In this episode of the Flex Diet Podcast, I discuss physiologic flexibility and the Physiologic Flexibility Certification, which is the Level 2 to the Flex Diet certification. The main focus is on understanding the four pillars of homeostatic regulation in the body: body temperature, blood pH, the fuel system (carbohydrates and fats), and air (oxygen and carbon dioxide). This podcast is brought to you by the Physiologic Flexibility Certification course. In the course, which opens again today, September 18, to Monday, September 25, 2023, I talk about the body’s homeostatic regulators and how you can train them. The benefit is enhanced recovery and greater robustness. We cover breathing techniques, CWI, sauna, HIIT, diet, and more.
In this episode of the Flex Diet Podcast, I discuss physiologic flexibility and the Physiologic Flexibility Certification, which is the Level 2 to the Flex Diet certification. The main focus is on understanding the four pillars of homeostatic regulation in the body: body temperature, blood pH, the fuel system (carbohydrates and fats), and air (oxygen and carbon dioxide).
This podcast is brought to you by the Physiologic Flexibility Certification course. In the course, which opens again today, September 18, to Monday, September 25, 2023, I talk about the body’s homeostatic regulators and how you can train them. The benefit is enhanced recovery and greater robustness. We cover breathing techniques, CWI, sauna, HIIT, diet, and more.
Episode notes:
[00:00:00] Dr Mike T Nelson: What's going on and welcome back to the Flex Diet Podcast. I'm your host, Dr. Mike T. Nelson. On this podcast, we talk about all things to increase muscle performance and improve body composition all without destroying your health in a flexible framework. I wanted to let you know that the Physiologic Flexibility Certification, this is the Level 2 to the FlexDiet certification.
[00:00:30] So if you have taken the FlexDiet cert already, or if you feel like you're pretty good with nutrition and recovery and kind of basic exercise, then the next question is what do you do next? How do you increase your body's ability to recover, become more resilient, anti fragile? This would be the Physiologic Flexibility certification.
[00:00:56] So a similar idea to the flex diet, which is a combination of metabolic flexibility and flexible dieting. So metabolic flexibility has three components. How well can you use carbohydrates as a fuel? Part two, how well can you use fat as a fuel? Part three, how well can you switch back and forth between fats and carbohydrates, depending upon the task at hand or what you're trying to do.
[00:01:26] This allows you the ability to still increase performance and to improve body composition and a framework of which to explain the different interventions. So in the Flex Diet Cert, we talk all about the macronutrients, protein, fats, carbohydrates, NEAT, exercise, sleep, micronutrition, and much more. So we took the same idea...
[00:01:53] And we expanded that to you as an entire physiologic organism. So can we take the same idea of flexibility and expand that out to cover you as a person? This will then allow you a framework of which to determine what things should you work on next. These come down to the four pillars of what's called homeostatic regulation.
[00:02:21] And that's just a fancy word meaning that Your body has a homeostasis, or its baseline, that it likes to hang out in. And there are different components of that, that we have to, and you have to, maintain constant, or else you're in a world of hurt, and worst case, you're dead. So those are going to be number one, body temperature.
[00:02:45] Number two is blood pH. Three is the fuel system. And then four is going to be air, oxygen and carbon dioxide. So there are a few other systems, of course, that your body has to regulate, but those are going to be the top four. And within that, we know that we can expand your kind of, your physiologic headroom, or what I call HDR, human dynamic range, within each one.
[00:03:12] So with temperature, you can do things such as a hot tub, sauna, exercise in the heat, that will expand how well your body can cope in a little bit more of extreme environment. You can go colder also. You could do air temperature, you could do cold water immersion, etc. Now we're not expecting body temperature to change a whole lot.
[00:03:35] In fact, your body is actively working to try to not have your body temperature change that much. But we can increase how well your body is adapting to Let's say the stimulus of increased heat, just like your right bicep would adapt to the load of putting more weight on it for a, say, bicep curl.
[00:04:00] It's the exact same idea. We're increasing the adaptations within the body. But we're doing that in a systematic way to target the systems that are going to be the most important. And I believe once we do that, the transfer or the carryover to you as a better functioning human organism is going to be a lot better.
[00:04:24] So one would be temperature, two would be pH. Again, we don't expect blood pH to change that much at all. If it does, you're going to be in a world of hurt. But you can do crazy stuff like really high intense intervals. These are commonly called in the lab, windgates. This is a high output of 30 to maybe 60 seconds.
[00:04:44] There's different types, but it's relatively short, extremely high output typically done on a bike, potentially a rower, other modalities, and they are not fun at all. If you've ever done them, you're easily in excess of 100 percent of your VO2 max. They are ridiculously hard, but if they're done in the correct manner, They are very effective.
[00:05:07] And when you do that, you are literally dumping acid into your bloodstream. You're producing a ton of what's classically called lactic acid. This is better known as lactate plus hydrogen ions. Hydrogen ions are literally the definition of a change in pH. The change in the concentration of hydrogen ions.
[00:05:28] So you're dumping these hydrogen ions from the muscle into the bloodstream in the local area, and this has the potential to then change the local and overall pH. So your body has to get better at buffering this via different systems. The two main systems are going to be the intra and inter muscle buffering.
[00:05:51] The main one there is going to be something like the supplement beta alanine. Beta alanine is consumed around six grams total per day. Maybe three grams depend upon the research. This forms with the other amino acid that's in the body, lhi and forms intramuscular carine. So carnasine is a buffer of hydrogen ions.
[00:06:15] We also have buffers that are more located in the blood. Bicarbonate is gonna be the main one, and there are supplements you can take to increase blood levels of bicarbonate. You do have to be careful with that because you end up with some GI distress if you get a little bit too crazy. So there are ways that we can augment these adaptations to the system of pH.
[00:06:40] So in fuels, we expand that out to the high end of carbohydrate use, which is going to be the formation of lactate and hydrogen ions. So you're starting to see how these systems now overlap. If you are doing, let's say, a 30 second Wingate, which is all out max for 30 seconds, your body is producing a ton of lactate and hydrogen ions.
[00:07:06] So we have to contend with the hydrogen ions that are trying to change the potential pH. But lactate actually is a very good high energy fuel. Your brain loves to use lactate, the cardiac system loves to use lactate. The muscle itself can pull lactate and use it directly as a fuel. Otherwise, it can also go to the liver and be converted to glucose via the Cori cycle.
[00:07:31] That does take a little bit longer. Spinning off lactate is not necessarily an issue. It's the pesky hydrogen ions that come with it. We talk about what to do with the fuel system when you're using a lot of carbohydrates for fuel. And again, this is going to be great for weight training, high intensity intervals, speed, power generation, etc.
[00:07:55] On the other end related to metabolic flexibility, the cousin of high fat use is going to be ketones. Ketones are spun off when the body is using a ton of fat, generally in a low carbohydrate condition. Ketones have some very fascinating effects upon physiology. Again, the cardiac system and the brain love to use ketones.
[00:08:19] They may be used as a fuel for muscle. Some of that is a little bit debatable, depending upon the context. But the spinoff of the ketones, the ketone bodies, we can now potentially get via a supplement. So you do not necessarily only have to do a ketogenic diet. With supplements now we can increase ketones, these ketone bodies in the bloodstream, while still potentially having a higher carbohydrate, even moderate carbohydrate background.
[00:08:50] So this opens up some very cool things we can do related to physiology on both. The fat end of the spectrum via ketones and also the carbohydrate end of the spectrum via lactates. Part four is going to be air, how you breathe oxygen and get rid of CO2. While that sounds very simplistic, it gets to be really messy really fast.
[00:09:14] Again, all these systems are overlapping. And the one, I think, mistake I made with the early version of the class when it first came out, is I spent two years before I even had the first class done with iterations of it. I started thinking about this and writing notes down and reading the research and all that stuff for literally a decade before I even attempted to do the first version of the class.
[00:09:43] An issue I had was teaching them as a little bit separate systems because it is much easier to understand if you throw everything at you. It's very complicated and complex, and it becomes very hard to understand the components. So what I did that worked better, is I broke them down into the four areas, temperature, pH, fuels, air, O2, and CO2.
[00:10:10] And then within that, showing what are the overlap and why this is important. I think on that second part this is like the fourth iteration of this version of the class. I've gotten much better at showing them individually, and then as the class progresses, how they all fit together, and again, why this is important.
[00:10:34] Because without understanding it, You'll probably make mistakes and apply the wrong intervention at the wrong time, which can lead to worse results, especially for more effort that's applied. And if you can understand the big picture, you'll know the context of what direction to go in. That's going to be impossible even with a longer certification like this.
[00:11:00] to go through every possible scenario that you're going to run into. So knowing the context there, how these systems work, and why, focusing on the hormetic areas, or I should say homeostasis areas, is going to be better. As the class evolves, I've been adding more videos now to show how they're related and why they're useful.
[00:11:24] So each intervention has 10 specific action items. So you'll know exactly how to apply it within the framework of that area. And like I said, I'm adding more videos currently right now to show how these are all interrelated. And again, the physiology in this area does get complex. For example, the O2, the CO2 area, and I think that was the hardest area to do right after the cold water immersion research.
[00:11:52] I think that one took me almost a year to get the modules finally out. I am very happy with how they turned out. So here's an example of why this stuff matters and an action item you can look at from a high level that's useful. So now with technology, I'm a big fan of using heart rate variability.
[00:12:16] There's various devices to measure that. The Aura Ring is good for sleep. While we can have a debate about how accurate it is for sleep cycles, I think three of the underappreciated areas from Aura, just as an example, and there's other devices that'll do this, my Garmin watch will do this, I know the Apple watch will do this heart rate variability measurements, we can get from that.
[00:12:37] That has some pros and cons, so there's a few gotchas to watch out for that, especially if you have athletes who have extremely low resting heart rates, but it's generally helpful body temperature, which aura is actually very accurate with I found that's super useful. I've noticed it is tied to metabolism and potentially metabolic rate, or at least appears to assuming that your last meal is at a normal time.
[00:13:03] And then also to cross check with heart rate variability to see if you're really having some immune hits. Alright, so everybody knows that if your immune system is becoming overtaxed, Temperature will go up, and so we can see that in the temperature. The third is the respiratory rate. Now keep in mind when we're looking at aura, for example, or garmin or whatever, most of the time they're going to measure respiratory rate over the course of sleep.
[00:13:28] So if we exclude people who have sleep apnea, which I have seen that a fair amount, which is going to be a referral out, respiratory rate's going to get very screwed up in that case. The new Aura and some of the other devices also have oxygen saturation, so we can look at that and get a really good idea, does this person need a referral out for a sleep study?
[00:13:50] Because if they're having sleep apnea or sleep issues, it is literally going to mess up everything in their body. So that's going to be a referral out, so it's good to look at those things. The other part to look at is respiratory rate and is somebody over breathing at night? So this is some of Patrick McKeown's early stuff.
[00:14:10] I want to give a special shout out to my buddy, Dr. Andy Galpin, who I work very closely with at Rapid Health Optimization. So I do look at a lot of the profiles of athletes and high level executives and people we have that come through Rapid. I help looking at overall stress levels, all their testing and everything, and coordinating that into an action plan.
[00:14:31] So I have been able to see a lot more data on this over the past half a year. I've seen this in my own clients over many years. I also want to give a shout out to Brian McKenzie at Shift Adapt. I've got an interview with Rob Wilson in the Physiologic Flexibility Cert where we talk about hands on work, breathing, and everything else.
[00:14:50] And also Emily Hightower, who's talked about this stuff for quite a while too, along with Brian. Emily's also helping us at Rapid Health with these too. So I want to make sure to give them credit because they've been talking about this for quite a while and have seen this, and their education, at least helping me along the way, has been super helpful.
[00:15:08] So if you have someone who has a high... Respiratory rate at night. Now, what is high? There's some debate on that. But I'd say 16 to 17 to 18 breaths per minute is definitely on the higher side. Now keep in mind, this is during sleep. This is not during exercise. Not even walking around. This is while your body is not really doing much of any movement.
[00:15:34] So it gives us a nice inside look at what the body is doing, not under any load. When you are breathing more, when you inhale, if you really overly simplify it, you are inhaling to get oxygen, you are exhaling to get rid of CO2, carbon dioxide. So carbon dioxide is not necessarily a waste product, it is also a signaling molecule.
[00:16:01] It is something that very much controls our breathing rate. So CO2 levels are the main system the body is using to determine breathing. Oxygen is a backup system to it. So a lot of people think oxygen is the primary system. It can be better thought of as more of a backup system. If you imagine exercising really hard, you are doing a lot of muscular work.
[00:16:28] Therefore, you do need to offload more CO2. Therefore, your respiratory rate will go up. Your body is really working to get rid of that CO2 via the lungs. But at rest, or during sleep, when you are over breathing, Again, this is not necessarily from a pathological stage or due to a disease process. This is just an adaptation that can happen in the body for a whole wide range of reasons, which is well beyond this podcast, but we can spot it.
[00:17:01] And when you are breathing faster, you are getting rid of more CO2. Now at face value, you might think, Oh, whatever, I'm just clearing out more CO2. This shouldn't really be an issue but it can cause other issues. So if we go all the way back to some of the classic physiology work that was done, you'll find something called the Bohr effect, B O H R.
[00:17:27] This was originally described in 1904 by Christian Bohr, the Danish physiologist, and what it states was that the oxygen binding affinity of hemoglobin is inversely related to acidity, so pH, and carbon dioxide concentration. So our oxygen binding affinity of hemoglobin. So hemoglobin is going to be the main molecule that the body is then using for offloading CO2 and delivering of O2 to the muscle.
[00:17:58] So oxygen binding affinity is just how well the oxygen molecule is stuck to the hemoglobin or we could use a red blood cell in place of it. This is inversely related to acidity. So when you have local changes, let's just zoom in and look at the muscle level. When the local pH changes, this changes the oxygen affinity.
[00:18:23] You can imagine back to our example of doing some high intensity interval work. What are we doing? We're running glycolysis very hard. We're burning through a bunch of glucose. We are still using oxygen. This is not purely an anaerobic event, although we do have some of that going on. And you're spinning off lactate and hydrogen ions.
[00:18:44] So this is going to happen especially locally, because of muscle. is going to dump hydrogen ions locally. Hydrogen ions, you literally dump more of them into the blood, you're making it more acidic. Therefore when this happens, you're changing how well oxygen can bind to hemoglobin. Which in a way is ingenious, because if you zoom all the way back out again, there's something in physiology called the local control.
[00:19:14] So local control tends to trump any A systematic thing going on and this is good because locally we need to make sure those effects are taken care of. So locally the muscle needs to get oxygen and it needs to get rid of CO2 in order to have a high level of performance. So if we go back to what is called the Bohr effect, the oxygen binding affinity of hemoglobin is inversely related to acidity and carbon dioxide concentration.
[00:19:47] What this means in English is you need a little bit higher level of carbon dioxide at the local muscle level for the oxygen to move off of the hemoglobin into the muscle itself. So for the offloading of oxygen, this is locally done as a passive process just due to the changes in partial pressure, which is amazing because it doesn't cost your body any energy per se to do that.
[00:20:16] You need to have a higher level of carbon dioxide. If you don't, what happens is you have a lot of oxygen that's attached to the hemoglobin, but it just zips by and doesn't get to the muscle when needed. Now you can get fancy and look at all this stuff with Metabolic Heart. I have a Pinoy system. You can look at this with a, like a Knox device.
[00:20:40] You can listen to a podcast I did with Evan on that. or on a MOXIE device, which is what's called a NEARS device. The MOXIE device, which I have three of them, you stick it over the muscle and it's going to look at what's going on locally with oxygen concentrations. So you can see some of these changes locally using a MOXIE or a NEARS device or a NOX device and you can see what's happening to them systemically.
[00:21:10] Now again, you don't need all that fancy thousand dollars worth of equipment unless you're a super nerd like me and this gets you all really excited. But the takeaway there is if we go all the way back and we go, okay, what's happening when we increase our respiratory rate? When we increase our respiratory rate, we are exhaling more CO2.
[00:21:31] So we are dumping and we are getting rid of more CO2. When we do this, we don't have as much of the Bohr effect at the muscle level, so you're not oxygenating your tissue as effectively as you should. And you can imagine that this then is going to run into some issues. The Bohr effect explains how a low pH, remember I said acidity, decreases hemoglobin's affinity for oxygen.
[00:22:02] So this makes it also much more likely to offload. So those changes in pH that we saw when the muscle is becoming more acidic benefits the muscle to try to get more oxygen in. The accumulation of CO2 does the same thing. Which, when you think about it, is a brilliantly designed system that when you are under stress and you're under more load, the body is trying to accommodate more work in that area.
[00:22:31] However, if we have something like respiratory rate, for whatever reason, is increased, We are then changing CO2 as part of that equation. That is going to change how well oxygen can get to tissues. Now again, if you go down this rabbit hole, it does get very complicated. There's something called the Haldane effect also.
[00:22:52] So the Haldane effect is the ability of deoxygenated hemoglobin to carry more carbon dioxide than in the oxygen state. But we're not going to talk too much about that because that gets really messy really fast. But the high level view of all of this is to say that these regulatory systems within the body, temperature, pH, fuels, air, are all related to each other.
[00:23:18] And with some of the modern wearable devices, we can try to unwrap some of this stuff. Now, we won't know chicken or egg, we won't know what caused what, but we can see that in the case of an increased respiratory rate, Then getting rid of too much c o two is gonna lead to some issues, especially with performance.
[00:23:41] So again, knowing that, then you can reverse engineer what you would do to try to wrap your arms around how to change it. Now, the other component that I didn't tell you here is that c o two levels are controlled by these chemo receptors throughout the body. And if you look at studies where they've inhaled pure CO2, which is not recommended, you very much get a panic sensation and you feel like you want to breathe as soon as possible.
[00:24:13] But these chemoreceptors that are detecting CO2 levels in the body, because this is the main way the body is trying to determine breathing, They have a kind of a gain range, and the gain on them can be changed over time. Meaning your body can get accustomed or hypersensitive to CO2 levels. This can result in trying to breathe at a little bit faster rate.
[00:24:38] Now the good part is these can be changed over time. So if you are someone who is over breathing at rest, you're not necessarily stuck there, because the beauty of all the systems is that it's very adaptable. The question then is, what stimulus do you need to put in to get it to adapt in a better direction?
[00:25:01] Knowing what we just talked about, you would want to try to target a slight increase in CO2 levels, but not ridiculously high levels. So you'd want to try to accumulate more CO2. My bias there, again, there's a lot of ways you can do this. Some breathwork can be useful in that area. Doing like a Wim Hof style breathwork or superventilation method, where you have a very high respiratory rate and you are trying to get rid of more CO2.
[00:25:35] Would not be my starting point. You would want to do the opposite. You would want to have slightly higher levels of CO2, and you would want to prolong that for a period of time. So you want to try to change the system in the brain, these chemoreceptors that are triggering areas in the brain, to realize that, hey, this is my new normal, so I can chill out and relax a little bit more.
[00:26:01] So Brian McKenzie's talked a lot about this with like zone two training or he has a gear system Which is super useful low to moderate intensity work. So zone two Generally, you're gonna be able to have a conversation It'll feel like you are exercising or someone is listening in it would say yep You are definitely exercising, but you'd be able to continue to have a conversation When you do that, you are increasing more co2 levels Now, I would also restrict airflow.
[00:26:33] Now, you don't need to get any fancy devices. Again, they may or may not be helpful. Just breathe in and out of your nose. And breathing in and out of your nose has a fair amount of benefits. A low to moderate intensity exercise. And by definition, you are restricting airflow. Which is what we want to do in this case.
[00:26:49] We want to build up these slightly higher levels of CO2 for longer periods of time. So you could do some Zone 2 stuff, only breathing in and out of your nose. For some people, even walking can be enough to help. Breathe in and out of your nose just as you go. And this will be super helpful for that. So the takeaway of all of this is, if we understand the high level system, we can understand how each pillar works together, and then we can understand the interventions that we would need to do to increase our performance.
[00:27:27] And to make the body more resilient overall. So if you enjoyed that, definitely check out the physiologic flexibility certification is open now, September 18th through Monday, September 25th, 2023, go to physiologic flexibility. com. If you have any questions on any of it, please drop me a line. I hope to see you in the certification.
[00:27:51] Thank you so much. Talk to you soon.
[00:27:53]
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