Kara Collier | How To Stop Eating Sugar: The CGM Solution & NutriSense | Wellness Force #Podcast

I always say there's no one size fits all. Some people are more all or nothing than others. But with sugar especially, it truly is an addictive substance. It lights up the same pathways as a drug does. And so we don't tell those who feel like they're addicted to drugs to have a little bit each day in order to wean themselves off. We cut that off and we go through a period where it kind of sucks and. And then you feel better. And I really recommend that if you feel like you are truly addicted to sugar, because that happens. That's a real thing. And that first starts with controlling your environment. So if you're working at home, you're home all the time. And in your pantry that you can walk to at any second of any day is a bunch of candy and chips and pretzels. And that's going to be calling you again. Just like social media or technology like we were talking about, these food products are literally designed to be addictive. There's nothing natural about them. And that's. I take your similar point of view of that's part of the problem with trying only to go through intuitive eating, because it's very hard to intuitively eat candy because it's not a natural food that our body is prepared to handle. So I really think first, having control of your environment, don't purchase those things, don't have them right next to you where it's tempting and you're having a hard time saying no, and instead focus on choosing whole foods as much as possible. And truly, when you get in that routine and then you taste that candy again, it tastes so much sweeter. It tastes so much different than when you were eating it all the time. And it was just part of this lighting up my dopamine system type of behavior. So then you can eat something mindfully and every once in a while because you can sit there and eat it slowly and enjoy it, rather than it's something that your brain is driving you to do.

Era welcome to Wellness Force.

Hey, Josh, thanks for having me.

This is fun because we have explored so much about the physiology of blood sugar and really why people gain weight. To no surprise, their best efforts don't always come through. Their physicality is an expression of their internal mechanisms, their stressors and all these different things. So this company that you are partnered with that you're actually an employee of, you're the director of nutrition for Nutrisense. Nutrisense is a company that came across my radar last year from a friend here, Paul Saladino, and Paul is just a wonderful voice of truth in the wellness world, and I believe so are you. When I prepared for the show, I dug into your background and one really great thing that I feel from you is you really just want to know the truth about what works. You know, taking science and religion and taking them off the table and just going, okay, what does the data show us? What are the numbers actually saying about people? So give us the skinny on who you are and what you stand for in the world if people don't know you.

Yeah. So I am a registered dietitian and I started my career really in a pretty traditional sense, where I was working in the hospital systems, mostly ICUs, working with critically ill patients. So that's where I really began my frustration with some of the things that occur in the healthcare system today, and also my passion for addressing some of those root causes of chronic illnesses. So just as a few examples, working in an icu, you're less likely to have somebody come in with a gunshot wound than you are to have someone come in who needs their leg amputated because of a diabetes complication. Most of the people coming in that door are having severe suffering due to a complication from a lifestyle related chronic condition. And that was really frustrating and hard to see and hard to work with when you knew if you could have caught that person decades earlier, they might not have had to go through this. But instead we're catching them really late. We're addressing the intense symptoms that they're coming with and not necessarily the root cause. And the traditional recommendations that we were taught were not actually working that well. So if you could break to breakthrough to someone, even though it was kind of late, then I'm supposed to tell this diabetic to match their carb intake with their insulin dosing and be on their way. And then that's not actually working. And they come back two months later. You start to really have to take a look at things and be realistic and figure out what works, even if that's contradictory to the status quo. So that's where I really turn towards data and prevention as something that's important to me. So jump ahead a few years. And I helped start Nutrients, where I'm now the director of nutrition, as you mentioned. And what we're doing there is we're using continuous glucose monitors, which is a technology that essentially monitors your glucose 247 so that you can get a peek on the inside for once of what's actually happening in your body, instead of having to follow the vague advice given by American Diabetes association or maybe given by your doctor or your brother, you can instead see what's happening on the inside. And that's where I find data so interesting. You know, as a dietitian now, working with clients and seeing this data, you immediately have to throw away a lot of your preconceived notions. You can see what works and what doesn't work. And you can also see really quickly how unique we all are as individuals. What's going to be optimal for me is not going to be the same thing that's optimal for you. So there's really no one size fits all. But it's hard to know that and execute a plan that's appropriate for you if you don't have the right information going into it.

What's one of the. Sorry to interrupt you, because I'm just having this burning question come through. What is one of the biggest things you learned in the traditional academic setting that you realized wasn't going to work when it came to what you do now?

Yeah, there's a lot of things I could with one of the big ones.

I'm sure there's a whole podcast we can do on what's wrong, but list one that people might not know that might be kind of shocking.

Yeah, definitely. For me, it is the traditional advice given to diabetics. Like, I absolutely cringe in retrospect thinking about some of the diabetic education that gave. And essentially what we're taught is consistent carbohydrates. So if you're a female, that's 30 to 45 grams of carbohydrates at each meal steadily throughout the day. And if you're a male, that's 45 to 60 grams of carbohydrates at each meal steadily throughout the day. And the goal is that it's consistent. And then you're not having glucose dips, you're not having glucose swings. But in retrospect, I know for a fact somebody who's a type 2 diabetic and their metabolic system is broken and we give them 65 grams of carbohydrates in one meal, and then two hours later we do it again. We're not seeing steady glucose levels. We're seeing these absolute massive glucose peaks. It doesn't even matter what the carbohydrates are. It's just not a right approach for the physiology that's going on in that person. So seeing that in action, you realize right away that that just doesn't work. And those. I don't know where those traditional Guidelines came from, but they didn't come from real data from somebody's body.

Yeah. And. And this is a really great conversation point for us because a lot of times it's so easy for us, because of our negativity bias, to go to the problem and try to demonize the AMA or the CDC and all these things. And I've fallen into that trap too, Kara, where we are in the middle of probably one of the most challenging times I think, in my 40 years I've ever seen, for sure. And maybe our grandparents and our great great grandparents would argue with us that their times were harder. Reality is for all, for so many people. I think for all of us. We're under more stress now than we've ever been before. We're disconnected. We're trying to navigate this craziness that is, in my opinion, the war of information. And that war of information starts in the academic setting, where, for example, at the San Diego State Nutrition for up and coming nutritionists and people that want to help people from their deepest heart. We have Kraft Foods that are sponsoring the curriculum. We have these large food companies and pharmaceutical companies that are coming in to these academic settings and they're telling people, give diabetics orange juice. Give diabetics, like you said, so many things that are deleterious. So again, this conversation isn't about spotlighting all the things that are wrong, but I think it is a good context in a frame for the truth that you're going to bring us, specifically the world you came from. Because when I think about how many people, like you said, could be saved if they were just given the right information. How does continuous glucose monitoring give people unique, personalized information that really allows the noise of what they should be doing to dampen down and the signal of the truth to come in?

Yeah, so a little bit, I guess, about the device itself. So a continuous glucose monitor is a small disc like device that you can put on the back of your arm. You can do this at home. You don't need anybody to insert it. It's completely painless. And then it stays on the back of your arm 247 for two weeks straight. And then anytime you're curious about what your glucose levels look like, you just scan your phone over the device and you get a new updated graph of your glucose levels 24 7. So this changes how we can approach diet and lifestyle advice for anyone, not just diabetics, because everybody has glucose running through their system at all points in time. So this is an important metric for all people to Be monitoring. And it sounds like you've really dug into why glucose is important. But if we are on board with glucose as an important metric, then we want to see what's happening at all times of day. Because just as an example, I used to prick my finger all the time to try to capture what my glucose was doing. So I tried a bunch of different fruit to see what my glucose was like. An hour and two hours later, I'm trying all these different fruit and I tried pineapple. And at one hour later and two hours later, it's the same as my glucose was before I even ate the fruit, around 80. And so I was like, that's really good. It's an impressive glucose response. But then I put on a cgm, eat the pineapple, and I see I actually have a huge glucose spike. But it came down really quickly right after. So I completely missed that there was misinformation. So really the only way to know the nuances is, is to actually see a full curve of the data. So you can capture things like your responses to food. What do you respond better to? Are there any abnormalities in your metabolic system? You can also see what's happening when you're sleeping. What is the effect of a meal that's later at night. What is the effect of some alcohol before bed or maybe not enough sleep in general? So all these points that are important to good holistic health, the core pillars of what makes us a healthy human being, glucose is going to respond in reflection to, and it's the little nuances and the trends between days that give us these big picture insights. Then we can grab those insights and actually do something about it and then prevent, hopefully those big ripple effects that come from dysregulated glucose day in and day out. So my goal really is that people can find those insights and then they're stopping that negative ripple effect. They're swapping things that are easy for them to swap so that it's not day in, day out. I'm doing something detrimental and I didn't even realize it was detrimental.

I found that it was shocking to me because certain foods would spike me and certain foods wouldn't do that much. And I was deeply inspired. And I don't know if you've heard of his work, but it directly relates to your expertise. And that is the 30 day carb test from Rob Wolf. Have you heard of Rob's work or do you know about. So we've had him on the show three times now. And what just was fascinating to me was his Wife would eat lentils or beans, I think it was, and then he would eat chips and they would have drastically different spikes in their blood sugar. And I want to contrast this with really the big elephant in the room and that is there's damage control, which is reactive health procedures like the diabetic procedures that unfortunately you told me are still practiced and that really break your heart. And then there's proactive use of data like doing smart, efficacious research on yourself. You know, The N equals 1. Doing a 30 day carb test. How does your approach through nutrients really take an honest look at the continuous process that's unique to the individual?

Yeah. So our goal really is to give this information to anybody who is willing and excited about improving their health or learning more about themselves. So we go back to the traditional system. These devices, these continuous glucose monitors are only available by medical prescription. And 99% of the time a physician is only going to write the prescription. If you are a type 1 or a type 2 diabetic, which is, as you said, kind of reactionary. It's okay. We have this condition, we need to manage it. Here's a tool to help you manage it, which is useful. We definitely want diabetics also wearing these. But it's not being used in the flip side of the equation of I'm pre diabetic or I'm healthy, but I want to stay healthy and be as healthy as I can. That's not the use case in the traditional system. So what we're trying to do is help those people get the data that they also need to be the best versions of themselves. And so me as a healthy non diabetic individual, when I put on one of these devices, I can be proactive, as you're saying, and I can try those different carbohydrates like in Rob Wolf's experiment where you're testing different things and I'm going to learn things about myself where maybe pineapple isn't the best fruit for me. But ironically, this is actually a true story about myself. Bananas are the fruit I have the lowest glucose response to.

Wow.

Despite bananas being historically a starchier, higher glycemic index fruit. But for me, for whatever reason, my body tolerates them really well. And I just, you know, you wouldn't know that because it's against what is the traditional recommendation.

Your, your situation doesn't fall into a mass template like that's so unique. Most people that eat that high of a GI food, their, their blood sugar would spike regardless. But for you it's like, how do you even explain that? Can you explain that? It's. It's bio individuality really.

Yeah. And we have a few ideas from the research of what's driving that bio individuality. We definitely know microbiome makeup plays a role, probably genetics. But I guarantee you there's thousands of other factors we can't even identify at this point. We're just on the cusp of personalized nutrition research and so we're still figuring that out. But what we do know for certain is that everyone responds differently and there's no one size fits all. And something like the glycemic index is taking a population average. So on average you're going to respond higher to a banana. But there's definitely people who are higher or lower than that average. And how you know is, you know, you have to have the data to actually figure that out.

Yeah, BMI is the same way. I'm clinically obese on bmi. They don't take into account muscle tone. And so there are these like very old school, almost dogmatic Kara, almost dogmatic lenses that are just funneling people into boxes so it looks neat on paper. The human beings are not boxes on paper. Like we're human beings. So who can use this? Like, who are the people that are a perfect fit for this? Is this truly for everyone, this continuous glucose monitoring, or is there certain people that maybe aren't a fit for it?

I really believe it can be for anyone. And you know, we always describe metabolic health as a spectrum. On one end you have your metabolic superstar who is probably like a athlete of some sort, and they have really good glucose control, but they're still going to have those individual responses in their not going to know it without the data. And on the other end we have somebody who maybe has diabetes and cardiovascular disease, but we still want them to have access to this data to help manage their condition as well. So anywhere in that spectrum, you can certainly learn something about yourselves personally. At Nutrisense, there are a few people that we don't think is a good fit for our program. That doesn't mean they're not a good fit for a CGM in general. But we do not take diabetics who are on insulin therapy because we want them to be working with a medical professional, like their physician, to also help with insulin dosing. We're trying to capture the people prior to that stage. And then we're also a little weary sometimes of people who have active anorexia because excessive tracking can sometimes steer you in the wrong way. And the last thing we want to do is make disordered eating worse. So those are the categories of people that we really give resources to elsewhere.

It's a fine line with your work because you're really like, part psychologist, part nutritionist. I'm sure emotional issues and behavioral issues come up and really are the root cause of why people reach for the foods that are deleterious. I mean, that's. That's the real story. I mean, I used to be 280 pounds, and when I look on my life through a reverse lens of 30,000ft, most of my choices that led me to be 280 pounds were driven by lack of self love, lack of self worth, lack of self confidence, lack of purpose, depression, anxiety, all these things. How do you walk the line between being a nutritionist that's really helping people with their food choices, but also knowing that their food choices are a byproduct of their emotional intelligence?

Yeah, it's a great question. And it's complicated. They're very interrelated. Food and eating is emotional for most people. You know, it's not just something that we do purely to nourish ourselves. Most people are not like that. And so as a dietitian, you do get trained in behavioral psychology and some counseling techniques. But again, there's always the fine line where somebody maybe needs a mental health professional or somebody more specialized in that field. And that's when we just have to be honest and say, I can help you with xyz, but I really identify that. I think someone with this expertise would be great to help you with this thing you're struggling with. And then we can direct them to where they need to be. But really, interestingly, a lot of times the data itself helps connect people to that mind body connection. There's a lot of research on this for data in general, but also specifically CGMs, enhancing people to eat more intuitively because it enhances our interoceptive sensitivity, which is just a fancy way of saying how we feel our body signals. So a lot of people will leave this program, and what they tell us is their unexpected benefit is that they can now have a better connection to their body. So a lot of times you might be having that midday slump, and it is maybe a dip in glucose, and people didn't realize that, and now they have a connection with, okay, when I feel this way, it's because of this, and now moving forward, I'm able to make that connection. So it's a really interesting where there's a fine line of the we don't want the data to trigger disordered eating. But also sometimes the data helps you connect better with your body's natural signals.

How so? Like how? What's the connection between knowing and doing? This is a big one. And we explore this on the podcast so many times in so many different categories. But as a dietitian, as someone who's had so much experience with working with people from like all walks of life, I'm sure you've seen the gamut on food preferences, emotional intelligence, self deprecating behavior, self sabotage. When it comes to food, what is it about the data? Which is essentially, I believe, what Nir Eyal calls the external locus of control. Having the data as the mirror of mindfulness versus someone not needing the data at all. What's the real value in the data when it comes to true behavior change?

Yeah, it's a really good question. And that's something where a lot of times the reason people are gaining benefit from the program and using the data is because they learn something. So that's education, knowledge. And then they're already disciplined and they're already going to do it on their own. But a lot of times people already have the knowledge. They're like, I know exactly what I'm supposed to be doing, I'm just not doing it. And then they come and the CGM just being on their body is enough for them to actually stick with what they know they're supposed to do. In nutrition and dietetics, we always say that the knowledge is only 10%, 90% is motivation and behavior change.

That sounds about right.

There's only so much you can do with information. It's just gonna sit there. That's not helping anybody. So there's a couple reasons that I think the data itself helps drive behavior change. But then there's also the aspect of at Nutrisense you get a one on one dietitian with a program. So there's also there a human aspect which some people find more motivating than data. So it's really a kind of a personal what drives you. But the data itself allows immediate feedback, of course. So our brains are hardwired for immediate gratification. We love immediate gratification, which is why social media, partially why social media is so addicting. But most health habits have delayed gratification. If I eat a piece of picture candy every single day, or let's say like a whole cake every single day, I'm probably not going to see the long term consequences for a little while. I'm not going to get diabetes tomorrow. But it feels really good in the moment because it tastes good. Same with if I go to the gym every day. It's actually not very fun. If you're not somebody who's used to working out, it's not fun in the moment and I'm not going to see the benefits for a little bit of time. So there's this delay and our brains don't like that. Where if we have the continuous data, same with like a Fitbit or an HRV tracker. When you see that immediate gratification, it helps to bridge that gap in the time delay. So when I eat the piece of cake and I see a giant glucose spike, I knew it was going to spike because that's a little bit obvious. But nonetheless it helps bridge that gap where now I have an immediate consequence. I'm like, oh, I don't like seeing my glucose go out of the optimal zone. Not as motivating. I now have a pain point that's balancing the reward of the taste. So for a lot of people, I think that the immediate gratification of the data is really meaningful. But I also think the data enhances intrinsic motivation since you know it's coming from you. It's much more motivating for me to not eat tortilla chips because I know they're basically poisoned my body. One tortilla chip gives me the biggest glucose spike I ever have, and I don't even really like them that much. Now I'm much more intrinsically motivated to skip that and choose something else because I have actual data from my own body. It's not like I read it somewhere in a blog or my mom told me it's bad for me. It came from my body and it's more motivating than some external information that somebody told me. So those are two of the reasons, I think that it really helps drive behavior change from the data itself.

What's the best in class feature of Nutrisense? In other words, what is unique about your approach, you know, directing people? Is it across the world? Is it United States only? So is it across the planet, by the way, that you're helping people, that people can access this?

Right now we're just in the US and Canada. US and Canada want to expand. Yeah, we're about two years old as a company, so we'll get there. But right now, US and Canada, but.

With this client case that is building, you know, thousands and thousands of people that are coming in all the time, is there a common thread that you see with people and then is there something best of class when it comes to Nutrisense on how they really approach this sustainably?

Yeah. So at Nutrisense we are doing things a little differently than maybe some of the other companies out there and that we really strongly believe that the best behavior change and long term lasting health benefits come from the right information plus the right expertise, plus the right mindset. So we're really trying to focus constantly on those three aspects. And so we have the data and we don't want to just be a CGM company forever. We want to have other data points that are helpful for you reaching your health goals. So that's our long term vision as a company. And then we have the expertise which is the trained one on one dietitian who is curious and open minded and aware of the way things might be and not just following traditional recommendations and they're there to help you along your journey. And then the third aspect is that we really gear a lot of our educational content, our dietitian coaching and our information in the app around helping you try to build a sustainable mindset so that you can actually stick to these things over time. So we have that human aspect which is really unique I think to our approach. A lot of people just want to do AI and sophisticated software, but a push notification isn't always as motivating as a real human meeting you where you're at and helping you journey.

Yes. So it's so powerful because the scaling of this, this is the good side of technology. You know, so many people are like, technology is the devil and like technology is bad. And I'm like, you know, anytime that we have evolution of any kind, even if you look at Moore's Law, where I think it was about six or seven years ago, Kara, that the technology curve is exponential, like a hockey stick on a chart. If you look at human evolution, we change like 0.001% every hundred years. We're basically the same, we're cavemen and cave women. But we're in this extremely evolved society that is so dependent on technology. How do you personally balance the two? This is a just an organic question that's coming through here for me. It's something I've been thinking about a lot. How do you manage the technology component of life and use that as a mindful employee of you, but still keep you the CEO? In other words, balancing the technology with you as a person?

That's a great question and I think everyone's probably going to have a different answer to this. Of what works for them. And this is something I try to be really mindful of because a lot of technologies are meant to be addicting, right?

Sort of by design.

By design, yeah. Pretty intentional for the most part. Part. And so I try to be in control of my situation rather than something else controlling me. So I really adhere to stoic style philosophy and I try to live up to that. So I'll do monthly, once a year, technology breaks where I don't use my phone, I only use email once in the morning to do the type of things I need to do for work. And I try to take breaks from technologies. And I hope that I feel like that helps break the cycle of the addiction. Because then you realize you're like, I check Instagram every day. What am I going to do for a whole month without checking Instagram? And then four days in, you don't ever think about it and you're like, oh, I guess it doesn't really change my life that much. So I like to take breaks as one thing, but then I also like to think of these things as tools to help me rather than things that are controlling me. So it's not like if I'm wearing a cgm, I can't ever have a glucose spike. Like, the data is controlling me and I'm glued to it. It's. Instead, it's a helpful tool for me to make better decisions. But that doesn't mean I can't make a mistake or forgive myself or have some freedom. So I think there's a fine line there. And I think everyone's psychology is a little bit different on how they approach that. I tend to be an all or nothing, which is why I like to take actual extreme breaks.

Have you ever had a time in your career, in your practice where you've seen the perfectionism dragon come up?

Yeah, I mean, I tend to be a perfectionist in some standpoints, but not all. So I also, I like the 8020 rule of, like, you have to be able to figure out where we're starting to have diminishing returns for my efforts. So where it's like enjoying something on the weekend. If we're sticking to food and glucose in this conversation. If I'm going to have a glucose spike because I'm going to a bottomless brunch with my friends, it's like, that's a fair trade off. But I thought about it ahead of time and it's totally worth it because I'm going to have a great time with my friends. I'm going to Be social and I'm going to have fun. Whereas mindlessly eating on something I'm not really even enjoying, that's not a good trade off. I wasn't really thinking that through. So maybe it's not perfectionism, but it's trying to be at least mindful of the decisions I'm making so that I'm not giving in to my impulses, but I'm instead allowing myself balance in a way that adds something of value to my life. If that makes sense.

It makes perfect sense. And for everyone watching with us wellnessforce.com397 to learn about Nutrisense, go there right now. I mean, if you're feeling interested, if there's a ping in your nervous system or in your mind, head over wellnessforce.com 397 where you can learn more about what this actually is. And I'm learning in real time too. You know, I use the cgm and for me, what was utterly fascinating was eating any type of carbohydrates, like first thing, if I had too many carbs in the morning, I don't know if it was because I had the ApoE3.4 genome. The allele that expresses it could be a multitude of things. It could be my Sicilian heritage or my English heritage. The reality is, rather than me trying to chase why my glucose spiked, it's really just accepting and surrendering to the truth that it did. And I think that's the most freeing thing of this entire conversation that everyone can really trust is like your data is yours. It's not like you're plugging into some imaginary system that's built for everyone to work the same. We're a unique human. It's like the thumbprint that we have is all unique and we're the same way with the uniqueness inside. Do you have a case or an example you could talk about that was just super inspiring for you. You know, like someone that just literally had a life transformation from learning about continuous glucose monitoring paired with dietetic coaching, nutritional coaching.

Yeah, absolutely. And somebody asked me recently, like what I'm most optimistic about. And honestly our customers make me most optimistic about the way nutrition and health is changing because they're so motivated to improve their health. It's just awesome to work with people every day that are just excited to learn about themselves and take action on it. But a story recently, a client of mine that I had, that was really inspiring. So he did not have a diabetes diagnosis, but clearly when we put put on the cgm, he had dysregulated glucose values. So traditionally you might get an A1C and a fasting glucose level taken from your doctor. And those both came back normal for him. But we were able to capture some abnormalities that were happening behind the scenes. And so then he also went and got a fasting insulin level tested when we started, and he was getting a little concerned, and it was 42, which is considered quite high. For those out there, we want to see it more like five to eight. And so we worked together for six months and we did sustainable tweaks, so we didn't have to go extreme because we could see the things that might work for him. So that's tweaking diet, finding an exercise routine. That is actually something he's going to do, Doing the right eating window for a lot of people, him included, eating late at night, was increasing his glucose levels 20, 30 points the next day. So trying to shift meals earlier. And then for him, it was really focusing on stress management. But he was able to see those things that he needed to do. And six months later, he just messaged me, actually this week, so it's fresh in my mind. He retested his insulin, it was down to 16, and all of his glucose values have been in the normal range. So for someone like that, it's so exciting to me because he wouldn't have captured on traditional labs that his glucose was abnormal for maybe another decade. And by then things would have been worse and it would have been harder to reverse. And if he wouldn't have the right information, it might have been another decade that passed of not really addressing it appropriately. So it's thinking about those ripple effects, improvements that can happen in these situations that get me super excited.

It's incredible because I think most people look at the continuous monitoring as like a diabetic thing. It's like, no, this can truly change your life. If you're open to really looking at the truth of what's going on. Have you found that some people, they're just not ready to receive the truth? Like they might have two weeks into the nutrisense program and their, their glucose is all over the map and they're all over the place. What makes people stick with it versus letting go?

Yeah, and there's different, you know, stages to readiness for change. So there's pre contemplation where it's really not even on your radar. There's contemplation where I'm kind of thinking about it, but you're not totally bought in. And sometimes those people will start, they'll See really high glucose values and they will shut down and maybe move back to pre contemplation. So an example of that was somebody that happened recently. And so what they think, I'm assuming what they're thinking, but what could be going on in that situation is that you see all these things going wrong and it's much higher than you anticipated and it feels overwhelming. It's like, how the heck am I supposed to bring this back down to normal? Do I have to change everything I'm doing? You know, it feels like much more of a commitment than they might have thought it was going to be. But that's where I think the human aspect really helps. Because we can intervene and say it's okay, you know, we don't have to fix this overnight. Let's set realistic expectations. Like maybe our goal isn't to be into the normal ranges in two weeks. Maybe our goal is to get there in three months and in the next two weeks we want to lower it by just 1% and let's try this one thing and stick to it. So I think for a lot of people it's meeting them where they're at and doing small, realistic, consistent changes to get there. But you have to have some sort of buy in, which I think is what's great about tools like this companies out there that is putting the power into the people's hands to take control of their health. Because if you have that buy in to take that step, it's, you know, we're now past that pre contemplation stage. Rather than your doctor referred you somewhere and you're not even bought in at all and you're not going to listen or do anything. But I think the key is like you don't have to make all these changes overnight. We want to do something that you can stick to. The most important thing in reaching your health goals is consistency. You know, if you're doing a diet today that you don't think you could do two years from now, maybe we need to switch it up a little bit. So that's kind of how we try to talk to people, is a way of being realistic rather than extreme.

It reminds me of this movie. Have you seen the movie what about Bob with Bill Murray?

I have not.

Oh my gosh, you'd frickin love it. Somebody please post it in the comment link right here. Wherever you're watching this, there's this phrase that Richard Dreyfuss, I believe is the actor. He has this book, it's about changing your life and he has this phrase, baby steps. You know, baby steps, small changes, baby steps, baby steps. And it's so funny because sometimes, like, the most powerful truth can be really, like, not hidden, but showcased in humor. And I think when we look at the jokes around all the social media memes when it comes to food and all the ways that people kind of poke fun at really eating healthy, it's because it's really hard. You know, for a lot of people, they learn these habits from their parents. They learned it at a very young age that food equals love, food equals connection, food equals emotional solace, food equals a way out of feeling whatever it is they're feeling. How much does glucose drive willpower? How much does glucose drive behavior and sadness and depression? Like, what's your. What's your academic and also your personal view on that?

Yeah. So this is a really interesting topic related to mood and anxiety and depression. And the research is probably not there. There's not a lot out there. There's definitely research to show that there's an association, a connection, but the mechanisms behind that and what might be driving that connection hasn't really been identified at this point in time. But I can tell you from working with a lot of people wearing CGMs is it is tightly connected. There's also something interesting just related to anxiety. A lot of people will come to us and they're like, I'm anxious all the time. I want to get control of my, you know, my feelings, how I can see the world. And when they're having these higher glucose spikes, they're like, that's when I feel anxious, I feel shaky, I feel nervous. And just by being able to study those energy levels, they're able to also study how they feel, which makes sense. You know, glucose is the primary source of energy for the body. I always describe our metabolic system as our cellular engine. It's what drives us to make any sort of process. And the main fuel that's going into that cellular engine is glucose. And so if your fuel system is all over the place, you're going to feel all over the place. So that's not necessarily a technical explanation, but that's how it feels for people, is that when I feel dysregulated, I can actually see it on the inside and those things are matching up, whereas if I can even that out, I just feel better. Um, so that's. That's been my clinical experience.

Profound. Because I think people miss the emotional quotient of this. Like, there's one thing to see how you, quote, feel after you eat a piece of food, but then there's a whole different understanding on a granular, like personal, heart based level of looking at your phone and just checking, wow, that actually drove me to like 1:75 or 1:50. There's something so uniquely powerful about that kind of awareness because it's nuanced. Look, I understand people have this argument where they're like, oh, let's go back to intuitive eating and eat like we used to when we were living in tribes. Well, guess what, people, we're not living in that world anymore. Yeah, we're on our computers, we're sedentary, we're in cars, we're like, we're not in that world. So of course we need. Of course, this is as Kevin Kelly talks about the technium bringing consciousness to us. Consciousness experiencing itself as technology. The founder of Wired magazine, Kevin Kelly. So when I look at something like a CGM on my arm and checking it on the phone and then working with a real human being, oh my God, what a great bridge between technology and human connection. Like, it is so profound and so powerful. How do you see this unfolding in this age of whether it might be forced mask wearing or further lockdowns or politics aside. Right. With the craziness that we're seeing right now just all over the map. It's just utterly. I know so many people are hurting right now because they don't know where to turn. The most powerful thing they can do is monitor their own health. So how do you see nutrients specifically plugging into this bridge? Give people some relief, to give people the answers during this time of increased stress.

Yeah, and I mean, it still is over a year later, really a time that is very stressful for people. And we have seen, again, I'm inspired by our customers. We have seen more and more people turn to tools like this because when something happens, you can either go in the opposite direction and you can feel bad and not do anything about it, or you can have that as inspiration to take control of your health. And we have so many people who are like, okay, now is the time where I actually need to get things under control or I need to know about my body, I need to get stress under control, or I need to know what I should be eating. And they're using this as a motivation, which I think is so inspiring. Again, it's not the negative side, it's the positive side of this is a moment of potential change for people where you could take a peek inside and actually see how things are affecting you. And is Your stress as bad as you think, what is your sleep cycle doing to your body? So it's a chance for people to actually take control. When it's a time when we feel really out of control and might not be able to control what the regulations are around you or how your family and friends are doing, but you can take control of your own health. And I think that it's important for people to realize that it is a place where we can do better and there's things we can do and we can always improve ourselves and it's not a hopeless situation.

How many times per week or per month is there that human connection with Nutrisense? Because every day people can scan and record. And that's, I guess the coolest part is like you just. I used it. You literally just hold your phone up to it and it makes this little click sound and then it buzzes the phone and then it just records it for you. Like, you don't have to manually write anything. It's actually a lot less effort. But there is effort when it comes to human connection, especially looking at the dark parts of ourselves that are driving the food behaviors. So how many times a week or how many times a month actually is that or does it depend?

It depends. So we really want people to be able to utilize it, whatever's best for them. So if you're a new client, your dietitian is going to reach out to you on that first day and kind of make a connection with you. And for some people, they message their dietitian every single day while they're on the program. So some people really take advantage of it and that's totally fine, they can use it that way. Whereas other people, they just want the dietitian to reach out occasionally to help point out things they might not be seen in their data. So maybe the dietitian's reaching out on average for those people once or twice a week. So you can really use it, however is best fit for you. But they're there to answer direct questions. But they're also going to reach out and kind of help guide you along as you're getting started.

One thing that was burning in my mind too when I was doing my research for this conversation was the element of stress and the element of food. Like, for example, if you ate a donut, maybe you're in a weak moment, or maybe it's just the right time because you love yourself and eating a donut is the best choice in that moment. I'm not here to demonize donuts, but let's just say that somebody ate a donut and it gave them a spike. Would it be very similar from a CGM reading if they had acute or chronic stress? Like, are those similar in some way?

They are. So an acute stress moment. And we see this all the time. You'll have a huge glucose spike just like you ate a donut. So we see this when people are having a fight with someone when they got in a traffic jam and they're mad and they're yelling at the car in front of them, when they're giving a presentation and they're nervous and they're stressed. We'll see that glucose spike just like you ate something sugary, which is amazing. And that's another mind body connection where you're like, whoa, I did not realize what this might be doing. And for some people, that might be every single morning on their commute to work. And it's not just this isolated, random, stressful event. And so when you can make that connection that this is really what's happening on the inside, maybe this is more impactful than I might have believed it was. That to me is just like a huge moment of connection and how you're feeling, how you're dealing with the events that are thrown at you and what's really going on. Wow.

And what a nuanced conversation that is. Right. There is no way that we could bullet that in one show. But if you could give some guidance to maybe somebody who is struggling right at that point. And obviously if you're feeling inspired like I have been just even learning about Nutrisense, let alone using it. Wellnessforce.com 397 you can go. There's a very special deal there for you there. And also there's a place where you can ask questions like, this is a open dialogue. This isn't Kara sitting on a mountain telling you what you quote, should do. This is a loving communication feedback here. But with that said, you know, is there a piece of guidance you could give somebody who is dealing with, with, should it be the donut or should it be the stress response? You know, they're fighting, they're in that moment of decision. That inflection point of like, should I eat the food or should I take the nap? What guidance could you give to them right there in that choice point?

I think it's really helpful when you're faced with tough decisions where the, the whatever's happening in the moment might be pulling you more than that Bigger picture goal to have a bigger picture motivation front and center for some of our clients that struggle with actually executing those things. I always go back to the big picture goal, like, what are you doing this for? Why do you want to be healthy? Why do you want to have good control of your stress? And for someone, it might be because I want to be a good example for my children or because I want to have a loving relationship with my spouse or because I want to be in control at work, feel confident, Whatever that big picture motivation is, I think it's much more important to keep that front and center. When you're in moments that are difficult. It's like, okay, I'm not doing this because I want to lose 5 pounds for bikini season. I'm not doing this because of XYZ short term reason. I'm doing this for something much more meaningful. And that helps, I think, overcome the in the moment temptations that will come up all the time in modern lifestyles.

Have you ever directed somebody to put like a picture of their baby or a picture of their husband or wife or on the fridge, like a 12 by 12 high definition photo of their big why, you know, on their fridge? Has that ever come up in conversation?

Yeah, whatever it takes. You know, some. For some people, it's literally phone reminders that go off in moments that they know are typically stressful for them. Like 3pm yeah, whenever that is. Or, you know, hanging it at your desk somewhere where you're going to see it. I think that's absolutely a good technique.

Metabolism. We've had so many experts on the show talking about metabolism, but I think about the way that metabolism is driven by so many processes in the body. There's metabolic health, there's metabolic dysregulation, and obviously this isn't a masterclass of that. But if you could just contrast CGM and metabolic health versus metabolic dysregulation just so people know what that is, so they can really trust this nutrisense and the cgm. So just contrast the two, please.

Yeah. So coming back to, I guess the analogy of the engine, you know, inside our bodies is a cellular engine. This is metabolism. So metabolism is two sides of the coin. It's breaking down things like the food you just ate to fuel your body. It's also using that to build other processes. So metabolism is this big picture thing and then what goes inside it is different fuel systems and different pathways that it can take, and the primary of which is glucose. But that doesn't mean it's the only picture to metabolism. I refuse to be myopic about that. Yes, we're using CGMs, but that doesn't mean glucose is the only thing that matters. We also have fatty acids in our system. We have micronutrients helping out these processes. We have ketones, potentially. There are other fuel systems, but it's all to help the cellular engine work at its best. I think about describing this as, again, a spectrum of metabolic health versus metabolic dysfunction. And as we move to that scale of dysfunction, that system is starting to break down. And maybe the engine is, you know, you're running it, you're putting the pedal to the ground all day long and the system is getting hot, it's burning down, it's running through all its fuel, it's having to figure out how to keep running at 100%. If we're putting so much pressure on our metabolic engine, then eventually systems are going to go wrong and, and you're going to see that through the different fuel systems, things like glucose and fatty acids. And so as we move through that spectrum, we want to catch it as early as possible and find out ways to help optimize our metabolic system in reverse. So it's a spectrum. It's not black and white. It's not like I have insulin resistance or I don't, I'm metabolically healthy or I'm not. There's a wide spectrum that takes decades to develop. It does not happen overnight, which is why the earlier we can catch it, the better. But we can catch it anywhere and always work towards better by having the right information about how that's running. You need to be able to diagnose the car in order to improve it. And we're the same way again. Then you have to have the motivation. Just like maybe your car, you know what's wrong with your car, but you don't care enough to fix it, then it's not going to get better the same way. In our system, that would be my very simple explanation of metabolism.

That's very powerful too. And as we wind down here, before we direct people what to do next, can you just give whatever your clinical and also your personal lens on this really is how to stop eating sugar. It is probably, I would say, in our community the number one thing people are stressed not sleeping enough, and a lot of that is driven by sugar. So how do you answer this question? How do you stop eating sugar? And also, where does the CGM play into this?

Yeah, and again, I always say there's no one size fits all. Some people are more all or nothing than others, but with sugar especially, it truly is an addictive. Substance, you know, it lights up the same pathways as a drug does. And so we don't tell those who feel like they're addicted to drugs to have a little bit each day in order to wean themselves off. We cut that off and we go through a period where it kind of sucks and then you feel better. And I really recommend that if you feel like you are truly addicted to sugar, because that happens, that's a real thing. And that first starts with controlling your environment. So if you're working at home, you're home all the time, and in your pantry that you can walk to at any second of any day is a bunch of candy and chips and pretzels, and that's going to be calling you again. Just like social media or technology like we were talking about. These food products are literally designed to be addictive. There's nothing natural about them. And I take your similar point of view of that's part of the problem with trying only to go through intuitive eating, because it's very hard to intuitively eat candy, because it's not a natural food that our body is prepared to handle. So I really think first having control of your environment, don't purchase those things, don't have them right next to you where it's tempting and you're having a hard time saying no, and instead focus on choosing whole foods as much as possible. And truly, when you get in that routine and then you taste that candy again, it tastes so much sweeter. It tastes so much different than when you were eating it all the time. And it was just part of this lighting up my dopamine system type of behavior. So then you can eat something mindfully and every once in a while, because you can sit there and eat it slowly and enjoy it, rather than it's something that your brain is driving you to do. So there's a long process, I think, in breaking a sugar addiction, but the first step is taking control of your environment and removing temptations that are calling at you every day.

So the CGM adds a window of awareness to why someone's eating sugar in the first place.

Yeah, absolutely. And again, it helps enhance that intrinsic motivation where it's like, maybe before it was just a mindless habit that every day at 4pm I grab whatever XYZ temptation I have. But then when you make this connection of, whoa, that's really what's happening. It's not just this harmless habit. It's actually affecting my whole day. And for a lot of people, then when they've started that temptation it ends a trickle effect of them craving more carbs, more sugar of the similar type, when instead, if they don't have that habit, then it sets the pace for the rest of the day. So it brings that awareness, just like you were saying.

And with increased awareness comes different choices, different behaviors. So it is literally. I can't stress this enough. It is literally the power of technology that is helping human beings reconnect with themselves. Like, I'm a very deep guy, I'm a spiritual guy, I'm an emotional guy, but I enjoy science. I think there's a war right now between, like, that's how I started our podcast together, right? Like, you. What I love about you and what I loved in just knowing you, before we even got into more knowing of you in this podcast, was when I looked at your work and I looked at the other media you had done, it was like, you take religion and science, you throw them off the table, and you're like, hold on, what's the real truth? How can we use the data of what's coming out of people's bodies to then apply the emotional intelligence, the science intelligence, and also the anecdotal intelligence that you've developed from working with so many people? So to round out the sugar question, because I want to dig just a little bit deeper. When people are addicted to sugar, there's the microbiome element, but there's also the behavioral element. How do they use the CGM and the phone to address both of those? When it comes to choosing new foods, obviously there's a human connection.

Yeah, absolutely. So I think, again, the behavior component to that is being able to make the connection of what's actually happening when you're reaching for that snack. A lot of people think it's like, it's a small amount of food. It's not really doing that much, but it might be having a ripple effect that lasts six hours. That's a huge chunk of your day. So it's building that awareness of truly what's going on on the inside, and then also allowing you the ability to make some substitutions, try something different the next day, and see how things differ. Like, you are in control. It brings the control back to the person because they can easily see what a substitution or what a switch might actually do to their body. So, again, it's an immediate gratification that helps build sticky habits is what we call them. You know, what we're trying to do is build sticky habits because they're intrinsically motivating, and you realize you can do it. A lot of times, from a coaching perspective, we'll just say, this is just an experiment. I'm not telling you you can never eat sweets again. But let's just experiment for three days in a row, not having that treat in the afternoon. Let's just see what happens. Let's see how you feel. Let's see how the data changes. And when things feel like an experiment, they don't feel as scary or as difficult because you're just trying something. And then maybe at the end of those three days, you see what a dramatic change it makes. You're much more motivated, you're more bought in that you're like, this actually worked. Maybe this is something I should stick to. So a lot of it is really finding ways for people to understand what's going on and to find something healthy to replace it with.

So powerful. And we have to have you back at some point. To talk more about the emotional side, I really wanted to cover the biometrics and what CGM means for behavior modification, behavior change. I think we did an amazing job of that. I'm really excited about this podcast reaching as many people across the world. What did we miss? You know, we covered a lot of ground when it comes to the external locus of control and habit reformation and continuous glucose monitor readings and what those mean as far as behavior and intuition. But what's something you haven't been asked on a show or something you really want to get out there to the world that potentially hasn't been covered?

That's a great question. Well, I think a lot of times we're really focused on, I guess, the ripple effect. Like, people are like, okay, if I get my glucose under control, I'm going to feel better, I'm going to be healthier, and I'm going to prevent diabetes. But something that made me just. It was on my mind because you said that you are an A.P.O.E. 3. 4. I'm an A.P.O.e. 4 4. So. Oh, wow, my heart. I feel you there. But that's also intrinsically related to metabolic health and glucose control. And so what I want people to realize is just what a ripple effect this can have. It's not just diabetes, but it is our mental health, our brain health, our cardiovascular health. The effect of being able to address a metric like this has a massive ripple effect. You're going to be able to optimize in all these different pillars of good health. I always say that our most common chronic conditions, which is neurological, cardiovascular and diabetes, sits on a bed rest of metabolic health and Metabolic good, good metabolic function. So again, that doesn't just mean glucose has to be good, but with the going with the 8020 rule, if we have really well controlled glucose levels, we've done a big percentage of the work towards good metabolic health. So it gives somebody one metric to focus on which is easier than trying to optimize 500 metrics or simplifying things. But I think that's important for people to realize is that it's not just this one condition that glucose is affecting. It's a molecule that goes through our entire circulation. Our blood touches pretty much everywhere. So if our blood glucose levels are abnormal, that's going to have an effect on every system in our body. So it's holistic, so to speak.

Sarah, Mike Drop. So much wisdom you share the show. Super appreciate your work in the world and what you and Paul and the entire team are doing at Nutrisense. So as we say goodbye with this quotient of technology and humanity and nutrition and glucose monitoring, how do you live your life? Well, what's Kara's definition of wellness? If you had to define wellness, what does that mean to live your life?

Well yeah, internally we use this phrase called health potential. So our goal, our internal mission is really to help anyone reach their health potential. And that's really how I think about wellness is we might have different health potential potentials. Again, there's no one size fits all. If I got into an accident as a child and I wheelchair bound for the rest of my life, I might not be able to run a marathon, but I can still have wellness, I can still have health, but my health potential is going to be slightly different than somebody else's. But I think wellness is being able to discover your health potential. So that means having the right data and insights so you know what you might not know before but then also being able to actually work towards that and constantly reaching towards your health potential. And I think that that is what wellness means at the end of the day it's multidimensional as you mentioned. It's not just physical, it's also emotional and it's also social and it's subjective and it's personal. But everyone has this unique health potential and I think we are all capable of working towards that and working towards optimal and true potential rather than just OK or management. And that is really how I view wellness and health.

Love your answer. I love the premise of potential. You know, reaching our potential involves sometimes having things outside of ourselves to remind us how awesome we are, how much we love ourselves. How much we are worth it. So everyone please go to wellnessforce.com397 you have a special deal. There's a special link. You can click there to connect with Kara with Nutrisense and start this journey of like understanding yourself so you can live your best life. Kara, thanks for coming on the show.

Thanks so much for having me. Sa.