in the mouth. You can't digest fats and proteins in your mouth. But in your mouth, you produce an enzyme called salivary amylase, and it begins to break down sugars as soon as they enter the mouth. That's why you can put, like, a saltine cracker in your mouth, hold it in there, and within about one to two minutes, you will actually feel it begin to break down and begin to taste sugar in your mouth as all of those sugars or those starches from the saltine cracker get broken down into simple sugars and begin to absorb. Now, the question is, if you were to take, like, a sports gel and hold that in your mouth, would you actually be able to absorb enough sugar to be able to supply you with, with some extra energy? Well, you know, at first thought, it seems like this might be a good idea. After all, you look at a lot of, like, liquids or soft pills, and many of them can be delivered more quickly via a sublingual route, meaning that you put them under your tongue and they get absorbed because the vitamins actually pass through what are called the mucus membranes that are underneath your tongue. So underneath your tongue and in your entire mouth area, you have all these tiny little blood vessels called capillaries. And then you have a mucous membrane that covers those. And like a vitamin going under your tongue, passes through that mucous membrane directly into your capillaries, and then it gets transported into your bloodstream via the larger blood vessels. It completely bypasses digestion and you get a little bit better absorption. For example, one version of vitamin D, like a vitamin D spray, is a lot better than a vitamin D pill, because the vitamin D spray gets absorbed sublingually, doesn't have to go into digestion, and you also get. You get better absorption because it's not having to be digested. Now, the thing is, vitamins are very, very low in calories. You're not trying to absorb sugars when you eat a vitamin. You're trying to absorb the actual vitamins, which are a lot easier to absorb underneath the tongue than, like, sugar molecules. Now, the deal is they do make special oral glucose packs for diabetics, okay? So when diabetics get hypoglycemic, they have these packs that they can put underneath the diabetic's tongue, which is especially useful if they're so hypoglycemic that they can't chew and swallow and focus on that type of thing. And you get an increase in blood sugar from this absorption. And as a matter of fact, they have done studies on glucose absorption in human oral cavities. And you do get enough absorption to be able to bring the blood sugar levels back up if the actual substance that's being put underneath your tongue or in your mouth really is glucose. So the actual studies that have been done were done specifically in a type of glucose called D glucose. And D glucose is a simple sugar, and you're going to find it as an ingredient in some gels. Although most gels these days are kind of a combination of a complex sugar and a simple sugar, meaning that they'll combine something like maltodextrin, a complex sugar, with fructose, a simple sugar. But either way, maltodextrin is not too difficult for the salivary amylase in your mouth to actually break down, and so you can get absorption of the sugars in your mouth. The actual rate of absorption in terms of calorie rate of absorption is not something that I could ascertain through any studies that have been done on these diabetics, but it could technically be up to 30 calories per minute that you could absorb. So if you were to put a gel into your mouth, most gels are about 90 calories, and you were to, like, hold it underneath your tongue for about three minutes, and I haven't personally tried this yet, then you could be looking at most of the absorption from the sugars in that gel. Now, all of the water and the filler and any amino acids and any vitamins and electrolytes and some of the other things that they put into that gel, some of that might not be totally absorbed. So you're still going to have food stuff in your mouth. It's not like the gel is going to disappear from your mouth. But within three minutes, you should be able to bump up your blood sugar levels a little bit by holding that gel in your mouth without having to worry too much about the GI distress that might come from swallowing that gel all at once. And then you can swallow what's left in your mouth and move on. No studies have been done that I'm aware of that have involved actually using a gel or a sugar inside the mouth for absorption. Now, some studies have been done on putting a sweet solution in the mouth and seeing if it improves performance to see if the taste of something sweet will help you to go harder or go faster. And that's actually been shown to help with performance, specifically in cyclists. The same study that they did in runners didn't help quite as much. But regardless, you can put something sweet in your mouth and it will help you perform, studies have shown. But I couldn't find Any sports studies that actually show how long you can actually stave off like hypoglycemia or complete loss of carbohydrate by not swallowing carbohydrates but instead just putting them in your mouth to be absorbed. However, the idea itself has merit. It could work. You could get up to 30 calories per minute from your mouth. So it's a great question, Jeff, and it's worth a try. Alright, here's a question from Tony, a question that is not breached too often on this show, but it is a question about poop. And Tony says, I have a question about poop. My poop used to always sink. I used to follow a diet pretty close to vegetarian with some salmon and very rarely I would have red meat. I have changed my diet and now follow your low carbohydrate guide for triathletes. I have added more omega 3 fats and animal fats to my diet. My poop used to sink to the bottom. Some still do. But now occasionally there are floaters. And the floaters are more often than before I switch to eating more fat and less carbs. Is this a problem? Well, there are certainly entire medical textbooks that are devoted to the topic of bowel movements and the contents of bowel movements. And not just floating versus sinking, but also, you know, whether it's whole, whether it's in pieces, what type of color it is, etc. But let me kind of give you, give you the basic overview on your stool, answer your question, and then go into a couple other important things to think about. There's kind of two different opinions when it comes to stool. One camp says, one poop camp says that stools should float because buoyancy in your stool is a good sign that your body has absorbed a lot of the minerals in your food and that all of these minerals and vitamins and nutrients aren't in your stool but have instead been absorbed by your body. And then the other opinion says that if you're eating enough bulk, enough fiber, enough vegetables in your diet, then your stool should sink. Now, what has likely happened in your case is that you've increased the fat in your diet, you've slightly decreased your vegetable intake, and so you've kind of got a double whammy here against sinkers. Not only is your stool going to be more likely to float because of slightly increased fatty acid content, which can cause stool to float, but it's also more likely to float because there's less bulk and fiber ending up in your stool. This is not indicative of Any type of serious health issue or anything like that. It's just a change in your macronutrient intake, your percentage of carbohydrates, fats and proteins, the amount of vegetables that you've been eating, that has affected the way that your stool actually acts once it hits water. So nothing really to worry about. There are certainly things that you should worry about if you're looking at your stool, and it shouldn't be whether it's floating or sinking. For example, if you have a very high processed sugar, processed carbohydrate diet, you're eating too many starches. You could get almost like a little bit of a light green appearance to your stool. That would be something that should concern you a little bit. If you have a problem with your gallbladder or a problem with your liver, meaning that you're not producing enough bile to emulsify fats, then you may get kind of a really pale or clay colored stool. And that would be something to worry about too. And you may want to get your gallbladder or your liver checked up. If you have an overgrowth of bacteria in your GI tract, if you have like some type of inflammation in your GI tract, if you've got a lot of food allergies going on, typically you're going to have a lot of mucus that's produced and your stool actually looks like it's covered in mucus. And sometimes it can look a little bit bloody. That would be an issue where you may need a complete change up in your diet. And it's very easy to test for this stuff as well. For example, you can get a GI panel. I'll actually put a GI panel in the link underneath your question in the show notes. But you can find out if you have parasites, yeast, fungus, food allergies, food intolerances, whole range of things by a simple. It's almost like a poop in an envelope. Test and send it in and you get results within a couple weeks. Really really comprehensive, telling you everything that's going on inside your digestive tract and with your body. If you tend to be really constipated and your stool is almost really, really thin, really ribbon like a lot of times that can mean that you're not getting enough fiber in your diet. There's a little bit of a constipation issue going on. In a case like that, you can do something as simple as add a fiber pill and a glass of water when you get up in the morning. I use one called Capra Cleanse occasionally, especially like the Day after I've done a triathlon. Triathlon. And I've had a lot of sugar and gels during a triathlon. I tend to be constipated. I've found that when I pop 3, what I use is one called Capra Cleanse. I pop three of those in the morning with a big glass of water or in the evening after I've done a triathlon and really helps clean out my system and get rid of a lot of that sugar based constipation that I have after doing a race. Really, really loose, watery stool. If you're looking down at it and it's got undigested foodstuffs in it, like pieces of corn and stuff like that, again, you're looking at possible dietary intolerances, food allergies, malabsorption issues. Maybe you don't have enough probiotics or digestive enzymes in your diet and those would be things to add in. So that's certainly something to look for as well. If you get really, really sulfurous, really bad smelling bowel movements, typically that's also an imbalance of your int bacteria. I actually had that issue until I started doing a lot of probiotics, a lot of kombucha, a lot of yogurts. I kind of rebuilt my intestinal flora and used the fan a lot less in the bathroom now. So, you know, we've really just scratched the surface of some of the characteristics of stool that you want to think about. But ultimately you don't have to worry too much about like floaters versus sinkers, unless the floaters have a lot of like greasy film on them and they're really mucus covered. And in that case it could indicate that there are some things missing in your diet from a digestive enzyme and a probiotic standpoint and possibly some food allergies or food intolerances going on there. So great question. And I think it's something that people should be more aware of in terms of checking out the bowel movements and seeing what goes on. I'm certainly no expert in that topic area, but there are a lot of resources out there when it comes to like medical textbooks on bowel movements. And if you're concerned about something, you could certainly get that GI panel that I talked about. There's also a book. I'll put a link to it. There's a book you can get off Amazon. It's called what Is yous Poo Telling you? And just goes into analyzing your poo. Might be a good book to keep by the toilet and Read over the next week. Alright. Andrew says if muscle fatigue is the cause of most cramps, then the answer would be to train to alleviate this. But how do you go about that for Ironman training? Would that be, for example, going out for six hour bike rides at race pace followed by a long run? Or put differently, how best to accomplish this type of training for long distance races? What Andrew is referring to here in his question is the fact that there's not a ton of evidence that electrolyte loss during exercise is what causes cramps. Certainly if you go into a long exercise session or race totally sodium depleted on a low, low sodium diet for a long period of time, you haven't been salting your food, you haven't been taking in any minerals, you can certainly have an electrolyte related cramp. But more often than not, the cause of cramps is more likely due to the fact that you're asking your muscles to do something that you haven't asked them to do before. Either you're asking them to contract and produce a much larger contraction than they're used to, or you're asking them to produce those contractions over and over again for a much, much longer period of time than they're used to doing now. Andrew's question is interesting because it goes into an area that hasn't been studied much in sports science and that is if cramps are related to muscle fatigue, can you completely alleviate muscle cramps by simply doing training that exactly replicates what your body is going to experience during a race? And obviously, probably the reason that studies like that haven't been done is because you'd have to go out and have someone do, for example, a 12 hour training session to prepare them for something like an Ironman event. And then you'd have to replicate that among a large number of subjects and then study whether or not those subjects actually cramped during Ironman compared to a control group that didn't do those very, very long training sessions? So it would be a tough study to pull off and one that doesn't really exist. But I can tell you from personal experience and from looking at the training protocols of a lot of successful athletes that there is no need to do 100% of the total volume of what you're going to do in a race, whether it be a marathon or a triathlon or whatever else during your actual training. So to train your body to not cramp from muscle fatigue during Ironman, you don't have to go out and on a Saturday morning do a 4K swim and 112 mile bike and a 26.2 mile run. Typically, you can get away with doing about 60 to 70% of that volume in a few kind of longer training sessions leading up to the race and be just fine. I would recommend that you do your training sessions on the type of terrain you're going to experience in the actual race. And what I mean by that is if you're going to be running on concrete or asphalt for an entire marathon during, say like an Ironman triathlon, you shouldn't go out and do all your long runs on trails and dirt and gravel and grass. The same can be said for swimming. If you're going to be experiencing a 4K open water swim in choppy water, you shouldn't be doing all of your long swims by churning out 80 laps in your relatively flat and calm pool. So trying to replicate race environment and terrain is going to be very important as well in terms of staving off cramps related to muscle fatigue. But I would suggest that you throw in a few longer training sessions that are at least 60 to 70% of the volume that you're going to experience during an Ironman triathlon. You try to train on the surface you're going to be on and you should be just fine. I know that from my own training as well as from the athletes that I've actually coached who have successfully done Ironman without cramping. Now, as far as electrolytes go, you know, we're just at the cusp of not using electrolytes during Ironman. I personally have begun recommending to my athletes that they consider not using electrolytes during their races and long training sessions. And I personally will not be using electrolytes in the race like Ironman Hawaii and have not been using electrolytes since. We kind of breached that topic with the interview with Dr. Tim Noakes right here on this podcast. And if you're curious and want to know more about this whole issue with not using electrolytes in training, go to a search for noakes@bengreenfieldfitness.com and you can go back and listen to that electrolyte study. That's with Tim Noakes. N O A K E s question from Mark, who says I lost about 85 pounds in the course of two years or so. Almost two years ago I decided to get an abdominoplasty to remove a great deal of loose skin from my stomach. The results were great and now I feel very confident in the appearance of my upper body, but my lower Body is a different story. I still have loose skin on my butt and thighs and stubborn fat deposits that seem to stick to this loose skin no matter what I do. I also have thick thighs and cankles that run in my family. I know I can't spot train those areas, but my question is, should I avoid lower body weight training to avoid filling out my legs even more? Well, my suggestion here is to actually not do a lot of what would be referred to as anabolic training for your lower body. I wouldn't be doing a lot of weight training and I wouldn't be doing a lot of like high intensity interval training or steep hills or things like that for your legs. And the reason being is that this pear type body shape that tends to have thick thighs and cankles simply responds by growing thicker in those areas with that type of training. And I instead recommend what would be considered catabolic style training for those areas of your body. And that would be primarily running. If you have bad knees, you can do cycling, but you'd want to do cycling at a fairly high revolution per minute or a high spinning cadence and a low force. So it would work out even better if you were to do those type of sessions in a fasted state so you can get even just a little bit more catabolic as you do them. So for example, you could alternate every other day between running one morning and cycling one morning, 30 to 60 minutes steady state aerobic and doing that on an empty stomach. And that would be the type of training that you'd want to do for, for say, cankles or fat deposits in the lower legs, big thighs, things of that nature. I'm actually in the process now of writing an entire book on this subject because it really can be confusing who's supposed to do what, because if you take that same style of training and you have someone who has thin legs do it, they're going to waste away to nothing and they're going to get sick and depress their immune system and have a really nasty hormonal response to that style of training. So it really does depend on your body type. But the way that you describe your body, your lower legs are going to respond best to that style of kind of catabolic training that's going to break down fat. It's going to break down a little bit of muscle too, but ultimately it will result in a leaner appearance in the lower body. So that would be my suggestion for you and I will keep all you podcast listeners posted as that book comes closer to completion. Now, I would also recommend you go listen to a podcast I did on how to get rid of loose skin after weight loss. That was Get Fit Guy podcast and I will put a link to that in the show notes. This is episode number 165 over@BenGreenfieldFitness.com just go through the show notes there and I'll put a link to that episode on how to get rid of loose skin after weight loss. And that should help you a little bit more with some of the loose skin that you have. Kayoko asks, I take one rest day every week, though. You introduce good information about food. Do you have any special meal selections during rest and recovery days? Well, my basic suggestion for this is based off of what's going on hormonally when you're resting and you're recovering. Because when you're not exercising, any type of blood sugar fluctuations are more damaging to your body. Not only can high calorie intake and large increases in blood sugar and subsequent large increases in insulin cause anything from cholesterol oxidation to nerve and blood vessel damage to fat gain, but it can kind of lower your energy levels and it can reduce your fat burning efficiency. So on rest and recovery days, I actually recommend that you switch to a higher fat, moderated protein, low, very low carbohydrate type of diet and you not worry about, say, filling up the gas tank for the next day's workout. It is a better idea to fill up the gas tank for that next day's workout just two or three hours before you do that workout on the next day, rather than preparing for it the day before. Now, the only exception to that would be if you're getting ready for, say like a big marathon or a triathlon, then you kind of throw all these health considerations to the curbside and instead focus on filling up and topping off your body's energy stores to get ready for the next day's event. So there definitely is a trade off there when it comes to health versus preparing for optimal performance. But the way that I recommend that you do it is you moderate your diet. You choose higher fat, moderate protein, lower carbohydrate type of foods on your rest and recovery days, and then the next day that you're actually working out, you take any type of depletion that happened on your rest and recovery day and you fill back up your energy stores by doing something like, you know, having a couple sweet potatoes or yams two or three hours before your first workout of the day. The day after a lower calorie Rest and recovery day. So lower calorie rest and recovery day. You know, let's say you usually have carbohydrates for breakfast. You'd instead switch to having a couple eggs with some spinach for breakfast on a rest and recovery day. And let's say you usually have maybe some, some fruit or serving of wild rice with lunch on a normal workout day. On your rest and recovery day, you would not do that. You would instead maybe have a bed of greens with some avocado or a cut of fish or some olives for dinner. You would forego your carbohydrate portion when you're on a rest and recovery day and instead do something like a nice serving of meat with big helpings of roasted vegetables or a side salad. And you really kind of leave most of your snacking to the wayside as well on that rest and recovery day. And that would be how you kind of set that up compared to a full on workout day. So hopefully that gives you some direction. Kyoko Jan says can you discuss when to use chia seeds before an event? I'm a little bit confused about how to get the maximum benefit out of them. Well, chia seeds, or chia seeds as some people call them, have been quite popular of late among people who are into health food. And it wasn't just the book that came out that was very popular, Born to Run, that talked about the long distance runners in that book, actually using kind of a gel made out of chia seeds to fuel their long distance training sessions. But there's a lot of legends about chia seeds in terms of being used for ultra runners, for warriors, and for people who need to be sustained for long periods of time. And that's because chia seeds have some really cool properties to them that allow them to give you like a slow release of energy. They've got a lot of fatty acids in them, they've got some amino acids in them, not a ton of sugars. So it's a real, real stabilized type of energy source. And they tend to work really well when you mix them and use them for energy. So they're not something that you would necessarily fuel up with before you head out and work out. They're something that you could use as you're out there exercising. One really popular drink that you can use and just like take in flasks is you can mix in about a 9 to 1 ratio water to seeds, take about a tablespoon of dried chia seeds, and add about 9 to 10 ounces of water and you let the chia seeds sit in the water for about five minutes and then you stir them or shake them and then let them sit again. And the more it sits and then you stir and shake, the more gel like the consistency of the seeds mixed with the water is going to become. Now you can let that get as thick as you want to, but eventually you'll transfer that into a flask or water bottle or something that you can take with you out there to exercise. And 1 tablespoon of chia seeds is going to give you about 60 calories or so. So if you were going to be going for like, you know, 200 calories an hour, you'd be up around, you know, three to four tablespoons of this chia seeds and you know, closer up to about like, you'd have anywhere in the range of like 30 to 40 ounces of water mixed with that. So this would be like, like for a long training session. If you want to add some sweetener to that, you add a little bit of lemon juice or lime juice, like a few teaspoons of lemon juice or lime juice. If you want to sweeten it, add some stevia, add some honey or add some agave. Basically just a little bit of something to give it, give it kind of a sweet flavor to make it more palatable, not necessarily to add calories. And that's how you would use the chia. As you're out exercising, you can use like a fuel belt that has these little tiny flasks that you can drink it out of. You can just use like a full on water bottle. But that's basically how you'd use the chia seeds. Of course, you can sprinkle them on salads, use them in recipes, use them pretty much the same way that you would use any recipe that contains flax seeds. And you can also put them into smoothies. But as far as using them during exercise, that's how you do it. You make them into a gel by mixing them with water and you head out with your chia seeds. So hopefully that kind of clears that up for you. But that's the basic way that you would use these things during an exercise session. Kyle says, my passion is ultra running, yet I would also like to be able to walk when I'm 50 years old and hopefully still be running, including supplements, types of training, etc. What are your best tips for keeping joints healthy and strong to ensure that we continue doing this endurance sport of ours into the future? Well, man, this is a good question. You know, we've broached this topic before when we've talked about, you know, you go back and you look at a lot of like, say like pro triathlete, pro triathletes, ex pro triathletes. And, you know, a lot of them do limp. You know, you take like Scott Tinley, he's had a hip replacement. He was one of the Ironman champions back in the day. A lot of them are, you know, they look kind of, kind of beaten up. And when you're revving up your car and driving it at high speeds on the highway, it is going to wear down a lot faster. But there are certainly lifestyle and dietary modifications that you can make to ensure that your body lasts for as long a period of time, even when you're beating it up, doing things that it probably wasn't meant to do in the first place, like ultra running. Let's face it, it's not in our natural state to get up in the morning and run 50 miles. We're kind of fighting against nature when we do that. But if it's fun and you enjoy it and it motivates you and challenges you, then more power to you. You don't want to live life in a bubble, you want to enjoy life. So a few things that I would do and that I do personally to make sure that my body is going to be able to do what I do for as long as possible is, first of all, I cross train. And that's what I actually do. Really like about triathlon is you hit different parts of the body on different days. So you try not to run on consecutive days, and instead, you know, the day after you run, maybe you bike and swim and then the next day you run and you lift, and the next day you bike and you swim. The next day you run and you lift. So you're hitting different body parts by doing lots of different cross training methods, hitting your muscles at different angles, hitting your joints at different angles, and never getting chronic repetitive motion on just one joint. I mean, you want to wear down a knee as quickly as possible. You get on a treadmill and you run without changing direction, without changing movement for as long a period of time as possible, day after day. And that's a good way to wear down your knees really quickly. You know, one nice thing about ultra running is you're on trails a lot of the time. You're changing direction, moving side to side and so you're hitting your joints at different angles. But I would certainly recommend that you also introduce cross training into that. Doing things like cycling and elliptical. And you know, the ultra runners that I coach will tell you that they don't run a ton. They have kind of this big training session, you know, one day a week. But other than that, it's some short, intense runs and then cross training. So cross train. The next thing that I would recommend is that you strengthen your core and your hip and your glutes, which are going to help you to absorb a lot of the impact that your knees, your ankles might be taking. So you should be doing some type of weight training session or body weight training session that targets your core at least two to three times a week. You know, a good 15 to 30 minute core training session for your abdominals and your low back. During that session or during a different session, you should also be training your butt muscles and your hip extension muscles. I like to recommend that people do a lot of like kicks in all directions with cables or elastic bands. Do an exercise like a kick out, like a fire hydrant, like a hip hike. These are a lot of the exercises that I recommend in my bulletproof knee program over@Bulletproofnee.com because they are what can protect a lot of the joints that tend to be susceptible to injury. So that's what I would recommend as well. In addition to cross training, focus on always strengthening every week. Your hips, your core and your glutes. Specifically, avoid inflammatory foods, avoid sugars, starches. You know, I've got a few books out there about these type of things. Holistic Fueling for Ironman Triathletes is one that I wrote that teaches you how to fuel your body with the thousands of calories per day necessary for exercise and not destroy your body. I'll put a link to that one in the show notes for you. It's called Holistic Fueling for Ironman Triathletes. The other one that I more recently wrote that that is again, something that involves a lot of foods that are not inflammatory, that are not going to cause the same type of joint pain that a higher sugar, higher starch diet can cause is called Low Carbohydrate Guide for Triathletes. I'll put a link to that one in the show notes as well. But either of those books would be great resources for learning how to fuel your body with foods that are not going to cause what's called glycation or formation of advanced glycation end products. And that's when a sugar combines with a protein in your body and the result is a lot of inflammation and a high sugar, high starch diet is a perfect way to get a lot of advanced glycation end products. Winding up doing things like aggravating your joints. The next thing I would do is make sure that you include good phases of rest and recovery. And this doesn't just mean like having a rest day or having a recovery day, but each year actually have periods of time where you give your joints complete rest and recovery. You let them completely bounce back, produce all of that synovial fluid that's going to lubricate the joints, allow the cartilaginous areas to regenerate, allow a lot of the muscles to completely repair, and you actually have a period of time when you lay off a lot of times. For a lot of folks, these are the holidays where you're exercising less and kind of sitting around a lot more. You know, winter, because the weather is not as conducive to going out and pounding your joints, seems to be kind of a natural time to work in at least some phase somewhere of some pure R and R. For me, I'm a really active guy. I don't like to take a lot of rest and recovery. It kind of drives me nuts. Typically during a year, I have about a week. Typically it's at some point during a vacation time where I'm really not doing any type of exercise aside from splashing around, doing some snorkeling and some walks on the beach and stuff like that. So try and make sure that you work in a period of time during the year when you actually are getting some serious rest and recovery, meaning you're actually laying off your body for several significant days in a row. And that might be a one to two week complete break. I don't really think you need to go a lot longer than that. But I'm talking about really not doing much at all. And that does not mean, if you're an ultra runner, that you take a couple weeks to go focus on spicing up your volleyball game for a couple of weeks. You want to choose some type of rest and recovery that really is low impact on the joints. The last thing I would consider is from a nutritional supplement standpoint, I don't want to throw a huge number of supplements at you. Probably the one I would recommend the highest would be Capreflex. I actually have some sitting here on my desk. I can go over the ingredient label with you. It's got a mineral blend in it. Goat milk, mineral concentrate, calcium phosphate, alfalfa grass, oat juice and L carnitine. It's got a collagen blend in it. So chicken collagen type 2 bioactivated green blend which is a blend of barley and alfalfa juice. It's got lutein in it. It's got a flex blend of really potent anti inflammatories like cherry juice, ginger, turmeric, white willow bark, feverfew, valerian, acerola, cherry and lemon positer and it's got an enzyme blend in it, protease, bromelain, papain, amylase, lipase, cellulase, peptidase. This is kind of like the perfect joint fuel, bone and joint formula and this is one that I would recommend. I always have it on hand. I don't take it every day whenever I'm feeling beat up. I certainly do add it into my profile whenever I'm injured. I add it in for sure, but it's called Capreflex. I love this stuff. I'll put a link to it in the show notes for you. That's what I would recommend in terms of nutritional supplementation. Hopefully those things help you cross train, strengthen your core and your hips and your glutes, avoid inflammatory foods, include some rest and recovery phases and take a dietary supplement like Cap Reflex. We have one more question here.

Hey Ben, this is Chuck and I have a question for the podcast. Like you, I'm qualified for ITU World's Long Course in Las Vegas on November 5th and had a couple questions about training for it. Actually right now I'm on my way back from Augusta Half Ironman and have another Half Ironman in a couple weeks along with a couple half marathon spaced in between there. And I was wondering if this is a good way to go about training for that race. It's about the ITU World race is about 3/4 of an Ironman as you know, and I was wondering if doing these Half Ironmans is kind of a good way to get in long distance training at intensity. So hopefully I'll be prepared for the ITU race or if it would have been better had I just focused more on long distance training. I have a few weeks when all these races end, but just wanted to see your opinion and if what I'm doing is a good idea.

Well, you know, I personally do a lot of racing because I find it to be far more motivating than just say going out and doing a long training weekend. But the issue is that racing takes a longer period of time to recover from, especially if you don't hold yourself back during the race, which I personally have a very hard time doing. And racing also requires you to taper leading up to that race if you want to do well and not kind of feel miserable during the race. And when you taper, you lose fitness. So ultimately you're kind of faced with a decision. You either race and you race well, but you risk losing your fitness in all of these little races that you're doing leading up to your big race or you race but accept the fact that you're going to have to do a lot of subpar races and possibly have a lot of your friends and the people that you normally beat beat you because you aren't tapering for the race and because you aren't going as hard as you can during the actual race. At which point, I mean, for me personally, it becomes a toss up. Do I want to go pay $250 to do a half ironman that I'm not going to taper for that I'm going to feel tired during and that I'm not going to race very hard because I know if I do taper and I race very hard, I'm going to have to take a longer period of time before that race of not working out much, take a longer period of time recovering from the race and thus lose my fitness for kind of the big race that's coming up. Racing too much is a great way to just kind of start, spin out your fitness and never get any faster. It's certainly fun, you know, from a social standpoint and an activity and event standpoint. But there is a point where you have to kind of say enough is enough and focus instead on quality training without a lot of the pressures or the logistical issues that come with having to race a lot. So I'd just be careful, ask yourself those questions and be aware of the implications of racing a lot. So good question. All right, folks. Well, we're going to be moving forward into our skinny people just don't get it. Interview after a quick message did you.

Know you can get personalized nutrition and fitness consulting from Ben Greenfield? No matter who you are, if you want to run a triathlon, lose a few pounds, reinvent your diet, or have Ben create a training program or nutrition plan that's customized to you? Here's what you need to do. Visit tinyurl.com helpfromben that's tinyurl.com helpfromben Ben will personally contact you within 48 hours. What are you waiting for? Visit tinyurl.com helpfromBen today and get the body and results you've always wanted. Featured Topic.

Hey folks, It's Ben Greenfield here and I have on the call with me Dr. Joseph James Colella, who.

Actually practices gastric bypass, weight loss and.

Bariatric surgery over in Pittsburgh, Pennsylvania. He is a well known weight loss specialist. He's one of the only surgeons in the United States to have done robotic weight loss surgery. And he has actually written a new book that's entitled Skinny People Just Don't Get It. Today we're going to talk with Dr. Colella about what his book is about, some of the more non run of the mill things that he has to say about fat and skinny and some of the practical solutions that he has, not only for weight loss, but also for spicing up your General Health. So, Dr. Kolala, thank you for coming on the call today.

Oh, it's certainly my pleasure. Thanks for having me.

No problem.

So let's start with the basic premise of your book, which is titled Skinny People Just Don't Get It. What's the idea? What inspired you to write this book?

As you know, I've been doing bariatric surgery now for about 10 years and in the care of so many people who struggle with their weight. And oh, by the way, and by definition, all of my patients are professional dieters. I mean, they know the ins and outs of almost every diet program that's out there. And so many of those diet programs have resulted in failure for my patients. And so I get to hear their stories over and over again now to the tune of over 4,000 patients that I've operated upon and countless others that I've talked to over the years. And really what it boils down to is that skinny people just don't get a number of things. That applies to skinny people and it applies to people that are overweight. Let me start with skinny people. It doesn't matter so much what you weigh. It's what you eat that affects how healthy you are. For instance, those patients and those people who eat healthy diets, their weight issues take care of themselves. They never gain weight because they're eating the right foods in the right proportion. And we've learned that chiefly from our experience with gastric bypass patients after their surgery, when we follow up with them and we take care of them and we teach them new ways to eat, we basically teach them to eat the healthy way, the healthy way that most other healthy people eat that never gain weight. So the important point there, again, is that what you eat is just as important, if not more important than what you weigh, because again, the weight will take care of itself. The other critical thing that some skinny people just don't get. And I talk to patients in seminars all the time, prospective gastric bypass patients. And it's interesting because when they come to see me, they often have a skinny relative or a skinny spouse or a skinny friend that's in the room with them. And it provides for a very spirited discussion. Because when I say in my seminars that skinny people just don't get it, all the skinny people shake their head yes, and all the overweight patients shake their head yes. And there's a disconnect. And that disconnect is skinny people just know what it's like to push away from the table. They don't understand why their overweight counterpart can't do that, can't exercise more, can't achieve weight loss on their own. It's an interesting, very interesting discussion. And the answers are in the book, really, the answers are in there as to why those people, people that have a BMI over 30, 35, can't lose the weight on their own and keep it off.

So based on what you just said about what it sounds like you're referring to as maybe like will or self control, is that what you're getting at? And if so, why would it be that someone who is obese has lower will or lower self control when it comes to something like food? Is that a genetic mechanism, a mental mechanism? What's going on there?

Sure. Well, in fact, just the opposite is true, that it's not a problem with will or self control in those who are gaining weight at an aggressive rate. It is a genetic predisposition. And those people fall into what I call the simple carbohydrate cycle and they become addicted to sugar. Sugar, of course, as you know, is ubiquitous. It's everywhere in our diet. We can't eliminate it, we can't stop it. And to those who are predisposed to be addicted to it, it is the most powerful addiction on this planet. And so it goes as follows. People consume simple sugars, whether that's in the form of orange juice. And oh, by the way, who would have thought orange juice could be bad for you, right? So whether it's in a simple sugar consumption like orange juice, regular soda, ice cream, milkshake, or here's some surprises, a big piece of Italian bread, a baked potato, white rice, pasta, applesauce, honey in your tea and I could go on and on, jelly on your toast. Those simple sugars get you into this carbohydrate cycle where your blood sugar goes up, your blood insulin Closely follows that, causing an up and down swing in your blood sugar. That up and down swing in your blood sugar is what your brain perceives as extreme hunger. I can't tell you how many of my patients tell me they're hungry all the time. They've just eaten a 2000 calorie meal and they're ravenously hungry. You and I both know that's impossible to be real. It's not a real physiologic function. It's basically your blood sugar playing a trick on your brain telling you that you need to eat to survive.

Gotcha. Do some people have a higher propensity to be addicted to carbohydrates than others in your opinion?

Oh, absolutely. There's a predisposition to it, and I think we all have it to some extent. But there are a certain group of the population that is highly predisposed to it. And those people have the toughest time because again, it's an addiction to a chemical just like any other addiction.

Are there studies that have found the gene that's responsible for this?

No, we really haven't. Yet we know that one of the most complex mechanisms in the human body is our appetite. And in the book Skinny People Just Don't Get It, I refer to that and discuss the human appetite in some detail, but in layperson terms so that you can really understand how your appetite works. How the cutlets influences that occur in our daily life affect our perception as to whether or not we want to eat. And really at the end of the day, that's all that your appetite comes down to. You either eat or you don't eat. And leading up to that decision are literally thousands of inputs to your brain on a moment to moment basis. The calculus at the end of all that either leads you to the refrigerator, to the pantry, or away from it.

So what do you do? I mean, is surgery the answer or are there other options?

My goodness, sure. Surgery is not the answer. And again, this book is really written to help prevent or slow down or stop America's collective procession into the very active surgeon's operating room. And as you may know, the fda, the Food and Drug Administration, just this past spring liberated the criteria for lap band surgery to patients with a body mass index of 30 or greater in one obesity or weight related medical problem. That's a substantial opening up of the population relative to the criteria for bariatric surgery, essentially doubling the group of patients that we need to operate on. And we're already falling so far behind in our surgical care of the Extremely obese. But really, this book is written to the people who have not yet gotten there, who are not yet extremely obese. It's written to the two thirds of the Americans who still have an opportunity to maybe intervene and maybe stop this progression towards obesity and its incredibly, incredibly disastrous consequences.

Gotcha. So, as I mentioned earlier, what are a few of the things that people could do if they find that they're addicted to carbohydrates? Maybe they have just this genetic predisposition. Can you throw a few solutions out our way?

Oh, most definitely. And again, I talk about these solutions at length in the book. Really, the key is preemption. You have to preempt your appetite. You cannot allow yourself to get hungry. Because when human beings get hungry, we make bad choices more often than not. The bad choices are everywhere. They're everywhere in our life. They're in our pantries, they're in our refrigerators, they're in the convenience store, they're at the fast food place, and they surround us. They're in the office, they're on the desk. Wherever you look, there's a potential to make a mistake in terms of what you put in your mouth. So the way to prevent all that from happening is to basically script what you do. Preempt hunger. And the way to preempt it is with lean sources of healthy protein and complex carbohydrates. If you'll let me take just a moment to explain those to you. Let's start with complex carbohydrates, because I think the important difference between simple and complex carbohydrates is critical to understand. And it's really pretty simple. Simple carbohydrates are simple sugars, table sugars, stuff you put in your tea, stuff you put in your coffee, sugar that you put on anything that you might eat. Breakfast cereal loaded with sugar. You get my point. Those sugars are simple. They're easy to absorb into your intestine, they're easy to get into your bloodstream, and they cause immediate effects on your blood sugar. Complex carbohydrates or complex sugars are the ones found in fruits and vegetables. Oh, by the way, here's another caveat that I mentioned in the book. If you're hungry for orange juice, eat the orange, don't drink the juice. Eating the orange, and I'm about to explain why, is essentially calorie neutral. Drinking the orange juice is essentially poisoning your carbohydrate cycle and igniting it, if you will. The complex carbohydrates, those are the sugars that are hard to break down. Your body actually has to work to get to the sugar that's in broccoli, for instance, by the way. By the time it gets to that sugar, it's moved so far down your digestive trigger that less of it is absorbed than might be absorbed if it was pure simple sugar consumed as a glass of orange juice. Your body actually has to expend energy to get to the carbohydrates in broccoli, for instance, or in an orange, or in a grapefruit, or in asparagus, if you see my point. Your body has to work to get to those sugars. They actually extend energy. That's why they're essentially calorie neutral. They don't affect your weight up or down, and they don't contribute to the carbohydrate cycle because they don't cause spikes in your blood sugar. The key thing to do is to keep your blood sugar level. And the way to do that, again is with lean sources of healthy protein. And one of the greatest foods on this planet is salmon. But fish meat, chicken, pork protein shakes, healthy protein bars that are low carb, those things need to be placed throughout your day, throughout your diet to intervene before you get hungry and before you have the opportunity to make a bad choice.

Now, what about fats? Don't they have a pretty decent appetite satiating effect as well?

Sure, fats do have a pretty decent appetite satiating effect, and they don't affect the carbohydrate cycle as much. However, they're loaded with calories. So on a per gram basis, you get the most calories into your body when you consume fatty foods, which is one of the reasons why. And if you think back to the Atkins diet, it allows for the consumption of large amounts of protein that was laced with fat. Bacon drift and hot dogs were another bad choice. Really, what I'm advocating is lean, healthy, low trans fats or no trans fats, types of protein sources. That's the key. And really, when you consume those types of foods, you intervene and you interrupt the carbohydrate cycle. And if you're aggressive about it and you're dedicated to it, before long you'll be able to walk right past the apple pie and look at it and laugh at it. You'll pass up the chocolate chip cookie, you won't need the ice cream, you can look at it, and you'll be able to move away from it.

In your book, do you talk about the process of kind of discomfort that goes along with breaking a sugar Addiction. Because. Because myself, I'm a sports nutritionist. I've certainly had individuals who live a very high carbohydrates, like endurance athlete or athlete lifestyle where they're eating whatever they want to. And when we try and get the carbohydrates back, there's certainly a drop in energy and a drop in performance and kind of a blah feeling. Do you have ways that you found to help people overcome that feeling?

Well, certainly. And I, you know, being an athlete myself and doing those things, I get the whole carbohydrate deficit issue, and that is high performance. Athletes, people who go at it very, very hard, certainly need more carbohydrates than the average person. But by the same token, they're burning a huge. They have a much higher furnace, a much higher calorie burn rate. And so in order to sustain their performance and to sustain their muscle mass and to sustain their ability to function at that level, they need to consume more carbohydrates. The key, though, the key for those people is to increase the portion of complex carbohydrates in their body again because they will have a longer steady state, stable blood sugar, even allowing for greater performance than they would if they just consumed high, simple servers like pastas and bread. There's a role for them, but the main thing that they can do to improve their world, and I'm going to mention one more important thing about it in a moment, is to increase their level of complex carbohydrates. Again, fruits and vegetables.

You wouldn't consider fruit to be a more simple, sweet carbohydrate than a complex carbohydrate?

Well, yeah, most fruits. Most fruits you have to work to get to the sugar. And they're a little bit more simple than broccoli, for instance, or asparagus, but they're still way better than drinking the juice. Again, the juice is basically presenting yourself with almost an intravenous infusion of sugar to carry it to an extreme, whereas consuming the fruit itself, it takes time for that sugar to get to where you can absorb it. And oh, by the way, you have to work to get to it. So there is some calorie expenditure on the way to the absorption. One of the other things I think about this book that is unique and it's really the first time that it's been mentioned sort of in the popular press and the popular writings, is the inflammatory nature of the simple sugars.

Yeah, I was going to ask you about that. You have like an inflammatory scale in your book, correct?

I think that's one of the things that makes this book unique. There are two chapters really in the book that make very, very, very bold statements about the health related effects of eating simple sugars. Now in one chapter, I talk about those health consequences of allowing those simple sugars to get you overweight, because that's a deadly combination. High diets in simple sugars and being overweight at the same time. Those are the patients that really get into trouble as their BMI rapidly expands. But then there are the group of people again, the skinny people that just don't get it. And I'm sure you know many of them. And these are the people that are skinny that are not athletes or skinny that are not high performance athletes. And they're not the ones that are burning calories at an incredible weight. I'm sure you know that they can eat anything they want and never get an ounce. That's always very frustrating to those of us on this planet who when we do eat three pieces of cheesecake in a week, notice it on our waistline. But those people who are eating those high calorie simple sugar diets, not gaining weight, think that they're healthy because they look healthy. What's really happening on the inside is the high amounts of, of simple sugars in their diet are destroying their blood vessels. They're causing inflammation on the lining of our blood vessels, leading to obviously injury to the lining of our blood vessels, the development of plaques and clots in our blood vessels, damage to the inside of our body, destroying ourselves from within. That damage not only happens to our blood vessels, but it happens to our solid organs as well. So interestingly enough, those patients in many cases have certain predilections for a higher predilection for various cancers. And oh, by the way, when those cancers occur, they tend to be more aggressive. So I fired a warning shot in the book about people who consume these high simple sugar diets that they're bad for you on a number of levels, not just because they make you heavy.

Are there certain nutritional supplements or medications that you recommend to people to help control carbohydrate cravings or help to satiate the appetite?

Sure. One of the interesting things that I found out when I started reading all the diet books that were on the market is that they all make compromises with simple, sobering. At some point they sort of allow the dieter or the diet or the regimen, if you will, the plan that they're on to go ahead and have the ice cream or go ahead and have the cheesecake, or go ahead and have the bread. And really what we found is that in the patients who are predisposed to that, it opens Pandora's box. It gets them caught back up in that addiction phase. So one of the key things, and realizing that people are people and they can't stay away from those things completely, which is why, by the way, almost all diets ultimately fail, is because you always end up going back in some way to the eating behaviors that got you in trouble. We've seen that over and over again. For most people, all diets ultimately fail. For people like you, who never have to really go on a diet, it's a different animal. But for those who are trying to constantly lose that extra 10 to 15 to 30 pounds, these diets ultimately fail. And they fail because people lapse back into the dietary habits that they had before they started dieting. It's just the natural course of events in bariatric patients, what we teach them to do. And this teaching, again, applies to people that have not had surgery. We teach them to eat the protein and their complex carbohydrates first. And, oh, by the way, after you've done that, and if you want a sweet treat, go ahead and have it. But the beautiful thing about it in bariatric patients is there's not much room left over for it. And we see, though, as time goes on, when people get used to not eating those things, then they don't want them anymore. It's an amazing thing. People can wean themselves away, and they don't want it anymore.

Have you come across anything when you're looking at the genetic predisposition to obesity, Anything in terms of the way that people's parents ate affecting the child's or the baby's propensity for gaining weight or having a sugar addiction?

Well, sure. As you may know, September was childhood obesity month. And without question, we see obesity trends in families, and we see that the environment that children are brought up in can lead to again, if the predisposition is there, it can lead to the issues of childhood obesity. And things are happening in that unfortunate group of people that we've never seen before. We've never seen children and adolescents with type 2 diabetes with elevated cholesterols, with high blood pressure. We've never seen that before. And you know what? We are starting to see it now. And it's a very, very scary phenomenon again. In the pantry, you'll find there are the simple sugars, the breakfast cereals. There are all the fruit and snacks, treats, the ones that are laced with Sugar, the pop tarts, for instance, things that are just high enough in sugar that keep these young folks addicted and caught up in that cycle. All of the juices that they consume, all of the energy drinks that they're given as beverages, not as supplements to working out. And so the consequences of those behaviors in families are devastating. And on the flip side, when we do unfortunately ever make it to bariatric surgery in a patient, it's amazing the health benefits that spill over into their family and friends because they now are having to eat differently and their children and maybe their spouse, those around them, they adopt a different eating habit, a different eating regimen because of the eating regimen of the patient who has had surgery.

Interesting.

So in terms of this book, when does it come out? When can people actually get their hands on it to read it?

Dr. Sure. We're hoping to have it out just after, just around the holidays or hopefully in the spring.

Okay, gotcha. Yeah, I think it's very, very interesting that you've touched on, I think something very important that if you are skinny, if you are fit, if you can naturally eat anything you want and get away with it, then you really do need to be aware that not everybody is built like that. And it kind of goes one step further, as you've kind of hinted to in our interview, that even something as simple as seeing a food and resisting the urge to grab it can possibly go beyond just like an appetite craving and can be genetically rooted.

Absolutely. And I think that when you learn to walk away from these foods and when you learn to push them back because again, you are now no longer addicted to them, you will realize that you're actually investing in your life. You're investing in your health, you're investing in your overall well being. People get out of what we call this carbohydrate sarcoma. They're more functional, they're more alert, they're happier, they sleep better, they look better, they get sick less often. They're going to the doctor so much less often. Their medication regimen, if they're already on anything, starts to shrink and you realize that you're going to live longer and healthier because of it. And if there isn't a better motivation than that, I don't know what is.

Yeah.

Yeah.

All right. Well, Dr. Kohla, thank you for coming on the call today. Any other resources that you have for people? Are you going to have a website for the book?

Sure. The website for the book will be available within a week. It's called drjocarella.com okay, fantastic.

All right, well, thank you for your time today. And we will put a link to drjocolella.com in the show notes for those of you who want to go check out Dr. Colella's website.

All right, folks, well, that's going to wrap up this podcast. But remember, if you want me to answer your questions about what goes into training to attract and traveling healthy, tweet me a question and use konaquestion Engreenfield and I'll put in the show Notes podcast episode 165 for this podcast over at BenGreenfieldFitness.com exactly how to phrase your question, but just address it to En Greenfield and use konaquestion. And remember, there will be no podcast next week. Instead, there will be a series of videos each day starting Sunday, October 2nd, all the way through the actual race in ironman Hawaii on October 8th. That goes through everything that goes into traveling to an event like this and traveling healthy and preparing for something like Ironman World Championships. So be sure to stay tuned to BenGreenfieldFitness.com for that. Be sure to remember and nominate the Ben Greenfield Fitness Podcast for the podcast awards@podcastawards.com and of course, leave us a ranking and a rating in itunes so we can beat out all those other podcasts on itunes and get to the top of the health and fitness category, which would rock. All right, folks, have a healthy week. This is Ben Greenfield signing out from BenGreenfieldFitness.com Sam. Sa.