Dr. Emily Dow, PhD, RD, researches where nutrition, resistance training, and gut health actually meet — and where the science gets oversold. We get into what her 12-week vinegar-and-lifting study really showed, why most direct-to-consumer microbiome tests aren't worth your money, and why peptides deserve far more skepticism than hype.
Dr. Emily Dow, PhD, RD, is a researcher and registered dietitian working at the intersection of nutrition, resistance training, and gut health.
Does vinegar actually do anything for your gut or your blood sugar? Can you trust a $200 mail-in microbiome test? Emily built her dissertation around questions like these, and her honest answers are a lot more useful than the marketing.
Expect to learn what a 12-week resistance-training-plus-vinegar protocol did (and didn't do) to gut permeability, why a null result in a healthy population is still worth your attention, what the research really says about vinegar and glucose control, why the peptide boom warrants a hard dose of skepticism, what direct-to-consumer gut testing genuinely can and can't tell you, the underrated role stress plays in GI symptoms, and why the best practitioners do both research and hands-on coaching — and much more.
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Get the Daily Fitness Insider newsletter (free): https://www.miketnelson.com/newsletter
Connect with Dr. Dow: Website: https://www.dremilydow.com Instagram: https://www.instagram.com/dremilydow
Episodes you'll enjoy next: #127 — The Effect of Antibiotics on Muscle Mass & Cardiovascular Performance with Dr. Sara Campbell: https://flex-diet-podcast.simplecast.com/episodes/episode-127-the-effect-of-antibiotics-on-muscle-mass-aerobic-cardiovascular-performance-and-more-an-interview-with-dr-sara-campbell
#222 — Nutrition, Supplements & Training with RD Sean Casey https://flex-diet-podcast.simplecast.com/episodes/episode-222-expert-insights-on-nutrition-supplements-and-training-with-registered-dietician-sean-casey
Enjoying the show? Follow the Flex Diet Podcast in your podcast app so new episodes land automatically — it's the single best way to help others find it.
Timeline
0:00 Intro
02:29 Vinegar Research Origins
04:12 Study Design & Training Protocol
07:42 Biodex Explained: Strength Testing
11:49 Research Tradeoffs & Null Results
14:49 Possible Mechanisms: Acetate
19:55 Glycemic Control & CGM Findings
22:21 Peptides: Hype and Risks
28:54 Microbiome & Performance Research
30:47 Gut Testing Skepticism
36:23 Stress and GI Symptoms
39:22 PhD to RD Fast Track
41:04 RD Exam Reality Check
44:25 Scope of Practice Basics
45:56 Referral Networks That Work
49:29 Research vs. Coaching Gap
58:51 Clients Drive Better Questions
01:05:26 Why She Started Instagram
01:09:58 Social Media for Academia
01:13:18 Training Goals and Tattoos
01:15:45 Where to Follow & Wrap Up
Speaker 3: [00:00:00] 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, improve performance, improve body composition, all within a flexible framework without destroying your health. Today on the program, we've got Dr. Emily Dow. And we're talking all about a huge range of topics from her research on vinegar and possibly glycemic control, to probiotics, to how your gut affects it, tips for training, nutrition, and a whole lot more.
I think you'll really enjoy this podcast. Pretty wide-ranging. Uh, she is both a PhD and an RD, so licensed in both fields, which I love talking to her, and she also works in research in addition to working with clients. So if you want more information from her, check out all of her great info below. She's got wonderful stuff she puts out on Instagram.[00:01:00]
If you want more stuff from me, go to the link below to the newsletter. Hop on there and get free content delivered directly to your inbox. So without further ado, enjoy this podcast with Dr. Emily Dow
Dr Mike T Nelson: Awesome, and welcome to the podcast. How are you?
Dr Emily Dow: I am great. Thank you so much for having me.
Dr Mike T Nelson: Yeah. Thank you so much for being on. Uh, my good friend, uh, Andrew said, uh, "I need to get you on the podcast," and I looked up your stuff and I was like, "Oh, this is awesome. I love this stuff."
Dr Emily Dow: I appreciate that.
Andrew's been very, very helpful in spreading the word.
Dr Mike T Nelson: Ah, cool. Have you been able to meet him in person then or just via the old internets?
Dr Emily Dow: Not yet. Via the old internet. I think both of us are speaking at a summit next spring, so that'll probably be the earliest opportunity.
Dr Mike T Nelson: Oh, cool. Do you know which summit or which one?
Dr Emily Dow: Yeah. It's the Real Coaches Summit. Um-
Dr Mike T Nelson: Yeah ...
Dr Emily Dow: okay, so you are aware. You're [00:02:00] familiar.
Dr Mike T Nelson: Yep. Yeah. That's, that's awesome. Aram's a good man. Uh, he does a great job with it. And my only bugger is I, I don't know if I'll be able to make it to the one next year 'cause we're usually gone at that time, which is why I didn't make it this year.
But, uh, yeah, I was honored to speak at the first one and been there a couple times and it's, yeah, super fun. Anyone listening, highly recommend that they check out the event. It's always a good time.
Dr Emily Dow: Yeah. It sounds like it's, it's gonna be a blast. I haven't been able to attend yet, so I'm excited.
Dr Mike T Nelson: Awesome.
My first question was I heard you did something with vinegar in your dissertation and found some interesting results, 'cause it, it seems like there's always- The trend of whether it's apple cider vinegar or this or that, or I'm waiting for resistant starch to be the next big thing. I wrote a whole article on that because anything that seems to modify glycemic results or digestion or anything by just sprinkling this magical substance [00:03:00] on it, people love that kind of stuff.
But you actually did actual hardcore research on vinegar.
Dr Emily Dow: Yeah. It, and it's funny 'cause that's, that was kind of like the origin. My PhD mentor, um, has researched vinegar for a long time, and a lot of that has been in the realm of glycemic control, um, like weight loss, uh, intervention, things like that.
Dr Mike T Nelson: And- And who was your mentor?
He was at ASU, right?
Dr Emily Dow: Yeah, Dr. Carol Johnston was my
Dr Mike T Nelson: advisor. Oh, okay. Nice.
Dr Emily Dow: Um, so she's awesome. We did-- I was, I was fascinated with the gut microbiome, gut permeability. That was kind of like my wheelhouse, um, specifically in response to different kinds of training interventions. And based on some interesting findings from sort of a pilot study that we did early on in my PhD, she suggested that we try incorporating vinegar- Hmm
um, because it contains, um, acetic acid, which is similar and quickly gets converted to acetate, a short-chain fatty acid. [00:04:00] The hypothesis was essentially that it would be, like, an exogenous source of these short-chain fatty acids, um, that could have complimentary outcomes to what we saw in that pilot trial.
So yeah, essentially what we looked at is we exposed everybody in the, in the study to a 12-week resistance training intervention, uh, very basic concept of progressive overload within that. And then half of our participants received vinegar as the kind of supplemental intervention, and then half of our participants received, um, ba- basically vinegar pills, which have such low doses of acetic acid that they resemble taking vinegar because of the odor and because of, like, the way- Mm-hmm
but they don't have an effective, a clinically effective dose of the acetic acid itself, um, which Carol had seen in previous work that she'd done. So essentially, half of our, our study population received that as sort of the placebo [00:05:00] control, and we were looking specifically at the gut permeability outcomes and then potentially any relationship with mood and mental health outcomes.
Um, we ended up not ... Uh, the results were, like, not that exciting on that front, but we did see some- ... very interesting, like, um... We had a few exploratory outcomes related to performance metrics that were interesting. So it seems like it warrants a lot more investigation per usual with these things. Um, but yes, we got to, we got to study vinegar in a pretty novel application, so it was very interesting.
Dr Mike T Nelson: What were some of the things that you, you found with it? 'Cause I mean, I'm sure it's like- Anything else, you do one study, you've got smaller portions. And I don't know if your advisor was similar, but when I did my PhD it was try to do one big project per se that, you know, you can write... I had to publish, like, three studies was a requirement, and then those three studies had to be related.
That was basically then your, your dissertation, and you put it all together, et cetera. [00:06:00] And along the way you find all this weird stuff you didn't expect and these other little rabbit holes. And so did you find stuff that you're like, "Well, if you squint at it, you know, with one eye it might be significant, but it's not really significant," and those types of things?
Dr Emily Dow: Yeah, essentially. So, and I followed a similar format. We had options in my program where we could just do one big project, we could do more of a three paper dissertation. So that was the structure I chose, and we kind of used that pilot study. We got two papers out of that. Um, and then the final paper was sort of like this culmination project that we developed.
Um, and yes, so our, our primary outcomes were not that exciting. Um, as I stated, I think because of, like, the biomarkers that we chose, our population was healthy adults, and their baseline, their baseline values for those, uh, metrics were already so low that we, we could-- we probably couldn't have seen anything, [00:07:00] um, even if the intervention would've been sufficient to see something.
Um, but we looked at, we looked at performance-related outcomes as well. So we measured strength using, um, the BioDeck system. And we did see, and this is not published and I don't remember the exact figures, but we did see significance in some of the strength outcomes for the group of individuals who were taking the vinegar and not the placebo.
Um, so everyone got stronger, as you would expect when you're following a 12-week strength training program, but the group that was taking vinegar did get significantly stronger in a couple of... It wasn't in all of the tests that we ran, 'cause we ran a ton of tests on that BioDeck system, but in a few of the key ones
Dr Mike T Nelson: Wow.
And explain the Biodex for people who are unfamiliar with it, and why do we use... 'Cause one of the criticisms of Biodex, which I like, I think it's a, a pretty cool system, is that, well, people don't really train that way. But explain why, what it is, and why would you use that in a research setting.
Dr Emily Dow: Yeah. So [00:08:00] it's, it's an isokinetic dynamometer.
So essentially, the way that it functions is you set a predetermined speed at which the individual sitting on this piece of equipment is able to move the resistance, and you can set it up in a number of ways. So we did knee flexion and extension, so we essentially configured it so it looked similar to a leg extension machine.
Um, therefore, we were able to test quad strength, hamstring strength in that position. And then we also did elbow flexion and extension, so we were able to look at, like, bicep, tricep-related outcomes. Um, and you can, you can set it to all sorts of different configurations, but we were looking at, um, the, essentially the peak force production at those speeds, and that essentially controls for a lot of the variables that you can't control for in what would be a more ecologically valid setting.
Like, in the pilot study, for example, we did more probably ecologically valid strength assessments, where [00:09:00] we did more, like, six rep max testing that resembled the pr- what the program actually was, but there's, of course, criticisms with that when it comes to, like, while you are training these novices, and they're going to get better at the movement pattern just because of, like, the neurological adaptations, you can't necessarily isolate strength in that same way, and because of people's different, like, biomechanics, and, um, the quality of movement kinda comes into play.
So it's a little bit more controlled in that regard, and that was encouraged by one of my committee members, um, for that reason. But we did implement, like, in the resistance training program, we did implement movement patterns that were meant to closely mimic the settings that we implemented on the Biodex system so that it was at least as close to the training adaptations themselves as we could get.
Dr Mike T Nelson: Yeah. I think if people have never set up a study or- Even watch novices train, they have no idea of the amount of variability. I mean, I remember running the [00:10:00] 400 level exercise phys lab when I was doing my PhD work, and my advisor came up with this thing where we're gonna have them squad and we're gonna have them do all this stuff.
And I was telling him, like, "This is gonna be a freaking disaster. Like, you are not gonna be able to..." He's like, "No, no, you gotta do this." I'm like, "All right, I'm telling you, I'm gonna do it for, because you told me to, but if this is an absolute shit show, then I'm gonna be back in your office the following week."
And oh yeah, like, the, trying to get people to squad who've never squatted with a bar, horrible idea. Like, at the end, we relegated it to just pushups, sit-ups, I think a lunge using a Smith machine, and, like, one other thing. And even the pushups looked like a seal having a seizure on the floor, and you had to, like, explain to them what...
You know, 'cause guys were the worst, unfortunately. It was just, like, this rapid up down of them just sticking their head forward. I'm like, "You're not even doing a full pushup. It's a pushup for crying out loud." So I think if people haven't trained people, like, the [00:11:00] amount of variability, and if you're doing it as part of a study, you're just watching that going Oh, no, this isn't gonna be good.
Dr Emily Dow: Yes. It's, it's so true, and especially, like, when you come from a background where you're very, like, thoroughly engaged with exercise. Yeah. You think that these things would be somewhat intuitive, and they're not. Um, so like the Biodex is helpful because some- these individuals are, like, strapped in, like in a straitjacket.
They've got, like, seatbelt situations going on. The joint angles are fixed. Everything is so tightly controlled that really we're able to at least more closely look at differences, specifically in the force production. Um, so while that is... that could be like a criticism, it makes sense when you've, when you've had to, like, be so involved in these, these designs.
Dr Mike T Nelson: Yeah, and it's a big thing where you have to pick, like, okay, am I gonna try to isolate some of these variables? And if that's true, I'm probably gonna use a freaking Biodex, because there's almost no [00:12:00] other way for them to do the movement. Like you said, they're strapped in, the arm's already moving. Like, the amount of variables or constraints is extremely limited, which is great, because that means your data collection is probably gonna be a lot cleaner.
The criticism is that while people don't, you know, use that mode of training per se, even though there's plenty of studies showing that it... if you have someone get stronger on that, it does transfer, it does show up on the Biodex. But if you try to make it a study where, oh, it's more valid to people going to the gym, the amount of variability you have is so high.
You're probably getting average college students. You're probably limited in how many you can get. And, you know, just statistics 101, if you've got a lot of variability and you've got 18 college students, you may not find anything. And then trying to get a journal to publish a null result, you know, good freaking luck with all that, 'cause most of them don't even wanna look at it per se.
Dr Emily Dow: Yeah, it's, it's hard. Like, designing, I didn't even know what I was really getting myself [00:13:00] into with these pro-
Dr Mike T Nelson: Nobody does when they start.
Dr Emily Dow: No, you're... and I... like, that's exactly, I got into this program wanting to do something that resembled the real world as closely as possible But then you're, you're staring down this tunnel of a 15-week training study, and you're losing people left and right, and recruitment is- Yep
a nightmare. And you just can't anticipate all those things that are gonna pop up. So some sacrifices have to be made, and that's just kind of like part of this process.
Dr Mike T Nelson: Yeah. And I think that's good for people listening to know because when you're reading research, it's very hyper-specific to the group, to the thing you're looking at.
And no one study, no matter how good it's conducted, is gonna give you all the answers you want. And who knows if that's even reproducible, right? So you have that whole issue on top of it. But it's a starting point, and without it, we have no idea of anything that's going on, and it's just this slow kinda plodding thing that moves forward, and this person looked at this, and maybe this person [00:14:00] replicated it, and ooh, this person did that.
And you kinda have to read the tea leaves and put everything together with what you think is the best practice.
Dr Emily Dow: 100%. And that's why, like, like we had some interesting findings, for sure, but even I'm, I'm arguably the person who's most excited about that 'cause I was the one in the trenches, like, conducting all the research.
And I'm... People still ask me, you know, as a product of that, like, "Oh, well, what do you recommend I do for vinegar?" And like, "How much do you recommend I take?" And those are such big leaps. I'm like, I don't- I'm not prepared to make any of those suggestions based on this pool of 12 people that we got to investigate in this specific context.
Um, so yes, I think, I, I mean, there's so much more that needs to come together before any, like, sound recommendations can be made.
Dr Mike T Nelson: Is there any speculated mechanism as to-- I'm just trying to think in my head, like, ah, putting vinegar on my food, why would that make me stronger? [00:15:00]
Dr Emily Dow: Yeah, it's, it is a little co- So the, there has been some work in rodent models that has kind of pointed to this as well, and we did also see, I didn't touch on this yet, we did see the group who was, that was taking the vinegar did also see larger cognitive improvements.
Hmm. Interesting. And those mechanisms may be somewhat related based on some of the rodent data that I was looking at when I was trying to unravel all of this. Um, my advisor wants to potentially run some metabolomics on some of the leftover blood samples that we have because she's seen in future projects, or sorry, in past projects with vinegar, she's looked at it in the context of, like, mood dysregulation also, and they've seen in combination with, like, mood related improvements and reductions in depression, these up regulations and pathways related to, like, the NAD salvage pathway and AMPK signaling.
And there's a potential [00:16:00] role for the acetate in some of those mitochondrial energetics, and that's a little over my head, like those specific mechanistic hypotheses. Um, but that's potentially what could be going on there, but it's still, again, just so early, um, that it's really hard to parse through all of that at this point.
Dr Mike T Nelson: So do they think acetate may be sort of increasing some of those metabolic pathways, sort of like a creatine or beta-alanine, which I know those are completely different mechanisms and stuff like that, but just kind of these intermediate... It's like there's a bunch of work that's been done on pyruvate with, like, hit-or-miss results, and they've even tried, like, ribose to increase adenosine pools.
And it seems like we've tried almost every intermediate along the way, and most of them are just like, "Yeah, I don't know. Probably not."
Dr Emily Dow: Right, and that's, that is kind of like, I think, where this falls. And a lot of... There has been a decent amount of work. It's [00:17:00] interesting, 'cause I didn't realize this going into it, but there have been a lot of acetate administration trials specifically- Hmm
in rubens. Um, because it's the most abundant short-chain fatty acid, there's a lot of interest in seeing what the exogenous introduction might do for a number of different outcomes. And some of it's interesting, but it, it's tough to say, like, what the magnitude of effect would really be for something like that.
And my mind always goes as well to, okay, we understand that these short-chain fatty acids have health-promoting effects. We can make them endogenously though, and I, I would suspect that part of the processes that produce them endogenously might also be for some reason important in ways that we might not yet understand, where just, like, administering them exogenously might not necessarily even have that same effect.
So it's very... I'm sure... Like, I know butyrate has kind of been similar, where I think everyone's trying- Yeah ... to, like, to develop a product based [00:18:00] off of these.
Dr Mike T Nelson: Yep.
Dr Emily Dow: And my conclusion is always like, let's just eat enough fiber and enough, like, diverse- ... food groups that we can, we can, like, optimize these processes as they would be happening anyway.
Dr Mike T Nelson: Yeah, I would agree with that. It... And then you add, I know you've looked at this too, like the microbiome on top of it. You're looking at younger, healthy people. Maybe they have the right amount of little gut bugs that deacetate or these short chain fatty acids like, and they secrete something that helps maybe the immune system or increase strength or who knows what.
But that may not be reproducible in, in non-healthy subjects or people who have, you know, some dysbiosis or things like that going on too.
Dr Emily Dow: Yeah. It does, it does seem like the, like the landscape of the individual microbiome probably has a huge effect on how all of these processes take place. So that just adds another layer of complexity because we also don't understand the microbiome itself very well at this point.
[00:19:00] So yes, it's, it's tough to jump to any of those like concrete conclusions despite everyone really wanting to know because it's a super interesting field.
Dr Mike T Nelson: So we may not see vinegar as the next big ergogenic aid. I'm sure someone will sell it.
Dr Emily Dow: I'm sure someone will. And I did find like I found one like cycling intervention where it was implemented.
I- there was so little human data looking at, looking at vinegar as like a performance enhancing supplement. Um, I could see some people trying to sell it that way for sure, but I don't- ... think it's to have that big of an effect. I mean, I don't think it's a bad idea to consume fermented foods, foods that contain pre and postbiotics.
It's probably not gonna hurt. Dietary diversity is valuable. But yeah, no, I, I would not say that it's appropriate to jump there yet.
Dr Mike T Nelson: Got it. And did you look at glycemic response or any like glucose markers or anything like that also, [00:20:00] or not in this particular study?
Dr Emily Dow: Not in this particular study. It would have been interesting to, um...
And we did have a master student who I helped out with a little bit that did a similar-- She did a crossover study. It was small, um, I think like 10 or 15 subjects as well, where they use continuous glucose monitoring but using the same vinegar protocol that I employed in my work, um, at least in terms of like the dosages.
And those results were not-- They weren't huge either. This paper was just published, actually. Um- Oh, nice ... I can send the citation if it would be helpful. But- Yeah, yeah, that'd be
Dr Mike T Nelson: great ...
Dr Emily Dow: mostly what we saw with that was like a- Fewer, fewer glucose excursions. These were in adults with prediabetes, um, and there was no exercise component.
So the vinegar itself, like it, it- it's again still, like, pretty early. It may have a positive impact, [00:21:00] but that's also not as much, like, in my specific area of expertise. So some of the details I don't remember perfectly.
Dr Mike T Nelson: Yeah. Yeah, no, no worries. Like, gives me flashbacks to a lot of the bodybuilding supplements that are still around, like the old glucose disposal agents, like vanadyl sulfate was one of them, which is also toxic if you take too much of it.
And I could never wrap my head around, okay, so it's a glucose disposal agent, so it's supposed to be, what, putting more glucose into the muscle? But we know the muscle can only hold so much glycogen, so I could never get anyone to explain to me what the hell a glucose disposal agent is doing. And if it is lowering glucose, where is the glucose going?
Are you just pissing it out so it disappears out of your system? Or like the whole, I don't know, the whole story around that just never [00:22:00] made any sense to me, I guess.
Dr Emily Dow: Yeah. I know, yeah, and that's definitely not a question that I can, I can personally answer. Yeah. Um, I think the bodybuilding community is willing to do crazier things than I am.
Oh,
Dr Mike T Nelson: they'll do anything.
Dr Emily Dow: That's usually, like, where I end up falling with any of those kinds of questions.
Dr Mike T Nelson: On a related note, you're not big into peptides, I know. I saw your little rant on it, so I just had to throw that in there.
Dr Emily Dow: That, yeah, that's funny. I just... I mean, it's just-
Dr Mike T Nelson: Did you get lots of hate mail for that?
'Cause I get hate mail from both sides now, 'cause I'm not totally against them, but I think they're way oversold, way out over their skis in terms of the actual data, and it's just this mechanism and, "Oh my God, well, this has gotta work in humans." It's like, do you know how much shit's been done in rats that just never transfers to humans?
Dr Emily Dow: It's... Yeah, I think, like, generally speaking, it's like the Wild Wild West. Now I'm, I'm definitely... I'm looking at it from the outside. I don't engage with [00:23:00] that literature whatsoever, but I agree, it's like, it's another one of those things where it's like this huge crazy uptick in people... It, it just always blows my mind, like, if...
I think if 10 years ago someone told the public that this many people would be willing to inject themselves- Yeah ... with these compounds-
Dr Mike T Nelson: Yeah. That still boggles my mind.
Dr Emily Dow: It's... And I, I get that I, I think we've kind of been, like, looking for something like this for some time, and it seems like now the magic pill to people, so maybe that is helping them overcome whatever reservations they may have had.
But it's crazy to me just how easily all this was adopted. Um, and it is funny 'cause I think just, like, as a professional that's kind of in this space, people come to us with these questions. I don't, I don't know why they're asking me. I don't know anything about this. Yeah. Nor am I a medical doctor. So that's, that's what that reel was referring to.
Dr Mike T Nelson: Yeah, [00:24:00] which it... I mean, I'm... I have used them under the guidance of a physician off and on, mostly BPC-157 and Thymosin Beta-4 and, I don't know, like, some of the clients I had, they're like, "Oh my God, this was the greatest thing we've ever done for my ankle, shoulder," whatever, like 60%. But then, like, 40%, like, the, the same doc at the same time, same source at the time, which unfortunately doesn't exist anymore, different conditions, generally healthy people, they're like, "I don't know.
I didn't see any difference. Like, nothing." And I'm like, how is it such a bipolar, weird response? And again, super small numbers, you know, N of, you know, maybe a couple dozen, whatever, different things, knee pain, shoulder pain. There's not a l- a whole bunch of variability with it. But the thing, like you said, that blows me away is people are injecting these.
That's the part that I, I find that used to be only the crazy bodybuilder-type people. But do you think [00:25:00] with GLP-1s, which up until recently were all injectable, that injecting peptides has just become more normalized because of, like, GLP-1s?
Dr Emily Dow: I feel like probably, and-
Dr Mike T Nelson: That's my guess. I don't know. It's just an opinion.
Dr Emily Dow: That would be my guess, and especially, I'm sure social media has played a role in this too, because I know my- Oh,
Dr Mike T Nelson: for sure ...
Dr Emily Dow: like, I see reels of people injecting themselves with these peptides. Yeah,
Dr Mike T Nelson: like on the video themselves, and like, "Here's my needle, and I'm in-" What the hell am I watching? And this is, like, mainstream.
Dr Emily Dow: It's crazy, 'cause I, yeah, I think, I feel like, I feel like, again, like a decade ago, everyone would've been shocked to see that kind of thing posted on the internet, or to even imagine injecting themselves with something. That feels very extreme, but now it doesn't for some reason. And I feel like that normalization has probably occurred for a number of reasons, but I feel like social media's probably part of it.
GLP-1s are probably part of it. [00:26:00] Who knows what else?
Dr Mike T Nelson: Yeah. I, I had a client who, not under my advice in this particular case, he tried everything for his knee pain, and then on his own, which you love it when clients do stuff and don't tell you about it until after the fact, which is great, I'm like, "Bro, you could've just asked me.
I could've at least tried to give you some semblance of, you know, where to go, what to look at, et cetera." Obviously I'm not their physician, but he's like, "Yeah, all of a sudden my knee pain got better." And I'm like, I said, "Well, w- what happened? Like, what was different?" He's like, "Well, you know, I got some peptides from this guy, and I, I didn't reconstitute them right, and so I realized later I injected, like, 10 times the dose of what I was supposed to."
Oh, no. And he's like, "But my knee pain's better." I'm like, "Oh my God."
Dr Emily Dow: That's, you see, that's like, that's where I get nervous.
Dr Mike T Nelson: Yeah, and I'm like, "You're doing what?" Yeah.
Dr Emily Dow: Yeah. These are, these are, like... If, if, my thought process is always like, if it's powerful to [00:27:00] have an effect where it's... If, if it's powerful enough to have an effect that's large enough m- that it's worth taking, we should probably be, like, somewhat careful-
Dr Mike T Nelson: Yeah
giving it to
Dr Emily Dow: them, where we're sourcing them, those sorts of things.
Dr Mike T Nelson: Yeah, 'cause you know that like there's, there's things in, like, physiology with asymmetric responses where there are a rare few things that you can see a potential upside and not much downside, but a lot of the things that have a very large upside also have a very large downside, depending upon, you know, what you're doing.
I think of, like, psychedelics probably in that area too, of, yeah, there's definitely a lot of bev- benefits from it, but, you know, Bob, who wants to do ayahuasca in his apartment this weekend 'cause he got some from a guy down, down the hall is, like, a horrible idea.
Dr Emily Dow: Yes. Indeed. And, like, the, especially, I mean, talking about dosage is, like, the easiest, that's the lowest hanging fruit in that area.
Yeah. Even caffeine, you, you could die if you- Yeah ... get the dosing [00:28:00] incorrect with something like that. And so, yeah, it's, it's always, that always makes me a little bit nervous too.
Dr Mike T Nelson: Yeah. And there's unfortunately been cases of- People using anhydrous powdered caffeine, which I don't think can be sold anymore because of, like, a couple people died because they took way over the dose.
In general, you know, caffeine has a really high therapeutic window, but at some point, yeah, you can definitely take too much and die. You can drink too much water and die too, so everything has a, a downside. And to me, it just... I get most annoyed by the, the peptide pushers who are like, "Oh, it's a natural string of amino acids."
Like, "There's no downside at all." It's like, we have no idea on that. Like, we have no idea.
Dr Emily Dow: Yeah, and natural things can have downsides, so
Dr Mike T Nelson: it's like- Lots of natural shit'll kill you.
Dr Emily Dow: A lot of it, yeah.
Dr Mike T Nelson: Yeah.
Dr Emily Dow: Some of the most deadly things are natural, so...
Dr Mike T Nelson: Yeah. Any cool research you've been reading lately that you're like, "Oh, wow, this is pretty [00:29:00] cool"?
Dr Emily Dow: Oh, man, I, in term- I... Reading research lately, I'm getting... I'm digging back, I'm diving back into a lot of it now because as you can imagine, like, during the semester, I was just... I was grading, I was teaching. Yep. I was engaged with the literature in that sense, but not necessarily reading a bunch of new stuff, and now I'm trying to get a couple of manuscripts out this summer, so I'm, I'm diving back in.
Um, but let, let me... I mean, I'm, I'm always... I'm partial to, like, the microbiome stuff, 'cause that's, that's the area that I fell in love with in my master's program. Yeah. But I, I keep, like, reading more about, writing more about. Um, that's what people keep asking me about. So as that landscape continues to evolve, I'm, I'm really intrigued by the dynamics between the microbiome and athletics, performance, exercise, what have you.
[00:30:00] Um, and I think there is some really interesting stuff kind of coming onto the scene with, like, specific bacterial strains being helpful for performance for different reasons. Um, I think bacteria are just so cool and underrated in general. Like, there are potential strains that can consume lactate, that can con- that can, like, convert these different byproducts into other byproducts, and those processes right now are so poorly understood that I'm really excited to continue seeing that come out.
Um, but even, like, outside of, outside of our space, like, there are bacterial strains, I believe, that can consume plastic now. Like- Yeah ... those, those sorts of developments I think are absolutely fascinating, so that's kind of where, where all of my interests on my minimal amount of free time tends to be directed.
Dr Mike T Nelson: Awesome. And I know you work with lions, too. Do you do any, like, kind of gut testing of any form? I f- I feel like that's another area that's been- oversold [00:31:00] by quite a bit, although I feel like it's gotten a little bit better. But I remember, like, three years ago pinging a, a friend of mine, Dr. Sarah Campbell, who has been on this podcast, will be on here again, asking her about this company claims to be testing this, this, this, and this at, like, you know, $200, $300 price point.
And I'm like, I... This is outside my wheelhouse. I'm not an expert in this, but I have a hard time believing they're losing massive amounts of money to do this or found some magical way to get this testing. And then the report you got back, 'cause I had a client who did this and paid for it. Did- again, didn't tell me.
Sends me the report, and it says, "Yeah, um, I shouldn't be eating broccoli and carrots because of my microbiome." And I'm like, what the? Like, we are so far away from being able to tell you individual foods. But again, I get it why people are drawn to that because if there was a test that was 100% useful and told me that, I would take it tomorrow.
But I just think we're, [00:32:00] we're so far away from getting to that point
Dr Emily Dow: I think we are too, and I personally have never, I've never offered, um, gut testing directly for that sort of reason, among others. I've, I've looked at them also, like I've seen reports, and there are definitely some clinicians, like dieticians, who work in this space who see them all the time, that I think- Sure
can draw some useful conclusions from some of those. Oh, for sure. But yeah, the problems that I have with them primarily are, one, like these direct-to-consumer kits especially, they aren't using any sort of established reference ranges. They're setting their own criteria for what constitutes like good versus bad, optimal versus suboptimal.
So where those definitions are placed, to me, is very wishy-washy and difficult to, like, practically apply in any meaningful way. Um, and two, like this is something that I've, [00:33:00] I've become sort of jaded on as I've engaged with this literature more and more. When it comes to like fecal sampling, that's the be- that's the best that we've got right now- Yeah
in terms of testing the microbiome. But it might not be telling us what we think it's telling us either, because we're capturing a snapshot of the end product. Um, we're not actually like biopsying the co- bi- biopsying the colon. We're not actually getting a true picture of what's happening in the microbiome on an ongoing basis.
We're kind of just seeing this, this output that may or may not represent what's going on internally. So that is tricky to me, and that's why I, like in my research, I, I didn't do any of that. What we looked at instead were more permeability-based outcomes, more functional outcomes related to how the gut is operating as opposed to what the gut itself looks like.
And while there definitely is value, especially in a research setting as we try to understand these dynamics better and better [00:34:00] in characterizing the gut on an individual level, but in practice, I just, I think there's so much more information that can be gleaned through easier means than testing the gut.
I think that would be like my absolute last resort if I could not come to reasonable conclusions in other ways.
Dr Mike T Nelson: Yeah, and I have, I've used some of the, like, the GI effects, and I'm looking at using Tiny Health and some other companies. And again, I, I think it's interesting. I think in some cases it has been super helpful, but rarely do you find a case where the person was completely asymptomatic, their gut testing comes back absolutely atrocious.
You make a change, and they're like, "Oh my God, I feel so much better." Like, those cases e- exist, but so often than not it's like I just send them a, a, a, a legitimate, like, verified questionnaire, and most of the time you can get what you need off of that. 'Cause I'm like even if we get to the point where gut testing is super inexpensive, everyone's [00:35:00] gonna wanna play with their poo and keep it in the refrigerator and send it in, which I did that, and I told my wife after the fact I had done and stored them in the fridge for, like, five days.
Um- Sure ... but I'm gonna do, and I don't know what your thoughts would be, some type of rotation. Like, okay, I'm gonna pull out gluten for a while. Let's pull out dairy. Let's... You're gonna do some type of elimination diet at the end anyway, and maybe if they needed a gut test to get them to actually do that, okay, maybe that's a, an, an argument.
But I don't know. I know a guy who runs a whole practice where they did tons of testing, tested hundreds and probably thousands of people, and he's like, "Yeah, I don't really use them much at all anymore because I can get to almost the same end result now that I did with the testing and save them a ton of money at the same time."
Yeah. "And the testing wasn't always telling us 100% what we wanted to find anyway."
Dr Emily Dow: Yeah, that's, that's kind of where I would land also, because w- when you're dealing with someone with [00:36:00] gastrointestinal symptoms, if you're getting those test results back, what are your recommendations going to be? A lot of the time they probably resemble what you would do based on symptoms or- Mm
they resemble each other quite considerably. So yeah, I think, like, an elimination diet is a much more practical way of parsing through a lot of this, and I've seen this time and time again too. I think stress has a much bigger impact on GI- Oh, for
Dr Mike T Nelson: sure ...
Dr Emily Dow: symptoms- Yeah ... really. And we always immediately wanna point to food.
Everyone does. Myse- I've been guilty of this myself, assuming it's an allergy or an intolerance of some sort, and lo and behold, it tends to oftentimes parallel some significant life stressor that maybe popped up or some physiological stressor that's new. And I think it's easy to almost, like, really miss the forest for the trees with this stuff when we're trying to be so meticulous with the testing and with, like, isolating specific foods.
Dr Mike T Nelson: Yeah. I mean, I made that mistake early on too [00:37:00] where- One person in particular, we could not figure out his gut stuff, could not figure it out. Sent him to another person, they could not figure him out. Sends him back to me, and I started looking at him one day, I'm going, "Eh, your HRV scores have been dog shit, like, this entire time."
And I'm like, "Oh." Like, what happens when you're stressed? Oh, shocker, you divert blood flow from your gut because your body thinks it's gonna run from a lion or whatever. Maybe that's part of it. There's probably a lot more, you know, up, up the chain, down the chain changes there too. But we did a ton of work on, uh, his stress level, got his HRV scores a lot better, and eh, miraculously all of his gut problems went away.
Dr Emily Dow: Yeah. It, it's crazy 'cause I s- I've seen that so often too, and you have to also be careful with, like, the way that's communicated because I find that- Oh, for
Dr Mike T Nelson: sure ...
Dr Emily Dow: the client on the other end hears that, and they think you're saying it's all in your head, and that's- Right ... absolutely not the ca- Like, there are, there are measurable things going on.
Um, but I went [00:38:00] through the same thing. Like, in the first year of my PhD, I was losing my mind trying to figure out what was causing these GI issues. I was logging all my symptoms and all the ingredients that I was eating leading up to them, and it was just the first year of my PhD. It all went away. And I felt really silly at the other end of it when I, I couldn't put that together on my own.
Dr Mike T Nelson: Do you find it ironic doing a PhD in, you know, like exercise physiology and performance area, all that stuff, is probably the most unhealthy thing you can do for yourself? That was my my ironic takeaway at the end of it. It's like I'm living on caffeine power naps in the back of my car at 9:00 in the morning and sleeping in the lab, and realize, oh, this is pretty horrible for your health after five, seven years of doing this shit.
Dr Emily Dow: 100%. It's, it's like a genuine act of self-sacrifice to do these kinds of things, because, yeah, your ability... Like, I was maximally, uh, max, I was training, like, [00:39:00] two to three times a week, like, at that stage, um, not sleeping whatsoever, stress was through the roof. I'd be lucky if I got, like, one real meal in across a day.
And then you're, you're guiding people on all these things that you're absolutely failing at personally, and it does- Yeah ... but, like you're like, "What's happening here? This isn't supposed to have this impact on me."
Dr Mike T Nelson: Yeah. And you, in addition to being, doing a PhD, you also did your RD, so you're super crazy.
Dr Emily Dow: Super crazy. It kind of ended up... I did, like, I did the ISP pathway, so it was- Explain that ... what
Dr Mike T Nelson: that
Dr Emily Dow: was for, um, so it's... What does it stand for? Individualized supervised... Individual supervised practice something or another. Essentially, what it's designed for, because the academy wants more PhD RDs, specifically, I think working in academia is kind of the idea- Yeah
with that. Um, and so as a means of sort of encouraging that pipeline, [00:40:00] um, anyone who has their PhD can sort of fast-track aspects of the RD credentialing process. Oh,
Dr Mike T Nelson: nice.
Dr Emily Dow: Um, so I still had... My undergrad was in dietetics. I still completed all the coursework that was required. But what they essentially do is they allow you to fulfill certain competencies to sit for the exam with experiences that were acquired during your PhD training.
Dr Mike T Nelson: Um- Oh, very cool ...
Dr Emily Dow: so you get to sort of, like, make up some of the hours that you would normally have to spend in an internship rotation. So what that looked like for me was finishing my doctorate, and then I did, like, a compressed internship, 'cause I mostly just needed the clinical rotations.
Dr Mike T Nelson: Mm-hmm.
Dr Emily Dow: Um, knocked those out, and then that summer I just took the exam and tried to get everything done as efficiently as possible.
Um, but I'm glad that I did. It was definitely... It was worthwhile to just, to have both, because it does also increase... Now I'm able to teach courses that only dieticians are permitted to [00:41:00] teach, um, which was kind of my goal in that process.
Dr Mike T Nelson: Yeah. I looked at doing it briefly, but back when I was doing it, you had to do all the...
All RDs are gonna hate me, but they had to do this, like, the whole neck rotation. So, like, I would've had to spend, I don't know what it was, like three or four months- Oh, at least ... or something like that, like, serving food and all this, like, very logistics heavy type stuff. And I'm like, "I have zero, I have zero desire to do any of those."
Dr Emily Dow: Yeah. It's cr- I don't think anyone knows, if you haven't explored the RD path, I don't think anyone knows how much of that exam and of those expectations revolve around food service-
Dr Mike T Nelson: Yep ...
Dr Emily Dow: food science, and, like, managerial theory. Yeah. Things like that you would not expect. And that's why that, that exam was the hardest exam I've taken in my life, because the breadth of topics is just so large that, like, you have no idea.
One question's gonna be about, like, fluid electrolyte imbalances, and the next is gonna be about [00:42:00] costing for a restaurant, and you have to just be all over the map with it. So it's an undertaking, for sure.
Dr Mike T Nelson: Yeah. And I'm glad it's, it's better, because to me it's like everything else has become more specialized.
And so, you know, now we have RDs who just specialize in sports nutrition and, you know, one of the first books I ever read was from my good friend Susan Kleiner, is a P- you know, a PhD RD. My good friend Lonnie Lowery is a PhD RD. There was people who had been doing it, but they had to suffer through all this other stuff that at the end they were never using at all, and I think that's, unfortunately, pushed a lot of people out of that field, although it's getting a lot better now.
Um, so I think just allowing people to specialize more, "Okay, I just wanna do clinical. Great, I wanna be an in-hospital RD." Great. You can take more of the clinical stuff. Or, "I wanna work more with athletes," or, "I wanna work more with the general population." Like, to me, it just makes a lot more sense to gear it towards the end result of what they're wanting to do, instead of just forcing [00:43:00] everyone through, like, the same old school curriculum from, like, 1975.
Dr Emily Dow: Yeah, that I totally agree. That field, like it needed and still needs some work in terms of how, how professionals get to move through those steps, 'cause it is, it is tough. There's the master's degree requirement now that's like- Yep ... new in the past few years, and then you have this unpaid internship that is normally like an, an entire year long.
I got to come back-
Dr Mike T Nelson: Yeah, and people forget that's unpaid. Like, so for me, that was the thing. I'm like, "Where do I get money when I'm doing this?"
Dr Emily Dow: Unpaid and full-time, like eight- Yeah ... 8:00 to 5:00, 8:00 to 6:00 sometimes PM at a hospital. You don't have time to make money in any other way. That's actually why I didn't do the...
I, I was going to complete the dietetics aspect right after undergrad the way most people do, but I didn't have the time or the financial means to not make money for a year. So I was like, "I'll just go to grad school," and then that just kept things [00:44:00] moving. Um, but yeah, that, especially when like the median salary's only like...
It's not high enough to- It's
Dr Mike T Nelson: horrible. ...
Dr Emily Dow: all of that buy-in on the front end. So I don't, I don't blame people for not wanting to pursue all of that. Um, and I think the, not every university offers the pathway that I went through, but I think more should because it would definitely, I think, facilitate more professionals like us getting out there.
Dr Mike T Nelson: Yeah, because as you know, like there's some states, and it's usually a state requirement, where there's a lot of things you can't talk about be- unless you're an RD, and we can argue if that's good or bad. But on the flip side, I think I've worked with some trainers who are so paranoid to talk about anything nutrition-related.
I'm like, "Karen's coming in, who doesn't even know what a protein is. For God's sake, you can teach her about proteins and micronutrition," and like really basic stuff. Just you don't say you're gonna cure her diabetes or... And there's other weird stuff. But like you can still [00:45:00] talk about nutrition and basic things for health too, which I think would help everyone.
And then if there's special things, by all means, like refer them to an RD who has specialty in that case. By all means, like do it at that point.
Dr Emily Dow: Totally, and I, like I know, I know a lot of RDs, and hopefully they don't hate me for saying this, like reasonably so are very protective of that title, and don't- Oh, for
Dr Mike T Nelson: sure
Dr Emily Dow: personal trainers to be giving nutrition advice, but like we all, we all can recognize the fact that there's some nutrition advice that we could have given a semester into undergrad that we didn't need- Yeah
this career to be able to provide. Um, but we can also be reasonable with like, yeah, when it's actually justifiable to bring in someone who is more specialized. Um, because some of it is not so complicated, and it's definitely not dangerous to give certain types of advice with nutrition.
Dr Mike T Nelson: Yeah. And then just, it's like all things, just know what you know and know what [00:46:00] you don't know.
And it's okay to refer them out to people. Like, if I had to start over again, you know, when I started, 2005, the thing I probably screwed up is I would've spent more time trying to find much better referrals, 'cause I w- I kinda felt like, oh, I should handle this, but this is way outside my scope, but I don't have a person to send them to.
And you, when you have, like, a good referral network, it's just so much easier. Your clients are gonna get better results. There's less legality. It's just a better experience for everyone, like, all around.
Dr Emily Dow: Yeah, and I, I totally agree, and especially 'cause I feel like clients sometimes don't know, like, where your knowledge sort of ends.
Mm-hmm. So I know I've experienced clients asking me about specifics of, like, injury rehab, for example, or things like that, where it's definitely not my area of expertise. I'm better off referring them to a, a PT. But I think it gets messy when, like, the consumer doesn't necessarily understand what individual's scope of practice is, and then as the professional, [00:47:00] you're experiencing pressure from your clients to be able to answer these questions, and you feel like maybe you should be able to answer them.
So I totally agree. I think having, like, a very good, strong network where you can just easily send people is m- one of the best advantages as a professional.
Dr Mike T Nelson: Yeah. And it, it actually saves you a lot of headache because then, okay, the professional's gonna deal with them as, you know, in my case especially on, like, on the, the psychological side.
Like, I've lost clients entirely who are like, "Okay, you need to see a psych specialist. Go see this person or that person, and when you're better, come back." But, like, with nutrition, they can do that at the same time. It's like, yeah, go work with the, you know, the RD or the professional that you trust, and they'll get you better information.
I'll help you implement it, and it's, it's a simple win-win, and most of the time you're gonna keep that person as a client anyway.
Dr Emily Dow: Totally. Yeah, and people appreciate that kind of honesty. Like, yeah, it's another hoop that they might have to jump through. It can be kind of a pain sometimes. But I've found that when I'm [00:48:00] very forthcoming with people about those sorts of things, they respect you more for it at the end of the day, not less.
Dr Mike T Nelson: Yeah, 'cause I think they realize that you're actually trying in their favor to get them the best result, even if that's not you, which I feel like that's kind of a, a rarity now, where I feel like trainers get kind of pigeonholed, especially when they're new, that you don't know what you don't know yet, and you, like you said, you, there's this kind of unwritten rule that it feels like you should be able to answer every question that they come up with, which is just completely unreasonable.
Dr Emily Dow: Yeah. Yeah, and I, I've noticed that especially, and I, I love that, like, science communication and evidence-based fitness content is becoming cool now. But I do feel like there's this new sense of pressure on, like, early professionals or, like, the people who maybe just want to coach clients in person, that now they're gonna have this crazy level of expertise that, like, people who have gone through the steps of getting a PhD-[00:49:00]
have. And that's not a fair expectation to have for yourself when you're- No ... a professional. Um, so I think it's, I think it's much more valuable to maybe develop a network in some senses, and also develop, like, a set of resources or people that you could point your clients to for more of that niche specialization, um, instead of expecting yourself to know everything and then having to, like, quickly ChatGPT every question that your client asks you that's over your head, because that's helping no one.
Dr Mike T Nelson: Yeah. And I feel like it's at this weird area where I feel super conflicted that there's high-level, like, very legit PhD people giving out information, which I think is good that, oh, wow, we're actually looking to people who are educated in the, the background, not just, you know, Bob who passed his weekend cert and now knows everything.
But the other part that also just bugs me, and I know you worked with clients, obviously did a PhD, RD, is that- [00:50:00] Some of these people, and some of them are my friends, they've never trained a single fucking soul in their life, and they're giving direct... It's usually exercise advice that pisses me off the most, that is it valid by the research study?
Yes. Is it something the average person is gonna be able to do and execute? Hell no. Like I think of the Tabata thing, right? Mm-hmm. So Tabata was a very real study, you know, the 20 seconds on, 10 seconds off. But no one's read the study. It's 170% of VO2 max in high level, I think it was sprint skaters, right?
And so everything is like, "Oh, look at all these amazing effects we got from this Tabata study." It's like, how many people are even doing 170% of VO2 max on round one, much less eight rounds? Mm-hmm. So like the information they gave is not necessarily wrong, but I just feel like it's so inappropriate for where most people are.
And if you've trained a single person and put them through that protocol and tried to follow it, you'll realize that like most [00:51:00] people can't do that at all, period.
Dr Emily Dow: 100%, and that's, that's so valid, and that's a frustration that I've had, too. And I, I feel very lucky that like having the opportunity to gain the hands-on experience of working with people and seeing those behavioral aspects that come into play- Mm-hmm
and the psychological aspects that come into play, I think it makes you a more effective researcher. And then having- Yes ... the research experience makes you a more effective practitioner. And so I really hope that more people are going to maybe be willing to like double-dip a little bit in that regard, at least at some point in their careers.
Um, because yeah, you want, you wanna be able, as a scientist, to ask the questions that are actually gonna g- go back to the people that you're trying to help, uh, especially if that's why we're in this field to begin with. Um, and then you also need to be able to actually like effectively bring that research back to the person in a way that's reasonable and going to help them, as opposed to just like sounding smart because you're [00:52:00] citing the studies, but nobody cares if they're not gonna do it.
Dr Mike T Nelson: Yeah, and I think the compliance aspect just gets left out. You know, the other one that bugs me, too, is like the Norwegian four by four. It's like yeah, cool study. Um, but you have to take the principle away from that, that yeah, exercising maybe around four minutes of VO2 max is helpful. But again, how many people on day one are gonna make it through four rounds of that actually at a legitimate output?
Like almost no one. Again, valid study, like the principle is, is true, but you don't know how to m- make that- applicable to that person so that they then can actually do it. 'Cause I've lost track of how many people have come to me and they're like, "Yeah, I tried doing this thing. I did it for, like, four weeks or five weeks, and I didn't see any results."
And you look at their output and it's like round one, pretty good. Round two, eh. Round three, like 50% of your output of round one. They're like, "Oh, but they told me to do four rounds." It's like, ah.
Dr Emily Dow: Yeah. Yeah, and it's, it's funny 'cause [00:53:00] people will, like, pick... They'll pick, like, the aspects of a protocol that they do wanna follow, and then the aspects- Yes
that they don't wanna follow, and then assume that they're gonna see the same results that that specific combination elicited maybe in that one study. Um, and it's funny 'cause, uh, like, uh, it's problematic on both sides because then, like the academics, we tend to get in this head space where it's so easy for us to geek out on these things and think that, "Oh, this is so cool, this finding's so interesting."
But at that point we're just, like, bouncing off of each other and, like- Mm-hmm ... our own, this echo chamber that doesn't actually ever have any relevance in the world at a certain point, other than just being cool. Um, and so I think walking that line is definitely a challenge, and I'm... The reason I love working with people, even if it's just a small handful for the rest of eternity-
Dr Mike T Nelson: Yeah
it
Dr Emily Dow: keeps me grounded in the way that I'm thinking about science so that it doesn't just become that, like, self-masturbatory process.
Dr Mike T Nelson: Yeah, 'cause it's very easy to get stuck in the [00:54:00] silo of, "Oh, well, this study and that study, and everybody needs to do this. Everybody needs to do that." And then if you're... But similar, I always thought that the overlap, that's where the...
To me, like, that's where the interesting stuff is. Like, yes, know the research. Yes, learn how to apply it. Actually work with real humans in some capacity to know what's actually available, and it's a whole, I guess, applied realm seems to just get split into... I often joke, like, you probably get this too, like, you'll just get hate mail from both sides.
Like, I'll get hate mail from academics who are like, "Oh, you've only published so many papers. I've done hundreds, and you're, you're not da, da, da, da, da." And then coaches are like, "Well, I have, you know, 15 more's experience of, years of experience in the trenches than you do." And I'm like, those things are probably never gonna change, you know?
Yeah. But I think the experienced people could learn a lot more from the researchers for new ideas to try out and to figure out what is a better way to do it, and vice versa. The researchers can learn a lot from the people in the trenches of [00:55:00] what are they actually doing, what are some of the trends.
Like, you know, a lot of times they're doing things that probably work, but we don't really have any research to say that they work, and we don't really know the mechanism, but it looks like that it's working, so maybe we should spend more time and effort and, and study those particular things too so that we move everything kind of in lockstep, like, forward.
Dr Emily Dow: Yeah, I totally agree. I think, I think there's a lot for the researchers to learn from the practitioners because like, like, to your point, a lot of, like, coaches, for example, are working with so many people and churning through, like, all these opportunities to test something. And if, if they see that something is consistently working, it, it might be for reasons that we don't understand yet.
And it's annoying as a scientist to then, like, boo-hoo that as, "Oh, this isn't evidence-based." Yeah. "Oh, this doesn't have grounding in science yet." But that doesn't necessarily mean that there isn't a rationale for it. And I think just asking each [00:56:00] other questions makes a lot more sense to me. But it is funny how, like, the, the egos kind of get involved a lot in that process, and I think it limits everybody.
Dr Mike T Nelson: Yeah. 'Cause I got in le- legitimate arguments with my advisor who was like, "I don't know why you're spending your lunch hour going to talk to..." 'Cause I was in the same building as Cal Dietz with the exercise phys. And so I'd go over and talk to Cal on his lunch period and be like, "Hey, you know, what about this or that?"
And he was like, "Oh, we did this study with this force plate, and we did this and this and that, and this is what we found." And to me, it was, like, fascinating because I could take a research idea I had, and he had actual data, and he's one of the rare people who's actually tested it with force plates, Omega wave, whatever.
And to me, that was, like, fascinating because that's, you know, the intersection. My advisor would just yell at me. He's like, "I don't know what you're doing over there talking to him. You're not gonna learn anything. You gotta spend more time in the lab." I'm thinking, "Why would I not talk to one of the winningest coaches in college sports who's literally, I can walk to his [00:57:00] desk and he'll answer questions for me, and I can get there in 30 seconds?"
Mm. Like, why would I not talk to him?
Dr Emily Dow: Yeah. Why, why not? You have access to resources like that. That's... I, I always think, like, the best questions come from those sorts of interactions, and I've had clients ask me questions that spark ideas that I never would've come up with on my own. And I just think it's so naive to discredit any of those, any of those different little, like, silos in our field, especially because when we do all talk to each other, usually that's incredibly productive.
Dr Mike T Nelson: Yeah. And even then, like, I'm totally fine with if I... God knows I've had many conversations with Cal, and I'm like, "Uh, are you sure this thing works?" He's like, "Oh, yeah." And if it was an average person who hasn't tested that many people, I'd be like, "Ah, I don't know." But, like, historically, he's been right a lot more times than he's been wrong, and he sees way more athletes than I will ever see in my lifetime.
So there's probably something there, even if it's [00:58:00] not what we hypothesized or maybe it's not for the mechanism. You know, I think if you've done stuff with people long enough, you just get this kind of idea of, "I think there's, like, something here," and that then sparks a way, "Okay, let's look at that in a formal research setting to see what's actually going on."
Dr Emily Dow: Totally. Yeah, and I, I mean, I've seen that even, like, on the side of the, the psychology piece and, like, the communication piece. Like, I- Oh,
Dr Mike T Nelson: for sure ...
Dr Emily Dow: I've identified patterns in just, like, the way that I say this to someone tends to have this effect versus um, maybe a different method. And so if you pay attention to those little, like, those little anecdotal experiences and how they kind of com- compile over time, there's so much to be gleaned from that.
Um, and I think it, I think it just makes for much faster advancement.
Dr Mike T Nelson: Yeah. What kind of clients do you typically work with?
Dr Emily Dow: Oh, it's been all over the map. I, for the majority, now I keep my roster, like, very, [00:59:00] very small. Um, I'm not really taking on anyone new right now. It's a few clients that have... Mostly, like, recreational athletes is kind of my bread and butter.
Um, I've worked with, like, high school athletes. That's super fun for me. Um, but before that it was really just, like, general population, people who wanted to, you know, lose some body fat or improve their metabolic health for whatever set of reasons. Um, that's kind of, like, everyone's origin story, I feel like.
Yeah. And ended up, like, in the gym setting when I was training people in person, I really enjoyed that. I enjoyed the general population demographic. Um, but now because it's, like, it is fun to get a little bit more niche with, like, some of the sports nutrition recommendations and some of those nerdier components.
Um, so I have a small roster of, of people who I get to do that with, which is a blast.
Dr Mike T Nelson: Yeah. And like you said, like, I... The amount of stuff I've had to learn over the years from... 'Cause I just get so annoyed when I can't solve a [01:00:00] client's problem or I can't get them to someone who can give me the answer, that the amount of stuff I've had to learn is, is crazy.
But I think if I didn't have those clients, I, I would not have that huge reason of, like, oh my God, this person's paying me a shit ton of money to figure this out. Like, I'm gonna figure it. You know, like, there's a huge incentive to spend the time to figure out what's going on or to find a professional who can, who can help them.
And the amount of stuff I've learned just through that process, I don't think I would've learned without that kind of pressure.
Dr Emily Dow: I totally agree, and I think it's such a cool learning opportunity. Like, I, I get a lot of, like, students and early professionals who ask me, like, "How do you, how do you stay engaged with the research, and how do you, like, come up with topics to talk about on social media and stuff like that?"
And it's, it always comes down to questions that I'm asked by clients or by, like, random people in my life that I find it fun to go down those rabbit holes and to be like, okay, well, also maybe I've been asked this question a [01:01:00] million times, but I'm not gonna just regurgitate the same answer because the answer I originally had may have also changed.
So any time that I'm asked, like, a complex question, I like to go down those rabbit holes and use it as an opportunity for my personal growth, and then I get to practice disseminating that to the client and tell them, like, "Hey, this is what I found. This is what the research says. This is what you've been in, been dealing with for whatever set of reasons."
And that benefits everybody, and especially if you're transparent about that process with the clients that you're working with. They love that because they kind of get to, like, learn alongside you. Um, and I think there's just a lot of value in that entire process, and more professionals would probably benefit from using that as those kinds of opportunities instead of, like, panicking or thinking that they have to have a per...
Or, like, coming up with some answer on the fly that they end up, you know, fixating over 'cause it was wrong for, like, years to come or that sort of thing.
Dr Mike T Nelson: Do you find a lot of the... I've noticed this myself, like the harder cases I have are always [01:02:00] overlaps of like two or three areas. Like I think we're kind of beyond the I don't wanna say simple answers now.
It's almost like in research. Like, the simple questions have already kind of been answered. Like, the difficult ones have not. And so I'll typically see someone who's got high stress, poor performance, and their gut's a mess. Or I had one person who, huge autonomic issues, blood pressure regulation, you know, s- tons of workups, ECHOs, all sorts of stuff.
But no one was able to look at all those things and how do they fit together, because a lot of times they'll go to a specialist and they're like, "Ah, you're fine." They go to the next specialist, "Oh, you're fine." They go to the next specialist, they're fine. But they're all, like, borderline not fine, but they were good enough to pass the requirement.
And then when you overlap all these things, they're like, "Oh, I got all these weird symptoms I can't figure out."
Dr Emily Dow: Yes. So, and that's like, that's the part that's so [01:03:00] intellectually stimulating, I think, about this field. Yeah Especially, like, once you kind of get to that point where you do feel like you have good answers for a lot of the simple questions, is when you have to or get to, depending on how you look at it, play detective in those sort of situations, and figure out, like, what's playing into what, under what context.
But then also having to figure out what it makes the, the most sense for that person to prioritize because- Yep ... tackling all of that at once usually isn't feasible either. Um, so yeah, I think that's, that's where I think the most fulfillment for me comes from too, is, is being able to, like, connect some dots for someone who's been very frustrated for such a long time because nobody else is looking at the big picture.
Dr Mike T Nelson: And that's where it's... I mean, obviously I'm biased because my background was exercise phys, but I think just having a solid background in basic metabolism and exercise physiology just goes so far, because you, when you have that background you can then kind of reason your way [01:04:00] through things and be like, "Maybe let's try this, or maybe let's try that," right?
But I think a, I just get nervous for a lot of, especially new trainers and coaches, that the... Everything is ultra advanced, but they miss the basics, and the basics could answer a lot of the ironically more complicated cases they see, where it doesn't seem to transfer the other way. Like, if you get really good at this advanced stuff and you're missing the basics, you're gonna get stymied by advanced cases that paradoxically could be solved by knowing the basics in just two areas and where they overlap.
Dr Emily Dow: That is such a good point, and I do think a lot of... And I get it. Especially, like, a 21-year-old's brain is not necessarily going to think through all these next steps. No. But, like, especially, like, if you're sitting for the CSCS exam or something, like, you feel like those are things that you need to know acutely so that you can pass the exam, and then you're never gonna need to know them again because it's true that no one's gonna pop quiz you on, like, the intermediates of the [01:05:00] Krebs cycle and- Right.
But they, it's easy to also miss the fact that, like, those, that background knowledge really does allow you to just, like, think things through differently, um, in ways where, yeah, you might not have to know, like, that specific answer and how to spell it, how to pronounce it, what have you. But it does make such a big difference in the critical thinking piece that is often the most important role that we play in our line of work
Dr Mike T Nelson: And talk to me about why did you start the Instagram channel?
And I've been watching a lot of the stuff, and I was actually, like, super excited. I was like, "Oh, here's, like, a legitimate, like, research person who works with clients," who was explaining, I would say not super complicated topics, but things that are more complex than what you typically see on Instagram, and, you know, getting a lot of views and a lot of interaction.
And I'm like, "Oh, there's hope for all of us. There's hope for the industry."
Dr Emily Dow: Well, that's how I feel too, actually. Like I, um, I don't really know what prompted [01:06:00] me to, like, start the account. I started that account six or seven years ago at this point, and it was kind of like, it was kind of nothing for a very long time.
But especially once I started teaching in the university setting just this past January, um, I realized that, like, I love, it makes me very happy, it makes me feel very fulfilled to communicate those concepts in a way that it actually lands with someone, and they don't necessarily think it's something that they just need to learn temporarily to pass an exam.
But they're like, "Oh, this is cool. I actually wanna remember this and understand this." Um, and so I was experiencing that with students, and I was like, well, my thing is I, I do actually think more people would be interested in these concepts if it were presented to them in the right way. Um, and I was fortunate enough to have that experience, like, in undergrad, in grad school.
I had really awesome professors and mentors, and I think if we can just, like, ignite that for people, they're capable of [01:07:00] understanding all of this. Oh, for
Dr Mike T Nelson: sure. Yeah, yeah.
Dr Emily Dow: It's not, like, way too high level for the average person to get, but I just don't think anyone's really bothered to communicate to them in that way.
Um, and so I think, like, my goal, 'cause I'm really, like... I had no specific aim w- with my Instagram account, but at this point I think my goal is to kind of, like, make some aspects of that collegiate level education of exercise physiology, nutrition as a science, accessible to people without having to go through that process, because it's relevant to everybody, but obviously not everyone necessarily wants to work in this field.
Um, so that's kind of, I guess, my goal with it. And then, again, I just piggyback off of what people are asking me about, what people are interested in, um, because I think there's a way to, like, make all of this exciting and interesting for people, and not something that they dread having to think about.
Dr Mike T Nelson: Yeah. I, and I get it. Like, it is kind of a, I don't wanna say it's a pain to do [01:08:00] social media, but it seems like it's a- a weird content game. And so people I know in the industry who are really intelligent, I keep pushing them to like, "Oh, just put more, more stuff out, like, because you have really good information that more people need to see."
And they're always like, "I don't know what I'm gonna do or what I'm gonna talk about." I'm like, "The same thing you said." You get, what, 5 to 12 client questions a day because you're actually working in the field. Just answer one of the questions you had during the day. Like, I guarantee other people will have that, that same question, and you're getting better information out, which is just gonna help everybody.
Dr Emily Dow: 100%. I could not agree with that more. And I get, like, the barriers to entry are there. Um- Yes ... and it's definitely n- sometimes, uh, there was definitely a, a lot of growing pains for me too, where it was not enjoyable. Like, the editing was a pain. I didn't wanna do it, didn't wanna take the time out to, like, script something up and film it.
But you kind of find your style of communicating, and I [01:09:00] think if you're pretty authentic to what comes naturally to you, it can actually be a much, like, lower effort process than you may be making it out to be in your mind. But it is, like my friend, uh, Alyssa spoke about this today or yesterday it might have been, like, it is tough to convince people in academia especially to just do more, like, unpaid work, is what it really is.
Oh,
Dr Mike T Nelson: yeah. Good luck with all that.
Dr Emily Dow: We don't have time. We don't have free time, like- Yeah, yeah ... we're already doing so much beyond what's in our job description. Like, I understand that's, that's very legitimate. Um, but I do think there's tremendous, like, professional opportunity. I think I've made, like, some incredible connections through social media with peers, and I've gotten to collaborate on a lot of cool projects and, like, speak to bigger audiences because I've been willing to do some of that.
Mm-hmm. So I think there's definitely balance to be struck where everyone can benefit, um, if you're willing to kind of get past some of those growing pains.
Dr Mike T Nelson: Yeah, no, I, I remember having this [01:10:00] conversation with Bill Campbell, God, probably, let's see, five years ago, and we
were just talking about social media, and he was super cool 'cause he would always ask me questions. He's like, "But you're a weird academic, but you make your living in the private sector, so, like, you have to do things to get clients and stuff." So he was always asking me what I was doing and stuff, and I was telling him, like, "Ah, just, I don't know, just start...
You, you got great information, Bill. Just start putting stuff out on Instagram." And then a couple years later he came back and he's like, "Oh." And he realized that he was getting inquiries of people to work in his lab from Instagram. And we had a conversation maybe three or four years ago, and I'm like, we both kind of agreed that if you're an academic, like, it's, it should almost be part of your job now because in terms of, especially if you're, you know, one of the department heads, like, you're in charge of enrollment, you're in charge of funding, and if you can't get students to show up in your lab, you're not gonna have a lab, you know?
And so now I think even social media is a way of [01:11:00] getting people who are already interested in the things you're doing. They know what your lab's doing. They've seen you put out stuff. And so I do think in terms of a weird recruiting method, even for hardcore academics, it's not gonna be that long before administrators are, whether they'll ever admit this or not, they're probably gonna look to see how big your Instagram or your Facebook following or your YouTube following is to think, "Oh wow, this person can actually draw people to our institution and to our actual programs without us spending a dime."
Whether that's- Yeah ... a good thing or not a good thing, we can argue about that later, but I, I'm pretty convinced that it's definitely gonna go that direction.
Dr Emily Dow: Totally. I could, I could absolutely see there being, like, a tremendous amount of pull in marketing the program, you know, through- Yep ... having faculty members with some degree of, like, a reputation, like a good reputation in the field that's through social media.
Um, absolutely. And I also think, um, [01:12:00] I don't, like, I don't necessarily know that this was part of why I got hired for the position that I got hired for, but there is also a tremendous need for, like, academics with skillsets related to, like, social media communication or even just, like, technology period.
Like
Dr Mike T Nelson: Yes.
Dr Emily Dow: I've now, I've now been given the responsibility of, like, converting a lot of our courses to online courses because I have this experience communicating in an online format that a lot of my peers don't have, and that's very valuable in a lot of ways that I didn't necessarily even expect it to be.
Um, but it's, it's fun, I think, to be a part of that process, 'cause, like, I'm having students create infographics. I'm having students, like, practice these skills because it's gonna be even more relevant for them once they enter the field. Um, and so I think the more that... I, I think more that the, like, high-level professionals can adopt that, I think it is going to continue to help the younger [01:13:00] professionals as well, um, so that we're not getting, like- Those are skills that I didn't necessarily get taught in a, in an academic setting, but I was able to, like, build them just on my own, and I think if we could kind of converge all of that, that's also incredibly productive.
Dr Mike T Nelson: Awesome. Last couple fun questions. Uh, what are you working on right now for your own training? 'Cause I know you still train a fair amount when you can. Obviously you got nothing else going on, but
Dr Emily Dow: Right. Um, yeah, with all my free time, I'm, I'm a little up in the air on, like, a specific event. Um, I mostly just train for fun.
I al- have always mostly just trained for fun, to be honest. I'm not a very competitive person. Um, so I do a big mix of, like, Olympic weightlifting. I'm learning, I'm learning some more, like, gymnastics-style CrossFit stuff right now, 'cause I happen- Oh, fun ... to live next to a CrossFit gym. Um, but the goal on the aerobic side, I, I was supposed to run a marathon last fall, [01:14:00] had to s- stop training for it, like, right as, as I was peaking because of an injury.
So my eyes are set on maybe, like, some trail 50K this year.
Dr Mike T Nelson: Oh, wow.
Dr Emily Dow: Once I can get... I've been working on speed while I'm in, like, a lower volume context right now. So, like, once I can kind of build my mileage, that's something that I'll probably set in stone a little more concretely, but that's been, that's been, like, in, that's been in my eyesight for a little while.
Really like to be able to actually do it.
Dr Mike T Nelson: Awesome. And any stories behind the tattoos? I'm always curious.
Dr Emily Dow: Not really, to be honest. Like, not... I have a couple that have, I guess, like, some significance, some meaning to them, but to me they're mostly decorative. Like, I just love- I, I, I love art in that fashion.
Like I, I, I like the aesthetic of them, I suppose. Um, I have a lot of animal skulls on my body and a lot of like florals, and I'm a huge [01:15:00] nature person. Animals have been like the love of my life since I was a small child, so that's kind of where most of them are tied to. Um, but nothing like super specific story-wise.
Dr Mike T Nelson: Awesome. Any other hobbies or recreation you do when you're not in the lab or in the gym?
Dr Emily Dow: Oh, no. Um- Not really. I've, I've like dabbled in, during my PhD when I was like really needing a hobby to take my mind off of everything, I dabbled in like some watercolor painting. Um, I like creative outlets like that.
I, I like write like poetry a little bit here and there. Like that sort of stuff is, is really what I lean towards. Um, but nothing super fun, honestly.
Dr Mike T Nelson: Yeah. Cool. Awesome. And uh, where can people find more about you? I know you have a website and you've got an Instagram. You know, you said you're not taking any clients or anything now, but any further info where people can follow all your great stuff?
Dr Emily Dow: Yeah, Instagram is definitely gonna be the best place, uh, to keep [01:16:00] up with me. Um, eventually I might be able to... I'm thinking about like putting together a wait list of some sort, 'cause I do have like people wanting to work with me that I just can't necessarily, I don't have the bandwidth for it right now.
Um, so if you were to reach out to me about that, I might be able to set something like that up. Um, but Instagram is really the best place to find me, and then my website's linked there. So if you have specific like speaking requests, specific questions, things like that, you can always find those resources from Instagram.
Dr Mike T Nelson: Awesome. Well, thank you so much for sharing all your research and everything you got going on, and I appreciate all your education and all the wonderful stuff you put out. It's been awesome.
Dr Emily Dow: Thank you so much. I really appreciate it.
Dr Mike T Nelson: Thank you.
Speaker 4: Thank you so much for listening to the podcast today. We really appreciate it. Huge thanks, Dr. Emily Dell, for coming on the podcast. Enjoyed our conversation very much. Hopefully you got some cool stuff out of it. Uh, make sure to check out her Instagram. She's got a ton of really good stuff [01:17:00] there, and what I love about it is it's, I'd say, higher level stuff, but it's explained in a way you can understand, and it's not the, "Here's what you need to know about this topic in 17 seconds."
So she takes the time to break everything down, which is great. So make sure to check out all of her stuff there. Huge thanks to her for being on the podcast, sharing all of her great knowledge there. If you want more stuff from me, go to the newsletter, which is Fitness Insider. It's completely free to subscribe.
Go to the link down below, miketnelson.com/newsletter. Got a ton of cool stuff coming out to you there, and some stuff that is only released to all the newsletter people there. As always, thank you so much for listening to the podcast. Really, really appreciate it. If you have a few seconds to give us the old likes, the thumbs up, the downloads, the subscribes, even leaving us a short review goes a long way to help us with the distribution of the [01:18:00] podcast.
If you share any of this online, uh, please check out my Instagram. You can do it there and label myself. I'm under Dr. Mike T. Nelson. Uh, you can find Emily's information down below, too. So share the episode there. Spread it around. Thank you so much for listening to the podcast. Really appreciate it. Talk to all of you next week