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Topics:
1. Diane’s updates [3:46]
2. Our guest, Jimmy Moore [4:55]
3. Jimmy’s new book, Keto Clarity [7:43]
4. A ketogenic diet and nutritional ketosis [10:33]
5. Finding your carbohydrate tolerance level [15:14]
6. What impacts carb tolerance levels [23:59]
7. Is there benefit in cycling a ketogenic diet? [29:54]
8. Gluconeogenesis, friend or foe? [38:44]
9. Ketosis and thyroid dysfunction [40:25]
10. How low is too low? [45:29]
11. Does going low carb too long affect your metabolism of carbs? [47:53]
12. Physiological versus psychological benefit of “off” days [50:47]
13. Optimal athletic performance on ketosis [53:39]
14. Gut bacteria and a ketogenic diet [1:01:16]
Links:
Keto Clarity
LIvin’ La Vida Low-Carb
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Diane Sanfilippo: Hey everyone! Welcome back to the Balanced Bites podcast. This is episode number 150. Whoo! Coming up on 3 years of this podcast. It’s been quite a fun ride. I am Diane. And I am here without Liz today, but I have a fantastic guest for you all, and I know you’re going to absolutely love this interview. Definitely one of my favorite guests to talk to, we always have a really great time, and cover a lot of really fantastic information, so hang on just a second here while I talk about our sponsors.
We have Pete’s Paleo, bringing fine dining to your cave. If you’d like to make eating paleo a little easier on yourself, check out Pete’s meal plans. They are great for those nights when you’re just on the run or out of time and need real food fast. Pete’s Paleo now offers 21-Day Sugar Detox friendly meals, which will also make your life that much easier on the 21-Day Sugar Detox, which I’m going to guess a bunch of you are starting on August 4th, which is our next group that kicks off. So check out http://petespaleo.com/ for all the details. Be sure to check out chef Pete’s new cookbook, Paleo By Season, which has just released.
Chameleon Cold-Brew. One of our absolute favorite cold-brew coffees. Their new ready to drink single serving bottles are hitting store shelves all over the place. They have a black coffee, as well as a vanilla and a mocha. The vanilla and mocha are both every so slightly sweetened with organic cane sugar. The black coffee is just straight up black coffee. They also, of course, have their concentrates. So if you’re looking for something that’s got a powerful punch that you can kind of water down a little bit to make it just to your liking, check that out. They are rolling out in new stores all over the place. I know I’ve seen lots of folks commenting, I can’t find it near me, or I’m jealous! Just stay tuned. Keep checking their website, or just keep checking the stores shelves, because they may not have had it last week, and they may have it next week. You never know. And I think they’re hitting a bunch of Target stores, and a bunch of big chains. So just stay tuned on that.
And finally, last but not least, our newest sponsor, Splits59. They are a high performance and high fashion active wear company based in LA. I absolutely love their clothing. I’m pretty much always in at least one piece of it, and my favorite is the Ashby tank. So if you’re looking for a fantastic tank top to wear to the gym, especially when it’s really hot out or you’re looking for one you can wear, I don’t know, to sleep the night before, then all day, and then to the gym later {laughs} which is pretty much what I do, definitely check that one out. Their new collections are launching August 1st, and that will be tomorrow from when this podcast airs, as well as September 1st, so check out the new lines. They have generously offered you guys, our listeners, 15% off any regularly priced merchandise with the promo code BALANCEDBITES. So check out http://www.splits59.com/.
1. Diane’s updates [3:46]
Diane Sanfilippo: Let’s see. A really, really quick update before I get into it with our guest here. The next 21-Day Sugar Detox is starting on Monday; so if you’re listening when this podcast first airs, which will be a Thursday, that new group starts August 4th. So if you haven’t checked out the new online program, absolutely go check it out at 21DSD.com or 21DaySugarDetox.com. If you’re catching this episode a little bit behind schedule, you can always start a 21-Day Sugar Detox whenever you want. I think people really love starting with a group, because our moderators kind of move you along and check in with you along the way in terms of which day you’re on. But you can absolutely start it any time it works for you.
But, we also have a new group, don’t forget, that starts the first Monday of every month. So, if you’re mid-month and you’re wondering when the next one starts, it’s always that first Monday, so the next one, coincidentally, will be September 1st. So we don’t always start on the first of the month, but it’s always the first Monday, and you can just check that out at 21DaySugarDetox.com. The brand new online program is currently available, so I can’t wait for you guys to see that. I’m super excited about that.
2. Our guest, Jimmy Moore [4:55]
Diane Sanfilippo: Ok, done with my announcements! I’m really thrilled to have our guest here back; I don’t know if this is the second or third time. But it’s Jimmy Moore. And Jimmy has catapulted onto the scene in 2004, after a phenomenal 180-pound weight loss success enabled him to come off of prescription drugs for high cholesterol, high blood pressure, and respiratory problems. He’s the co-author of Cholesterol Clarity, and the energetic personality behind the uber popular LIvin’ La Vida Low-Carb blog, and host of one of the top ranked iTunes health podcast, the Livin’ La Vida Low-Carb show. He’s interviewed well over 900 of the world’s top health experts, and dedicated his life to helping people get the best information possible, so they can make the right decisions about their health. Jimmy lives with his wife, Christine, in Spartanburg, South Carolina, where they can often be found playing Frisbee golf out in their front yard. Learn more about Jimmy and his work at http://livinlavidalowcarb.com/. Welcome, Mr. Moore!
Jimmy Moore: Mr. Moore. That’s my dad’s name!
Diane Sanfilippo: {laughing}
Jimmy Moore: {laughing} Yeah, I think this is number 4 you’ve had me on.
Diane Sanfilippo: Is it! Oh my goodness.
Jimmy Moore: Yeah, because you guys had me on way back when, and then I was on post-PaleoFx one year, and then Cholesterol Clarity, so this is number 4!
Diane Sanfilippo: You’re memory is better than mine.
Jimmy Moore: {laughs}
Diane Sanfilippo: I have no idea.
Jimmy Moore: It’s those ketones, Di.
Diane Sanfilippo: {laughing}
Jimmy Moore: {laughs}
Diane Sanfilippo: Well, we’ve spent plenty of time together on the low-carb cruise, and at PaleoFx and AHS, and all these places, so I lose track. I lose track.
Jimmy Moore: It’s all good my friend. It’s all good. And congratulations on 150! That’s huge.
Diane Sanfilippo: It’s crazy! I can’t even believe it.
Jimmy Moore: 150. Wow. I remember that. {laughs}
Diane Sanfilippo: You know what’s really funny. {laughs} I remember the very, very first episode. There must have been maybe 3 other paleo specific, or 4 or 5, paleo specific podcasts out.
Jimmy Moore: Yep.
Diane Sanfilippo: And I remember the first question was from a guy that we knew, Bobby, shoot I’m forgetting his last name. But anyway, he asked, you know, what’s the critical mass on paleo podcasts! {laughs}
Jimmy Moore: {laughing}
Diane Sanfilippo: And I’m really laughing now, because of course, there’s probably 10 new ones since we’ve started.
Jimmy Moore: Well, and they dominate the top of the iTunes charts now.
Diane Sanfilippo: I know, it’s crazy.
Jimmy Moore: It’s amazing.
Diane Sanfilippo: It’s crazy. So, you know, I’m glad we’ve got our little spot here in the community. You know, Liz and I love to answer questions, but I also, I really love interviews like this because I get to be a little bit self-indulgent. Ask you questions that I want answered, as well as, we have a ton of listener questions today, so we’ll get into all of that. But I just want to get a little bit of background from you, because obviously there’s always folks who come to the show who, as you know, haven’t listened to the last 149 episodes.
Jimmy Moore: Yeah.
Diane Sanfilippo: So they maybe missed some. So why don’t you just give us a really quick rundown of why you wrote this book. I know Cholesterol Clarity came first. What kind of came of that, and what did you learn from that that then maybe pushed you into writing Keto Clarity?
3. Jimmy’s new book, Keto Clarity [7:43]
Jimmy Moore: Yeah, you know it was interesting. When Victory Belt actually approached me, and said, hey, we think you’ve got a pretty neat platform, would you like to write books. I was like, {stuttering} uh, uh, yeah! {laughs}
Diane Sanfilippo: {laughing}
Jimmy Moore: And so they said, pitch us a few of the book ideas that you have, and of course at the time they asked me to write books, I was in the middle of my N equals 1 experiment into this concept of nutritional ketosis that’s kind of been all the rage the last few years. I was like, well that’s the one I really want to write. That’s the book that is my heart and soul right now. And they said, well, that’s great. What else you got? And so I started telling them some of the other things. I said, well, there is this one that’s kind of been bugging me about the whole cholesterol issue leading to heart disease, yadda-yadda. And they were like, that’s the one we want you to write first! And I was like, oh, but I really want to write the ketosis book first! {laughs} But they were smart about that, because when you start talking about eating a high-fat diet…
Diane Sanfilippo: Yeah.
Jimmy Moore: The first thing people are going to say as an objection is, oh that’s going to clog your arteries, raise your cholesterol levels, give you heart disease, and you’re going to die of a heart attack. So they were very wise in getting me to do the cholesterol one first. Not that I didn’t have my heart in Cholesterol Clarity, because I did, and I really, I feel like I’m more adept at that issue now than I even was 2 years ago. It’s just made me that much more excited about the next book, Keto Clarity, which has kind of been the heartbeat of everything I’ve been doing the last few years.
Diane Sanfilippo: I think it probably gave you a little extra time to get through a few more experiments.
Jimmy Moore: Right.
Diane Sanfilippo: And kind of see what else. Inevitably, even if you have a project that you’re burning to do, more time is sometimes frustrating, but you can’t help but have better insights, or just more information over that additional amount of time. Because it’s just on your mind so much, right?
Jimmy Moore: And you know this, too, having written books. Even when you send it to the publisher and your manuscript is all turned in and it’s all banged out, in those months leading up until the release, you still are like, oh man! That would have been great to put in there! {laughs}
Diane Sanfilippo: {laughs} Oh yeah.
Jimmy Moore: So it’s like, you’re always going to be adding to it, that’s for sure.
Diane Sanfilippo: {laughs} That’s definitely one of the things that I stress the publisher out with.
Jimmy Moore: {laughing}
Diane Sanfilippo: Weeks before the book is supposed to print, I’m like, hold on! We have to add this!
Jimmy Moore: But wait, there’s more!
Diane Sanfilippo: Yeah, totally. Yeah, I definitely get that. So before we go into a lot of questions, and kind of more details. I want to definitely recommend, if you didn’t listen to the episode that we did on Cholesterol Clarity, just go back through the archives. You can search on BalancedBites.com or search the web for that interview, and definitely check that out. I’m pretty sure we have a transcript on it, so if anyone wants to check that out first.
Jimmy Moore: Yep.
4. A ketogenic diet and nutritional ketosis [10:33]
Diane Sanfilippo: Because we’re not going to talk a ton about cholesterol today, because we’ve already covered that. But I want you to define nutritional ketosis for people, and just talk briefly about the difference between a dietarily appropriate “ketogenic diet” that you might look at off the bat on a piece of paper, like, yeah, that’s a ketogenic diet. But what’s the difference between that and nutritional ketosis and how that applies to different people.
Jimmy Moore: Oh, and I love this question. We kind of take it on in Keto Clarity by telling the difference between, say a traditional Atkins diet, which is often times looked at as a ketogenic diet, and then this concept of nutritional ketosis, and it’s subtle, Diane. It’s really not something… I mean, it’s possible that Atkins could be a ketogenic diet, but not necessarily. People just automatically think, ok, if you cut your carbs, you’re going to get into ketosis, and that’s all fine and dandy. And I’m like, ok, I wish it was that easy {laughs}.
Diane Sanfilippo: Mm-hmm.
Jimmy Moore: For some of us who are especially metabolically resistant for some reason or another, you may need to be doing some other things. So, the three main hallmarks of a ketogenic diet is finding your personal carbohydrate tolerance level. That’s first and foremost. Absolutely. Everybody knows that that has ever gone on a low-carb diet. Some people can have upwards of 100 grams of carbs, and be just fine. Others need a lot lower than that. For me personally, it’s right around 30 grams that I know is my tolerance level, and that’s about the max that I can do without having blood sugar issues or weight regain. And then the second thing, and this is the big thing I learned during my experiment, was protein moderation. And that sounds weird, because everybody’s heard that a ketogenic diet is a high protein diet. Well, no, it’s not. Actually, by definition, it’s low in carb, moderate in protein, so you need to find whatever that protein threshold is that there is some threshold that that’s the maximum, because when you eat protein in excess, it will turn to sugar in the body. While it’s not a 1 for 1 thing, like, it’s the same as eating carbs. No, I’m not trying to say that! {laughs} But it does respond in that way. Especially if you are like me, one of those people that can’t tolerate a whole lot of carbohydrates, it only stands to reason you can’t stand a lot of protein, either. So, for me personally, protein is right around 80-100 grams per day. Which doesn’t sound like a whole lot, but I’ve been eating this way a few years now. It’s really no big deal anymore. It’s about 4-6 ounces of meat, for example, in a day. I also like to have…
Diane Sanfilippo: In each meal, do you mean? Or in one day? Wait…
Jimmy Moore: Well, and we’ll get to the meal frequency thing here in a minute. Sometimes I’m only eating once or twice a day.
Diane Sanfilippo: Ok.
Jimmy Moore: So, yeah. It could be for the whole day, 6-8 ounces, maybe, maximum. But you can’t have a whole lot when you’re only limiting yourself to 80-100. Now, I’m not saying everybody needs to do that. That’s just what I figured out is my threshold. In the book, we tell you what you can do to figure out what you’re tolerance level to carbs is, what your threshold to protein is. And the final element; here’s the one that I think is the biggest thing. And I’m going to write a blog post about this sometime {laughs}
Diane Sanfilippo: {laughs}
Jimmy Moore: But I think we are a fat deficient country. We’re not eating nearly enough fat in our diet. And it goes back to the conventional wisdom that has always vilified fat. It’s always vilified excessive calories. And we all know fat grams have 9 calories, and protein and carbohydrate have 4, so obviously we should gravitate to protein and carbohydrate, right? Well, I think that’s been the big, big mistake. So we are saturated and mono-unsaturated fat deficient. We’re not eating nearly enough, and I’ve got to tell you, Diane, I gave a copy of Cholesterol Clarity to my neighbor. She’s an obese lady, type 2 diabetes and all this stuff, and she is now eating lard.
Diane Sanfilippo: {laughs}
Jimmy Moore: She was having vegetable oils as all of her fat before, and now she’s living with her daughter, and she’s having lard and her daughter is giving her a hard time. Her daughter is also obese. A hard time about the lard. {laughs} But she’s sitting there going, nope. Jimmy Moore says it’s good. {laughs}
Diane Sanfilippo: {laughing}
Jimmy Moore: So those are the three elements.
Diane Sanfilippo: Right.
Jimmy Moore: Carbs to your tolerance level, protein to your threshold level, and eating enough of those fats to satiety. And if you do that, it would be nearly impossible not to create ketones.
5. Finding your carbohydrate tolerance level [15:14]
Diane Sanfilippo: So, I’m just going to touch on this briefly, because I know you get into it in depth in the book, but when you talk about figuring out your carb intake, your protein intake, there are testing devices and implements that people can use to figure that out, because I think people don’t really know what that means.
Jimmy Moore: Right.
Diane Sanfilippo: They’re like, well how do I know what my carb tolerance means? I know, there are some sort of qualitative ways to figure out carb tolerance for some people. We can look at, I mean, from what I’ve learned in the Poliquin biosignature, I can look at where somebody stores their body fat and see if what their eating carb-wise might be too much for them.
Jimmy Moore: Yeah.
Diane Sanfilippo: But when it comes to actually getting into ketosis, that’s where you probably have to test it unless you’re seeing you’re eating the same number of calories before, but you’ve dropped the carbs and now you’re having success with whatever it is you’re looking for. Right? I mean, for some people that may be fat loss, for some people it may be different.
Jimmy Moore: Absolutely. And even some standard blood tests that people run will kind of tell you, ok, I’m eating a few too many carbs, or whatever. One of those things is your triglycerides.
Diane Sanfilippo: Mm-hmm.
Jimmy Moore: If your triglycerides are over 100, you’re probably eating a bit too many carbs for your personal tolerance level, because the hallmark of triglycerides when you’re healthy is that they’ll be under 100, and optimally under 70. And, not to harp on cholesterol too much, but that is a very easy thing that so many people have had run.
Diane Sanfilippo: Yeah.
Jimmy Moore: And then the doctor will say, well it’s 148 so you’re normal.
Diane Sanfilippo: Yeah.
Jimmy Moore: Because they think normal is anything under 150. But that might be a bit too much. Back off on the carbs some more, watch those trigs drop like a rock, and then you’ve found your carbohydrate tolerance level.
Diane Sanfilippo: So, quick question on that, because I’m a huge fan of triglycerides being a much better marker of what’s happening with your blood sugar, blood fat because they are circulating blood fat.
Jimmy Moore: Mm-hmm.
Diane Sanfilippo: How quickly does triglyceride respond to dietary changes? Because we know that cholesterol sometimes responds differently in the short term than it will in the long term.
Jimmy Moore: Right.
Diane Sanfilippo: We know that one cholesterol measure is not really that, you know, doesn’t really tell much of a story. It’s like reading one paragraph of an entire book, perhaps.
Jimmy Moore: {laughs}
Diane Sanfilippo: But how quickly do triglycerides respond? And how easy is that to kind of manage?
Jimmy Moore: Yeah, it’s very fast Diane. I can tell you a story about my wife, Christine. She had triglycerides approach 300 back, what was that 2008, Christine? 2008? And she was still eating M&M’s and Skittles.
Diane Sanfilippo: {laughs} Oh no!
Jimmy Moore: We finally got her off of those things. Because she’s always been thin, never had a weight problem, so she didn’t worry about that kind of thing. So anyway. We saw the 300, and I said, well you know how to drop those. And she went, aww, crap. I’ve got to go low carb? {laughs}
Diane Sanfilippo: {laughing} Well, lower than M&Ms and whatever else!
Jimmy Moore: I know.
Diane Sanfilippo: Love you Christine! I’m waving.
Jimmy Moore: She came off of those things, and within 6 weeks, it dropped from nearly 300, down to 130. Today, it’s what, 50-something Christine, right? Because you’re hardcore keto now.
Diane Sanfilippo: {laughing}
Jimmy Moore: But yeah. It happens extremely fast to dietary change. And it’s something anybody can do.
Diane Sanfilippo: Right.
Jimmy Moore: And it will tell you exactly how many carbs you can tolerate. I mean, if you’re able to drop those trigs below 100 with 60 grams of carbohydrates, then go for it! I think that’s awesome. You’re able to have a very healthy metabolism, and you’re able to show that in your triglyceride levels, I think that’s beautiful.
Diane Sanfilippo: I think that’s also, before we keep going on the nutritional ketosis because I have a ton of questions here for you on that, but I do think that that triglyceride number also, even for the people who are listening who may not be interested in ketosis or nutritional ketosis for themselves…
Jimmy Moore: Yeah.
Diane Sanfilippo: I do think that triglyceride number, it is your marker. I mean, most people, we have two kinds of people. Some who really store a lot of fat in their blood, and some who store it on their fanny. {laughs}
Jimmy Moore: Right.
Diane Sanfilippo: And you know, it seems, I’ve seen this too. My mother is kind of the same way. Her body fat, she really does not gain body fat very easily. She’s looked pretty much the same for the last 10-15 years, but her triglycerides definitely take a hit when she’s eating more carbs than she should, and she’s active in yoga but she doesn’t do much cardio activity, she doesn’t lift weights, that kind of thing. So, I think that what I see with people, and I know that the listeners we have for the show, a lot of them are crossfitters, for example, and I know a lot of them, we do have questions about exercise and ketosis and all of that, but I think that people misunderstand. They aren’t sure that they can be super healthy and have really healthy triglycerides while eating more carbs, and they can.
Jimmy Moore: Yeah.
Diane Sanfilippo: It’s just that what you’re saying, if they’re eating 200 grams a day of carbs, and their triglycerides are still under that 100, then that’s working for them. Especially if their body fat levels are kind of in a healthy range where they want it to be. That’s your marker. That’s what you have. Especially, I think especially for my athletes who are worried about it all the time.
Jimmy Moore: Yep.
Diane Sanfilippo: Look at what your triglycerides are telling you, look at your body fat, and that’s the story at that point. So, I don’t know. That’s kind of the marker for me. I remember a couple of years ago, I know we probably talked about this when we did the cholesterol episode the last time I had blood work done, because {laughs} I’m like the opposite of you. You’re like the, let me read all of the numbers, and I’m like, scared of needles.
Jimmy Moore: {laughing}
Diane Sanfilippo: You know, I’ve done some ketosis blood testing, a couple of years ago I did it. But I remember a couple of years ago, when I was finishing Practical Paleo, I wasn’t eating low carb specifically, I was just kind of eating… I don’t even know. Whatever I could, because finishing a book was like, for me, pretty much the only thing I could handle thinking about. And my triglycerides were probably 42.
Jimmy Moore: Yeah.
Diane Sanfilippo: And that was without really thinking about it. I’m sure I was eating fruit and other things, and so for me, that was kind of the tell-tell. OK, my body can handle this.
Jimmy Moore: Yep.
Diane Sanfilippo: Whatever it is. I like that. I like that number, and I really want people to kind of take that as something to go on. Because triglycerides are measured in your standard panel, so that’s one really good number that you guys can all be looking at. And remember that that 150 being normal, that’s just compared to what the doctor sees across the board.
Jimmy Moore: Right.
Diane Sanfilippo: So, those of you listening to this show, you are not {laughs} you are part of this really small percentage of people who has a completely view of what to eat and what is healthy, and so to compare yourselves, not to be elitist here, but I really think the people who listen to these nerdy podcast, we’re not normal.
Jimmy Moore: {laughing}
Diane Sanfilippo: You know. So, to compare yourselves with what might be normal out there, I just think that that sets you up in a totally skewed way.
Jimmy Moore: Yeah. One more caveat on triglycerides.
Diane Sanfilippo: Yeah.
Jimmy Moore: If you are actively losing weight, get weight stable for a couple of months, and then test your triglycerides because sometimes, and Dr. William Davis actually pointed this out to me, that you’ll have those triglycerides floating around in the blood stream as you’re releasing body fat, and it will give you a false-positive high, so just be aware. If you’re losing weight, get weight stable, and then test.
Diane Sanfilippo: OK, that makes a lot of sense. It’s kind of the same thing we say with cholesterol, too. I mean, obviously different type of number, but cholesterol is kind of the same way. You can’t test it and get something that you think is super accurate while you’re losing weight. There’s a lot going on there, at least according to Chris Masterjohn.
Jimmy Moore: Right.
Diane Sanfilippo: Sorry, I’m hearing a scratching, and it sounds like my cat might be trapped somewhere.
Jimmy Moore: {laughing}
Diane Sanfilippo: I’m looking around my office.
Jimmy Moore: {high-pitched} Help me!
Diane Sanfilippo: Like a crazy person. I have no idea what’s going on here. Ok.
Jimmy Moore: {laughing} Meow!
Diane Sanfilippo: I think he could be trapped.
Jimmy Moore: Ok, go get him. I’ll wait on you.
Diane Sanfilippo: No, he’ll have to wait until the episode is over.
Jimmy Moore: {laughing}
Diane Sanfilippo: Paleo kitty.
Jimmy Moore: Meow.
Diane Sanfilippo: The dog is asleep, and I’m not helping you. I don’t know where you are, but I’m not helping you. Ok.
Jimmy Moore: This is why I love the Balanced Bites podcast.
Diane Sanfilippo: {laughing}
Jimmy Moore: You just let random things pop up.
Diane Sanfilippo: We let it go.
Jimmy Moore: I never do that on the LIvin’ La Vida Low Carb show {laughing}
Diane Sanfilippo: Our listeners really like when we digress and talk about random things. You know, I know I like it when I’m listening to a podcast.
Jimmy Moore: Yeah.
Diane Sanfilippo: I appreciate polished podcast, but I also, I listen to guys like Robb Wolf, and Chris Kresser.
Jimmy Moore: Yeah.
Diane Sanfilippo: And they just kind of go off on a tangent, I don’t know. Especially if I’m driving, it kind of keeps me awake.
Jimmy Moore: Yeah, I heard one recently with a couple that was on the low-carb cruise this year, and we had all kind of mistakes happening, and technical issues, and people said, that was the greatest podcast ever man!
Diane Sanfilippo: {laughing} Yeah, you know, you just want to listen to a conversation, and we’re just talking here.
Jimmy Moore: We’re just jibber-jabbering.
6. What impacts carb tolerance levels [23:59]
Diane Sanfilippo: Totally. Alright. So, let’s see. I’m just curious what you think impacts carb tolerance level. I have kind of a few questions built into this one, so what do you think affects carb tolerance level. What have you seen for yourself, and what you think that might extrapolate out to, you know, for other people. I’m going to say, probably besides activity level because I think that might be an obvious one, but you can throw it in there. Do you think that can change over time, up or down, and just kind of your general take on what affects that.
Jimmy Moore: Yeah, that’s a super interesting question, and we really didn’t get like, real in depth about the root cause of that. But here are my kind of theories about that. I think insulin resistance over a sustained period of time is probably going to make you a lot less, or a lot more, excuse me, sensitive to carbohydrate. I mean, I was 410 pounds at one point in my life, and had that weight for most of my life. So no doubt, and I don’t have any clue what my blood sugar or fasting insulin levels or any of that was prior to the age of 32 when I finally made the change and lost the weight. I think all those years of that persistent insulin resistance that did not get fixed or have any kind of treatment on it, it took a toll on my body. And so, that’s why carbohydrates are still a big issue for me. Will it improve over time? I’ve been doing this a decade now, Diane, and I’ve tinkered around with higher amounts. My answer for me is no. It hasn’t come back yet. Maybe I was that bad off, and I need more time {laughs}, but I know people like Dave Aspry has said, well it might rebound if you keep at it for a few more years, you’re body will finally heal and you’ll be able to tolerate more. But I don’t know, I don’t think that’s universal for everybody.
Diane Sanfilippo: So I’m curious what you think, too, when you say after years of insulin resistance.
Jimmy Moore: Mm-hmm.
Diane Sanfilippo: Do you think, because we know what happens when people eat very low carb is that they appear insulin resistant in some ways.
Jimmy Moore: Right.
Diane Sanfilippo: Not visually necessarily, but their blood work.
Jimmy Moore: Right.
Diane Sanfilippo: But it’s not from a pathology. They’re not ill, insulin resistant because they’ve over done it, or their body is just kind of metabolically challenged in that way.
Jimmy Moore: Right.
Diane Sanfilippo: Do you think that, you know, what if somebody is eating, they are a generally healthy person, they decide to go ketogenic and be eating keto for 10 years.
Jimmy Moore: Mm-hmm.
Diane Sanfilippo: Do you think that that might, you know, make it so that their body is then adapted to that to the end that they can’t then go back. Would that maybe break their system? I mean, this is just perhaps guessing. But if they’re insulin resistant for a long period of time without the pathology behind it, do you think that would affect their ability to digest or tolerate carbs in the future?
Jimmy Moore: Whoo, that’s a loaded question.
Diane Sanfilippo: No. I’m just, it’s just my curiosity.
Jimmy Moore: No, no, no. I mean, I’m thinking through that because I think most people who get into wanting to be on a ketogenic diet for weight loss purposes, they already come into it pretty severely insulin resistant already. I was. I didn’t even know what insulin resistance was at the age of 32, but I know I had it. {laughs}
Diane Sanfilippo: Right.
Jimmy Moore: And I guess what I hear you saying is, is the very low-carb ketogenic making it even worse. Is that what you’re asking?
Diane Sanfilippo: Not necessarily for you. So, your experience was, you became insulin resistant probably due to both nutritional deficiencies.
Jimmy Moore: Right.
Diane Sanfilippo: Actual micronutrient deficiencies because what you were eating was not healthy food, and over carbing, under nutritioning {laughs} yourself. That’s my term right now.
Jimmy Moore: Mm-hmm.
Diane Sanfilippo: But, for somebody who is eating a low-carb diet with pretty good nutrient levels. I’m just curious. You don’t have to have an answer. It’s just a curiosity that I have.
Jimmy Moore: Yeah.
Diane Sanfilippo: I kind of assume, I don’t know. I assume it wouldn’t make you unable to tolerate carbs, but at the same time if you look at an evolutionary perspective, right? Some of these cultures that did eat very low-carb diets, they probably weren’t then eating a very high carb diet necessarily unless that was just seasonally appropriate for them.
Jimmy Moore: Right.
Diane Sanfilippo: Like, the Eskimo cultures, there isn’t ever a time where there are mangoes all over the place.
Jimmy Moore: Right.
Diane Sanfilippo: I don’t know. These are just guesses.
Jimmy Moore: Yeah. I think I get what you’re saying now. So it’s pretty much, I think if you eat this way, why would you turn back if you’re seeing benefits? And that’s kind of what we talked about all through Keto Clarity. You’re doing this with a purpose in mind; the purpose in mind is health benefits, and we name them all and give 185 references in the back of the book if –you want to see that this has actually been shown in science to help with. So there’s a purpose in mind, and getting into ketosis and in that pursuit of it, you just have to keep your eye on the ball, so to speak {laughs}.
Diane Sanfilippo: Yeah.
Jimmy Moore: And, if these things along the way, I had a fasting blood sugar that’s 101, but your A1c is still 4.9 overall, it’s really not a big issue. I don’t think. But I do see that happening in people. I do have people freaking out because they have the high fasting blood sugar, and, oh what’s this mean? Am I insulin resistant? Am I turning to diabetic? I’m like, no. Overall, you’re metabolically much healthier now than you would have been but for the ketogenic diet.
Diane Sanfilippo: Ok, so why would somebody not want to keep going that way. I mean, I can have a really easy response to that. I don’t know, cookies?!
Jimmy Moore: {laughing}
Diane Sanfilippo: You know, people want to eat cookies or cake.
Jimmy Moore: Yeah.
7. Is there benefit in cycling a ketogenic diet? [29:54]
Diane Sanfilippo: Ok, so my question here. Sorry, clearing my throat here. My question here, before I get to our listener questions, I promise we’ll get to those next, as I’m coming up on about a half an hour here. So my question is, and it’s a little bit self-indulgent because I’ve been doing a cyclic sort of low-carb thing which I do, I don’t know, whenever I feel like doing something different. I find that my body responds to it. If I feel like I’m eating too many treats or I’ve just kind of not paid attention.
Jimmy Moore: Mm-hmm.
Diane Sanfilippo: My body responds really quickly to too many carbs. I will easily just gain that little layer of extra body fat that I maybe don’t want. So I will eat lower carb. But for me, what makes me keep my sanity is one day a week, I’m not eating low carb.
Jimmy Moore: Right.
Diane Sanfilippo: And it’s not that I’m eating gluten and junky stuff, maybe it will be some gluten-free pizza. But it’s generally going to be just that I’m eating fruit.
Jimmy Moore: You don’t do the Kiefer cherry turnovers? {laughing}
Diane Sanfilippo: No. I can’t. No.
Jimmy Moore: {laughs} He’s one of my experts in Keto Clarity, by the way.
Diane Sanfilippo: Yeah. I actually was going to listen to his episode over on our friend, Sean Croxton’s show, too. I’m interested, I’m totally interested in what he has to say. I’m just not a low-food quality person.
Jimmy Moore: Yeah.
Diane Sanfilippo: I’m just, I get it, but meh. I’m not interested in it. I’m kind of past that.
Jimmy Moore: You’d rather have sweet potato anyway.
Diane Sanfilippo: Uh, yeah, I don’t know. Yeah or fruit. I mean, I just want to eat 5 mangoes. I think mangoes are delicious. {laughs}
Jimmy Moore: {laughs} You could have 30 bananas a day if you ask Harley Johnstone.
Diane Sanfilippo: I know, right?
Jimmy Moore: {laughing}
Diane Sanfilippo: So, what I’m curious about, your take on it, because we’re not talking about just eating low carb here. We’re talking about nutritional ketosis and what your focus in Keto Clarity is. From what you’ve seen, in your experiment and maybe from talking to others.
Jimmy Moore: Mm-hmm.
Diane Sanfilippo: Is it the type of thing you have to do 100% of the time, or are there little bits of give and take where somebody could cycle it, where they’re doing 6 days. And I’m sure this will come back to testing and seeing how your body responds, but have you seen people be successful with nutritional ketosis with spikes in their carb intake here and there? Maybe it’s regularly once a week. Maybe it’s every couple of weeks, something like that.
Jimmy Moore: Yeah.
Diane Sanfilippo: Or have you seen that just absolutely not work and there’s no lee-way. I’m asking that, because what I see in working with people is, not having lee-way for a short amount of time is fine. People can handle 3 weeks, 4 weeks, maybe 6. But after that amount of time, people are like, you know, I just don’t want to feel like I can never have X, whatever that is. So what has been your experience with that?
Jimmy Moore: You know, I think it varies on the personality. I’m the type of personality that’s like, you know what, I can do this hardcore for months on end, it doesn’t bother me. But I get it. I do know there are people who are not robots like Jimmy Moore. Just kidding. And they have to have that lee way where they’re able to have an indulgence. And what I’ve found personally, and I’ve actually heard from a lot of people about this, is if you get out of ketosis because of a higher carb day or a bit more protein or whatever on some given day, you get back into it pretty darn quick. I know for me personally, and I test, and we can talk about the testing in a minute, but I test voraciously to kind of see where I stand. And, if I get completely out within 2-3 days, I’m back in. Now, I know some of the low-carb experts out there; Dr. Steve Phinney, especially, he’s kind of thrown out this, well if you have one indulgent meal and get out of ketosis, it could take you 3-4 weeks to get back into ketosis. Well, that’s not necessarily true. Maybe early on, if you’re not already low-carb or already kind of in a groove ketogenic wise, that’s probably true. But in terms of people who have been doing this a while. And again, been doing this for several years now, you get back into it very, very quickly. No, I don’t think it’s the end of the world if you’re doing what you’re doing right now with a cyclical ketogenic. How quickly do you get back into ketosis after having your one day meal of carbs?
Diane Sanfilippo: {laughs} That implies that I’m currently testing it.
Jimmy Moore: Ahhhh. I want to know your results.
Diane Sanfilippo: I’m curious. I mean, I don’t like needles. {laughs}
Jimmy Moore: Yeah.
Diane Sanfilippo: I don’t have a breath tester. Maybe …
Jimmy Moore: We’ve got to get you a breath tester.
Diane Sanfilippo: That, you would get me to use that. That I would use.
Jimmy Moore: {laughs}
Diane Sanfilippo: If I don’t have to pee on a stick, or do the {laughs} do the blood test.
Jimmy Moore: Yeah.
Diane Sanfilippo: I’m definitely a firm believer in the blood tests being a little more accurate than the keto sticks, which you talk about that as well.
Jimmy Moore: Yeah.
Diane Sanfilippo: But yeah. I really, hmmm. Basically, I think what happens for me with the low carb approach. And I am sticking around 30 grams.
Jimmy Moore: Mm-hmm.
Diane Sanfilippo: If I exercise, which, when I do it, it’s very intense. As you know, I do Crossfit, and I really like the intensity of that.
Jimmy Moore: Yeah.
Diane Sanfilippo: Some days, it will go up to like 60 if I’m exercising, and I’m just feeling like I need a little more something.
Jimmy Moore: Yeah.
Diane Sanfilippo: But for me, I think the reason why it works well is I have better satiety and I’m just more attentive to what I’m eating. And it’s almost like, uh, it’s a qualitative not quantitative ketogenic approach. I’m counting, but I don’t know if I’m getting into ketosis. I can’t imagine how I couldn’t be over time with that low.
Jimmy Moore: Right.
Diane Sanfilippo: Of a carb intake, and with my activity level, but I think what happens is I’m just not as hungry because, you know, the fat is more satisfying. And I’m usually eating around 2,000 calories a day on ketosis. So, I don’t know.
Jimmy Moore: Yeah.
Diane Sanfilippo: I don’t know. I’d have to test it, and a breath test would be great for me.
Jimmy Moore: Yeah. We share all about, and I gave a lecture on the low carb cruise this year.
Diane Sanfilippo: Mm-hmm.
Jimmy Moore: I gave up my cholesterol lecture to you so that you could talk.
Diane Sanfilippo: You did. {laughs}
Jimmy Moore: But I actually got to give that at Perdue University last month, so that was a lot of fun. But I did a whole talk on just all the different ways to measure for ketosis. And everybody likes the urine strips, and they’re ok, but unfortunately for some people, you lose those urine strips, and it becomes more of a negative for those people rather than a positive reinforcement. So I don’t really like those, and they’re kind of mess. And then the blood test really is the gold standard right now. The precision extra meter really is the best one, but it’s so fricking expensive {laughs} nobody wants to spend all that money like that. And so, there is kind of an in between technology that measures for breath ketones. So there’s three different ketones bodies; the one in the urine is called acetoacetate.
Diane Sanfilippo: And, I’m sorry to just kind of crack and go here.
Jimmy Moore: Oh, you’re good.
Diane Sanfilippo: It’s not your partner as the breath test of what {laughs} your ketones may be.
Jimmy Moore: {laughing} Yeah. Honey, does my breath stink?
Diane Sanfilippo: Does my breath smell like ketosis?
Jimmy Moore: Yeah, we get that one a lot too. It’s like, my husband doesn’t want to kiss me because I have keto breath. I’m like, tell him it’s sweet breath.
Diane Sanfilippo: {laughing}
Jimmy Moore: And pop a mint.
Diane Sanfilippo: Yeah.
Jimmy Moore: {laughs} So, yeah. Acetoacetate is the urine ketone, and then the blood ketone is called beta hydroxybutyrate. That’s the one that’s actively free-flowing in the blood. And then the last one is kind of an emerging technology, it actually was around way back when. I know Dr. Atkins had it in his clinic from the late 70s all the way to the late 90s when the thing died and they went out of business. But it’s a breath ketone meter, measures acetone in the breath. Well, there’s a bunch of companies now, there’s even some companies in Japan, trying to work on an app that would allow you to do it right there with your smart phone. You just blow into it, and it tells you your level of ketosis. So, a lot of great technologies that are out there; find the one that works for you, and find the one that you think you can do if you’re like Diane Sanfilippo and you’re freaked out by pricking your finger.
Diane Sanfilippo: {laughing}
Jimmy Moore: Don’t do that. Go blow, or pee on a stick, but do something because you don’t really know. It’s just totally a guessing game if you don’t know your level of ketosis. You really have to test. And we did put this nice little acronym in the book to help people know how to get into ketosis. So, it’s keto, K-E-T-O; K is keep carbs low; E eat more fat; T test ketones often, and O overdoing protein is bad. So, hang that up on your refrigerator, and it will remind you what it takes to get into ketosis.
8. Gluconeogenesis, friend or foe? [38:44]
Diane Sanfilippo: Awesome. So, that actually leads very nicely into the first question that we got, which I think you’ve probably touched on, but if you want to rapid fire this one. From JC, his question is, gluconeogenesis, friend or foe? I’m going to guess.
Jimmy Moore: {laughing}
Diane Sanfilippo: We’re going to call that one a foe, but can you give people a quick heads up on what gluconeogenesis is and how it affects nutritional ketosis?
Jimmy Moore: Yeah. Gluconeogenesis is this long fancy shmancy word that just means when you eat a lot of protein, more than your body needs, the excess will be turned into glucose by the liver. And that’s a completely normal process. That’s one of the reasons, GNG is the short for gluconeogenesis, that’s one of the reasons why you don’t really need to eat any carbohydrate. You know, whenever you hear, us low-carbers, we like to say, well there’s no dietary need for carbohydrate. Well, that’s what we’re talking about is gluconeogenesis takes care of giving you all the carbs you need, that if your body wants to run on glucose, you never have to feed it any carbs and you can still get plenty of glucose to be a sugar burner, because of gluconeogenesis. Is it a friend or foe? I think it can be both. It’s a friend if your body has a specific need for glucose that needs to be somewhere in the body. But if you’re trying to be a fat burner, it can be a foe. That’s why moderating down on the protein, and of course keeping carbs to your personal tolerance level is so important. You’re trying to ward off the effects of that so you can produce ketones. Because you can’t have gluconeogenesis creating a whole lot of glucose in the body and expect to have ketones, as well, at the same time.
9. Ketosis and thyroid dysfunction [40:25]
Diane Sanfilippo: Awesome. So, this next question is kind of one that we have in a few different versions throughout what my listeners and fans have kind of posted. So, I know this is one you and I talked about a little bit, too. This one is from Danica. She said, “I have a question regarding Hashimoto’s. I’ve read conflicting information that ketosis may be harmful for those with this autoimmune disease. I would love clarity on this,” I like her use of that word.
Jimmy Moore: {laughs}
Diane Sanfilippo: I’m concerned that not enough carbs may reduce my thyroid function even more.
Jimmy Moore: Yeah, this has been out there for a few years now, and I’ve been quite frankly shocked that it hasn’t been responded to before now. And I hear it on every podcast. I listen, I’m a health podcast junkie, you would think doing 3, 4, 5 a week I wouldn’t listen to anybody else, {laughs} but I do. I listen to yours, and a whole bunch, and that one consistently comes up, because it has not adequately been addressed. We tried to address it in Keto Clarity, and here’s the bottom line. And, we did talk about this before we came on the air. I think the big issue is not so much very low carb, it’s more very low calorie. So, if you’re not eating adequate calories, than the thyroid function can be diminished. So, people, please! Up the fat, that will up the calories, and you won’t have those thyroid issues.
Now, is that true for everybody? Ok, maybe not. Maybe one of the experts in the book was Nora Gedgaudas, and she said, maybe some people came into a ketogenic diet already predisposed for something with their thyroid. So, we can’t blame it on the ketogenic diet; they were already headed that way to begin with. And my wife is over there raising her hand, because she recently had to go on Armour thyroid medication. And she’s eaten kind of low calorie as well. So it’s a confusing topic for people, because nobody has really adequately head on taken on that issue before, but it’s been out there as a meme, in the paleo community especially, well you can’t eat very low-carb ketogenic, it will damage your thyroid. And people have believed that. Hopefully we’ve given a good enough response in Keto Clarity to give people a little bit of peace of mind about that now, now.
Diane Sanfilippo: Yeah, I do think that everyone has to see what’s working for them. I don’t like the idea that just because you have Hashimoto’s and you hear that you shouldn’t do something. If you try it, or if you’re doing it, and you feel good eating that way…
Jimmy Moore: Mm-hmm.
Diane Sanfilippo: I think, you know, blood markers can be one thing. So this is kind of, you cover this, I know, in the book, that the blood markers that people are checking regarding thyroid function can sometimes tell a story that appears to be low thyroid function.
Jimmy Moore: Right.
Diane Sanfilippo: While they’re in ketosis, but the same sort of rule, I think, applies to what we’re seeing with that, as what we see with perhaps this appearance of insulin resistance that is not based on pathology. It’s not based on something being sort of wrong, or broken, or there being illness in your body. It’s just, maybe your body, your thyroid doesn’t need to produce as much if you feel good. If you feel energetic, your metabolism is working as you feel it should, those are the biggest signs of thyroid function is your body temperature, your energy, and your metabolism. Obviously there are a lot of other connected symptoms that can appear. But I think it’s just something that was kind of interesting to me when I was looking through the book and just kind of turned on a light bulb for me. Like, ok, so this is where we’re getting the same kind of effect where perhaps thyroid function might reduce, but it’s not necessarily because of a dysfunction.
Jimmy Moore: Right.
Diane Sanfilippo: Or the numbers may reduce, but it’s not necessarily a dysfunction, it’s just a lower need for that production.
Jimmy Moore: Yeah. One of my experts was Dr. William Davis from Wheat Belly fame, and on page 190, he has this quote. “This specific situation does not represent,” talking about lower thyroid numbers. “Does not represent disturbed thyroid function, but rather a physiologic adaptation to limit weight loss by reducing metabolic rate, a survival mechanism that is meant to protect the body from starvation. These hormonal adjustments are transient and correct themselves over several weeks after the weight has plateaued, but it does not represent some kind of thyroid dysfunction.”
10. How low is too low? [45:29]
Diane Sanfilippo: Ok. And I, you know, I just want to let people know, too. If you’re concerned about this stuff, definitely work with your doctor. We’re not attempting to give you specific medical advice, or anything. We’re just kind of letting people know kind of what the information is that we have based on the best research that we’re all able to do, and collect, and all that. Ok, so we’ve got one question. I don’t know this person’s name because it was an Instagram handle. How low is too low? I assume that means with regards to carbohydrate intake.
Jimmy Moore: Right.
Diane Sanfilippo: That was it. {laughs}
Jimmy Moore: So, I think it goes back to your personal tolerance level. I think there are some people where 100 grams is probably just fine. And then there’s other people 50 grams is just fine. And I would probably argue, Diane, that 50 grams, most people. Most people could probably be ketogenic at 50 grams. 30 grams for me, but there are probably people more messed up than Jimmy Moore out there {laughs} that might have to go 20, 15, 10. I don’t know. I don’t think there’s any such thing as too low. You just have to do those things that we talk about in the carbohydrate tolerance chapter of, do these test and kind of find where your tolerance level is. And if it’s 10 grams, then by golly, rock on with your 10 grams.
Diane Sanfilippo: And so, a quick follow up just from me on that, is if somebody really finds that eating, like you do, eat 30 grams a day, do you take a multivitamin? Do you supplement with vitamin C or some other nutrients that you may not get when you don’t eat carbohydrates?
Jimmy Moore: Yeah. Great question. And besides having organ meats where you can get a lot of those kinds of things into your body.
Diane Sanfilippo: Right.
Jimmy Moore: And I highly recommend, thanks to the paleo community, y’all have really influenced me on that one. Yeah, I do take an iron-free multivitamin, because I get plenty of iron in the foods that I’m eating, mostly kind of animal based products. So yeah, I take a multivitamin and other vitamins. So yeah, I do do that. Do you necessarily need to do that? It’s probably a good idea if you’re not eating a whole lot of carbohydrates, but you can get some really good bang for your buck nutrition from the organ meats and organic vegetables. You can still have some vegetables. Obviously, with 30 grams, I could have a couple of handfuls of raw spinach, for example. I really love raw spinach with avocado oil on top; oh, so good.
Diane Sanfilippo: Awesome. Ok, so let’s see. A couple more of the same type of thyroid questions, so I think we covered that. I think, I’m looking at some of these other questions. I feel like we’ve ended up covering them. There’s one on long-term low-carb versus the occasional carb night, which is kind of what you and I talked about.
Jimmy Moore: Yep.
11. Does going low carb too long affect your metabolism of carbs? [47:53]
Diane Sanfilippo: You know, this is kind of a follow-up. If you think being low carb too long can make you metabolically inflexible, like not really being able to handle the increased carbs without losing progress. I’m just curious if you have thoughts on that or if you’ve seen people really experience negative effects from longer term, and then trying to go back to some carbs. You know, a higher carb level. Have you seen anything on that?
Jimmy Moore: So, I would flip that question on its head and I would say, what are the long term effects of staying too high in carbs when you needed to be lower? I think the damage from that, and trying to go low-carb from that state is much more profound than trying to go low-carb, and ok adding in a few more carbs back into the mix. You know, I think this is kind of a moving target here. Like we talked about earlier. Some people probably over time will be able to tolerate a bit more carbs. And quite frankly, that 30 grams that I have now is about 10 more than I used to about a decade ago. So, slowly but surely {laughs} I’m getting a little bit higher on that. It just takes time for some people, and some people you just have to be happy with, and by the way I am very happy with, being at 30 grams of carbohydrate in a day. I don’t have those cravings anymore, the ketosis helps with that. I don’t have hunger anymore. Butter helps with that. All of those things, I just don’t see a reason that you would want to get away from it if it’s giving you optimal health benefits and it tastes good in the process.
Diane Sanfilippo: You keep forgetting about cookies.
Jimmy Moore: {laughs}
Diane Sanfilippo: {laughs}
Jimmy Moore: I don’t eat cookies.
Diane Sanfilippo: I don’t see a reason! I know. I know.
Jimmy Moore: I eat meat cookies!
Diane Sanfilippo: Meat cookies. I know.
Jimmy Moore: Maybe, what’s that, bison bar at the, Epic bar!
Diane Sanfilippo: Oh, yeah.
Jimmy Moore: Maybe an Epic bar. {laughs}
Diane Sanfilippo: Those are good. You know, I’m laughing because, it slipped my mind, you were talking and I thought of something, and then I kind of forgot. A few minutes ago you said something about being a robot, or not being a robot.
Jimmy Moore: Yeah. {laughs}
Diane Sanfilippo: I remember saying it, I don’t know what you were talking about, but anyway. I make this joke, I just did this video series for the 21-Day Sugar Detox, and in the last video I said, you know, it’s not very likely that over the course of the year, you won’t, at some point encounter eating something sweet. And, you know, obviously an example like a birthday cake, or something. Maybe once a year. Something. I said, unless you’re a robot! {laughs} And I was just laughing because…
Jimmy Moore: Because I said robot and you had just written it {laughs}
Diane Sanfilippo: Yeah, you’re just kind of like, maybe Jimmy Moore is a robot.
Jimmy Moore: {robot voice} I am a robot.
Diane Sanfilippo: He really doesn’t need anything sweet.
Jimmy Moore: What crazy man does 5 podcasts a week, anyway, right? {laughs}
Diane Sanfilippo: And then listens to all of the others.
Jimmy Moore: {laughing}
12. Physiological versus psychological benefit of “off” days [50:47]
Diane Sanfilippo: I’m curious. You know, I’m not