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episode #202

Re-Broadcast Episode: Interview with Dr. Ted Naiman: Satiety per Calorie, Protein to Energy Ratio and Is Obesity Contagious? Hide Details 49min 13s

November 14, 2022 in Podcast

Intro

This week I'm excited to rebroadcast a popular past episode with Dr. Ted Naiman!

Ted is a board-certified Family Medicine physician in the department of Primary Care at a leading major medical center in Seattle. His research and medical practice are focused on the practical implementation of diet and exercise for health optimization. In this episode we discussed:
  • His protein energy calculator,
  • How to avoid overeating junk food,
  • The best way to workout when you're short on time
  • The importance and role of protein in the diet
  • How to identify energy dense foods that will help you lean out!



Brian (0s):

Coming up on the Get Lean, Eat Clean podcast,

Ted (4s):

It turns out that there's this protein leverage phenomenon where humans basically eat until they get enough protein. So protein gives you way higher satiety calorie. And then the obesity epidemic is mostly from protein dilution. We have all these refined carbs and refined fats, sugar and oil Mostly you dump a bunch of sugar and oil into your food supply and it dilutes the hell out of protein. So now everyone's eating like a 12.5% protein diet instead of, you know, 33% like hundred gatherers. So the, the whole point of the PE diet is to prioritize protein much, much, much higher at the expense of lowering carbs and fats, especially refined carbs and refined fats that dilute protein really bad.

Ted (44s):

And it's just looking at your whole diet from this protein versus non-pro energy lens.

Brian (51s):

Hello and welcome to the Get Lean Eat Clean podcast. I'm Brian Grn and I'm here to give you actionable tips to get your body back to what it once was, five, 10, even 15 years ago. Each week I'll give you an in depth interview with a health expert from around the world to cut through the fluff and get you long-term sustainable results. This week is a rebroadcast of an interview I did back in December with Dr. Ted Naman. I thought it was so relevant with so many great topics around protein, energy, how to avoid junk food, best way to work out in a short period of time, and the role of protein in diet, exercise, and losing weight.

Brian (1m 31s):

I really enjoyed my interview with Dr. Ted. This is my, one of my most downloaded episodes. So enjoy and thanks so much for listening. All right. Welcome to the Get Lean, Eat Clean podcast. And second time around I got Dr. Ted Naman. Welcome to the show.

Ted (1m 46s):

Hey, thanks for having me, man. The, the podcast must be really slow that you have me back on again.

Brian (1m 51s):

Well, no to hear that. Not at all. I'm glad to have you back on. I think you were the most downloaded episode I've had in my year. Wow. I've been podcasting. I just had my hundredth anniversary and so congratulations. Thank you. Yeah, so it goes fast, but yeah. Well I'm definitely excited to have you back on and just talk shop and figure we can get into, you know, a little bit of some of the stuff that we talked about last time. Obviously I know, you know, with PE died and everything like that and you mentioned you're doing some work with Diet Doctor. What type of, what type of collaborations are you doing with them?

Ted (2m 29s):

Got it. Yeah, so Diet Doctor is doing some very cool stuff right now. They're working on an app that's super awesome and they're also just trying to branch out a little bit more in the direction I'm going in, which is satiety per calorie. So looking at things like higher protein, lower energy density, it's not just quite so like unipolar, unifocal, carbs are bad type thing, you know what I mean? It's a little bit more nuanced, a little bit more, you know, basically just looking at more than just carbohydrate content.

Brian (3m 7s):

Gotcha. And maybe, so people, obviously you came on my podcast, God, it's been almost maybe a year, maybe give people a little bit of a background. I know you're a health professional in what state are you in?

Ted (3m 19s):

I'm in Washington. I'm in the Seattle area.

Brian (3m 21s):

Seattle area, okay. And how long have you been practicing for him?

Ted (3m 25s):

I got out of residency 21 years ago. Yeah. So I'm like as old as dirt. Yeah. We didn't have electricity and stuff like that.

Brian (3m 35s):

Wow. Where

Ted (3m 36s):

You youngsters see.

Brian (3m 40s):

Alright. And then, so you've had your own, is it, is it, are you by yourself, your own practice? Are you with someone else or,

Ted (3m 46s):

Oh no, I'm in a huge multi-specialty organization with 400 something doctors. Oh wow. It's one of the larger major hospital based multi-specialty groups in downtown Seattle. And so I'm just part of their primary care department and I'm just punching a clock basically for a really big hospital system. And I, and I work in a satellite with dozens of doctors and lots of specialists and that kind of thing.

Brian (4m 13s):

Okay. And I'm just curious, so 20 years of practice, what, what has changed in your mind and what type of things are you starting to see with a lot of your patients and stuff?

Ted (4m 24s):

Yeah, I mean when, when I first started out, honestly what we were taught is that most of your chronic diseases, like your obesity type two diabetes and your home autoimmune diseases and all these things are just genetic, right? So like if both your parents are overweight, you're gonna be overweight. If both your parents are diabetic, you're gonna be diabetic. If you know everyone had autoimmune disease, you're gonna have autoimmune disease. And now what I've realized is that genetics kinda loads the gun, but your environment completely pulls the trigger. And even if you know, every relative you've got is obese and diabetic and has some sort of chronic degenerative disease, you can completely avoid that if you can change your environment.

Ted (5m 11s):

Now, if you have the genetics for diabetes and obesity and you're in the same environment and by environment I basically mean food environment as your relatives who have obesity, diabetes, you're gonna get it to, but you can change your environment and it's mostly food choice that we're talking about and exercise choice. And you can avoid all of that. Like it's still bad genetics, but you can com it does not have to happen to you. So that's been the big revelation for me in 20 years. It's that even if you have bad genetics, you can overcome that and sidestep a lot of the stuff that runs in your family just with diet and exercise. And that's just, you know, that's my huge focus.

Ted (5m 53s):

That's my major message.

Brian (5m 55s):

Yeah, because you know, a lot of times you see that like people are just a product of their environment and it, I think it's sort of sad in the sense that you'll see a, you know, a kid who's 10, 12 years old and he's obese and then you're like, well, you see his parents and same thing. And it's like, well he didn't have much of a choice in that matter. You know, as you get older you can move out, you can, you know, do your own thing, but you know, you sort of feel bad for these kids that are just getting obese earlier and earlier. Are you seeing that with families and stuff?

Ted (6m 25s):

Yeah, absolutely. I mean, it's a complete nightmare. You know, childhood diabetes double during the pandemic and we're just, every age category at obesity continues to just accelerate upward. It has not hit any kind of inflection point. It's still just steadily climbing with no end in sight for, for all ages. And it's growing really fast in the, you know, child and adolescent age range. So it's just some scary stuff in like we're, it's just getting worse and worse. It's kind of snowballing.

Brian (6m 59s):

Yeah, I mean I feel like with the pandemic people went one way or the other almost. Like there's some people who really took it as a, as a way to get in shape and, and part of it was too just cooking for themselves, right? That can go, you know, a long way. And then other people unfortunately went the, went the other way and you know, just ate worse and put on weight.

Ted (7m 22s):

Yeah, the majority people got worse. So the average adult American gained 13 pounds and most of our clients just really did gain weight, more diabetic, more cardio, metabolic dysfunction. But then, like you said, there's a few outliers here, like, oh wow, I'm just gonna, you know, do something different now that I'm at home all day long. I'm just gonna work out and make my own food. Right. And some people, you know, just arose like a phoenix from the ashes ripped and jacked, like it's very small percentage, but you can absolutely do that. And it really just comes down to diet and exercise.

Ted (8m 2s):

It's the only difference between the people who got better and the people who got worse.

Brian (8m 6s):

Yeah. And the reason I said it, I saw actually a few of my friends, I could tell like they, they they lost weight, they look much better and they were cooking for themselves and you know, if you're going out to eat all the time, it's not, that's not a good recipe for trying to lose weight.

Ted (8m 21s):

Yeah. I, it just automatically makes it harder. Although it can be done. There are people out there who eat out all the time and they're just choosing the healthiest thing on the menu every time they're getting the salad, they're putting extra lean protein on top of it, they're drinking a non caloric beverage. And you could actually go, I can go to any fast food restaurant on Earth or any restaurant and come out with something healthy. Like it, it, it's, you absolutely can do that, but most people don't. They just order whatever sounds and tasties to them. Right. And that's food choice is everything and most people are choosing foods that sound tasty and that's as far

Brian (9m 4s):

To get as I do. And I do agree. I think the only downside to, even if you pick something that maybe you might, you know, let's just say it depends what they're cooking in too, right? That can obviously play a role. You know, obviously I would imagine 95% of restaurants cook in vegetable. It's the cheapest and easiest way to do it. Right,

Ted (9m 23s):

Right, right.

Brian (9m 25s):

I I actually, I always tell my clients to ask for butter, ask if they could cook it in butter and it's, it's an easy request. And you'd imagine most restaurants have, they might have not, not have grassfed butter, but they, I would imagine they have butter.

Ted (9m 41s):

Yeah. I mean they probably do.

Brian (9m 43s):

Yeah.

Ted (9m 44s):

But maybe not. I mean, every once in a while you go to a restaurant

Brian (9m 47s):

Where they look at you like, what's the, you

Ted (9m 48s):

Know, they don't have like, like, you know, you order some coffee and they just bring you little cream, the artificial creamer and you know, they don't have half and have anywhere in that place or anything like that. Yeah. So maybe not

Brian (10m 1s):

On that note, let's talk a little bit about, I, it was interesting, I was looking at that your protein energy calculator, which I think is pretty cool on your, on your website, I think the website, well it goes to a separate website, protein percent.com Do you wanna check out this, this calculator? But it's cool, you can also search by foods and see sort of the, the macro counts of those foods and then how much energy, maybe just to give people a little bit of background of, of you know, what your theme is regarding, you know, protein and energy and, and you know, so just people have a better idea of what that is,

Ted (10m 37s):

Right, absolutely. Right. So we've got the three basic macronutrients, protein, carbs, and fats. And as it turns out, carbs and fats are really similar. They're just chains of carbons with high energy bonds and it's really just solar energy stored by plants. As these carbon changes, these high energy carbon and protein's completely different, it's centered around a nitrogen molecule, which plants have to absorb nitrogen in mineral form from the soil. And protein is used structurally in your body. So you use protein for a lot of the structure and the function in your body and you don't really burn a lot of it for energy. And then you're just constantly burning carbs or fats for energy by breaking apart the carbons off the chains in your mitochondria.

Ted (11m 23s):

And that's how we get all our energy to survive. So you can kind of look at your diet in a protein versus non-protein energy lens where it's like protein versus carbon fats and carbs and fats are super interchangeable where humans can live on a, you know, 0% carb diet, no problem. You can live on a 10% fat diet, no problem. A lot of seesaw action there. It's protein that's more crucial. And it turns out that there's this protein leverage phenomenon where humans basically eat until they get enough protein. So protein gives you way higher satiety calorie. And then the obesity epidemic is mostly from protein dilution.

Ted (12m 6s):

We have all these refined carbs and refined fats, sugar and oil mostly you dump a bunch of sugar and oil into your food supply and it dilutes the hell out of protein. So now everyone's eating like a 12.5% protein diet instead of, you know, 33% like country gatherers. So the, the whole point of the PE diet is to prioritize protein much, much, much higher at the expense of lowering carbs and fats, especially refined carbs and refined fats that dilute protein really bad. And it's just looking at your whole diet from this protein versus non-protein energy lens. And then like you said, if you go to the protein percent.com, you can just see a really nice graphical snapshot of foods that are high in protein versus any energy and foods that are low, of course the lowest is sugar and oil and the highest would be, you know, egg whites or whitefish or something that's, you know, mostly protein.

Ted (12m 57s):

And it's just a really good way of like thinking about your diet. You know, here's where you're at on this protein to energy ratio or protein percentage and if you just tweak that up a little bit, you literally have higher satiety with a lower caloric intake, you automatically eat less and your body weight just goes down.

Brian (13m 17s):

Yeah, yeah. And I love the graphics and my question would be like, for example, egg whites high protein to, well how would you, I guess my thought is like, you wanna have some fat too, right? You want, right? So like if you're just having egg whites all day, that's probably not the healthiest thing you want. Do you wanna have the yolk? What are your thoughts around that? So how do you balance that out?

Ted (13m 45s):

Absolutely. So e everything in life is on this U-shaped curve, right? Protein percent is on a U-shaped curve where if you're really low on protein percent, you're gonna massively overeat non protein calories to get enough protein, not be hungry. You know, if you're eating french fries, which are potatoes and oil, there are 6% protein. You have to eat like 50 pounds of french fries to get enough protein to not be hungry. So you wanna raise that protein percent and you're, you're trying to find the top of the U-shaped curve. If you go too high, like egg whites are all the way around the U-shaped curve. On the other side, you try to eat a hundred percent protein, just egg whites, you're basically gonna be out of your mind starving at all times and you'll just basically die of energy starvation.

Ted (14m 28s):

So you're trying to find the sweet spot right in the century, you know, and you know, the worldwide hunter GA or macrogen estimate is right at about 33% protein, which is amazing sweet spot. Like we have studies showing that if you can get protein to 30% of your calories, you're gonna cure every pre-diabetic out there. And this is basically because you just can't overeat these foods. You're just full, you're done, you're done eating, you know what I mean? So, so the goal isn't to go all the way to a hundred percent protein, which is completely unsustainable and horrible and you can't just eat egg whites and you're gonna like hate life and then die right afterwards.

Ted (15m 11s):

So you, you, you wanna find out where you're at on that you and most people are at 12 and half percent and then dial it up so you're at the top right? It's not gonna be all egg whites, it's gonna be two eggs and two egg whites. It's gonna be some Turkey bacon instead of regular bacon. It's gonna be cooking with just a little bit of butter instead of like a whole stick of butter. It's gonna be eating, you know, carbs from like salad instead of carbs from like pretzels and chips, you know what I mean? It's gonna be sort of low carb and low fat and prioritizing protein to get yourself at this like sweet spot.

Ted (15m 51s):

This kind of center of the of

Brian (15m 53s):

You. Got it. Okay. Yeah, that explains it. Cuz I'm looking at this graph and I'm like all the way at the top, you see whe protein and egg whites. I'm thinking, well that can probably be good in some situations, but like you said, it's, it's finding that balance,

Ted (16m 5s):

Right? And if you're looking@proteinpercent.com, you kind of wanna be at that 45 degree angle, that 1.0 PE ratio, that's kind of your goal. You can go much more extreme for very short periods of time. If you're trying to do like a protein spraying modified fast and lose fat really fast, that's not a good idea cuz fat rabid fat loss is, is never quite as good. You're always gonna lose a little more lean mass. It's always gonna be a little bit less easy to sustain it afterwards. You want, you do want to eat in such a way that you enjoy your food, you're gradually losing weight, most of what you're losing is pure fat and you're gonna keep it off and sustain it. So you just wanna find out where you're at and then go up a little bit.

Ted (16m 47s):

And you also wanna do progressive overload, just like, just like lifting weights. You know, you wouldn't just take a total NBE and put like 500 pounds on the bar and have them bench that, right? You find out what they can bench and then you add, you know, five pound plate on each side or some sort of micro loading and you're doing the same thing with the protein energy ratio of your diet. Okay, here's where you're at eating like cornflakes and baking, right? And you're just gonna raise that up a little bit by eating oatmeal and Turkey bacon and then maybe you're gonna go even a little bit higher with, you know, some egg whites and some way powder or something like that, you know, but you're not gonna go straight to a hundred percent

Brian (17m 31s):

Right? Okay. Yeah cuz I'm looking, I'm like, God, I'm like, I have ribeye and steak and eggs quite a bit and that's probably about a good sweet spot to be at.

Ted (17m 40s):

That's a super good sweet spot. Like my very favorite like maintenance zone would just be, you know, steak and eggs, that's 30% protein. That's great, great. But then if you're trying to lose weight, you know, maybe you eat a leaner steak like some sirloin, maybe you eat two eggs and two egg whites, maybe you cook it all in a little bit less butter. Maybe you throw in some green vegetables, which have a super high protein energy ratio and you're doing all these little tweaks, more protein, more fiber, less net carbs, less fat, and you're just slightly improving these ratios and then you're just gonna automatically eat less calories.

Brian (18m 16s):

Okay, that makes sense. Yeah, a couple nights ago we had like Turkey tacos and, and I don't have a lot of ground Turkey and like it was good, but, but I'm like, God, this just doesn't fill me up like a rib fills me, fills me up. I felt like I need to and, and that would be the thing is like if you're always having, like, that's actually a lot of clients of mine, they're like, I listen to what they're eating on a daily basis and they're doing chicken with salad and then Turkey with salad. I'm like, well maybe try adding in a little bit of fats there, maybe adding some avocado because wouldn't you agree like you're just having, like we mentioned before, but if you're just having chicken with salad, that might not be optimal.

Ted (18m 58s):

Yeah. I mean that might be too high and then you're hungry later, so absolutely. You might need a little bit more carbs, a little bit more fat. And again, you, you might wanna just incrementally go up from where you were before. So it's not all, it's not about getting a hundred percent ready, it's about like going slightly north and higher than last time to coach to quote coach greg dot, you know, so you wanna be like harder than last time, but you don't wanna go to a hundred percent because that's not sustainable and you're not gonna like your food. And like you said, so some people might need to throw in a, an avocado or something. And, and for me, when you're adding carbs and fats, you, you kind of want to get the lowest energy density, carbs and fats you can, like an avocado is amazing, right?

Ted (19m 46s):

A hundred grams of avocado is only 10 or 15 grams of fat. But if you pour it in oil, a hundred grams of oil is a hundred grams of fat. So you're getting like, you know, five times more calories for the same weight in volume. You're just not gonna get the same society per calorie. The avocado's gonna beat the oil all day long. Same thing with carbs. You want your low energy density carbs. You, you don't want your berries where, you know, a hundred grams to berries is five or 10 grams of carbs instead of sugar. Where a hundred gram to sugar is a hundred grams carbs and it's way, wait, wait, wait, wait. You know, 10 times more calories. So it's, so I love adding in carbs and fats if you have unsustainable high protein percent, but then getting the lowest energy density carbon fast you can.

Ted (20m 32s):

So you get to eat more weight and volume for less calories and you're just automatically fuller at a lower caloric intake. So it, it is kind of a two phase thing, cranking up the protein percent and then also reducing the energy density of your carbs, fat fats, your non protein energy, which is kind of one of the things I'm working on now. If you look@proteinpercent.com, this is sort of my original concept for the PE diet, now I'm working on more of a satiety per calorie mindset. And in fact if you go to satiety calorie.com or satiety score.com, you can see my new calculator, which has protein percent on the y axis energy density on the X axis.

Ted (21m 16s):

And you can kind of see, oh hey avocado is way better for satiety than oil even though they're both fat. Because with the avocado you get to eat, you know, five times more weight and volume and water and fiber and micronutrients and all this stuff versus oil, which is just literally just calories.

Brian (21m 35s):

Oh, so we got a new calculator.

Ted (21m 37s):

Yeah, check it out. score.com.

Brian (21m 40s):

Score.com. I will, What about thoughts on over? Is it, is it tough to over consume protein?

Ted (21m 51s):

You, you basically can't do it. Like you, you literally cannot eat too much protein and no one can do that. You physically can't do it. It's basically can't happen.

Brian (22m 3s):

And and what are your thoughts around, you know, like stimulating mTOR and, and then like as far as like balancing that out maybe with some fasting and things like that.

Ted (22m 14s):

Right, right, right. So you, you have to have animal, some some metabolism. Some metabolism. You have to stimulate mTOR and then not stimulate mTOR. You have to be eating and fasting. All these things have to cycle. If you just said I'm never gonna stimulate ior, you die. Right? You, you'll absolutely die. So you, it has to be a balance, has to be a yin yang. Protein stimulates ior Sure.

Brian (22m 41s):

And carbs do too, right?

Ted (22m 42s):

And and fat does too. Anything you eat is going to stimulate mTOR, that's all anabolic. And then fasting or exercise or anything that's hypocaloric is gonna be the opposite. And you do wanna balance those and, and it, it kind of comes down to calories in, calories out in a way. So, but what happens is if your calories are mostly protein, you're gonna be prioritizing your lean mass over your fat mass. If your calories are just carved to fats, you're gonna be prioritizing your fat mass over your lean mass. You know what I mean? So if you're trying to balance metabolism and metabolism and also have the best body composition, you really wanna focus on protein and then worrying that protein stimulates mTOR is kind of not helpful because what really stimulates mTOR is being over fat 24 hours a day and having chronically high insulin levels.

Ted (23m 40s):

So anyone who's over fat is just gonna have way too many, way too much energy in their bloodstream at all times. The pre fatty acids, triglycerides, glucose, it's all way higher in your circulation cuz it has no place to go. So over fatness is the very, very worst for, you know, this sort of IOR stimulation that everyone's afraid of. That's what hyper insulin, hyper insulinemia is. It's just pure over fatness. You're basically over fat. You've filled your fat cells, fat has no place to go in your circulation. That's why your triglycerides are always high. Your free fat acids are always high and your insulin's high because it's just trying to clear the fuels out of your bloodstream and that is gonna massively increase your risk for cancer and heart attacks and cardiovascular events and every chronic degenerative disease you can think of.

Ted (24m 28s):

And so the very, very worst thing of all is just pure over fatness And and honestly over the past 20 years of my career, I used to think, oh wow, people got diabetic cuz they ate too many carbs or you know, it was some specific element of their diet. Now I realize it's really just being over fat, full stop period. Like every bad thing you can think of, all of your metabolic syndrome is just pure over fatness. And that gives you your high blood pressure and your high triglycerides and your pre-diabetes and then your diabetes and every autoimmune disease that's associated with hybrid anemia and all your cancer risks and cardio metabolic diseases that are associated with high insulin are really just all a hundred percent downstream of over fatness.

Ted (25m 17s):

Like literally overfilling your fat cells and having no good place to put fat. And so, you know, people who are super thin and all their fat cells are only half full and they have tons of room to store fat. You know, even in the subcutaneous layer they, they never have high triglycerides cuz they can eat a bunch of food and their fat cells just suck it right outta their bloodstream. So all their fuels are really low, their insulin's really low all the time cuz there's no extra fuels in their bloodstream, their blood sugar, their triglycerides, their free fatty acids, everything's really really low. Their cancer risk goes way down, their cardiovascular risk goes way down and it's literally about just being fatter or thinner period.

Ted (26m 0s):

And so the whole goal for body composition for health is to basically get more lean mass and less fat mass. And the way you get fitter is to eat foods with higher satiety per calorie. And the way you get more lean mass and less fat mass is to prioritize protein over non-pro energy. And these all kind of dovetail together. You know, you eat a higher protein diet, you're gonna get a better lean mass to fat mass ratio. And then if you work on sat society per calorie with a higher protein, higher fiber, higher water, lower carbs, lower fat, you're basically gonna automatically stop eating at a lower Clark intake. You're gonna be thinner and all these numbers go down and all your risks go down.

Ted (26m 43s):

And it's, so the, the longer I do this, the more it just morphs into this one big picture where you're just trying to be thinner and basically have recom highly ma fat.

Brian (26m 56s):

Yeah, nicely said. And what would we say, you know, you talk about individuals being a, can be somewhat of a product of their environment obviously comes down to that person making choices on a day to day basis. But we see that a lot that if you're hanging out with people who have these certain habits, you're gonna have those habits as well. I mean it could be as something as, you know, you have a patient maybe just getting them to, to be around healthier individuals and I mean that can go a long way as well, right?

Ted (27m 28s):

Okay. Yeah. This is a terrible thing to say and this is not gonna be popular and I'm gonna get canceled for saying it, but obesity is literally contagious. Like it's literally contagious. And it's because humans kind of follow these herd mentalities and these group mentalities. And if you're in, in a household where everyone's just super overweight and they're basically just ordering Uber Eats all day long and they just eat, you know, just pizza and donuts and chocolate chip chinos and they never exercise and they literally just glued the couch all day, you're gonna be more likely to be that way whether you want to or not, whether you realize it or not, it's just gonna happen.

Ted (28m 7s):

That's human nature, that's totally kind of normal, kind of natural. And so you've got two options. Option one, and this is the easy one, is to try to surround yourself with people who are all way healthier than you. You know what I mean? I want everybody around me to be just completely ripped in Jack. They're like, they've got their digital scale weighing out their skinless chicken breast and they're like basically either doing cardio or lifting weights all day long. Like it, I I'm gonna be like, Oh wow, I gotta go do some cardio. You know what I mean? So the the hard one is to just be the example for everyone else. You're like, you know what?

Ted (28m 48s):

Everyone else is just watching TV and eating pizza. It, I'm actually gonna, you know, get on the Peloton and do an hour of hard cardio and then I'm going to eat like a salad with a piece of fish on top of it and you could actually kind of drag people towards you. But that's a real uphill battle. It's really, really hard. It, it's so, it's brutal, you know, But, but that's, that's what more people need to do and it's not easy.

Brian (29m 15s):

Yeah. You know, I coach high school kids in golf and, and the seniors are all leaving and I always think about, you know, what would be some good advice to tell those seniors that I said, you know, going into college, make sure you surround yourself with the right types of people, people who, you know, obviously have good morals but you know, maybe are working out and are healthy cuz that's just gonna lead to you doing those things as well. And you know, obviously in society we could all use, you know, surround ourselves with better people. It'll make, you know, the whole world better in a sense.

Ted (29m 48s):

Yeah. I mean if, if you can't surround yourself with better people and if you can't try to be the better person for them, which is Yeah, that's a,

Brian (29m 55s):

That's a tough one And part of it is cleaning out the, the, the pantry. I mean I have people who come to me and they're like, well you know, I snacked on this last time. I'm like, well how did it get there? You know, like, you know, I think the, a simple, easy thing to do is clean out your, your pantry of all the things that we, you know, you're talking about the, the sugars, the flowers, the oils that are causing you to go. Cause we, we all find fault, I mean, myself included, you know, we'll, we'll host a couple people over for, for like dessert and you know, we'll get stuff that I probably don't wanna have on a daily basis and we'll always have like leftovers, whatever. Let's just say it's cookies and I'm like just, I just told my wife just get that out of the house after they're done.

Brian (30m 40s):

Like give it to someone because if it's in the house, I mean as good as I am and you know, I'm sure you as well Dr. Ted, like you sometimes fall, fall victim to that stuff and if it's in the house you, you're more prone to having it.

Ted (30m 53s):

Absolutely. Like that's just the way humans are wired. Like if there's some super tasty food right in front of you, you are definitely going to eat it. And it's, so it does really start with food procurement and like buying food. Like that's how that food got there and that does make it really, really hard for the one person in the household who's trying to do better when nobody else is. Cause that food's just around you all the time. And that's really, really hard. There's basically always some kind of junk food in my house and what I try to

Brian (31m 29s):

Do. Who's buying that? Is your

Ted (31m 32s):

I try. Oh yeah, I buy some of it, you know, my family like, you know, everybody's pretty fricking healthy in our household but there's always some sort of junk food round for sure. And what I try to do is, is front load a bunch of healthy stuff so then I just eat a little bit of it, you know what I mean? Right. Like if I've gone outta my way to eat my, you know, my

Brian (31m 59s):

Wild salmon and

Ted (32m 1s):

My wild salmon and my salad and like all this stuff. Okay then I can just eat like one donut or one cookie or whatever. And that's, that's pretty much how I'm running it. It's about 90% clean and then 10% just pure garbage where I literally do eat donuts and cookies.

Brian (32m 19s):

Well see I'm good that we're talking about, it's good that we're talking about because I do think that if, you know, you listen to podcasts or you listen to stuff like it, you don't wanna see, it's not about being perfect, you know? Oh

Ted (32m 30s):

Yeah, hell no. Yeah, no I'm definitely eating junk but I, but I just try to crowd it out by frontloading the, the better stuff and then I can get by with eating a lot less of it and that's just like a, just a hack which I think is helpful in real life, you know, cause there's always gonna be crab food around for sure. I like, I walk into work and it's like a just minefield of like bagels and muffins and crackers

Brian (32m 58s):

And Well cuz people bring everything they don't want from the house probably to feed everyone else.

Ted (33m 3s):

Yeah. Yeah. The break room at work is just like a, just a junk food nightmare basically. Everyone just offloads all their crap from home there.

Brian (33m 11s):

Yeah, right. Well and also, you know what I never understood is like, you know, you go to some of these hospitals and the vending machines are so bad it's like why don't we get some healthy, like at least better options for vending machines in a lot of these facilities.

Ted (33m 26s):

Yeah, it's brutal.

Brian (33m 28s):

Yeah. So part of the, part of all of this is just not having it in the house and like you said, I think that's a good hack is front load everything that's healthy. It's like you go out to dinner, you don't want to just grab for that piece of bread. I always tell 'em, I always tell my clients, tell 'em not even to bring the bread, you wanna front load with, you know, better nutritious, you know, lower glycemic foods that aren't gonna like spike your blood sugar insulin levels. Right.

Ted (33m 52s):

Yeah. And we have a lot of studies that that actually a point to what you can do on a practical level. So there are these protein preload studies where if you eat protein and then you go to a buffet two hours later you're literally going to eat way less calories. If you eat a super low energy food, like if you start your meal with a super or a salad, you will literally eat less calories. And this is evidence-based and we have studies proving this and so anytime you can front load with high protein food or low energy density food, soup salad, pro protein shakes, something like that, if you're gonna go out to an event where there's just tons of junk food or a buffet or something, if you, you know, preload with like a protein shake or a salad or something like that, you are gonna literally eat less calories and it definitely works.

Ted (34m 45s):

And that's a really practical hack.

Brian (34m 48s):

Yeah. It's like never go to the store with an empty

Ted (34m 51s):

Oh yeah, that's the worst man. It's just like donuts and chips. Which is honestly one of the problems I have with extended fasting because people just get so hungry they refe on like a whole jar of peanut butter, some sort of low protein food. That's the way we're wired. You get really hungry, you just eat the highest energy density thing you can find. And so I have people like losing and then gaining and losing gain the same five pounds forever with if they're trying to drive most of their health with a fasting approach. And so, yeah.

Brian (35m 25s):

Yes, I I, I do agree. Although I will say that once you get acclimated to fasting and been doing it for let's just say years, I actually find that I get less hungry a lot of times, you know, if I, if I do, if I'm as I'm fasting. But yes, if you're just starting out fasting, I do agree. I mean you're, you know, the thought is that you're gonna gorge if you do like a longer fast. But I always tell people to sort of ease your way into it just like anything else and you'll just, your body will be more acclimated obviously using key cones and things like that for energy.

Ted (35m 55s):

Absolutely. And then the fasting's also on this U-shaped curve and you're trying to find the sweet spot and fasting's also something you wanna just incrementally progress rather than just like, boom, I'm not gonna eat for a week. So Yeah, like you're absolutely right. Totally agree.

Brian (36m 10s):

Any, any thoughts on raw milk? I actually, I was curious to ask you because my wife and I went this weekend to the farm, it's like an hour away and there was a line out the door for this raw milk and they only have a certain amount every morning and we just got, we were like the last two people to get to get the raw milk and I've been having it over the last years and I'm telling ya, I'm, you know, I was never a big dairy person or milk person, but I mean once you have this, it's like I wouldn't go anywhere else. Is do you have any thoughts around that? Have you ever tried it?

Ted (36m 40s):

Oh wow. Okay. So honestly I've never had it, I never sought it out. I would probably have to go outta my way to get some. Yeah. And I just don't know if it's magical enough for me to wanna go to that trouble. I'm also just old-fashioned enough as a doctor to think the posturization is a pretty good idea cuz I've seen people just get deathly ill with, you know, CanAct and salmonella and Ella and e coli, all these nasty, horrific bacterial infections and especially like infants or young people who have lower stomach acid and pH and they're getting these weird, you know, botulism and stuff. And so I'm old fashioned enough to think, oh hey, maybe pasteurization is good from a public health point of view.

Ted (37m 24s):

And so I really haven't branched out into the raw milk zone cuz I'm not sure if the risk to benefit ratio, like if it was like the, the elixir of the gods, like a nectar of health that just had some really objective thing that made me way healthier. I might seek it out, but like at this point in my life, you know, I'm 50 and I've never had it, so I'm probably okay.

Brian (37m 49s):

Yeah, yeah. No, I hear you. I hear you. I had a try. I've been, I keep reading about it, hearing about it here, there. I think it, I think the thing is if you get it from a a, a good source, obviously there's risk for anything, right? I mean I could have sushi tomorrow and get some type of, you know, some type of salmonella or whatever. But either way I just was curious, why don't we change notes and touch a little bit about routine and micro workouts is something I know you're big into. How are your workouts looking these days? I know we were talking last time a lot of body weight stuff. I know that's in the book doing body weight workouts. Yeah. What are you up to as far as workouts?

Ted (38m 27s):

Yeah. Still, still the same thing. You know, most of the book is just trying to solve the exercise equation for the shortest time investment. Right. Like cranking up the intensity so you don't need as much time since time and intensity are kind of on this seesaw. So the book was like, okay, max out the intensity and then you can just work out for a couple minutes. And I'm still kind of like, in that realm, I'm basically doing body weight resistance, just, you know, one set a day, really high intensity just kind of maxing out on push pull legs and that's,

Brian (39m 3s):

Hey, if it works, I don't, if it works, stick with it. Right. You know?

Ted (39m 7s):

Right. I don't spend a lot of time on resistance exercise cardio. I, I do more like, you know, I try to hit walk 10,000 steps today, but then I'm also trying to do some all out sprints for like, you know, 30 seconds or something. So I'm trying to hit every, you know, rep range on the cardio where I'm doing some low intensity, some moderate intensity, some high intensity. But I think the take home message in the book is that, you know, if you crank the intensity gap you can be done exercising in a really short period of time. I, which

Brian (39m 40s):

Most people like. Right?

Ted (39m 41s):

Yeah. I think some people like that. Yeah.

Brian (39m 43s):

Yeah. No, I like it. I mean, if it works, why change it? I mean, I'm sort of the same way. I've gone to more of like 20, 30 minute workouts and just hitting it hard and, and actually what I added this past that's a few months ago was the, this rogue echo bike might be something you might like, but it's those heavy duty ones you see on CrossFit with the fans. Yeah. And let me tell you, like right now I literally do four sets of 15 seconds all out and I rest for about a minute and a half between. And, you know, you try to rest to the point where you're pretty much recovered and ready to just give that same sustainable effort each time when the effort starts going down, then you know you're not resting enough.

Ted (40m 28s):

Yeah, I love that.

Brian (40m 29s):

Yeah. It's, it's killer. And I put it in my basement and I, I, I talk to Brad Kerns every once in a while and he touches a lot on this stuff, so I want it away. Obviously sprinting might be ideal, but I, I feel like especially as you get older, you know, I'm 41, like, I don't know if I want to go out and sprint. I'm not, you know, I could do it, but, you know, I think just like you said, the risk reward about regarding injury, I, I, you know, I want try to keep an eye out for that.

Ted (40m 58s):

Yeah. I love those air bikes because you can just pump so much wattage into it. Yeah. And such a tiny amount of time. It's just, it's like you just max out and red line every mitochondria in your body all at once. And I love that. I think that's really great. I don't have one of the, I have a concept two rower and, and I'll do like a one minute or a hundred meter or some sort of super all out fair. Which is, you know, kind of the same idea. But yeah, I love, I love anything like that where you can just really pump out the highest wattage you can generate in the shortest amount of time. And I think that's, I think that's good for you. I mean, I really do think you wanna hit every range on cardio.

Ted (41m 41s):

You wanna do some zone two ma atone, you know, steady state. You wanna just do some walking, a lot of walking, but then man, you hop on your airbike and just like dump out every wat in your body as fast you can. I think that's really good for you. And so I love that. Love it.

Brian (41m 58s):

Yeah. Yeah. It's been a great addition to my workouts. What about routine? Let's touch a little bit about routine. I'm a big morning and evening routine. What type of things do you maybe help with your patients or your self as far as like your morning and evening routines?

Ted (42m 14s):

Oh man. So I, I don't have, you know, all, I have no exotic morning routine. A lot of people are like journaling and meditating Sure. And thing, no, like I basically just, I've got, you know, cats and dogs and wife and kid and like, I'm just trying to survive, you know what I mean? I'm just trying to get outta the house, keep everybody alive.

Brian (42m 39s):

How many kids do

Ted (42m 40s):

You have? Oh, just one. Yeah, one. I have a teenage daughter. She's 14.

Brian (42m 45s):

Okay, got

Ted (42m 46s):

It. So I'm just in survival mode in morning. I, you know, my first patient is seven in the morning and I have a pretty long commute and I have to, you know, we're like walking the dog and doing all this stuff. So I have no fancy routine at all. I'm just basically like down in the trenches working hard.

Brian (43m 7s):

Well hey, taking the dog for a walk that's, hey, that's a good part of the routine, right? That's

Ted (43m 12s):

True. Oh yeah. And honestly, anyone who wants to up up their step count go adopt a pit bowl the way we did. It seems to explode your step count.

Brian (43m 21s):

Yeah. Or pretty,

Ted (43m 22s):

Yeah, definitely ups to step count. But yeah, I don't have any kind of fancy routine. My diet, I do 16 eight every day, so I basically don't eat until lunchtime. I eat, you know, two meals at, at our window, lunch and dinner, maybe a little snack in there in between. I workout every day with basically a triple set, you know, well one set to failure with some rest pause sets of some sort of pushing move pushups, dips, something like that. Some sort of pulling move pullups typically, and then some sort of leg move like pistol squats or that kind of thing. So I'm basically just doing a single, really, really hard set of pushful legs every day.

Ted (44m 6s):

And then I try to do some sort of cardio every day. Either it's just a 500 meters on the row machine or running with a dog. I do this thing where when we reach a hill we sprint up it as fast as we can and then we walk down. So I'm basically just sprinting uphill every chance I get. It's kind of like some low budget interval training I like to

Brian (44m 31s):

Do. Yeah. Easier on the joints, easier on the joints when you're going uphill a little bit too.

Ted (44m 36s):

Right, Exactly. So it, it's basically daily doing little bursts of maximum output cardio and little bursts of maximum intensity push full legs. And the the beauty of that is they can all be interstitial at different times, you know what I mean? Like I can do lunch break at work, I can do a set of pushups, I can do some pistol squads, but then later when I get home I got a pull up bar or something, I can do a set of pulling exercise, pull up throws, something like that. And then the sprints, it's like I might do when I'm walking the dog or I might do it on the running machine later or something like that, but I'm just doing these tiny little nano workouts, so it's like two minutes each, but it's as hard as I can possibly generate, but I'm just sprinkling them throughout the day.

Ted (45m 23s):

And that's, that's pretty much how it goes. I don't have a, what I really don't have a lot of is free time, so I don't have this exotic free time ritual at

Brian (45m 33s):

All. Well this is good to hear. I think this is good for the people to hear. Right. You know, cause I, I know you're, you, you, you know, you have books and you speak out a lot and I think it's good to hear it from you that, you know, you're busy just like them, but it, you know, it's not about making excuses, you're just finding a way to get it done.

Ted (45m 48s):

Yeah, yeah. I'm just squeezing the diet and exercise in there intitially and I don't have a bunch of time to just like journal and meditate and not doing Yeah.

Brian (45m 58s):

You know, it's not for everyone. I will say my wife and I have been doing meditation before bed and I think it's a good time to sort of separate, okay, this is what's gone on during the day and with work and with you know, kids and then you just sort of like, you got this cutoff, maybe you do it, you know, right before bed. And even if it's just we've been doing like 10, 15 minutes of like some guided meditations. Maybe that's something you can add. But it's a great way and it's nice to do it with, you know, a partner and just sort of then, you know, go right to bed and finish the goal. Cool.

Ted (46m 30s):

That sounds good.

Brian (46m 32s):

Yeah. So maybe next time we talk you'll try implementing a little meditation. Well, this is good. I think the moral of this story of, of this interview was prioritize protein. Find ways to just put in micro workouts throughout your day. Surround yourself with people who are healthier than you and get rid of everything that's bad in your pantry or 90% of I was trying 90%, you can keep the 10% right.

Ted (47m 3s):

Yeah. Or, or crowded out with more good stuff.

Brian (47m 7s):

Right, Exactly. Crowded out with the good stuff. If you have a few things, I'm the same way. Like I'll have a little things that are like, I don't know, I like, I've always liked peanut butter and jelly. It's like I, you know, so I'll have occasionally, but you know what I, instead of putting it on just like a, a bad whole grain bread, I'll do it. Like they have these egg white wraps that are really cool and there's, there's like nothing in 'em. It's like egg whites and then I think it's just like one filler just to hold it together. And so I'll put that on, you know, I'll put that or I'll, you know, on, on it every once in a while. And that's like my sort of like splurge. So you can sort of splurge but you're not like, you know, I'm not like having some horrible p you know, piece of bread that's just gonna like weigh me down.

Ted (47m 51s):

Right, Right. Yeah. So I like that you're basically just substituting out on the little bit lower carb gives you a little higher society for calorie little higher protein percent. That's brilliant.

Brian (48m 2s):

Yeah. I, I like it. I, nope, there's my dog. It's, he made it about, you know, almost 50 minutes without seeing a squirrel. But on that note, he, he wanted us to end the interview. Right. Well I appreciate you coming on again, Dr. Ted. And best place to check you out

Ted (48m 22s):

Is, oh, oh, you could just go to ted naman.com. Anything new I do. I'll probably throw there. So yeah, that's what I would check

Brian (48m 32s):

Out. Okay. Well check em out there and we'll put that in the show notes. And I appreciate you coming on the podcast for part two. So thanks so much and we'll talk down the road.

Ted (48m 43s):

All right. Great to talk to you. Thank you for having

Brian (48m 45s):

Me. No problem. Thanks for listening to the Get Lean Ecla podcast. I understand there are millions of other podcasts out there and you've chosen to listen to mine and I appreciate that. Check out the show notes@briangrin.com for everything that was mentioned in this episode. Feel free to subscribe to the podcast and share it with a friend or family member that's looking to get their body back to what it once was. Thanks again and have a great day.

Ted Naiman

Dr. Ted Naiman is a board-certified Family Medicine physician in the department of Primary Care at a leading major medical center in Seattle. His personal research and medical practice are focused on the practical implementation of diet and exercise for health optimization.

https://www.burnfatnotsugar.com/About.html

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