On this episode of the podcast we talk about fish oil and heart disease, coffee and neurodegenerative disorders, the build environment and obesity, and why coaching is about spending time being the best version of yourself.
[0:00] - Intro
[0:42] - Fish Oil and Heart Disease
[5:53] - BREAKING NEWS! COFFEE SAVES YOUR BRAIN!
[9:30] - The Built Environment and Obesity
[16:38] - Coaching is About Being the Best Version of Yourself
00:42
All right, we are kicking off the show talking about fish oil. And I know we've talked about this a little bit before, but I did have somebody actually directly message me and ask me to cover the topic of fish oil in a little more maybe detail and specificity. And so I want to go over at a high level how we think about fish oil and specifically how it relates to cardiovascular disease. And I want to talk about.
01:11
how it works, its efficacy, dosing, safety, et cetera. So just to start at the top, fish oil is a supplement that is consumed primarily for its high content of omega-3 fatty acids, specifically the long-chain omega-3 fatty acids known as acosa-pentanoic acid, or EPA, and docosa-hexanoic acid, DHA. So these are long-chain omega-3s that the body
01:38
can make from short chain omega-3s, but is super inefficient. So we really need to get them primarily from our diet. And biochemically speaking, these long chain omega-3s, this EPA and DHA, have specific functions in our body. And they work primarily as anti-inflammatory molecules. And they can alter our lipid profile.
02:09
kind of their function. Now, when we talk about zooming out from biochemistry all the way to a whole body physiology, is where we really need to ask the question. So let's talk about the efficacy of fish oil. Fish oil has been heavily investigated by modern medicine as a potential low risk, low side effect, kind of nutraceutical to help reduce cardiovascular disease risk. To date, the evidence is fairly mixed, and there's not a strong signal that it
02:36
directly reduces the risk of cardiovascular disease. That means in studies where you actually look at heart outcomes and fish oil, there's not a very clear or big signal of direct reduction. The most contemporary evidence suggests that fish oil alone does not appear to directly reduce the risk of cardiovascular disease, death from cardiovascular disease, or even all-cause mortality. If there is a direct risk reduction, it's relatively small and likely less than kind of 5%.
03:07
However, the evidence does seem to suggest that fish oil can improve your lipid profile, specifically by lowering triglycerides and maybe even raising your good cholesterol, your HDL. This effect kind of over time may indirectly reduce your risk of cardiovascular disease by reducing your overall risk factors. However, long-term supplementation has not really been adequately studied to understand if that endoress...
03:34
indirect risk ever really bears out an actual risk reduction. So to summarize, it appears that it's beneficial on kind of our risk profile, but in terms of like outcome-based risk reduction, relatively small. Now dosing. So dosing for fish oil supplements appears to be largely based on the amount of long chain fatty acids, specifically EPA and DHA, and there does appear to be a dose response relationship.
04:02
especially when we talk about reductions in triglycerides. So doses of around three to five grams per day of long chain omega-3 fatty acids appears to be kind of the low end of the therapeutic window. And so doses above this, except for in very specific situations, so for like the average everyday person, are not necessarily recommended and they may not provide any real additional benefit. And so now let's kind of talk about safety.
04:30
So fish oil is safe for most people to take when consumed within the target doses of three to five grams per day. There is some risk of increased bleeding above three grams, as it can have some minor anticoagulant properties. And so this is why if you're getting ready for surgery or some operation, or if you're on some other anticoagulant medication, generally they'll tell you to stop taking fish oil at least a couple weeks before surgery.
04:58
There's also some small risk of mercury toxicity if the fish oil is sourced from very low quality manufacturers as some fish can contain higher levels of mercury. However, the risk is relatively small as supplements tend to contain about one percent of the amount of mercury that's considered maximal for food safety. So it's a relatively safe supplement as long as you run it by your physician if you have any other kind of you know medical
05:26
Medicinal interactions or surgery scheduled and make sure you get it from a high quality supplier So that's kind of a very brief overview on fish oil And if you guys have more specific questions, feel free to email them in and we can do a deep dive on those as well So we'll take a quick break and we'll come back to the next segment of the show
05:54
All right, this is a very important breaking news announcement. We're doing a double nutrition highlight this episode, because this study was published last week. And I just feel like it has to be talked about, mostly just because it confirms my massive bias in life. We're not going to go through all the details of it, because if there's any details that actually discredit the findings, I'm going to be devastated. So this paper was published in.
06:21
my favorite journal, the American Journal of Clinical Nutrition. OK, this isn't my favorite journal. It's just the one that I always cite. It was published August 18, 2024. It is titled Associations Between Different Coffee Types, Neurodegenerative Diseases and Related Mortality Findings from a Large Prospective Cohort Study. So again, the caveats of it's observational, correlation doesn't mean causation. You know.
06:48
behavior patterns cluster, et cetera, et cetera. I think it's et cetera, et cetera, not et cetera. So just noted. But basically, this paper looked at 205,000 people from the UK biobank, which we've talked about before. And they basically tracked people. And they said, hey, how much coffee do you consume in a day? 0 to 1 cups a day, 1 to 2, 2 to 3, or greater than 3 cups a day?
07:18
And what type of coffee do you consume? Like black coffee, unsweetened coffee, or coffee with sugar or artificially sweetened coffee. Now.
07:30
They took those groups of people and they followed them and they looked at brain health. Basically, what is their risk of Alzheimer's and related dementia and things like Parkinson's disease, as well as all-cause mortality. And the highlights from this study were that people who consumed the highest amounts of coffee, so three cups a day or more, had a 25% lower
07:58
likelihood of developing Alzheimer's or related dementias, 29% less likely to develop Parkinson's, and 33% less likely to develop a neurodegenerative disease that relates to death. Now that last one was not quite statistically significant, but basically if you drink more coffee, you live longer and your brain is better. It's basically what the study said. But there's an important caveat.
08:28
This only held true for people who drank unsweetened, caffeinated coffee. So if you drank decaf coffee or kind of sugar or artificially sweetened coffee, there was no benefits. So my real take home from this is you should drink black caffeinated coffee as often as your body will allow you to. So that's the breaking news announcement. I will link to the study in the show notes. There's a lot more details in here we can talk about,
08:57
that was just hot off the press, breaking news. It confirms my entire bias of my entire life that more coffee is always the answer to everything. So take that with the grain of salt that I'm massively biased and the support set, but this is exciting. So we'll take another quick break and we'll come back for the rest of the show.
09:31
All right, so jumping into the next segment of the show, I really just want to focus this discussion on expanding a topic that is actually going to be discussed in the podcast that goes out later this week. It also I think will be available on YouTube within the next day or two. We did a live podcast in the Facebook group on obesity in general. And one of the topics that we talked about was, you know, root causes of obesity. And one of the discussions that I had
10:01
was really focused on the effective environment on just the likelihood of people becoming obese. And I think it's one of the most underrated aspects of what's driving these changes in body mass, body size, obesity rates, especially in places like the United States. And I.
10:27
One of the things that really got me thinking about this, this was maybe a decade ago. I took some classes in grad school. We talked about built environment. And I kind of just like do bike paths, really solve problems. And I think this is actually one of the most underappreciated aspects. And I really started thinking about this with a client I had probably 10 years ago. This was somebody who was.
10:52
You know, struggled with obesity. We're talking about, you know, 150, 200 pounds overweight. Like, this was a pretty big problem. But this was somebody who, it wasn't because they were lazy. This was somebody who had a massively successful career, like just really was at the top of his field, doing some incredible things professionally. It was not due to lack of willpower. It was...
11:17
It was just he just really struggled with making changes that actually affected his body weight. And at one point he had to move for work and he moved to a totally different place. Like he moved a place where the weather was better year round. He could actually like he didn't have to drive 30 35 minutes to work. He could actually either like take a long walk or he could ride his bike to work. He was within access of like close grocery stores like his entire environment changed. Like he didn't change how much he was going to the gym.
11:47
He didn't change that much about his diet when he moved. He ate out a little bit less, and he grocery shopped a little bit more. But within the span of about a year, he had lost about 60, 70 pounds just from changing where he lived. And I think this is really one of the most underrated aspects that people don't think about is, how much does your environment affect how likely you are to develop obesity, or how difficult it is for you to lose weight? Just based on the like.
12:17
the structure of your life based on your environment. And there's obviously a lot of research to this, and I don't want to spend a huge amount of time going through all that, but I just want to talk about just if you overlay the maps of like obesity rates, food intake, and physical activity, how much they align. So if you actually just go to the CDC website and you look at a map of overall obesity rates, and you kind of look at like the distribution,
12:46
the densities of obesity rates by state. So if you look like the obesity belt, so to speak, which is basically like North Dakota, South Dakota, Nebraska, Kansas, Oklahoma, Texas, Louisiana, Arkansas, Mississippi, Missouri, Alabama, Georgia, South Carolina, Tennessee, Kentucky, if you look at that belt, that's where primarily obesity rates are the highest. It's like 35% to roughly 50%.
13:17
probably 45% of the population has obesity, right? Then if you look at states like California, Colorado, Vermont, those places generally have much lower rates of obesity. It's sub 25% of the population. That's still pretty high, but that's much lower. What's really interesting, if you overlay a map of just food behaviors.
13:46
Right? So like average fruits and vegetables log per day. Places like California, Colorado, and Vermont generally have the highest rates of fruit and vegetable intake. Places like Louisiana, Mississippi, Missouri, Georgia, Oklahoma, Texas, they have the lowest amount of fruits and vegetables consumed per day.
14:16
Same thing with sugar sweetened beverages. Follow the same pattern. Average fast food intake, same pattern. If you kind of map the prevalence of food deserts, of the lack of fresh food in grocery stores, that also maps almost identically to these patterns. Then if you also overlay physical activity, the states that have the highest levels of physical activity are places like Utah.
14:45
Colorado, Vermont, Washington, Oregon. California is pretty close. If you look at the states with the highest level of physical inactivity, it is Oklahoma, Texas, Arkansas, Louisiana, Mississippi, Alabama, Kentucky, Tennessee, Georgia, Indiana, et cetera. So what's interesting is all of these environmental things drive behaviors, which then drive the outcome.
15:15
We just need to be much more cognizant and aware of how important the environment you live in affects your ability to maintain body weight, make good decisions, incorporate healthy habits of prioritizing activity, prioritizing being outside, prioritizing grocery shopping, healthy food. I think it's really difficult if you live in a place where you have to drive 20 minutes to the grocery store, you have to drive 20, 30 minutes to work.
15:45
There's no green spaces. Physical activity is not a big part of the culture. Those things all add up, and they start to really matter. And I think just acknowledging those pieces and how important they are goes a long way, especially as you're trying to figure out how you can prioritize these things. Sometimes, as simply as a matter of changing where you live can have massive influences on your ability
16:15
the trajectory of your overall health throughout your life. So I think that's just a really important piece. So we'll take a quick break, and then we'll wrap up the show.
16:39
All right. I want to wrap up the show today with kind of a little bit of a mind blowing perspective that I was basically told by a client of ours and it really shifted the way that I think about coaching and this this happened a while ago but I was really just thinking about it in the last few days because I'm getting ready to give a talk here. Oh God and about three and a half weeks which means I'm almost finished with my slides. I'm not quite.
17:09
So I got to get that finished. But I'm bringing this up in the conversation. I wanted to share with you guys here is, there has been kind of this trope, idea, meme within kind of the coaching space for a long time of, hey, your program's only good if someone is coached by you once and they leave and they just sustain their results forever and they never have to come back. Right, and a lot of times, and I've been guilty of this, it was kind of the old saying was like, hey,
17:38
Weight Watchers has like a 96% return rate. Like people are on Weight Watchers once and 96% of people come back.
17:46
And I think there's two ways to look at that. One is that means the program didn't work and they have to come back. Or two, if you have a highly successful program that gets people results and they leave for a while and come back, that doesn't necessarily mean that your program failed. And for this reason, as coaches, we are not one and done services, right? Like you're...
18:11
Your physician is not a one and done service. Your accountant is not a one and done service. Your tax attorney is not a one and done service, right? And the perspective this client gave me, because I remember I was asking, I said, hey, you obviously had amazing results with us. And as far as I can tell, you've sustained the weight loss. You look great. You've built all these new habits. They're sustainable. Why are you coming back to coaching? And their answer was, when I work with you,
18:40
you help me be the vet, the best version of myself. I'm more focused, I'm more driven, I have accountability, I have feedback. Like yes, I've maintained weight loss, but now like I want to try to find the next best version of myself. And there, and I was like, that's a great perspective. Tell me a little bit more. And they said, the reason I signed back up with coaching is I want to try to spend as much time as possible trying to become the best version of myself.
19:10
And every time I'm in coaching, I know and I feel like I'm actively working towards that. And I thought that was such a great perspective. And so I think as either as clients or, you know, if there's a client is listening to this, if another coach is listening to this, I think that's the perspective I think we really need to try to adopt and to give our clients is, hey, our job as a coach is to create an environment that helps you.
19:35
work towards becoming the best version of yourself. And as a coach, I want you to spend as much time with me, you know, working towards that. And that means goals change, that means life changes, that means all these things happen, but there's always a place for you to come back as a client and let's try to spend as much time as we can becoming the best version of ourselves. So that's it for the show. We have another show coming out in a couple of days. So stay tuned for that. That's it.
20:04
I'm Dr. Brad, I'm outta here, I will see you guys later.