Minimize Stress, Exercise Regularly, & Eat Real Food - Dr. Brian Lenzkes

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Jack Heald: Welcome to the Predictive Health Clinic. I am joined today by a man that I first interviewed a couple of years ago. I've talked to a whole lot of people since then, but some of the things he said in that interview have stuck with me ever since. And that's why I wanted to have him on the show. Welcome, Dr. Brian Lenskes. 

Dr. Brian Lenzkes: Jack, thanks for having me on. Great to be back. I don't get invited back very often so I guess this is my first time on this podcast so we'll see how it goes. 

Jack Heald: It's good to have you. So let's get right down to it. As this is a very tightly focused show.

We want to address a specific single specific health issue. And come up with actionable ways to solve it. So what one specific health issue do you want to address today? 

Dr. Brian Lenzkes: I think what I love to talk about is metabolic health. That's a bunch of topics that all roll into one, but I think that's the underlying topic.

Penning of all these things when we talk about diabetes depression, anxiety, dementia, all these things we worry about chronic disease. I think it all comes back to mitochondrial health and metabolic health. 

Jack Heald: So going off script here just a little bit for our listeners who are not real clear on the major problems that come from poor metabolic health.

Give us just a handful. You listed a couple there. Okay. 

Dr. Brian Lenzkes: The main problems we're seeing, we have an epidemic of diabetes and obesity, and so all of these are stemming when we talk about metabolic health, in general, we're talking about having a big belly, a big waist circumference, high triglycerides.

Low HDL cholesterol, high blood pressure and these are the constellation of things that we, and high blood sugars, and these are the constellation of things that are the underpinning of most chronic medical conditions that we're treating. 

Jack Heald: Okay. That's good to hear. So what got you interested in this issue of metabolic health?

Dr. Brian Lenzkes: What got me interested is my entire family, my mom's side of the family, everyone died at my age or younger, so growing up I was looking, thinking, Oh, this is not very good. And although what they had in common was they were all metabolically sick with diabetes, coronary disease, and early strokes.

And their mindset was like, Hey, just eat and drink and be merry. And then you just die. Basically. I'm like I don't want to go to med school all that and die when I'm 48 or 50. So It was out of my own desire for better health and I looked around and thought the way we're managing these conditions, it's not working for anyone, right? We can't just say eat cake and ice cream all the time. And we'll just give you more insulin. Or eat whatever you want and we'll give you more statin drugs. There has to be an underlying condition that we can change, something with lifestyle. And so that's why for me struggling with obesity my entire life I said, there's gotta be a different way.

And I came across Jason Fung and he starts talking about high insulin and metabolic disease. And at first, I thought he had to be crazy because he was going against everything I had learned, but once I started diving into myself and helping myself do better and then helping my patients do better, I started to believe that, yes, there is a better way to manage chronic disease. 

Jack Heald: I think you touched on a little bit, but let's focus the question. What's the biggest popular misconception about metabolic health? 

Dr. Brian Lenzkes: Gosh, I think there's just a lot of confusion. I think what happens is the patient hears one thing from one doctor, a different thing from a different doctor. So by the time they get to us, they're frustrated because they've tried everything. They tried the cabbage diet, they tried eating Melba toast, like I did. And, a little bit of rice cracker with a little peanut butter on it. That's your, or green shakes. And so I was doing that and I was getting, my sugars were going higher and higher. My weight was going higher and higher. My blood pressure was going higher and higher. And I thought there had to be another way. And so I think the biggest misconception is that. We all went for the low-fat diet. We said we have to eat low-fat or we're never going to get skinny. But the more low fat we got, the fatter we got. So there had to be a problem there.

Jack Heald:: Okay, so that takes us to question four. What's the truth about this? 

Dr. Brian Lenzkes: The truth is our biggest killer is insulin resistance, high insulin levels. The thing that makes insulins go higher and higher is eating more and more sugar. So we had the Entenmann's cakes back when I was growing up and they said it was low fat. Entenmann's? Do you remember, do you remember Entenmann's? It was like a, 

Jack Heald: Oh yeah. 

Dr. Brian Lenzkes: And then they had the snack wells and they got their low fats, you can eat as much as you want. So we got into this misconception that, get rid of eggs and now we're going to have cereal that's heart-healthy, whole wheat toast.

And so when you start looking at all those things, they all raise insulin levels and we know insulin levels being elevated or associated with coronary disease strokes, heart attacks. That's why diabetes is the number one risk factor for all these things, right? So when you look at LDL, cholesterol is what we focus on forever and you have to realize we have to look at the big picture.

So when we talked about metabolic disease, LDL, cholesterol is not even listed in those five things that we worry about high blood pressure, the big belly, all these other factors involved. So I think we have to circle back around and look at the big picture and say, What is the most likely thing to kill me and how do I avoid that? 

Jack Heald: Yeah that's question five. What's the most likely outcome if folks don't take action? 

Dr. Brian Lenzkes: Yeah, the most likely outcome is that we get more and more insulin resistant with time, because as we get older, there's a big interaction that happens, the more muscle mass we have, and this isn't well known for a lot of people, the more muscle mass you have, the longer you live, right?

If you look at all the factors, including smoking, drinking, muscle mass is huge. Why? The more muscle mass we have, the less visceral fat we have. Visceral fat is the really dangerous pro-inflammatory fat that we have around the organs. So when we start getting fat as a teenager, we get love handles and we get fat butt and hips and all that. But as we get older, we run out of those fat. Places to store fat, and then it goes to the visceral fat, which is the fat around the organs. So the older we get, the more fat we store in the visceral fat, and the more that inhibits muscle mass. And the more we inhibit muscle mass, the more visceral fat we get.

So if we're able to maintain muscle mass, staying active and fit, we can decrease that visceral fat. Thereby lowering insulin levels. So muscle is very insulin sensitive. So when you're exercising, you don't need a lot of insulin to shove that sugar into the muscle, because that's, you need that to run away from lions, right, historically of how we survive. So as we get older and we sit on the couch and we watch the reruns of the Brady Bunch or whatever we're doing, we lose muscle mass and then we smash for sure. Yeah. And then what happens with that, then we start getting out of shape. And, this whole thing of getting older and having all these body aches, it's not a normal thing, but in the United States, we think it's normal because that's where we all end up going if we don't intervene. 

Jack Heald: What specific action do you recommend people taking? It sounds like, at least at a high level, it's activity, it's exercise. Can we be more specific or does it matter? 

Dr. Brian Lenzkes: There's specific in this specific type of exercise, weight-bearing exercise. So anything we could do, and anyone could do these things, if we just get little bands, if you're 85 years old, you can get little exercise bands.

I have people who get the ironing board or anything like that they can lift up. Just movement for sure. Because, being limber and and staying active, they have Tai Chi in, in the Asian countries and that's just movement, and they're just moving, but they're 85 years old and they're still moving.

So instead of using the remote control only, so staying active any way you can, high-intensity interval training specifically works for people who are in better shape, that's just movement. So you don't want to injure yourself, but you can get on the bike and ride for as fast as you can for 20 seconds.

And then relax for two or three minutes and get your heart rate back down and then go as hard as you can. If your heart is okay. And you're checked out by a doctor and all, but really looking at the bigger picture saying, look, it's not just the exercise. It's what we're eating, decreasing the processed foods, Ben Bickman who's one of my heroes of mine and metabolic health areana, he goes, look, five things because I asked him this when I was working 18-hour days as a stressed-out doctor. That's part of the reason I changed my life because I realized he said five things you can do Brian, number one, don't be stressed out and work 18-hour days. And I'm like, okay, that's not very good.

I go, what's number two on your list. Number two is to get enough sleep. And at that time I was sleeping four or five hours a night. And I said, Ben, I don't like your rules. I'm on like, oh, for two. And he said that's why doctors die before everyone else. And then he said, next thing is eat real food. Cut out processed food, eat real food, eat real meat, vegetables, and things like that. Don't smoke or drink to excess and exercise regularly.

So those are the things we have control over. But when people go to their doctor, they don't talk about those things. They'll say eat less, exercise more. What do I do? How do I do that? If I'm addicted to food or I'm stressed out or depressed.

The huge thing that we're saying is if we get the stress level right, we get the exercise right, we get the sleep right. All these things combine to lower that insulin level. And that's what we're talking about from a metabolic standpoint. 

Jack Heald: Very good. Okay. So let's talk about compliments and complaints. What's one of the most common compliments you get in your practice? 

Dr. Brian Lenzkes: Gosh, from patients. The biggest compliment I get is that they have their life back and they're free of, worrying about what they're going to eat every 15 minutes, right? Playing their meal while they're eating this meal.

So to see people freed of that, to be able to say, you know what, I could skip lunch here and I'm, I can survive. I'm metabolically healthy enough. But the other side effect of that is we definitely see mood improvements, cognition getting better, relationships getting better. Nothing's better than to see couples come in together and they're trying to get on a metabolic health pathway.

And I'll ask them, ask the husband, how's things at home? And he'll look at his wife and look at me and look back at his wife. And he was like, should I say it or not? And then I'll go, honey, you're easier to get along with. You don't get as upset as you used to. And then she'll say, what do you mean I used to get upset, but he says, things that would really throw you over the top before you're handling it better now. There's a lot of metabolic mind being one of them that they're starting clinics at Stanford and some of the big universities looking at the improvements in mental health, right?

When we talked about this seven years ago, people thought we were nuts and doctors said we should have our license revoked for even considering that food could have anything to do with mood, but there's a lot of data coming out now on these, we have Harvard trained psychiatrists who are talking about it, probably people that you've interviewed on your show and it's amazing, but there's nothing better, cause you know, when I was in a documentary called Fat Fiction and they had five of my patients up there and they said, doc, you go sit in the corner and just let us interview this person about reversing diabetes and obesity, but all of them said that their mood got better. They, it was like, they walked out of a fog. They could laugh, they can enjoy life again. And there's nothing better than that to see someone get their life back where their joints aren't hurting all the time. And they don't have to sit there and watch their grandkids play. They can go and participate. So that's the compliment. 

Jack Heald: Yeah, that's a big one. Let's flip it around the other side. What's one of the most common complaints you get? 

Dr. Brian Lenzkes: Oh, and the most common complaint I'll get is people go to their other doctor and the other doctor says, yeah, you lost 40 pounds, you're off your insulin and all that stuff, but you're going to die doing this stuff.

You can't have fat in your diet. You can't eat avocados, right? And so that's what I was up against initially. But then what happened is a lot of the cardiologists I work with are now recommending a low-carb diet, cutting out processed food, like, processed foods are not necessary for life. Yeah.

We may not be happy without them. Like we'd like to have our chips, but when you have cardiac disease or diabetes, you have to really reassess and, and say, is this food really worth it? Is it worth it? A little bit of joy I get if I can't get out of bed or my sugars are bad and I have to shoot more insulin.

Jack Heald: All right. That takes us to the big one. Question number nine, if you could deliver only one message about health and you had only eight words to deliver it in, what would those eight words be? 

Dr. Brian Lenzkes: Nah, that's a tough one. Eight words. I have so many words wrapped up in my brain, but I would say I would just, what we're talking about right now, I would say minimize stress, exercise regularly, and eat real food.

Jack Heald: Minimize stress, exercise regularly, eat real food. Dr. Brian Lenzkes, thanks for joining us on Predictive Health Clinic. Folks want to get in touch with you. Tell us how they would do that. 

Dr. Brian Lenzkes: Oh gosh, I'm on Twitter at Brian Lenzkes and at B Lenzkes on Instagram and my practice, Arizona Metabolic Health and San Diego Metabolic Health.

Jack Heald: Very good. We appreciate you joining us. This has been the Predictive Health Clinic with Jack Heald and Dr. Brian Lenzkes. We'll talk to you next time.

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