Episode #412 – Full Transcript

Affiliate Disclosure


From podcast: https://bengreenfieldfitness.com/podcast/qa-412/

[00:00:00] Introduction

[00:00:38] Talking About Coffee

[00:07:32] News Flashes: Breaking News Story On Coffee

[00:26:41] Talking About Lipids

[00:28:13] Recent Thoughts from Cate Shanahan

[00:38:24] Special Announcements

[00:40:54] Podcast Sponsors

[00:45:11] Hyperbaric Oxygen Therapy (HBOT) vs. Exercise With Oxygen Therapy (EWOT)

[00:57:55] Tips On Increasing Progesterone Levels

[01:12:14] Do Jaw Exercisers Work?

[01:20:09] Closing the Podcast

[01:21:43] End of Podcast

Ben:  In this episode of the Ben Greenfield Fitness Podcast.

Is cholesterol and coffee bad? And how to make your coffee as healthy as possible, what to do about low progesterone, the effect of carbs on your immune system, and much more.

Health, performance, nutrition, longevity, ancestral living, biohacking, and much more. My name is Ben Greenfield. Welcome to the show.

Alright, Jay, turns out that there have been some studies coming out about coffee that we're getting into on today's newsflashes. So, that begs the question, what did you have to drink this morning?

Jay:  I thought you might follow up with that. I hadn't seen those articles until you showed me them and I'm excited to talk about them. But this morning, I did indeed, I had two cups of coffee, which is probably about average for me. And when I say two cups, I'm not talking about the traditional eight-ounce. I'm more like a ten-ounce guy.

Ben:  Ten-ounce, by the way, that's a thimble, dude. That is a thimble. So, I find amazing quote, and then I go to this website called Zazzle, and they sell — I want to say they're coming up on about 24 to 28 ounces or so, these giant ass mugs.

Jay:  Yeah.

Ben:  And I emblazoned a quote on the mug. And my wife gets annoyed because I just constantly have this stream of mugs coming in the kitchen from Zazzle with my favorite one being the Theodore Roosevelt, man in the arena mug. And they're very large, they're very large, but they allow me to, as I'm drinking my coffee, ferment in the wisdom of something I've read or something that inspires me. But when you say 10 ounces — what did you say, 10 ounces?

Jay:  Yeah. Well, I do two 10 ounces, so 20 total, but each cup or thimble is 10 ounces.

Ben:  Okay. Alright, keep going and describe more while I see if I can figure out how many ounces these mugs are that I can [00:02:02] _____.

Jay:  Okay. Yes.

Ben:  Got a few in my office, actually.

Jay:  Nice, nice. So, yeah. I will say that I am — connoisseur is not a good word. That's so cliché and overused, but I love just kind of like pure coffee untainted for the most part. And when I say untainted, I mean black, I want it kind of that. I love that bitter flavor to a coffee. I mean, again, this is like a shameless plug for the good old Kion company, but that's pretty much how I drink now in days is I keep it organic, I keep it mycotoxin free. So, for me, that's Kion. I also have a good friend of mine who will just randomly send me some bags of Kion Coffee. So, I enjoy —

Ben:  Yeah. I have a friend too that does that called my mom.

Jay:  Do you? Oh, nice.

Ben:  My mom owns a coffee shop. So, she sends me coffee that's not Kion. I thought I was getting disowned when I started a coffee company —

Jay:  Right.

Ben:  — and my mom did not disown me. She still even sends me coffee because we don't make decaf at Kion even though we're going to.

Jay:  Oh, yes.

Ben:  And so, she does a great Swiss water processed decaf and it has a wonderful coffee roastery in Moscow, Idaho. And so, she keeps me fueled up if I run out of the Kion Coffee, but I tend to be like you, I like it black, I don't put anything in it, and I mix it like mud. Like my wife has to water down my coffee, but that is the way I like it. As a matter of fact, we're watching something the other day. Oh, my kids wanted to watch a movie and I'm blanking on the movie. A young man makes a mug of — oh, it's a new movie that was really high ranked on Rotten Tomatoes because we decided during this quarantine because we're recording this during the coronavirus quarantine, that we do like one movie night a week where we order in, we support a local restaurant, we watch a movie. And I always will go to Rotten Tomatoes. And if something sucks ass on Rotten Tomatoes, usually that tells me that it's not going to be a great play.

Jay:  Do you go by the critic's review or do you go by the audience review? Because I think there's a huge difference there.

Ben:  Yeah. There is a big difference I average on. It's like if both are pretty far above 80%, then I'll watch it.

Jay:  Yeah. It's [00:04:16] _____.

Ben:  Or at least put it into consideration, considering were just doing one a week right now, but this movie was called “Abe.” It was about this little 12-year-old boy who's a cook, which is perfect for my boys because they're twin boys and they have a cooking podcast. And Abe makes a cup of coffee for his chef and he says something like, “I made it really black,” or, “I made it really muddy,” and my kids are like, “Just like you, dad.” That's definitely the way that I do it. We're probably boring people now before we — and everybody's on their edge of the seat about this new coffee research, so we'll get into that momentarily, but I'm trying to think. I had chaga this morning, actually. I didn't have coffee. I've been doing a lot more chaga just for the whole immunity component, and not that I'm burnt out on coffee, but I've just been on a chaga kick lately. So, because that mug — by the way, it's 20 ounces. It's 20 ounces, the mug that I get from Zazzle, which is still pretty big. So, I do a lot of chaga. I do four packets of the Four Sigmatic chaga.

Jay:  Dude, that is absolutely mud, my god.

Ben:  Yeah. And then, I put a little bit of vanilla stevia in there, and that's what I've been drinking.

Jay:  Nice.

Ben:  [00:05:24] _____ do a few twists on that. Sometimes I'll dump it back at a lion's mane in or whatever, but that is what I had this morning was chaga.

Jay:  Nice. If I add anything to my coffee, it is going to be just one of two things or both of them. So, I do like to put a little bit of Ceylon cinnamon in there just to help with blood glucose, blood sugar regulation. And then I'll also add, if I'm just kind of like looking to spice it up a little bit, and I guess it's not a spice, but I'll add a little bit of salt. So, I'll actually put a little bit of Celtic salt into my coffee. It kind of makes like that, I guess more like a cinnamon latte type flavor, especially to add like a little bit of butter or MCT oil. I don't do that a ton, but really, I just stick to the basics, but I do like a little bit of cinnamon in that coffee. It tastes pretty dang good.

Ben:  Yeah. Okay. Last thing. Last thing, everybody, I promise, then I'll move on. So, I agree. If you're listening and you haven't tried putting like a really good salt like a Celtic salt or a really good sea salt in your coffee or a chaga brew or anything like that, it actually is really good, it amplifies the flavor quite a bit. And then the other thing is I'll call you out for putting Ceylon cinnamon in there because that's an insulin-sensitizing agent, right?

Jay:  Yeah.

Ben:  That upregulates your glucose transporters. But theoretically, if you're drinking a cup of coffee in the morning and you want that glycogenolysis from a liver, you're breaking on the liver glycogen and you're mobilizing glucose in the bloodstream, you don't want to shove it right back out. You're going for that energy, that little bit of sugar high. So, I used to put Ceylon cinnamon in my morning coffee, then I thought, “You know what, no. I want that burst of energy. I want that burst of sugar to wakey-wakey in the morning.” So, I actually don't put much Ceylon cinnamon in my coffee anymore.

Jay:  I guess that makes sense. Well, I mean, I was just going to blame you for the reason why I started that. I mean, I guess I won't do it anymore since Ben Greenfield says don't do it.

Ben: Yeah, granted you're getting all the fiber benefits and some of the antioxidants in the cinnamon, so the —

Jay:  And the flavor. I mean, the flavor is good.

Ben:  And the flavor, I suppose, it doesn't all have to be about function. Alright, let's do this.

Alright. So, the reason we have been talking about coffee, the reason we have been talking about coffee is because CNN, actually a lot of news websites, but CNN is where I saw it first, they came out with this breaking news story, breaking news story, shove the coronavirus headlines and the [00:07:49] _____ headlines aside. Breaking news story on coffee. What they reported on was that there was a concerning new study that came out on coffee, specifically regarding the risk of heart attacks and premature death.

So, what the CNN headlines and many other headlines were saying was that cholesterol in coffee could cause heart attack or contribute to cardiovascular risk. And therefore, you should figure out a way to prepare your coffee in such a manner that would filter out some of these problematic cholesterols, particularly too called cafestol and kahweol. They're technically diterpenes. I'll explain what that means momentarily.

Jay:  Yeah. I actually didn't realize that coffee was high in cholesterol. I don't know if I was just completely looking over something, but I don't know if the common consumer actually knew that.

Ben:  Significantly high, actually. I've talked about it on the podcast before, but it's been quite some time. So, I'll review what that means. But in a nutshell, or in a coffee bean, I suppose I should say, what they did was they followed half a million Norwegian men and women over a pretty large age range and they analyzed what kind of coffee preparation methods these folks were using, and they analyzed them over a 20-year period. So, this was actually a pretty impressive number of participants and a pretty impressive time length for the study.

And what they showed was that drinking unfiltered coffee raised the risk of death in the older men. Okay. So, this was in the older men only, but still, I would imagine a few old men who drink coffee listening to this show, and we might be able to extrapolate some of this to younger people or women. But it raised the risk of death in men due to elevated cardiovascular mortality, and they did not observe this effect in the men who predominantly drank filtered coffee. As a matter of fact, filtered coffee, and most people are aware of this, there's a variety of health benefits to regular coffee drinking habit, filtered coffee was linked to a 15% reduced risk of death from any cause and a 12% reduced risk of death from cardiovascular disease. That was compared to unfiltered coffee and drinking coffee in any manner — actually, I'm sorry, drinking the filtered coffee compared to drinking no coffee at all lowered risk of heart disease by 20% in the female subjects. And, what we're talking about in terms of dosage is that the people who had the lowest mortality rate by drinking filtered coffee were drinking one to four cups per day. I don't know if it was a Jay cup or a Ben cup, but that's about how much they were drinking.

Jay:  Yeah.

Ben:  So, I dug into this study. Now, dirty secret, I've said this before, concerned that they might get shut down, but I'm just going to put it out there and I hope they don't get shut down.

Jay:  Uh-oh.

Ben:  Okay. So, slap on my hand, bad boy, I'm not contributing as much funding as I could to robust research, but I use a service that allows me free unfettered access to just about any journal article that exists out there.

Jay:  You bastard.

Ben:  I'm just going to drop a hint. I'm going to drop a hint. I'm not going to give all the specific instructions because it takes a little bit of a technological tweaking of your browser to do it, but it's called Sci-Hub. So, there you go.

Jay:  Okay. It is.

Ben:  Just a hint for any of you listening in. So, anytime I see a news report like this, I go and I read and I dig into the actual study because I thought, well, are they just saying that it raises cholesterol, and therefore, then saying that these people have cardiovascular disease or that they have a death related to cardiovascular incidence? And that was not the case. They were not using a correlative measurement. They were actually directly measuring mortality from cardiovascular risk. So, it wasn't like coffee raises cholesterol. Therefore, coffee is going to give you heart disease.

Jay:  Right.

Ben:  It was unfiltered coffee. It seems to be particularly problematic.

Jay:  And Ben, just to clarify, and again this is just maybe my lack of knowledge on filter brewing and unfiltered coffee, when we say unfiltered brewing, we're talking about when you just take beans, like ground them down really fine and then pour water over it, mix it up and drink it? Is that what we're saying?

Ben:  That would be the cowboy coffee definition of unfiltered coffee. Many people, and apparently, old Norwegian men will let the ground coffee beans simmer in close to boiling water, like in a pot, for example.

Jay:  Okay.

Ben:  Now, consider this. A lot of instant coffee that you dump into a cup could technically be categorized as unfiltered coffee. And so, this concerned me because if you look at instant coffee, for anybody who is drinking instant coffee, you shouldn't be doing that because instant coffee has a really high level of some problematic compounds. They spray dry it, and then they freeze-dry it, and then they sell it as coffee granules like Folgers instant coffee or Starbucks instant coffee. You're familiar with these. It's like coffee sticks or the coffee sachets.

The problem with instant coffee is it's very high in acrylamide. And they've tested instant coffee and it contains up to twice as much acrylamide as fresh roasted coffee. Acrylamide is problematic because it has been shown in multiple research studies to cause neuropathy or dysfunction of the nervous system. It may, although the research goes back and forth, increase the risk of cancer. And it's kind of synonymous to like eating a lot of fried food in terms of the effect that it has on you physiologically.

Jay:  Right.

Ben:  So, the thing is though, again because you got to go read these full studies, especially if you're like me and you like to just geek out on something that's near and dear to your heart like coffee, because I drink a lot coffee and our listeners drink a lot of coffee. So, I really wanted to talk about this in the podcast. Well, they categorized instant coffee as filtered coffee in this study.

Jay:  Really?

Ben:  So, we cannot say that these old Norwegian men were dying because they were dumping coffee sachets full of acrylamide into their morning coffee cup because that was not the case. So, that was not necessarily the issue. Now, is this potentially a socio-economic issue? And that they didn't account for so robustly. What I mean by that is like the poorer Norwegian men or people who maybe don't have access to like a — not that coffee makers are expensive, but maybe these are just kind of old-school poor Norwegian men who are making their coffee the old-school way not filtering it. And based on those socio-economic factors, maybe the rest of their life, they're not buying as much high-quality food, maybe they're not exercising as much, maybe there is something mentally that goes on that the person who makes cowboy coffee is also the person watching Netflix, eating Twinkies, and not exercising. And so, they didn't account for that. I realized that's kind of a far cry, but it's something that I was at least thinking about because they didn't really account for that in the study.

So, let's get into why this might have been the case. So, this cafestol and kahweol. So, these are diterpenes, like I mentioned. And, the interesting thing is that they exhibit a wide variety of pharmacological activities, these diterpenes that if you were drinking a large amount of unfiltered coffee, you would be drinking a lot of. They've been shown to have anti-inflammatory properties, anti-angiogenic and properties, anti-tumorgenic properties. They're pretty beneficial. As a matter of fact, one of the reasons that something like mixing fat into your coffee or using something like a bulletproof coffee approach or something like that is something that people feel gives them more energy, particularly for their brain, is not only because of the enhanced ketone production, if you're using something like MCT oil or caprylic acid, for example, but it's also because some of these bioactive cholesterols, these diterpenes, the cafestol and kahweol, they aren't cholesterols, they're diterpenes. I'll get into how they mimic cholesterol in a moment. These can actually cross the blood-brain barrier, and they can actually have some of their anti-inflammatory effects on a neural level. And so, that is why you would actually blend coffee with something like fats to get that cafestol and kahweol.

Now, the reason that they impact cholesterol is they specifically act on cholesterol receptors. And, to my understanding, when I look into the mechanism of action, it's actually on the receptors that these diterpenes are working. They're essentially blocking the breakdown or increasing the amount of time that LDL, particularly, would remain in the bloodstream, and they're also increasing serum triglycerides. Okay? So, if you look at LDL receptors, anytime that you are downregulating those, you're going to increase cholesterol, you're going to increase the amount of time that cholesterol spends in the bloodstream and you're going to increase triglycerides.

I don't think that's problematic unless you're in a scenario where the cholesterol can become atherosclerotic, which would mean if you simultaneously have high blood glucose levels or a high amount of inflammation, for example. So, the high amounts of LDL cholesterol in and of themselves are not problematic, but if you were getting a high amount of cafestol and kahweol from unfiltered coffee, bringing your plasma lipids up, and also had other oxidative or inflammatory factors present that would cause that cholesterol to be atherosclerotic, you could definitely say that high amounts of cafestol and kahweol would be problematic.

And so, this becomes an issue. It's like, well, they have all these cool antioxidant and anti-inflammatory and brain-boosting, and even anti-carcinogenic effects and potential anti-diabetic effects as well. And so, do you say, “Okay, I want to filter them out because they could potentially cause cholesterol issues, particularly these LDL receptors, or do I keep them because they have so many other benefits?” And, it's tricky because again, this most recent study seems to indicate that there might be some benefits to getting them out of the bloodstream. But, I think that although I don't know everything that was going on in this study, again in terms of these Norwegian men that if you are drinking unfiltered coffee or not filtering out quite as much of the cafestol and kahweol, then if you're not in a state of inflammation or have a lot of oxidation, you're living a pretty healthy lifestyle, I would hazard a guess that it's not going to be an issue.

Now, what you could do is you could use something like a French press, for example, which is a less fine pour filtration than say a paper filter. And so, you're filtering some of them out, but not all of them out. And so, that would be one way that you'd go about doing this. And this might be a moot point because I don't know how many people are doing like cowboy coffee.

Jay:  I can't imagine there's that many.

Ben:  Yeah, but it's something to think about. Now, there are a few other things that you should consider. First of all, when we look at the fatty acid content of coffee and these diterpenes, they have done other studies where they've looked at different methods to filter out these diterpenes or at least combat some of their effects. And, one of the things that seems to almost act in a synergistic way to balance out any of the potential harmful effects of these diterpenes is something called chlorogenic acid. So, chlorogenic acid is really cool. It lowers inflammation, it stabilizes blood sugar, it can protect the mitochondria. Meaning, it's kind of an antioxidant in that respect. And there's a lot of really good studies on chlorogenic acid, blood pressure, blood glucose, lower homocysteine, insulin sensitivity. And this is something that we do find in coffee.

You can actually, by choosing the correct type of coffee, increase the amount of chlorogenic acid. So, the main way that you would do that is you pay attention to the source of the coffee and the type of roasting that is used in the coffee. So, the big takeaway here is for maximizing the chlorogenic acid content. It would be a Robusta coffee versus an Arabica — how do you pronounce that?

Jay:  Arabica.

Ben:  Arabica, Robusta. So, to maximize the chlorogenic acid, what you would want is you would actually want an Arabica bean or a lower caffeine bean. Now, a dark roast will have the highest caffeine yield and the lowest concentration of chlorogenic acid. So, drinking more of a light to medium roast from a Robusta or an Arabica bean or drinking from an Arabica bean would actually increase the chlorogenic acid content and battle some of the potentially harmful effects that the high levels of the diterpenes might cause. So, that's one thing to think about is — and I'm going to try and bring this full circle and give you guys some practical takeaways. So, you want light to medium roast from a Robusta bean or you choose an Arabica bean when you're looking at your source. And a lot of good fine coffees these days are Robusta, not Arabica, so you just want to choose the light to medium roasted version of that.

Now, another thing that I would consider would be if you do decide you're going to use a filter, then glass or stainless steel such as you would use in a French press or such as you would use in one of those — how my wife makes coffee, what's the air thing?

Jay:  I know exactly what you're talking about, but the name is not coming to me either.

Ben:  Yeah. The AeroPress.

Jay:  Yeah.

Ben:  So, you can get a stainless steel filter for an AeroPress. You can get one of the little Italian coffee, Bialettis, or you can use a French press. Now, if you're using a metal screen, it's nice because you're not going to get quite as many diterpenes, but you get some of them and you're also going to avoid some of the issues with paper filters, which is particularly the fact that there is something called epichlorohydrin in paper filters. So, that's a chemical used to make epoxy resins, and you'll find it in coffee filters and in teabags. And this is actually in news last year when it turned out that tea bags, many of them, actually can hydrolyze the components of teabags. Its epichlorohydrin can hydrolyze to a carcinogen called 3-MCPD when you are filtering things through it.

So, this is why, for the same reason you're going to be careful what kind of plastic water bottles you drink out of, you'd want to be careful about the type of paper filter or the type of tea bags that you use. Now, something like a brown organic type of tea bag or paper filter, that's what you want to look for. So, if you are going to use paper filters — and we do use, we have a paper filter coffee machine. We have one that makes super-duper smooth coffee. It's called a Wilfa Precision coffee maker. My brother got it for me as a Christmas present a couple of years ago. It makes super smooth coffee, but I use a brown paper organic filter. If I'm not doing a French press or if my wife isn't doing the Italian Bialetti, those are the type of filters that we use. You can just get regular old organic brown paper filters. And I'll try and put links to all this material if you go to BenGreenfieldFitness.com/412 so that you guys can just see a list of everything I'm recommending here.

So, that's another thing to bear in mind when it comes to the coffee is the actual filtration method that you use. Let me think if there's anything else I wanted to talk about regarding coffee. I think that's it. I do want to get into a little bit later why — again, I don't consider cholesterol to be that problematic. But the long story short is use organic like brown filters for paper filters or for tea bags. If you want some of those cafestols and kahweols, especially if you're going to make like a fat coffee where you want more of those helpful diterpenes to be in your brain, then use a French press or an Italian Bialetti or like a stainless steel filter rather than a paper filter so you're not getting rid of all these diterpenes. And then if you do drink a lot of coffee, understand, it does affect cholesterol, it does affect lipids. Therefore, be hyperaware of things like vegetable oil, things like sugar intake, presence of inflammation or oxidation that might be causing the cholesterol to become problematic. And finally, if you're an old Norwegian dude, just don't drink unfiltered coffee, period. It appears to be a bad idea for old Norwegian dudes. Yeah, yeah.

Jay:  That's the biggest take-home point. Dude, so I've got to tell you this just because this is a crazy story. So, the first time, this is, I don't know, maybe two or three years ago, first time I ever tried a coffee enema, I really didn't know what I was doing. There wasn't a ton of great information out there on it. Not a lot of people were doing it. So, that first time I ever did it, I actually utilized unfiltered coffee and that was the biggest mess and worst experience I ever had, and it took me forever to do another one. And now that I know it's worst for me from a cholesterol standpoint, I cannot believe I did that to myself, Ben. I mean, what is wrong with me? What is wrong with Jay?

Ben:  Unbelievable. By the way, there's one other thing to consider. Are you South Asian or Yugoslavian?

Jay:  No, no. Neither.

Ben:  Okay. Alright. So, this is one other little thing I'll threw in there. There is a higher genetic risk of acute myocardial infarction amongst immigrants from South Asia and former Yugoslavia, and there are an interestingly high number of those high-risk groups living as old men in Norway. And I realized that's a total aside. That could be what we're talking about here. So, again, if you're an old man in Norway or if you're South Asian or former Yugoslavian, just drink your coffee full-on filtered.

Jay:  That's the biggest take-home point. So, we're going to get some great comments about that one.

Ben:  Anything at all from this entire podcast. Alright. So, let's go ahead and move on because people are probably sick of us talking about coffee now.

So, we just talked about lipids, and the fact that I don't necessarily think that lowering cholesterol at all cost is going to be a good idea. Now, this was something else that I recently saw. I want to talk about cholesterol and coronavirus, and I want to talk about cholesterol and sports performance because I recently came across a relatively old study, but I tweeted it because I had forgotten about this when — I'd seen it before, but it just gave me pause, and I don't think we need to spend a lot of time on this, but it was a study done on lipoprotein and lipid profiles of elite athletes in Olympic sports. They actually did lipid profiles of HDL and LDL and VLDL and triglycerides in elite athletes.

And generally across the board, VO2 max, which is a pretty important parameter, not only for aging and longevity, but also for of course sports performance, maximum oxygen utilization was positively correlated to HDL and total cholesterol to HDL ratio. Now, does that mean having high cholesterol makes you a better athlete? No, but it does mean that HDL appears to be quite favorable. What came first, the chicken or the egg? Well, we know that exercise can raise HDL, so it could be that these folks just had high HDL because they were good athletes, but they were testing across the board all elite athletes. And even amongst elite athletes, those with the higher HDL had better VO2 max, better fitness. So, that's something else to think about.

And then, that paired with some recent thoughts by Cate Shanahan, I think people should know about because Cate Shanahan, who's been a podcast guest before — and she actually just wrote a really great new book called “The Fat Fix“, and we'll link to that in the shownotes if you go to BenGreenfieldFitness.com/412. I read that book a few weeks ago and it was really good. I don't think I'm going to be having around the podcast to talk about it, but it's a good book to check out. And, she just recently published an article on her blog about a study in Wuhan, China that compared pre-infection cholesterol levels in hospitalized COVID patients with mild versus severe coronavirus. And it turns out that having a low HDL was a significant predictor of a more severe coronavirus infection, and that's because of the link that we already know exists between enhanced immunity and protection against an infection and high — well, in this case, high cholesterol, not necessarily just high HDL.

So, for example, we know if we look at HIV and AIDS, those with low cholesterol at the beginning of one big study on 2,500 men were twice as likely to test positive for HIV compared with those with the highest cholesterol. And, when it comes to death from AIDS, there was a death rate four times higher with death from AIDS in people who had cholesterol lower than 160 versus people who had cholesterol above 240. We also know that if you look at a heart disease as many people are now thinking about heart disease as having some element of infection, some element of endotoxin related inflammation due to lipopolysaccharides, it turns out that high cholesterol is correlated with decreased risk of this type of infection.

And there's also some pretty interesting studies that have shown a reduction in chronic heart failure and coronary heart disease are related to a decrease in these endotoxin concentrations related to a higher amount of protective cholesterol. In this case, particularly, HDL cholesterol. And then there was one other study that looked at infection rates and found that for low cholesterol — probably one of the biggest ones was one that looked at 19 large studies of more than 68,000 deaths, low cholesterol predicted an increased risk of dying particularly from gastrointestinal and respiratory diseases. So, cholesterol is appearing to have some type of protective effect, particularly for infection, and it seems to be enhancing immunity in some respect.

Now, if we look at most of these studies, really, it's HDL. That seems to be the most protective factor. And I think that most physicians, whether or not they're on or off the bandwagon that LDL is not problematic and less risk factors are present to make that LDL atherosclerotic, would agree with me that HDL across the board seems to be, aside from one study like two years ago that showed that it might be associated with all-cause mortality, but these were enormously high levels of HDL. And sometimes you'll see enormously high levels of HDL in a case where there's so much inflammation in someone that HDL — it's kind of like the firefighter at the fire analogy. It's like the firefighters aren't all there because they started the fire. They're there protecting it from the fire. So, in very high levels of inflammation, extremely high levels of HDL can be present. And there was one study a couple years ago that showed increased all-cause risk of mortality in people with very, very high HDL. But even that I suspect was due to the inflammation that that HDL was trying to control.

So, ultimately, let's get down to, kind of like we did with coffee, what's the practical takeaway here? What's the brass tacks? So, increase your HDL, increase your HDL for sports performance and for general immunity. How do you do that? A few ways would be to consume things that have butyric acid combined with fiber. So, like cook up your vegetables and like a really good grass-fed butter, for example. You don't need a lot of it, like tablespoon or so of butter that you're steaming veggies with or cooking vegetables in. We know that things like shredded coconuts, nuts and seeds preferably that have been prepared properly, soaked and rinsed, that's also wonderful for HDL cholesterol. We know that fish oil, which has some protective effects on its own from a cardiovascular standpoint, that can also raise HDL.

You could read Cate's book, “The Fatburn Fix” is what it's called, if you want to get into a lot of other HDL raising strategies. But I mean, really, it comes down to consuming good fats, high amount of omega-3 fatty acid intake, seeds, nuts, some fibers. There are some other compounds that can increase HDL, and I don't think we need to turn this into a podcast that's about how to increase HDL, but the big takeaway is increase your HDL.

Jay:  Yeah. Good stuff. Did you happen to see, Ben, on one of the supplementary table charts, I was looking at the differences in admission from those who survived COVID to those who did not, and I was looking at hs-CRP levels. And at admission, the survival group had an hs-CRP of 11, which is really high, but that's the survival group. At admission for the non-survival group, it was 72, like that's incredibly high. I don't know if I've heard of hs-CRP that high, actually. That's insane. So, yeah. I just thought that was a really interesting thing on the supplementary table.

Ben:  Yeah, yeah, it is. And I don't think it's any secret now that obesity, insulin resistance, inflammation, et cetera, definitely increases risk of severity from something like coronavirus. Now, one other question related to this I think is, okay, so if cholesterol is protective, although only about 20% of cholesterol max is produced as a result of dietary fat intake, nonetheless, would strict caloric deprivation, a hefty fasting protocol, et cetera, be something one would want to avoid in the case of a viral infection? And I think that there is a case to be made for avoiding excessive fasting and excessive calorie restriction, specifically when it comes to viral infections. For example, in rodent studies, we know that fasting can cause a worse response to viral infections, particularly because it seems to cause a hypercortisolic response at least in rodent models that upon exposure to a virus resulted in a detrimental effect on survival, compared to rodents that were allowed to have slightly higher blood glucose levels.

We know that viruses are nutrient-depletive, particularly, and some people have talked about selenium supplementation as one way to support the immune system in the case of a viral infection. Well, it turns out that selenium becomes pretty depleted in the presence of calorie deprivation. So, that would be another case to be made for avoiding excess fasting. And then we know fasting inhibits mTOR, right? And the problem is that blocking mTOR through fasting reduces the level of what's called interferon-inducible transmembrane protein. Now, yeah, that protein serves essentially as almost like a barrier to prevent viruses from gaining a foothold. And so, when we're blocking that with excess fasting and excess restriction of mTOR, we could potentially increase our susceptibility to infection.

Now, that's all related to viral infection. And it turns out almost everything is the complete opposite when we're talking about a cold or a bacterial infection. Okay? So, with a bacterial infection, it appears that ketone bodies can be protective. So, being in a ketogenic state or low carbohydrate intake, we know that increasing the number of phagocytes to allow neutrophils, to surround and destroy bacteria, that's also something that is improved with fasting. We know that low fasting blood glucose is a good predictor of what's called your neutrophil to leukocyte ratio, which is also going to be protective from an immune system standpoint.

So, ultimately, I think in the case of a virus that you would probably want to make sure that you're keeping your body pretty topped off from a nutrient standpoint. Whereas with a cold, you would actually benefit from some amount of fasting. So, it does kind of depend. I think the ultimate takeaway here is if you were like an OMAD person or you were doing these really strict like 6-hour compressed feeding windows, 18-hour intermittent fast, long five-day water fast, et cetera, during the time that this podcast is being recorded, in the case of a global viral pandemic, might not be the best idea. And I personally still am doing a 12 to 16-hour overnight intermittent fast, but I'm not doing much aside from that as far as any type of strict calorie deprivation or longer fasts or anything, just because I want to keep my immune system pretty tuned up so to speak from an antiviral standpoint.

Jay:  Yeah. I've been doing the same thing. I used to do like stop eating at 6:00 p.m., and I'll start back at 12:00 p.m. the next day. And so, I've really just been doing more like 6:00 to 9:00 instead of 6:00 to 12:00.

Ben:  Yeah, yeah. And for anybody wondering to bring this full circle before we move into our special announcements, no, black coffee does not break your fast unless you're Dr. Satchin Panda or a few of the selected researchers out there who feel that the taste of anything, sometimes even water, can cause a release of what are called incretin hormones that can result in you going into something like a fed state even if you're not having calories. But, you're not going to stop me from having my big old cup of coffee or chaga in the morning. Anything that doesn't have calories in it generally doesn't work fast.

Well, this is the part of the show where, A, we let folks know that there's not a whole lot to announce in terms of anywhere I'm going to be appearing or speaking because pretty much everything has been cancelled, which has been horribly, horribly distressing to me.

Jay:  Yeah. Why did they cancel it? I just don't understand. I'm just kidding.

Ben:  They can't make any money when I'm not going and speaking. Well, inside baseball —

Jay:  You can't make any money.

Ben:  The way that I pay the bills is I go and get on stages and speak to people, and then the people who put on that conference pay me to come and speak. I'm actually not joking. Even though I write articles, I have books and I invest in a lot of different health and fitness companies, I run Kion and I've got some other income streams, but often for me to keynote on stage, that's anywhere from 20 to 40K. And so, when you cancel 12 of those events over the course of a year, that adds up.

Jay:  That does. You just let everybody know your base salary, Ben.

Ben:  Yeah. There's websites out there that list people's net worth.

Jay:  Oh, yeah, yeah, yeah.

Ben:  But someone showed me one. They came across — for me, they said my net worth, I didn't even know what this means, they said my net worth is $2 million. And so, there you have it.

Jay:  So, are they right or are they wrong, Ben?

Ben:  You know what, I don't even know.

Jay:  You don't even know? Okay.

Ben:  And I'm not joking, that sounds irresponsible of me, but I have always been one of those guys who works my ass off, puts money in the bank, invest that money, and then hires an amazing team of people around me to manage that money. And so, I actually don't, off the top of my head, know my net worth. I'm more into just making sure there's enough money in the bank to take my kids out to dinner or to get myself a ribeye steak. And I usually drive my cars for about 10 to 12 years. I generally wear the same clothes almost every day. I'm not a very materialistic guy and I rarely glance at the actual bank account or the actual net worth. So, I can't say I'd tell you. I mean, I am one of those guys who will spend 10 minutes on Amazon looking for the coconut flakes that are a dollar cheaper [00:40:40] _____ coconut flakes.

Jay:  Yeah. That's how you get money.

Ben:  Not quite a spirit of abundance, but that's the way I operate.

Jay:  Well, you can just look at your bank account and tell us next time on the next podcast.

Ben:  That being said, one of the best ways to support this show is by using the fat discounts we have from our amazing sponsors. One is Kion. We already talked about Kion, so let me just say this. If you guys want to try any of our amazing coffee and maybe grab some of our coconutty, chocolatey, salty goodness energy bars to dip in said coffee, which is actually quite an experience, I don't know if you've ever dipped your Kion Bar in Kion Coffee

Jay:  Of course.

Ben:  — but it's quite a treat. It's almost like having cinnamon rolls for breakfast. So, you get 10% off of anything from Kion, clean the bars and the coffee. You just use code BEN10 at getkion.com. That's BEN10 at getK-I-O-N.com. And then, Joovv, the red light panels that actually pair quite well with drinking chaga, because when you have your chaga, it upregulates your melanin, and the photons of light hit your skin and you produce electrons with the higher amounts of melanin. And that's —

Jay:  You sell chaga, too?

Ben:  They should. They should bundle chaga.

Jay:  They should.

Ben:  Chaga or methylene blue or chlorella, any of those, they should bundle those with their red light panels. Just saying. Anyways, Joovv is giving everybody a free copy of my book “Boundless” if you get a Joovv light. And to get that, you go to joovv.com/ben. That's J-O-O-V-V.com/ben. And then for any of you who are not vegan or who don't have any friends who are not vegan that you could give this to, I don't know if I said that the right way, but I think people understand.

Jay:  I was trying to retrace that back in my mind and see if you did.

Ben:  If you have any use whatsoever for amazing meat, ButcherBox, they ship out every single month free-range organic chicken, heritage breed pork, which if you haven't had heritage breed pork, you're missing out on the way that pork is supposed to taste because old-world pork, they breed all the fat and the flavor out of it to make it the other white meat. But heritage breed pork is actually crazy, crazy flavorful, really good. Wild Alaskan salmon, they have all of these wonderful meats. They curate them, they ship them to your house. And what they're going to do is give all of our listeners two pounds of ground beef and two packs of free bacon if you sign up at ButcherBox. And they're going to give you $20 off your first box. So, for that, it's very simple. You go to butcherbox.com/ben. Just go to butcherbox.com/ben if you like to eat meat like me.

And then finally, Seed, what I would consider to be the best formulated probiotic out there. It's the one I take. It's the one my wife takes. They envelop it in like this algal medium that allows it to bypass the aesthetic nature of the gut. They've actually shown that this thing will seed low down in your digestive tract, like it makes its way almost through your entire digestive tract. And they specifically formulated it with prebiotics that feed the probiotics like pomegranate extract to produce what are called postbiotics. Like urolithin A is one really good one. It's almost like an anti-aging compound. Again, I look into a lot of probiotics and this I think is the best formulated one out there. So, it's called the Seed Synbiotic, S-Y-Nbiotic. So, you go to seed.com/ben, S-E-E-D.com/ben and you get 15% off with code BEN15.

Jay:  Nice. It's better than your $2,000 Immortalis.

Ben:  Oh, yes. Well, yeah, yeah. Did we talk about that about my homemade yogurt recipe where –?

Jay:  Oh, of course, we did.

Ben:  — [00:44:38] _____ being a penny pincher? I figured out how to take this super-duper expensive probiotic and make yogurt out of it so I could make it last a really long time.

Jay:  You told us in gran detail.

Ben:  That's right. We talked about that. When did we talk about that? Was it the last episode?

Jay:  I don't know. We've done a lot of these here recently. I think it was last episode or two episodes ago.

Ben:  BenGreenfieldFitness.com/411 or 410, one of the two. So, we'll link to all those sponsors, all their cool discount codes if you go to BenGreenfieldFitness.com/412 for this episode. And now it's time that we answer some questions.

Jeremiah:  Hi, Ben, I understand LiveO2 has an advantage over traditional hyperbaric chambers because of how fast it delivers oxygen without needing to spend so much time inside a chamber. But I wanted to ask if you see any unique benefit to also using hyperbaric chambers in combination with the LiveO2 unit or even in place of. Are there any unique benefits to the chambers?

Ben:  This is a good question. You know what, this is fresh on my mind because I was doing a bit of EWOT this morning, actually.

Jay:  Oh, okay. I thought you were going to say it's fresh in your mind because of the HBOT because I know you've been doing that a lot lately.

Ben:  I have. I've been playing a lot with oxygen lately between like ozone treatments and hyperbaric and the exercise with oxygen therapy. So, exercise with oxygen therapy, that's what EWOT is, EWOT. And they've done some good studies on it for increasing exercise capacity, VO2 max, red blood cell production, altitude performance. So, the research doesn't lie that EWOT is effective as a method of training. It's essentially exercising with supplemental oxygen. It's breathing high levels of oxygen while you're exercising typically with some type of an oxygen concentrator set next to a treadmill or a bicycle.

And the fancier devices like the one that I use is called a LiveO2 have a little switch where you can switch from low oxygen to high oxygen. So, you're getting vasodilation, vasoconstriction. And so, you get this rush of oxygen. And so, you're almost cycling the oxygen back and forth. And I've used just pure supplemental oxygen, and then I've used going back and forth from hypoxia to hyperoxia and the latter. You feel a lot more, and/or specific protocols. Like today, I was actually working out on the Vasper and had the LiveO2 set up next to it. And so, what I was doing was two minutes at hypoxia, then a 30-second burst where I'd flipped it to full oxygen, go as hard as possible for 30 seconds, breathing pure oxygen, and then flip it back to hypoxia. And so, every time you do this surge of oxygen, it's like you're just drinking a cup of coffee. You'd feel amazing. Then you lose all your oxygen, then it comes back, so you get this really, really cool effect in terms of oxygen. Really doing a good job saturating particularly the muscles that are being used. That's kind of the difference between EWOT and HBOT.

So, what I mean by that is when you're using exercise with oxygen therapy, some people will say, some scientists or researchers will say, “Well, that's not going to work because if you're at sea level or you're not at altitude or you're not in a high pressure chamber, then there's no way that you are going to increase the amount of oxygen available to your tissues because you can't just increase the concentration of the oxygen, you also have to increase the pressure of the oxygen. But they're wrong, and here's why. Oxygen is contained in the blood in two forms, dissolved in plasma, which is about 2% oxygen, and then it's bound to hemoglobin in your red blood cells, which is, let's say like 98% oxygen.

Now, breathing supplemental oxygen will saturate the hemoglobin and increase the concentration of dissolved oxygen in plasma. Okay? And I actually spoke with an anesthesiologist about this, who actually wound up writing an article on my website about the mechanism of action. I'll link to it in the shownotes, but he would have patients where he would administer 100% oxygen for three to five minutes and then induce general anesthesia, and the patient's oxygen saturation would go up to 100%, and sometimes that would be under anesthesia without a single breath for up to five minutes.

Jay:  Oh, wow.

Ben:  And that's because the concentration of oxygen in plasma is maximized. And so, when you look at exercise with oxygen therapy and the breathing of pure supplemental oxygen, that higher level of plasma oxygen does result in more oxygen availability to tissue as you're exercising, particularly to the tissue that you're actually working during the exercise session. So, as opposed to HBOT, hyperbaric where you're just laying in a high-pressure chamber breathing typically supplemental oxygen. It's more of a full-body oxygen delivery. And in many cases, it's having a pretty good effect on neural tissue on the brain, which is why HBOT is so good for things like TBI or concussion. Whereas when you're exercising with the supplemental oxygen, it's more localized to the tissue that's working the hardest.

Jay:  That makes sense.

Ben:  That's why I like to use a full-body exercise machine like the Vasper, or like a rowing machine, or an elliptical that has the arms working if you're using an oxygen concentrator because technically, the more muscles you're working, the more you're shoving that oxygen all over the body.

Jay:  So, it's kind of replicating HBOT, but while you work out if you do full-body, is that what you're saying?

Ben:  Yes, although because with HBOT, you're combining pressure with concentration, I think you're still going to get a higher amount of oxygen dissociated into tissue and into the brain. And we also know that HBOT has some effects on things like stem cells that EWOT does not seem to have, at least from the research that I could find. Now, of course, HBOT is very expensive. To get a hyperbaric oxygen chamber versus like an oxygen concentrator that you could set up next to a bike, it is more expensive.

And, there are DIY options. Like you can get, for example, an oxygen concentrator. You can even get a refurbed oxygen concentrator. There's a shop in Las Vegas called — I think it's O2CRS. They'll ship like refurbed oxygen concentrators anyone in the U.S. And you can just basically — and I have all the instructions on my website, I have an old article about how to do this, and you can just basically hook up some tubes to that and a little oxygen reservoir with a little trashcan that you seal the top off to create an inlet and an outlet, and essentially, make your own oxygen concentrator for not that much.

So, for any of you DIYers out there, I have a how to make your own cold tank article at BenGreenfieldFitness.com. I also have a how to make your own oxygen concentrator on there. But the one that I use is just done for you, not DIY, and that's the LiveO2. There's another company called Hypoxico that also sells a unit that a lot of athletes really like and use. So, ultimately, EWOT doesn't require you climbing to a chamber, lower expense, and probably for athletes, for pure athletes, could be a better solution. HBOT, more expensive, probably a little bit better oxygen delivery, but you're not exercising while you're doing it, so you're not killing two birds with one stone unless you're like me and you read books and magazines and take your naps in the hyperbaric chamber.

But anyway, so I use a LiveO2 out by my exercise equipment. I do have kind of like a less expensive hyperbaric chamber. It's made by HBOT USA. It's called a Vitaeris. And it's not quite as fancy as like the ones hospitals have or the hard shell chambers. They go up to really high pressure. But I like it, I use it, I nap in it. So, I do a little bit of both. And then, just one other thing that I wanted to mention about the hyperbaric therapy, it appears that there are a few things that you could do to enhance the effects of it. And I have a big article coming out about this, about the use of everything from like beetroot prior to counteract some of the vasoconstriction that can occur when you're inside a chamber to citrulline, some other things.

So, I have a big article coming out about it, but two things to think about right off the bat that seemed to work pretty well in conjunction with hyperbaric or exercise with oxygen therapy. One would be baking soda or sodium bicarbonate. It appears that that slight bump in alkalinity can increase the hyperoxygenation effect of either of these tools, like just taking a — you don't want to blow your ass out while you're laying inside a hyperbaric chamber.

Jay:  No, I don't.

Ben:  Yeah. A teaspoon or so of baking soda. And then also, a pulsed electromagnetic field therapy, either before or after. So, if you have any of these little like PEMF devices or PEMF tables or anything like that, that also appears to, based on the effect on cell membranes and also on less red blood cell aggregation, also enhance the effects of something like the oxygen therapy. So, if you're a true biohacker, take a bunch of baking soda, use some PEMF, take a little beetroot or citrulline, and then you use either of these therapies. To answer the question more directly, the use case is going to differ, but ultimately, the benefits of the hyperbaric would just be a little more oxygen deliverability because of the increased pressure, and also some of the better effects on things like stem cells, brain healing, et cetera.

Jay:  So, I know you use your NanoVi every time, or I don't know if it's every time, but after you use your HBOT machine, do you do that with EWOT as well?

Ben:  Yeah. That's interesting. So, the NanoVi is essentially a machine that limits oxidative stress. And it is like a desktop device where you're breathing water that contains these kind of like antioxidants that's getting a little woo-woo, kind of like frequencies. So, using specific frequencies to concentrate the antioxidant effect of water that you would breathe. And, the main idea to reduce that oxidative stress would be for better DNA repair. I have one. And when you're looking at anything that would increase oxidation, whether the use of ozone or HBOT or EWOT, shutting down oxidation at first glance seems like a good idea, but it's kind of like the reason you wouldn't take a bunch of high-dose vitamin C or vitamin E post-exercise is you actually don't want to blunt that oxidative effect or inflammatory effect, you want the cells to mount their own response.

Jay:  Exactly.

Ben:  So, you actually get more mitochondrial proliferation. So, yes, I use the NanoVi, but I don't do it right after because I actually don't want to blunt that oxidative effect too much.

Jay:  Yeah. That makes sense.

Ben:  So, yeah. I always separate anything like a long cold soak or high-antioxidant supplementation or anything like that a few hours out from an exercise session. Again, because you actually want to be a little bit inflamed and a little bit oxidized after an exercise session. And actually, I was reading a relatively new paper. It's really good. I'll tweet it out at some point. Eric Drexler, who has a really good journal called Strong, and also has — I think it's just ericdrexler.com. He has a really good new article that summarizes all of the latest research on antioxidants and whether they truly blunt exercise performance or not. And it is — let me think of the URL. It's strongerbyscience.com/antioxidants. I'll link to that in the shownotes. Really good recent article that just summarizes whether or not you should be using antioxidants pre and post-exercise.

And really, the big takeaway is it appears that old people, because they produce fewer antioxidants and tend to have more oxidative stress, actually do benefit a little bit from antioxidant supplementation even post-exercise. And for most of the rest of people, high-dose antioxidant supplementation appears to decrease inflammation and oxidation to a pretty significant effect, but at the same time, it doesn't appear to have that big of a deleterious effect on things like muscle building or actual sports performance. When you take it to the streets, it's like the person's not running a 5k slower even though they limited oxidation with high-dose antioxidant supplementation.

So, it's kind of in the weeds, but ultimately, it turns out that high-dose antioxidants might not be as big of a deal as we thought they were when it comes to shutting down your exercise response. And that if you're old, you may even want to consider antioxidant supplementation. But if you want to be super careful just because the research goes back and forth, avoid taking a bunch of antioxidants, particularly a high-dose vitamin C or vitamin E post-exercise, but don't worry so much about eating your vegetables or having a high amount of polyphenols or phytonutrients. Those don't seem to be as big a deal as the higher dose vitamins or the synthetic antioxidants. Anyways though, I'll link to the article. We don't have time to get into it right now, but I'll link to it or at strongerbyscience.com/antioxidants.

Jay:  Cool.

Sarah:  Hey, Ben. My name is Sarah. I'm in Denver, Colorado. I've been a huge fan of yours for many, many years. Own all your books, the guide to being superhuman, cold shower junkie, all the above. My question for you is no matter how closely I follow all of that or what I'm doing training-wise, I've had to take bioidentical hormones for progesterone for the past six years because my body doesn't really seem to make it. And I'm only 28 years old, so I feel like that's something that shouldn't be happening, and I find that I'm super sensitive to stress, like if one little thing happens, I just quit making progesterone. Do you have any tips or experience with this? Because I have tried numerous endocrinologists and female physicians and no one really has an answer for it.

Ben:  Progesterone. Yeah. It's a pretty important hormone. We can actually geek out on it, but before we do, I want to mention something, and that is that anytime someone's complaining about hormones and that their body doesn't seem to be able to make hormones, or that they're low in testosterone, or they have adrenal, what do you call it, adrenal fatigue, sometimes these folks are getting just like a serum test, like a blood test for hormones, which is a one-time snapshot that does not reflect what's truly occurring not only with the circadian rhythm or endocrine-based variation of that hormone during the day, but even the upstream and downstream metabolites of that hormone, which only a urine measurement taken multiple times per day can give you.

Jay:  Exactly. That's right. When people take just your basic serum cortisol test and they base the results off of that, it absolutely irks me, so irritating.

Ben:  Yeah. So, progesterone, for example, if you look at serum progesterone, which is what's most commonly used to assess, for example, whether a woman has ovulated, what they've shown in studies is that it has dramatic fluctuations throughout the entire day. I mean, one study looked at every 10 minutes for 24 hours during the luteal phase and due to pulsations of what's called luteinizing hormone, progesterone was just all over the place during the entire day. And so, if you're using one blood snapshot and it's showing low, that may in no way reflect what's occurring the rest of the day.

Jay:  Yeah.

Ben:  Now, when you look at urinary progesterone and urinary progesterone metabolites, A, because you're usually peeing on a stick five to six times per day, you're getting a lot bigger picture. And B, progesterone gets metabolized into two different things, one called 5A-pregnanediol, and 5B-pregnanediol. And both of those metabolites are going to have a little bit of a different effect, kind of like men can turn testosterone into DHT versus one pathway or might have more free testosterone via different pathway. So, the alpha pathway for pregnanediol, that one seems to be more problematic. Women with PCOS, for example, tend to have higher production towards that alpha pathway. And most labs, especially blood labs, are only measuring the beta pathway. So, you really can't even see what the progesterone is getting turned into either. So, for that reason, if you're going to test your progesterone, I recommend you do it with what's called the dried urine test. There's a company called Precision Analytical, and they make one called a DUTCH test, which I think is a better test for analyzing progesterone, or any hormone really, then the serum tests. Okay. So, that's the first thing to think about is make sure you're paying attention to your method of testing.

Now, next, when it comes to progesterone, so just you can wrap your head around this, it's one of the two primary sex hormones. So, the other one is estrogen, which most people are familiar with. It's primarily produced by the ovaries and prepares the wound for pregnancy. So, if an egg isn't fertilized during a woman's cycle and no pregnancy occurs, progesterone and estrogen both rapidly decline, then you get a period or the menses, and then you go back into the cycle. And if you do get pregnant, then the placenta actually starts to secrete progesterone, and the corpus luteum actually produces a bunch of progesterone too, and those shutdown ovulation for the duration of the pregnancy. So, they almost act as a natural birth control agent.

So, when we look at progesterone, it's actually important for a lot more than just preparing the womb for pregnancy. So, for example, a lot of physical and psychological problems, particularly at a woman's mid-life, are caused by an imbalance between progesterone and estrogen. And you may have heard the term estrogen dominance, which typically denotes a lack of sufficient progesterone paired with high exposure to xenoestrogens, chemicals that you would get from toxins, plastic water bottles, cosmetics, shampoos, et cetera, even environmental pesticides that you'd find on commercially grown fruits and vegetables. Those are a big source of these xenoestrogens. So, it's a one-two combo of your body not making as much progesterone, and then also a high amount of estrogen.

Now, progesterone, it balances blood sugar levels, it stimulates the production of new bone, it enhances the thyroid hormone activity, it alleviates depression and anxiety, it increases libido, prevents migraines. I mean, my wife started taking progesterone last year and just across the board noticed some really significantly positive effects. Now, some people are concerned about progesterone because of what's called synthetic progesterone or progestin. Now, progesterone that's naturally made, it's usually synthesized from either soybeans or wild yam. That's kind of a natural version of progesterone. Whereas synthetic progestins, which are typically sold as birth control pills or as a birth control option, those would be something like Provera, and those have actually been linked to blood clots, and acne, and weight gain, and depression, and do not appear to really be that great compared to like a natural progesterone cream or a compounded natural progesterone.

So, the form of progesterone, if you were going after some of the beneficial effects of progesterone, really matter. So, that's another thing to take into consideration is progesterone is important, but if you are going to replete it, you need to be working with a doctor who's using natural progesterone, a compounded progesterone. I wouldn't even buy a natural progesterone cream on Amazon because [01:04:38] _____ hormone here, and you don't want to F with your hormones. I would work with a good practitioner. Like the guy who works with my wife is Craig Koniver. He's been on the podcast before. I'll link to his website in the shownotes, but he's a real wizard when it comes to hormones. He's a guy I would trust to get you on something like a compounded hormone replacement using a good non-risky form of progesterone. And a lot of times again, these are bioidentical hormones, many cases derived from soy or wild yams. They're usually called natural or bioidentical.

Now, when we look at — let's say you do the urine or the DUTCH test and progesterone is low and you decide you want to consider getting on progesterone, I wouldn't necessarily use that as the first step. Just like for men, I recommend lifting heavy weights and good sleep, and red light therapy, and creatine, and minerals, and all sorts of things before you use something like testosterone. So, same thing for women. For example, the liver is really important here. I mean, the two different liver detox pathways, glucuronidation and sulfation, those are completely necessary to metabolize estrogen. And when those are not operating properly, that can create a state of estrogen dominance, which can cause some of these issues with the progesterone deficiency symptoms.

So, one thing would be to support your liver, and I'll get into a few ways that you can do that shortly. The adrenal glands, those are also important. And not only are the adrenal glands going to be responsible for assisting with some of the progesterone production, but some adrenal dysfunction can mimic some of the issues with progesterone deficiency. And also, if your body is prioritizing the hormone pathway of cortisol by directing the lion's share of pregnenolone down the adrenal steroid pathway, well, the problem with that is pregnenolone is also going to be a precursor for progesterone. It's called the pregnenolone steal. And so, if you're super stressed out and your adrenal glands are working overtime so to speak to put in very simplistic terms, you may not have enough building blocks for progesterone because you don't have enough pregnenolone because you're producing a bunch of cortisol.

Another issue can be thyroid. Thyroid, such as hypothyroid due to low calorie intake, low carbohydrate intake, poor iodine or selenium status, high intake of things like fluoride or other, I believe they're called halides that can interact with thyroid tissue, that can also impact progesterone functions. That's another thing to think about is, have you tested your thyroid? Have you tested TSH, total T4, total T3, free T4, free T3, T3 uptake, reversed T3, even thyroid antibodies to make sure there's not some kind of an autoimmune issue going on? So, you look at liver, you look at adrenal glands, you look at thyroid, and then once you've looked at some of that stuff, then you can begin to support if there are issues.

So, if you look at the liver, for example, we know that methylation is crucial for those detoxification pathways. So, if you have some type of methylation issue, you may need to look into something like methylated B12 consumption or the conception of a good organ meat complex, like ancestral supplements, or a paleo value organ complex, or a higher intake of organ meat in the diet. Glucuronidation, things like cruciferous vegetables or sulfur precursors help to support that pathway. So, the supplements like gotu kola, for example, is also really important for that pathway. We know that glyphosate almost completely blocks that pathway.

So, making sure that you're eating organic food that's glyphosate-free would also be really important for that sulfation pathway. Anything that's sulfurous like garlic, or leeks, or eggs, or a shellfish. Liver again is also really good for that, as is ginger, as is mustard. Begin to educate yourself about how to support what's called glucuronidation. So, those are a few things to think about when it comes to supporting the liver. And then of course for the adrenal glands, it would just be managing your freaking stress and sleep and not overexercising, and all those things we've just — we've kicked that horse to death on previous podcasts, but those are all really, really important things to bear in mind.

A few other things I would consider for progesterone particularly would be, we know that light is really important for circadian rhythmicity, and also for cortisol and pregnenolone regulation, so lots of time out in the sunlight. Coming back to cholesterol, right, we know that cholesterol is an incredibly important building block for a lot of this pregnenolone and for hormones in general. And we know that calorie depletion causes leptin dysregulation, thyroid dysregulation, testosterone dysregulation, insulin dysregulation. So, especially with women, being careful to potentially look into something like a well-structured Weston A. Price type of diet where there's a lot of ghee, and butter, and cod liver oil, and full-fat foods, and organ meats. That's pretty important, especially when you consider getting some of that liver support from things like fermented foods and some of the other vegetable type of compounds that would be in something like a Weston A. Price diet.

So, those are a few things to think about as well. And then finally, finally, the last thing I want to mention about progesterone is there are certain things that are precursors to progesterone, pregnenolone, I already mentioned. DHEA is another one that's synthesized from cholesterol through pregnenolone by the adrenal glands, and it acts as a precursor for some other important steroid hormones and can support progesterone as well. So, pregnenolone and DHEA can be helpful. Don't confuse DHEA with what's called 7-keto-DHEA, which you find in a lot of supplements now. Now, 7-keto-DHEA, I'm not opposed to that, especially for women who want to support optimal hormone function with age because that can stimulate liver enzymatic function, it can promote basal metabolism, it can help to decrease visceral adiposity. I think a lot of women in particular can benefit from 7-keto-DHEA. So, you could stack, for example.

I'm not a doctor, I don't want you to misconstrue this is medical advice, but prior to using progesterone, you could even look into just stacking something like pregnenolone, like life extension does a good pregnenolone. You could throw some DHEA in there like pure encapsulations. They make a good DHEA. All this stuff you don't need prescriptions for. And then 7-keto-DHEA, there's a digestive enzyme complex that has that in there, but can also be used on an empty stomach, and that one's called kApex. And so that you could stack something like pregnenolone, DHEA, and 7-keto-DHEA along with some of these lifestyle modifications and a Weston A. Price-ish diet and liver support, and these would all be ways, if you're struggling with low progesterone or estrogen dominance, to start to put a dent in that so to speak. So, long answer, but that is where I would start.

Jay:  Yeah, man. I covered it. I think that good testing is key, the key initial piece. So, she hasn't gotten that yet, I forgot her name, Sarah, she hadn't gotten that yet, then to get it because I know it sounds like she's been battling with this for a while. But again, testing is key.

Ben:  Yeah. And I mean, we could talk for two hours on progesterone, but that's at least going to give you some clues to start with. I wish I had the time to get into the full meal deal on progesterone, but that's at least where I'd start.

Matt:  Hi, Ben. This is Matt. I'm hoping you can shed some light on the efficacy and science behind jaw exercisers. I don't want to mention any specific brands, but I'm sure you're familiar with them. They always intrigued me and I would really appreciate your opinion. Thanks in advance.

Ben:  You know what's funny about this question, Jay?

Jay:  What's that?

Ben:  Have you seen these Jawzrcisers before?

Jay:  Dude, this is insane and I don't know why, but I have not until today, and I had not looked over our shownotes yet, but I got this random — I don't know if it was on Instagram or Facebook just sponsored ad and I watched the whole thing because I was like, “Oh, I think we're talking about that today.” But I'm not seeing it and I thought it was not maybe necessarily legit, and then I saw that you had it on here and I was like, “Okay. Let's talk about it.”

Ben:  They look like a giant squishy golf ball.

Jay:  They did, yeah, they do. It's like 40 pounds of resistance though, isn't it?

Ben:  Yeah, yeah. They're like the $60 little plastic devices. They sent me some like six months ago and I have three behind me here, and I have chomped on them a few times, but I chew gum, and I chew like hard-ass gum, like I should mess —

Jay:  You chew it all the time, too.

Ben:  I tend to chew mastic gum or this new gum called Slique, which is a super hard gum that's got a bunch of essential oils and peppermint and frankincense, and it's very stomach soothing. They say it helps to boost the metabolism. I don't know about that, but I think that chewing gum — I first started chewing hard gum like mastic gum when I interviewed Dean Karnazes, who did the Sparta race across Greece, and he would chew on it to increase salivary enzyme production and decrease appetite while running. And I started to chew it, and I swear, my jaw from my constant gum chewing, it just feels stronger. And I've even gotten comments about the shape of my jaw. So, it's doing something and I personally like to chew gum more than I like shoving a giant jaw exercise within my mouth. But there's something to be said for this idea of exercising the face, whether it's with some trendy exercise device or whether it's just by chewing mastic gum or some other form of gum that's a little bit harder to chew.

Now, one of the issues with some of these is that even though they definitely work out the jaw, you want to be careful because you can't get tension headaches, you can't get injury to what's called the temporomandibular joint. Just like you wouldn't want to do a thousand calf raises in a day if you wanted to avoid Achilles tendonitis, you do want to be careful. More is not better. So, you just don't want to excessively masticate. I think my mom used to tell me that, don't masticate so much. Maybe there's someone else.

Jay:  They tell you that a lot, Ben?

Ben:  I don't remember. Yeah. Yeah, I was going to go blind and get dirty hands [01:14:58] _____ the excess mastication. But I do think there's something to be said for exercising the jaw. And I'm not necessarily opposed to the use of these devices. And one of the reasons for that is that we know that, assuming you're not overdoing it, the shape of the jaw can change. Like Mike Mew, he's an orthodontist. And I talked about him in the beauty and symmetry chapter of “Boundless“. He has developed this process called mewing, M-E-W-I-N-G. It's pretty simple. You just rest your entire tongue on the roof of its mouth for as long as you can during the day. And when you do that, it can actually change the jaw structure. And the reason is that your skull is not just one big bone.

Anybody who's actually dissected a head or a skull in anatomy class knows there's a bunch of sutures, and that's connective tissue between the skull bones. That can change over time. When you shove your tongue up against the roof of your mouth, it causes a slight change in your facial structure due to a slight movement of those sutures, the mild pressure against what's called the maxilla. And, what they found in multiple studies that have looked at this type of mewing approach is reduction in snoreness — or not snoreness. What do you call it? Snoring, soreness?

Jay:  Snoring.

Ben:  Snoring. I don't know why. I just made up a new word, snoreness.

Jay:  Snoreness.

Ben:  I'm snoring all night so I'm snoreness. Anyways, so they've also found better development of the teeth in children, less sleep apnea, better facial structure. And so, this idea of mewing, this guy did a whole TED Talk and it's really cool, this whole protocol that he teaches about how to change your face and your jaw structure just from this idea of having a practice of almost like Kegel exercises that you do occasionally throughout the day shoving your tongue up against the roof of your mouth and just holding it there for as long as you can. He recommends pairing that with high intake of vitamin K2 and vitamin D3, which returns all the way back to the research from Weston A. Price showing that that can also be incredibly helpful for all the bones, but especially the teeth and the jaw and the face, and you even see kids with higher vitamin D, vitamin K intake, who also do nasal breathing, who chew their food a lot, who don't have a lot of like smoothie pureed baby food all the time. They have better teeth. They have better jaws.

Not that adults are just giant kids. Well, most adults aren't some of us are. We actually do benefit from the same type of things, exercising our jaw, chewing our food a lot, shoving our tongue up against the roof of our mouth. And you could also say the same thing for maybe these jaw exercising devices or chewing gum on a regular basis. I also think that jaw therapy, craniosacral therapy, I have a whole video I shot on how to do your own jaw realignment therapy, and I'll put a link to that video at BenGreenfieldFitness.com/412. But if you're going to exercise your jaw, understand you want to take care of it same way as you would take care of your calves. Again, if you're doing a thousand calf raises a day, you'd be foam rolling and doing deep tissue work and massage on your calves.

Well, jaw realignment therapy can be done by yourself. I mean, you can try it right now. You put your index fingers or your thumbs on a tender spot on either side of your jaw, then open and close your jaw a few times and you'll find some really tight and tender spots, especially when you get up into the cheekbones and open and close your jaw, so its pressure open and close. It's almost like — what do you call it? What's the form of therapy, massage therapy, Active Release Technique? It's like Active Release Technique on your jaw. So, you pin, open, close. Move to the next spot, pin, open, close. You can do that. A massage therapist can do it. But you get some really cool popping and a relief of stress and tension in the jaw when you do that. So, ultimately, yeah, I'm a fan of exercising the jaw. I think you can do it with a good high-quality gum. I think you can do with one of these jaw exercisers. I think you can do it with the practice of mewing. I think that if you pair it with vitamin D and vitamin K intake, you're going to get even better results. I think you should care for your jaw and do some massage and deep tissue work on it if you're going to really commit to exercising your jaw more regularly than you have.

And then finally, book recommendation for you when it comes to all of this and better understanding. Well, A, shameless plug, the chapter on beauty and symmetry in my book “Boundless“, I get into this a lot and geek out on a lot more. So, you should read that chapter at “Boundless” book if you haven't yet. But the other one is a Patrick McKeown‘s book, “The Oxygen Advantage.” That's another one that I would read when it comes to how to shape your face correctly based specifically on your breathwork patterns.

Jay:  Yup. It's really good information.

Ben:  So, yeah.

Jay:  Yeah. I had to look up what mastic gum was because I actually didn't — I wasn't familiar with that term and I was just looking on it on Amazon. I didn't know if people would be confused thinking that's just kind of like a pack of orbit gum, but that's like legit gum. I actually ordered some just now.

Ben:  It's an acquired taste, but it works, as is that Slique gum that I talked about. It's a little bit tastier and gives me similar effect.

Jay:  Yeah.

Ben:  So, yeah. Ultimately, I guess those are all of our questions for the day. Fantastic questions. So, what we're going to do is I'll link to all the coffee studies, I'll link to all the resources that we talked about from my giant ass 20-ounce coffee mugs to some different stainless steel filter options, all of our fantastic sponsors, some different options for hyperbaric therapy and exercise with oxygen therapy, some of those tests I was talking about for the progesterone, some of the books and the jaw stuff, we'd just put all that. We work really hard in the shownotes for you guys. So, we're going to put all that over at BenGreenfieldFitness.com/412. And I wish we had time to give away something good on a review, but I have another podcast I am supposed to be on in about 75 seconds and counting that one.

So, here's the deal. We'll give something away in our next Q&A podcast. All you need to do is go leave a review on iTunes or Castbox or Spotify, wherever you listen to this show. It really helps us get new listeners and get the word out about this show. But then, we'll also randomly choose a good review or any review and we'll read your review on the show and send you some cool swag. So, go leave a review if you haven't yet. Visit the shownotes at BenGreenfieldFitness.com/412. Jay, I'll let you go so you can go drink your teeny-tiny thimble full of coffee.

Jay:  I drink my thimble.

Ben:  And we'll come at you guys next time.

Well, thanks for listening to today's show. You can grab all the shownotes, the resources, pretty much everything that I mentioned over at BenGreenfieldFitness.com, along with plenty of other goodies from me, including the highly helpful “Ben Recommends” page, which is a list of pretty much everything that I've ever recommended for hormone, sleep, digestion, fat loss, performance, and plenty more. Please, also, know that all the links, all the promo codes, that I mentioned during this and every episode, helped to make this podcast happen and to generate income that enables me to keep bringing you this content every single week. When you listen in, be sure to use the links in the shownotes, use the promo codes that I generate, because that helps to float this thing and keep it coming to you each and every week.



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Listener Q&A:

Hyperbaric Oxygen Therapy (HBOT) vs. Exercise With Oxygen Therapy (EWOT)…45:11

Jeremiah asks: I understand that LiveO2 has an advantage over traditional hyperbaric chambers because of how fast it delivers oxygen without needing to spend so much time inside a chamber, but I wanted to ask if you see any benefit to using a hyperbaric chamber in combination with a LiveO2 device. Are there any unique benefits to the chambers you can't get with a LiveO2?

In my response, I recommend:

Tips on increasing progesterone levels…57:55

Sarah asks: Ben, I've been following your work for many years. I've purchased all your books, am a cold shower junkie, all of the above… It seems that no matter how closely I follow your guidance and recommendations or what I'm doing training-wise, I've had to take bioidentical hormones for progesterone for the past 6 years because my body doesn't seem to be able to make it on its own. I'm only 28 years old, and I find that I'm super sensitive to stress and that any type of stressor in my life will halt my progesterone production. I've tried numerous endocrinologists and female physicians and no seems to have an answer for it. Do you have any tips or experience with this?

In my response, I recommend:

Do Jaw Exercisers Work?…1:12:14

Matt asks: Hi Ben, I'm hoping you can shed some light on the efficacy and science behind jaw exercisers. I don't want to mention any specific brands, but I'm sure you're familiar with them. They've always intrigued me, and I'd love your opinion on them.

In my response, I recommend:


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