Ep 450: Discover Your Metabolic Potential With Advanced Metabolism Testing With Dr. David Duizer

Want a test to tell you what to eat and how to move?  Looking for advanced testing and protocols to help reboot your metabolism and mitochondria?  Dr. David Duizer is a naturopathic doctor and the host of the podcast Personalized by Vitamin Lab. Dr. Duizer uses PNOE metabolic testing combined with nutrition and workout protocols tailored to one’s specific metabolism results. In this episode of The Health Fix Podcast, Dr. Jannine Krause interviews Dr. David Duizer on advanced testing and protocols for enhancing metabolism and countering mitochondrial decline with age. 

Resources From The Show: 

• Noble Naturopathic 
• Dr. Duizer’s podcast Personalized by Vitamin Lab 
• PNOE Metabolism Assessment

Our Partners

Podcast Transcript

2:17 – Why Dr. David became a Naturopath

6:26 – How Dr. David came to focus on metabolism and metabolic rate

11:04 – PNOE testing

17:50 – Individualized care

21:10 – Dr. Davids approach to calorie burn

28:03 – What a typical fat loss program might look like

33:48 – Misconception about burning fat while in a caloric deficit and the effects on metabolism

40:25 – Mitochondria / Cardio / IV Therapy 

52:14 – Assessing a patient who believes they have a chronic viral illness

102:51 – Success story / first client lost 100 lbs!

107:46 – How to find Dr. David noblenataropathic.com/metabolism

110:19 – The one thing Dr. David says you can do to get started working on your metabolism today

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[Intro] Welcome to the Health Fix Podcast, where health junkies get their weekly

fix of tips, tools, and techniques to have limitless energy, sharp minds, and fit

physiques for life.

Hey health junkies, on this episode of the Health Fix Podcast, I’m interviewing Dr. David

Duizer.

He’s a naturopathic doctor just like me.

He is out of Vancouver, British Columbia, and he is one of the founders of

Noble Naturopathic. He is also a podcast host as well, the host of Personalized by Vitamin

Lab. And I was on his podcast not too long ago. So hope you can check that out. But today we’re

going to be talking about metabolism. We’re going to be talking about high tech testing,

such as the PNOE metabolic testing. We’re going to be talking about working out fitness, how that

plays in, resting metabolic rates. We’re going to get a little geeky, but trust me, it’s going

to be fun and you’re going to get a sense of what you can do if you’re fed up with

where metabolism’s at and you really want to hone in on things. Dr. David has the answers.

So let’s introduce you to Dr. David Duizer. Hey guys, welcome to Health Fix Podcast. I’m

Dr. David Duizer on and I’m really excited because I did a podcast with him, personalized

by vitamin lab. And we had a great conversation on that. And I was like, oh, yes, let’s talk about

your specialties. So here we are. So Dr. David, welcome to the Health Fix Podcast.

DR DAVID: Thanks for so much– Thanks so much for having me, Jannine. Really grateful to be here.

JANNINE: Well, you know, you have such a broad range of experience. And in particular,

the metabolism school, we got to talk about that because it’s probably the number one thing

that women over 40 come to me about that like, “Hey, I’m seeing things slow down. It’s not cool.

I don’t want to gain weight. My body’s looking different than it used to. Help!” And so anybody

who is focusing on, let’s say, saving women from their own madness, hands like high fives,

thumbs up, I’m all about it. So tell us a little bit about you in terms of becoming a naturopath.

I’m always curious about other naturopaths. What brought you to the bright side of medicine?

DR DAVID: Thanks for asking. So I wanted to be a physician my whole life. I wanted to work in medicine,

help as many people as I possibly could ever since I was young. But when I became an adult,

I realized that my interest in sort of align with the typical, the conventional pathways.

And so I had experience working in a chiropractor’s office when I was young. I had many family

members who benefited from alternative care, typically in cancer care, really. And when I was

in the Navy, I still did want to be a physician. I wanted to be a naval physician. But at the time,

it didn’t suit the pathway for me. It wasn’t like it wasn’t going to be happening. And so,

I was living in Victoria where naturopathic medicine is really, really popular. And I met a

a few people loved what they were doing, learned that they were doing manipulation,

they were doing adjustments, learned that they were practicing primary care in our

province, and also learned that they were doing evidence-based natural care.

So I had sort of like the benefit of all three.

I could work in physical medicine.

I could be a primary care provider and help a ton of people, but then also I could help

people stay away from medications as much as possible.

And so I ended up applying, got in, went for it, and then right away jumped into sort of

like integrative cancer care because that’s what benefited my family so much.

And I got a ton out of that and I felt like I was able to help a lot of people very early

on in my career, which was really cool.

JANNINE: Isn’t it funny how a lot of us come in from cancer care?

That’s kind of how I came into the naturopathic world, didn’t know anything about it.

And same thing with acupuncture.

I had no idea.

And that’s the interesting thing about the physical medicine side of things.

You can see, you know, the immediate results.

You can feel people’s energy.

You can work with them on, on that level.

And gosh, it’s, it’s just so fun to hear other people’s stories and how you come, you

came to it.

Now, you had mentioned before we hit record that you grew up just on the border of New

Brunswick and Nova Scotia.

Were there, were you having to travel very far with the family to see naturopaths there?

How did it work?

at this point, you know, there’s more natural parts in Nova Scotia, but I’m guessing back then,

there’s maybe less, like, tell us the story. 

DR DAVID: Not many or none? 

JANNINE: Yeah. 

DR DAVID: I know. We’re talking

about 15, 20 years ago now. They were traveling, my family members were traveling to Moncton,

New Brunswick, to an apothecary. So they were traveling to receive herbal medicines from a,

from a sort of like a natural pharmacy place. 

JANNINE: Very cool. Yeah, and that’s the story I hear a lot

that were folks in different provinces in Canada,

even today, you know, it’s kind of spread out.

I mean, even Wisconsin, we don’t have a lot of naturopaths,

you know, Washington State, West Coast,

definitely like you said,

lots of naturopaths in Victoria, Vancouver, you know,

those areas, but sometimes it’s a little bit

few and far between, so I’d love to hear kind of how folks

connect with them.

DR DAVID: Oh my gosh, for sure.

And I work on a street in Vancouver

with the most naturopaths of any street,

I think in North America.

So I’m like completely opposite.

The one street where everyone said not to work on

is where I ended up working on,

because it just suited my lifestyle.

So, it’s kind of unfortunate that it’s really difficult

for naturopathic physicians to open practices

in small towns, but it’s building,

but it’s really building,

becoming more popular in Nova Scotia

all across the maritimes really.

And Atlantic Canada, in general,

there’s a lot more natural best now, which is really cool.

JANNINE: I’m excited to see it.

I love the growth.

I love to see that people are embracing it,

but also just that, you know, our word is getting out, right?

And you have such a unique, let’s say, like program that you have,

and especially skill sets where you’re combining fitness,

which absolutely love, and then also working in metabolism,

working in some of the IV therapy.

And so guys, we’re going to talk about that a little bit more today.

What got you into wanting to work with metabolism as a whole

and creating the metabolism school?

DR DAVID: Well, I have kind of a funny story.

Like I’m I was an athlete in college.

I played basketball for the Royal Military College of Canada

back when we were in the university league.

We had an opportunity to play against some of your great schools

and get our ourselves beat pretty, pretty badly.

We actually had an opportunity to play against West Virginia,

which was really cool.

D1 school, which was really fun.

We’ve got think we got beat by 60 points.

Anyways, after college, of course, I was at the Royal Military College where we trained all day.

It was very physical. I was a sort of like a 400 club athlete, which is someone who reaches all

the athletic pillars, basically. So we were training all day long. And then I was playing

Varsity Basketball in the evenings. And after college, all that output went basically to zero

as I entered into naturopathic school. You know what the demands are like? It’s very, very intense.

The output went down to like a short walk, you know, kind of like at the end of the day.

And I gained 50 pounds. And I had been an athlete my entire life. In fact, I want to talk about my

my athletic journey as a as a high school athlete as well, because it kind of ties into metabolism

school a bit. But I had been an athlete my entire life and I was then 50 pounds overweight.

And I could not believe it. And I said to one of my professors in

naturopathic school, I said, I can’t believe this is happening. Like I am eating

less than I was eating before because we had unlimited food.

It was military colleges, it was a well-funded program in the country, unlimited food,

everyone ate all day long and everyone was very lean, of course, because we were

training so much.

And then to gain 50 pounds, I thought, this is wild.

I was actually studying chemistry and I was in biochemistry.

I knew all about metabolism at the time, but didn’t consider how impactful actual

metabolic rate is on your like sort of like lifestyle.

Like what happens when you go from training four hours a day to training zero?

What happens when you go from eating unlimited food to eating?

What, what, what really ended up being a small amount of food?

What happens to the body?

And so I think I lost a bunch of muscle and gained a bunch of fat.

And that really inspired me to think more deeply about metabolism.

And of course we’re training for longevity and for prevention.

And one of the tenants of naturopathic medicine is to consider prevention, of course.

And so we were talking about the role of obesity, how it’s related to disease and how it leads to disease.

And I was freaked, freaked out.

And so I got right into tightening up my metabolism, of course, lost all the weight.

And, and it’s, you know, my career has sort of been focused on that kind of in the second half.

I’m 10 years in the second half of my career has been heavily focused on helping people with their metabolic rate.

JANNINE: Isn’t it funny how you like kind of like get the career started and then you then you evolve into like what you initially were like,

Yes, this is why I’m doing this kind of thing. It’s– 

DR DAVID: yeah. Oh, totally completely. It’s it’s really cool in our medicine,

though, that we get to have these different kind of pathways within our career like, you know, 20 to 30% of my day is still integrative cancer care.

But there was like, there’s like a metabolism piece to it because we measure their metabolic rate and we help them eat enough so that they don’t lose.

So they don’t experience the sarcopenia of typically what happens in conventional care.

So we know how much calorie they need to be eating and they know we know how much protein

they need to be eating. We can track it. We can track the impacts of metabolism,

impacts of chemotherapy and radiation on actual metabolic rate. So we had this pathway where we

can do that, but then we can support people with weight loss. But then also, what about chronic

disease. Well, we’re talking about obesity, so there’s a weight loss piece, but also the fittest

people live the longest regardless. And so we have this pathway that sort of the chronic disease,

prevention, chronic disease, treatment pathway where we still are able to use the metabolism device.

So it’s like my career has just become so fun. It’s the best.

JANNINE: I love it. I love it. You’re still in the game at the beginning. Now you get the– yeah, it’s

It’s neat to see how you incorporate it and it evolves over time.

Now, one of the things that struck me in terms of your programs that you have is that you

have this technology known as PNOE metabolic testing.

I had to look it up because I was like, “Huh, what does that mean?

I haven’t heard of it before.”

So can you explain to folks what PNOE testing is?

I’m pretty sure that a lot of folks haven’t heard about that before.

thinking blood tests are thinking maybe like a DEXA scan to see what their body fat percentages.

Give us a scoop. 

DR DAVID: Absolutely. Well, in other countries,

physiologists have their own practices and they measure metabolic rate.

It’s just typically the device is connected to the computer. So for example, at all the major

universities across our country, the physiology departments have metabolism assessment device.

You breathe into it, it measures how much carbon dioxide you exhale. But it’s going through a tube

and the sensors are telling the computer live what’s happening with your carbon dioxide exhaled.

The only difference with this device, and there’s a series of other devices like it out there,

it’s Bluetooth. So it does a data dump every 30 seconds. So the sensors attach to the mask,

it goes to a pack on the person’s back, and the actual measurement is completed there,

and the data is sent via Bluetooth to the computer every 30 seconds. So I don’t get a live stream of

data. I get these batches of data that are dumped. But so it’s the same as your conventional

metabolism analysis devices. It’s just mobile. So I was first excited about it because the

American Heart Association said that the, I think it’s an atherosclerosis in 2017. They

published that the people with the highest VO2 max live the longest regardless of their

cholesterol, blood pressure, and blood sugar status. And then there’s a line after that says,

“Oh, and it can be tested in office.”

And I knew that there’s a physiologist at our hospital here

who measures metabolic rate,

but I never figured out, like,

how do people see that person?

And it’s like, it can be tested in office.

So I thought how looked it up right away,

found this Bluetooth device and went,

I’ve got right into it.

This was just over three years ago now.

So now we’ve tested 700 people’s different metabolisms,

both at rest and during exercise.

So we have this insane amount of metabolism information

like actual real life stuff that I can come on shows like yours and talk about.

And it’s been really cool.

JANNINE: That’s that’s neat.

So over 700 people, you must be seeing some trends.

You must be seeing kind of some some data outputs.

Are you guys doing any resource research or write any papers or anything or just

kind of taking the info in and utilizing it to help?

DR DAVID: Oh, I wish we were doing research.

Yeah.

I wish we were.

No, we’re not.

We don’t have the capacity yet.

We have two people trained and a third one coming soon,

a second location opening up,

and then hopefully that will give us some space

to be more organized and to consider projects like that.

But right now we’re just sharing information

within the group so that we can help the people

that we’re seeing as much as possible.

But yes, we’ve seen some trends, my goodness.

And it may be like your very typical trends.

I guess the key thing that people come in for

they feel like their metabolism has declined and then they come in, we measure it and they say,

we say yes or no. But also we get to say, if it’s a no, why do we think that’s happened?

Just through like a few questions. I’m sure you can imagine them. Do you sleep well? What are your

hormones like? What’s your stress been like and have you had any nutrient deficiencies?

Like we can kind of check the boxes. That’s aside from diseases and disorders, of course.

But then if it’s normal, then we can show them what a meal plan looks like. That’s a deficit if

if they’re trying to lose so they can know exactly what the portions should be to see

if they’ve actually done it before.

If the physician says, “Move more and eat less,” all of a sudden we have a program in

front of them that shows them what that actually means and provides predictable weight loss.

This morning, the person came in.

There are seven weeks out of their — since they did their test, we were supposed to meet

after eight weeks, but we ended up meeting a week early. We did six pounds per month.

So we were expecting 12 pounds, but it’s been seven weeks and they’re down 11, like exactly

35 year old female exactly lost the amount that we predicted they would lose with the deficit

that we that we created. It’s unbelievable. It’s so cool. 

JANNINE: Wow. Wow. That’s neat. That’s neat.

because I mean a lot of us, right, we’re kind of guessing.

And I even have a device here called the Lumen that measures the carbon dioxide.

And so folks could do this at home, but I still feel like even with the home devices,

it seems that there’s still a lot of questions that there’s not someone with you all the time

kind of helping. And I shouldn’t say all the time, it’s not like you’re following your people around.

But having someone guide you in terms of the information that you guys get and

And the actual, like, this is what you should be.

DR DAVID: The accountability piece is huge.

There’s two real pieces, right?

There’s the evidence piece.

Like you laid there for 10 minutes.

And then we took the smoothest two minutes of your breathing

to determine exactly what your resting rate is

over the course of 24 hours at its lowest.

And then we’re able to compare that to the basal metabolic

rate, which would be sort of like the predicted resting rate

and tell you if you’re a good burner or a bad burner.

But then also there’s a plan to suit it.

So if the metabolism is normal,

here’s a plan that’s going to be appropriate.

You don’t have to count calories.

You just follow the portion sizes.

So what I’m trying to do with this idea of metabolism schools,

I’m trying to bring the educational piece to the world.

Like, here’s what we know about metabolism so far.

Here’s the impact of thyroid hormone.

Here’s the impact of having low iron.

What does it mean to train every second day

to your actual resting rate?

Like, what does that do?

So if we pull out all these educational pieces,

I think that we could have this metabolism forward or metabolism first lifestyle that

can be incredibly supportive.

And even if a person believes their metabolic rate is low but can’t, doesn’t have access

to this test, well, that’s fine.

If you follow the educational pieces, you can kind of check all the boxes, right?

Like you can, you can check the testosterone box, you can check the estrogen box, you can

check the eight hours of sleep box, the stress reduction box, you check all these boxes.

And then, like not fasting, for example, consuming enough protein, strength training,

doing cardio every second day, like you check all these boxes, all of a sudden there’s

nothing else that could have been done for your metabolic rate anyways.

So then you can go with the predicted values.

And that’s the idea.

I want to have this educational piece that really supports the public for people who

won’t have access to this test.

JANNINE: Gotcha.

Gotcha.

Okay.

So independent of the test, you can still do this.

Now, I think what a lot of people are kind of looking at in terms of metabolism is what

I heard you mentioned testosterone and thyroid. A lot of people are like, what kind of testing

do I really need in terms of things? Are you guys doing blood tests? Are you doing saliva?

Are you doing urine tests for the hormones? What’s your gamut of testing for

metabolism-focused types of clients? 

DR DAVID: Oh, yeah, that’s cool. We have access to all of them,

of course, and we use all of them. So we individualize the care, you know, you don’t

mean my whole theme is like personalized individualize. That’s my whole thing. That’s why I love my

podcast because I get to talk about ask people how they personalize their their care. But when

it comes to hormone testing, we absolutely personalized care. And we only will go in all in on testing

if someone has a low metabolism. Like this is the example where someone’s trying to lose weight

and can’t. So they come in like for other people who have actually low test, low hormone symptoms,

of course, we test. But let’s say someone’s coming in and they have the suspect they have low

metabolism and they haven’t been able to lose weight. And then we do the resting test and it

turns out their metabolism is low. Like we predicted it using the Harris Benedict equation at 1800

calories per day, but it actually came back at 16 or 1500 calories per day. Well, then we have

have to go into the, we have to have some sort of line of questioning, like we have to figure out

how to best allocate resources for testing. So say when someone has symptoms of low testosterone,

you know, low libido, low sex drive, for example, they have, you know, they used to have more

muscle mass that, you know, they feel like they’re weakened, then it could be valuable to test

testosterone. And there’s a few ways of doing it. Like, we’ll use a simple blood test for total

T if we just need to have like a basic assessment. But of course, we’ll do saliva testing and

urine testing. If we want something a little more detailed, we want to go for bioavailable. If we

want to go for the actual metabolites of testosterone to see the whole cascade, we do the urine test.

But very commonly, what’s happening is we’re seeing women whose estrogen have gone low,

say for example, in menopause and their weight has gone up. And so it can be very valuable if

if they have a low metabolic rate to have a look at estrogen and progesterone because they do play a role.

And so we do a lot of that. And we’ll use in that circumstance either saliva or urine depending on the amount of information that we need.

If they have symptoms that would require us to know about the different progesterone metabolites, for example, whether it was some stress symptoms or some insomnia type symptoms.

or if we needed to know more about the estrogens like there was a genetic predisposition to,

for example, increase estrogen levels of one of the three types or increase estrogen receptors

or metabolites, then we may want to consider looking at those because it’s a really, really good test

to see the whole picture obviously. 

JANNINE: Yeah, I think it’s important to test. I think it’s important to

have some of the info at hand, right? So what we’re working with, obviously, none of us treats

specifically on just the tests. You know, we treat the person, but the data is helpful in this case.

Now, when it comes to exercise and fitness, and say you’ve got someone who is athletic,

maybe they play college sports, maybe they’re playing pickleball right now, since that seems

to be all the rage, or, you know, they’re trying to stay active, and they’re like, “Man, I’m physically

moving every day and am I just not doing enough intensity? Am I doing too much? How do you guys

gauge that based on the PNOE metabolic testing? Are you looking at resting heart rate? How does

that work? How does that factor in? 

DR DAVID: Are they trying to get fitter or lose weight or what is the deal?

Like what is the end goal for them? We typically start with that, right? The VO2 max test that we

do with the device gives us our VO2 max, the max amount of auction they can consume with their peak.

milliliters per minute divided by their kgs of body weight. So body weight does play a role in

VO2 max, by the way, you want to be fit and lean. But we also get nine other metrics. So we’re

looking at measures of oxygen consumed divided by the heart rate. So as the heart rate rises,

a consumption of oxygen should rise at a certain rate. We get to see their title volume, like how

much they can pull in per breath and how fast they breathe during exercise. We get to see the

efficiency of breath at the end of the test. So when they’re breathing super fast, how much oxygen

in the body is actually consuming. It tells us a bit about the lung, a heart, muscle connection.

We get to see metabolic scores for calorie burn. So we see about metabolic efficiency at the low

end, like whether they’re burning too many calories or not enough calories at the low end. And then

again, at the high end for mechanical efficiency, like they’re going all out, are they burning 30

calories a minute? Like is it a outrageous and a outrageous level of calorie burn? And then we also get to

to see the recovery capacity.

So when we do a ramp test, this is a ramp test to exhaustion,

we get to see if they’re in the first minute of cool down,

if the heart rate comes down 30 beats.

And then if the second minute they clear all the carbon dioxide that was built up

in the body, so we get all these different metrics and say someone who is

trying to be better at pickleball, then we get to pick, okay, it’s, it’s

classified for us as limitations.

The physiology team will classify the, the scores.

These are lab-derived scores, except the VO-max as evidence-based, obviously.

But all the other scores are lab-derived, but it’s a good lab.

They give us limitations, what we would predict for someone, same age, height,

and gender.

And then we get to work on those limitations.

So for example, you know, for an agility sport like pickleball, we’re

typically thinking, can you express this power, this ability to get to the ball

at the end of the event in the same way you could at the start of the event.

Well, that requires a significant level of endurance.

You need to have this aerobic capacity to do the same amount of work at the end

so that you can recover those ATP stores.

You say you can recover the creatine bonds so you can express those when times are tough.

You don’t want to be fatigued.

Well, the device tells us if your low end cardio is not good enough,

depending on your fat burning versus car burning in the first few minutes.

Say you have an endurance sport.

most so endurance sport we can go for. What is the actual heart rate that’s in zone two

and how much fat is actually being consumed for fuel in that heart rate. And so what we do for

endurance athletes is we try and shift that thing all the way to the right to the burning fat as

at as fast of a pace as they possibly can be. And it’s the worst for them when they switch

over to carb stores too early. They get fatigued, it’s unbelievable. So they say, you know,

train slow to run fast.

Well, we train really, really slow for them for very long periods of time,

and they get more efficient at burning fat.

So we find the limitations and we program.

On the weight loss side, we just find how many calories are burning at every heart rate

and say, if you train here for this number of hours, we can add that on to the deficit.

And while you’re doing that, hopefully we’re picking something that’s not going to make you

hungry and tired, but if it does, message us and we can change it.

And so that’s kind of how we program the calorie burn side of things.

JANNINE: Okay. Okay. So it’s a little trial and error, which, you know, with anything, you know, we’re

going to have that. And I think that’s really important for folks to hear that there’s going

to be some, you know, it’s, it’s not like you’re going to get this data and that’s the end all

the other either has to be a little bit of playing back and forth to see, you know, which direction

things like go now–

DR DAVID: Well, it tells us though, it tells it’s the coolest thing, sort of, it tells us exactly which direction

to go, the question is, can we send the right stimulus for that person?

So for example, say it tells us that their fat burning efficiency at low intensities is not good

enough. They need to train as much as possible during the week at low intensities without losing

their fast-twitch muscle fibers. That was my problem in high school. I wanted to dunk the basketball.

I wanted to be able to do this. And so I bought all the jump programs that were available in the

90s, like that was my thing. I bought them and I did them because my discipline was insane.

I followed them very closely, but I also ran cross country and I trained at night.

So I did the plyometrics. I did the heavy, heavy weights. I did all the leg work during the day,

but then I kept up my cross country times. I ran 3k every single night and longer runs on the

weekend up to half marathon runs and did really well in cross country. Of course, my genetics

put me in a position where I had a ton of slow-twitch muscle fibers,

I kept those and I developed them and I never gave my body a chance to adapt to the stimuli

I was sending it during the day. I never built the fast-twitch muscle fibers. I never was able to

dunk the basketball, even though I found evidence-based strategies to do that. I had good resources.

But it never worked for me because I was sending two signals. We always want to be sending the

right signal at the right time. We don’t do endurance training on the same day as zone five sprints

because it wipes it out. We don’t do weight training on the same day as zone five sprints

because it wipes out the benefit of the zone five sprints. So we’re able to get the limitations

from the test and then take an evidence based approach to programming, which is minimum two days

a week on its own of the stimulus you’re trying to send. For some people, that is enough. For some

some people it’s not enough.

So the trial ends up being like,

what is the actual volume and intensity

at which you need to create this stimulus?

And that, of course, we is easy to iterate as you go

’cause you can just ramp up something

and tone down something else.

That’s why I became a strength and conditioning coach too,

to try to like be able to figure out

when to turn the dials in which way.

And that’s been super, super valuable

combining that kind of approach with the data from the test.

JANNINE: Gotcha, gotcha.

Okay, now I understand a little bit better because yes, I think for a lot of people that

is a big question.

Am I overdoing it?

Am I not doing enough?

How many days should I be doing things?

What do I combine together?

And for endurance and for strength and for improving in a sport, that’s completely different

than someone who’s like, I just want to target a fat loss.

And so in terms of fat loss, could you give us an example of what that would look like

like in terms of someone looking at zone training,

looking at combining, looking at, you know.

DR DAVID: Absolutely.

No, totally.

Like whenever it comes to fitness,

we have to individualize the programming of course,

but fat loss individualized programming

is highly dependent on your ability

to follow the nutritional deficit.

JANNINE: Right.

– Like the most important thing is a nutritional deficit

because we program 70% of the results,

70% of that calorie deficit from the meal plan.

So it really, the exercise calorie burn is quite minimal

when you look at the actual total volume.

Say for example, we have a resting rate of 1500

and a daily activity burn of 500

’cause they have sort of like a desk job, which is everyone.

And then we have an exercise burn.

Say we’re doing four days at 400 calories per day,

then we would take that 1600 divided by over the seven days

to get about 200 calories per day

and add that onto the total.

So now we’re at 2,200.

If we want to lose a pound and a half a week,

we have to eat 750 less.

So we’re programming there.

That’s where we’re programming.

So we’re staying at that 750 less

than the total daily energy expenditure.

Whatever it takes to stay in that.

So let’s say that 400 calories

that we thought we were gonna get

from exercise four days a week

is something that we have time for and we can do.

If a person is really well trained,

then we take their limitations and say the best choice for you

would be to train for these limitations

’cause it’s gonna help you get fitter

and you’re gonna get the right amount of calories.

Say they needed to do some zone four tempos,

they’re doing equal amounts of zone four and zone two.

Because in zone four it’s kind of short,

they don’t tolerate lactic acid well enough,

we should train them.

Well, here’s the calorie burn that’s going to happen

and the benefit of doing zone four training

is you’re gonna have a significant afterburn

for the next 48 hours, the resting rate is going to be higher than we found today,

which means the results are going to be like a little better, but also it might make you hungrier.

So you got to check in with that. Let’s say, for example, within this whole thing,

we had someone who had a low muscle mass and they were eating, you know, we had them eating at 1450.

We had them eating at 1450, but their muscle mass is low. So there’s a risk here. We have to work

on building their muscle so that we can make sure that their metabolism is going to stay

strong when they reach their goal. We don’t want them to lose muscle to go from a low

state to an even lower state. So they need to strength train. So we have to send this

signal to the muscles that we need them to be growing. And we can do that in a deficit.

We’ve found that out many, many times here. It’s unbelievable the results that we’ve

had turning fat into muscle hypothetically, but it actually shows up on the page, which

which is so incredibly cool.

So we have to train for that.

So the stimuli would be two to three times a week

for every muscle group.

So that can end up looking like full body three days a week

for someone who’s never trained before.

Now they’ve got the bands, right?

They’re going through the bands

and doing some band work at home three days a week

and then walking for the rest of the calorie burn,

something like that.

So that it’s not making them too hungry

’cause the weight training might make them hungry.

So we have to individualize it.

From a metabolism standpoint, we can get afterburned

from more intense work.

We risk the hunger and the fatigue

because we’re eating in a deficit, remember.

For the untrained person or the person with low muscle mass,

we have this responsibility to make sure

that metabolism comes out at least the same or better

when they reach their goal.

So that maintenance is really easy.

And that means that they’re going to need

to be participating in strength training of some sort.

They could work with a trainer.

We have one who we send people to.

But really it’s about sending the right stimulus.

So for a lot of people it ends up being like dance class,

or it ends up being like spin class,

or whatever they can do to start integrating something

that is signal sending to the muscle tissue

that we want to send to.

And all of that will lead to fat burning

because they’re in a deficit.

Now if we look at just fat burning like during the movement,

it’s only low intensity movement that causes fat burning.

Like, you know, unless you’re going to run for like over an hour,

and then you burn through the glycogen stores and then you start tapping into

fat again, but there’s a lot of other complications that come with that one.

So we, for fat burning, we just look at low intensity work.

So we do the device spits out the fat max.

So we get to see at what heart rate they’re burning the most fat and how many

calories they would get at that heart rate.

That’s what body composition pros do.

You know, they just lift weights and then they just walk for three hours on an

incline. That’s what they do.

And it works like crazy.

It works so well.

but who has that kind of time?

So for the person who’s like looking to see,

you know, I’m, I now is not the time for me to get fitter.

I’m just trying to reach this goal

to prevent cardiovascular disease

from the obesity that I’m suffering from.

Well, let’s walk on an incline for as much as possible

just to maximize that fat burning,

not worry about afterburn.

We have the test with 24 hours of no exercise.

So we get to see what the resting rate is like there.

We’re not really considering afterburn,

just making sure they’re burning fat during their exercise.

So we do do that lots, lots.

JANNINE: I think one of the things I’m hearing that there may be some confusion out there,

maybe some folks are listening, might be like, wait,

you said that you’re going to have me burn fat in a deficit.

And I would love for you to help clear up some confusion because on social media,

there’s a lot of folks saying you can’t be in it.

You don’t want to be in a deficit.

Cause if you’re in a deficit, it’s going to go negative on you and you’re not

going to get the results that you need help folks kind of brew that a little bit in terms

of why someone might say that online and really what is truly happening, what you’ve seen with

your clients. 

DR DAVID: No, with like really long term lack of eating, but I mean, it’s pretty rare

to have your metabolism go down because you’re not eating enough, right? It doesn’t happen in

in a short period of time, that’s for sure.

So it happens when you lose muscle mass.

It happens when the mitochondrial function declines

’cause we have some levers we can pull.

We have mitochondrial function,

we have mitochondrial density informed somewhat

from by the muscle mass,

like the actual total volume of muscle.

So let’s go through some examples.

Some people can fast for long periods of time

and their metabolism stays really good.

Some people, they fast for a day and we’re seeing declines.

It’s going down.

And it’s incredibly individual.

Think about these mitochondria and think about their function.

Like we have lots of data about improving mitochondrial function.

Do cardio train high intensities, train low intensities.

Mitochondrial function will get better.

But we don’t talk enough about mitochondrial decline,

whether it be from nutrient deficiency or from inactivity.

We have some people here who have metabolisms

that are 500 calories less than predicted

who do not have hypothyroidism

or are medicated appropriately

and their TSH, T3, and T4 are optimal.

Like we have that,

we have a few who are like have resting rates less than 1,000

and you know, should be 14 or 1,500,

but all of the biomarkers that we would check

their disease for are normal.

So mitochondrial function is like this real wild card.

So let’s go through some examples.

It’s super easy for men to maintain muscle mass.

It’s easy.

We’re carrying around bigger bodies.

And so we’re sending a bigger stimulus

just by getting up out of the chair, right?

So the muscles are getting more stimulus

with the movements that we have.

We have more testosterone.

It’s easier for us to do.

But still, when men fast,

sometimes their metabolism goes down.

For women, it’s probably a little quicker.

It’s probably a little bit faster in my experience.

And that maybe for all those, the opposite of the reasons I just shared about men, totally risky to be doing fasting for long periods of time.

If you don’t have a body composition scale, if you’re not tracking your muscle mass, if you’re not subjectively journaling your energy and how you’re functioning.

So we do this, we do this, right?

Like let’s say we, what do we have for mitochondrial function?

We measure lactic acid here in the practice.

So we have some people with chronic fatigue syndrome.

When we prick their finger, check the lactate level.

It’s hot, it’s hot.

They’re making too much lactic acid.

It’s like they’re sprinting, but they’re at rest.

The mitochondria are not doing their thing.

There’s probably something up with the mitochondria.

But what if you’re at home?

How are you checking in on this?

Well, you need to stay strong.

Have to stay strong.

You have to keep the muscle mass.

And then also the energy has to stay pretty good.

So the question really is about how are we figuring,

how are we like going through the nuances

of online physician, you know, very like clear statements

like this happens to everyone.

No, we have to like know that that is absolutely not true.

We have some people here who think they’re metabolism

the tank, but it’s actually optimal and they’ve been eating too much for a very long time.

And it’s, you know, it, they’re eating less than what their partner’s eating.

So it doesn’t feel like they’re eating too much, but maybe their partner’s metabolism

is like way different than theirs.

Everyone’s mitochondria are unique, just like the rest of us are unique.

It says these little organelles have significant control over how much energy we’re producing

and expanding.

JANNINE: It’s good that you say that.

And I was hoping that was where you’re going to go with the mitochondria because that’s

where I come down to with a lot of folks.

And there’s so many gurus out there.

You got to fast, you got to fast, you got to do this amount of fast.

Everybody does the same thing.

And I’m like, I don’t find that to be as good of a blanket statement of everyone does

the same thing.

It is individualized.

definitely, you know, toxicity levels, methylation, things of that nature.

Um, I’m guessing you go down those rabbit holes with folks too.

When you’re, you’re kind of looking at someone’s metabolism.

That’s a little wonky when you’re like, huh, what’s, what’s up here?

Tell us a little bit about how those play into someone’s metabolism,

especially methylation.

DR DAVID: Oh, I mean, great question.

Yeah.

I don’t have a ton of experience.

Oh, we do, although I do work in this realm occasionally.

I don’t have enough experience to feel confident in any one statement because I’ve seen people

respond incredibly well to your typical protocols and other people respond incredibly poorly

to what we would call your typical protocols as poor methylators.

I find that it’s really difficult to know exactly what to do for the person in front

to me is so I sort of keep an arm’s length from it.

In my metabolism experience, I haven’t had a ton of need to actually think about the genetics

of methylation only on the hormone side of things, on the detoxification side of things.

But typically the person who’s coming to me needs to know how little to eat and how much

to move and so we make a program that fits that.

On the other part of my day, like the other part of my day, when people have serious anxiety

and they’ve already had the test done, well then I feel like I can comment on it a little

bit.

But other than that, I try to stay away.

JANNINE: It’s an interesting thing that you mention that because I think a lot of folks, when they

feel like their metabolism is broken, they will dive towards the most intricate aspects

of the mitochondria and get in the weeds.

What type of B12 should I be taking?

This and that, I’ve also seen different pathways

of folks going right into IV therapy

to try to reboot mitochondria.

I would love for you to speak to that a little bit too,

’cause I know you said you kind of keep an arm’s length,

but I would love to hear kind of what,

how you’re using IV therapy

and how you explain it to folks about metabolism

and how that plays into things.

DR DAVID: Definitely.

I would say I keep an arm’s length

from the methylation conversation

when talking about metabolism,

but IV therapy I’m all about, it’s amazing.

Yeah, so, but I would say like before that,

the thing that we focus on

when people are unsure what to do for the mitochondria

is cardio.

JANNINE: Yeah.

DR DAVID: Like it’s running.

It’s, if you can’t run, it’s biking.

If you can’t bike, it’s a recumbent bike.

If you can’t do that, it’s a dance class.

It’s like something that you can do for cardio

because that increases mitochondrial function.

Then we have to think about

if the mitochondria has enough resources.

So, you know, I use IV therapy in chronic fatigue syndrome

and for people who have incredibly low metabolisms

and get good benefit from it.

I see it as a bridge.

It’s a bridge to getting enough nutrients

in through the digestive tract

’cause that takes time.

Sometimes there’s damage.

Sometimes there’s inefficient absorption

and we have to work on it and it can take months.

And so IV therapy really is a bridge to that.

We don’t have a standard IV program for everyone.

We customize, individualize the programming.

We go based on how people are feeling

and we try to give ourselves time

to optimize for absorption.

That’s how I approach it.

JANNINE: Gotcha, gotcha.

And see if someone’s digestive system is doing okay

and you’ve done some of the metabolic testing

in terms of let’s say an Oat test,

you know, or a nutrient-eval but you know about something

like that, those of you guys who are listening

that don’t know what I’m saying,

organic acids testing is one of the ways we look

at vitamin and minerals, we look at what the mitochondria

are doing in terms of breakdown

of your fat proteins and carbs.

But when you use this, or you also, in some cases,

supporting with custom vitamins,

using vitamin lab basically, for customization on that,

like someone’s, let’s say a custom multivitamin

or a custom mitochondrial formula for an individual?

DR DAVID: We do it, we do it all the time.

Yeah, I use vitamin labs so much.

Of course, if anywhere is it familiar,

vitamin labs and sponsor my podcast, personalized

and I just love them so much.

We use all the professional brands in our practice,

but we use vitamin lab a lot for those custom formulas

following one of those tests you’re describing.

And I see it as being incredibly valuable.

For one, it saves people money.

And for another, you’re avoiding all the things

that you really may not need.

And that can make a significant difference

for the mitochondria, as you know with the OAT test,

you get to see the organic acids assessment.

You get to see if there’s some imbalance

in the metabolites that would be present, for example,

in your mitochondria.

And what’s happening in the Krebs cycle

is sort of elucidated by this assessment.

And if something is overdone,

if you consume too much of one nutrient,

one of the co-factors, you can find that this whole process is hung up.

Now it’s pretty rare. It’s pretty rare.

This is separate from, um,

this really ends up being separate from the typical weight loss program that we

make 99% of our weight loss, not 99,

90% of our weight loss programs is like pretty cut and dry.

Metabolism is just about normal. Here’s the deficit.

Follow this, get used to these portion sizes

and do it for this number of weeks

and you’ll be good to go.

The other say 10%, okay, there’s something else

happening here that we need to think about.

And sometimes we catch things.

And I love the organic acids test for that.

And I do think that it informs the protocol

really, really well, rather than just saying like,

here’s alkalinity and alpha boag acids and b vitamins.

And AC and CoQ10, just go for it.

We get a good idea of exactly what to do.

And I love that.

JANNINE: Yeah, I find it refreshing to hear that it’s the basics, really.

90% of the time.

And I think a lot of people, like I mentioned earlier, we tend to think, what are all the

things that are broken?

You know, it can’t be what I’m eating.

I’ve tried that.

I’ve done this.

I’ve done that.

And so oftentimes I will get a little pushback from folks when they go, oh, you’re just going

to tell me what to eat and how to eat it.

not going to do it. I’ve done that. So I’d love to hear kind of, you know, obviously you’ve got

the testing to back you up, right? Versus someone just recommending like, here’s your macros,

and it’s off the top of their head, right? They’re just guessing, you know, and I’ll be honest,

like in the beginning of my career, I did do a lot of that because I was working on, you know,

in the fitness kind of realm and we would just kind of eyeball it at first. But you have the data

behind it. So when you have the data behind it and you’re telling folks like, hey, really, it is

just this. Do you also, because I know you have a comprehensive program, are you also

combining that exercise or will you just do nutrition first?

DR DAVID: No, we do both. We do both. Absolutely. Because we want to benefit from the calorie burn during

exercise, but we also want to get fitter. We have this data. We might as well use it.

But I would say even for people who didn’t have the data, let’s say, before I did this,

I just did low carb plants. Like I was holding low carb and fasting for like seven years.

50% of people lost weight incredibly effectively and did so well and it was great.

But the other 50% of people, what is this?

This doesn’t work.

We’re just estimating, we’re just guessing, we’re just trying some restriction thing.

And I feel worse off.

So what am I supposed to do?

So now let’s say I’m in a scenario where I can’t test.

There are situations where we can’t do that.

And how would I counsel someone?

Well, we have the predicted metabolism.

We have the predicted calorie burn.

but we always predict daily activities anyways.

And then we could predict exercise calorie burn,

although treadmill will do it, all the watches do it.

So we can get an idea, we can get a ballpark.

That’s people like a lot of online fitness people,

what they do for weight loss, right?

Is they take your weight, you multiply that by 10,

that’s the number of calories you should eat,

if you wanna lose, multiply by 12 for maintenance,

that’s the kind of thing that people do.

We can take the estimated calorie burn,

but then we can take all the strategies

to optimize for metabolism.

And so let’s go like low hanging fruit here.

I don’t wanna make it sound too easy

because correcting an iron deficiency is not easy.

Nah.

Building an activity pattern, right?

Building this daily movement pattern

that either increases your daily activity output

so we can then estimate higher

or actually is dedicated exercise

so we can add on something new.

That’s not easy.

I was recently talking to someone who Dr. Gupta,

he’s a weight loss physician,

and he talks about activity patterns.

He talks about like, what are you doing?

What are your, what are, what is your daily movement like?

So I compete on the Apple Watch

with 5,000 other people for calorie burn.

That’s the only way I can do it

because I’m an athlete in my heart.

And if I’m not competing, I’m not moving.

I’m sitting behind this desk.

It’s unbelievable.

So we have to figure out what is that thing for you

that is going to get you afterburn.

How are we going to pull this one lever?

That’s not easy, that’s not easy.

Some things are just a given, right?

Like menopause is happening.

Before menopause, the actual loss of metabolism

is really only related to muscle loss.

Like over large epidemiologic trials,

metabolic rates decline with muscle loss

before the age, I think it’s a before the age of 50.

After 50, it’s 1% per year, which is not zero.

This is aside from muscle loss, but it’s not zero,

but it is something.

So I would suggest that for some,

like because that’s an average,

for some people it’s way more pronounced,

it can feel like it needs to be supported.

So we can measure that.

And if we’re not in the office, of course,

we can just take it seriously and act upon it.

So that’s, I don’t wanna be like,

spend this whole time with you making it sound like

It’s really easy.

Just measure and do this, do that.

No, these are things that can be done at home,

sleeping through the night can be worked on.

It has a significant impact on metabolism.

It has an impact day to day.

When people do recurrent metabolism tests,

the actual variability is only 50 calories.

So the tests are incredibly accurate.

But let’s say that’s all other variables the same.

Let’s say someone didn’t sleep through the night

or has a viral infection.

Their metabolism is way different the following day.

Like it’s totally different, the resting rate.

And so we have to consider that other things are happening.

So we can tie all these up.

And it can be very difficult.

You say, “Well, sleep better, but how do I do that?”

Well, that could take like three months to figure out.

But then once we figure it out, it’s amazing

because metabolism goes up and everything becomes easier.

So that’s why I’m saying like,

we could check the boxes, we can go through these.

And just following people online

who feel like they have all the answers,

like I don’t claim to have all the answers,

I claim to have a list of things that could be optimized.

And when we optimize all of them,

I do think things get better

and I have the luxury of measuring

to make sure things get better.

One of the easiest ones is fitness.

We have done so many tests for athletes now.

This whole stream is like taking off.

Everyone wants to know their VO2 max,

which is really cool.

They burn more calories at rest.

Athletes do, their resting rates are higher,

but their calorie burn during exercise is lower.

At a heart rate of 100,

they’re only burning four calories a minute.

Everybody else is burning six.

So it’s very obvious that having this fitness first,

this fitness first thing, where it’s like,

we have this data for VO2 max.

Maybe we should actually try and get fitter first.

Well, we’re gonna get the value of the calorie burn,

whatever, that’s great.

We’re gonna get the afterburn.

But also what’s going to happen longterm

is the resting rate is going to be better.

And we’re gonna be able to challenge ourselves

at higher intensities during the exercise.

And that’s gonna be good for a whole assortment of things,

including hormone.

JANNINE: I think definitely intensity is something that we

overlook, I think in especially in fitness,

it is something that’s overlooked especially

with the hormone status and seeing where someone is

on that level for sure.

And just kind of one of the things you were mentioning

as you were talking about, it’s not easy,

is you would mention a viral illness

and sometimes a lot of folks that’ll have an acute one,

of course, that’ll mess with your metabolism.

But what about the folks who have the chronic reactivated

mono, chronic reactivated CMV, which would be your chronic

fatigue patients, of course, but I will sometimes see people

that have these and they still work out

like on a regular basis, but intensity trashes them.

How would you approach, you know, what would you,

you know, obviously you’re gonna do the same

kind of testing things of that nature.

What would you, let’s say,

what would you say to someone like that

who’s like, I know I have a chronic viral thing going on,

I haven’t kicked it, I need to figure that out.

What would be your approach in that case?

DR DAVID: Well, we measure lactate at rest

and that I think provides a ton of value

because you can then start something that’s

supporting the appropriate macronutrient usage.

So let’s say for example,

where we’re finding someone has elevated lactate at rest

and it’s present on some of the organic gases test as well.

But I like testing with the meter

and just having this live thing.

I think it provides a ton of value

because we can consider the supportive care

for for example fat burning and glycogen usage.

But what are the lifestyle aspects that go into that?

Well, in this scenario, the immune system is overactive

and if we have any challenging work,

then all of a sudden there can be post-exertional malaise

and that really impacts someone.

Well, we have seen people’s metabolisms decline

over time in conditions like this

because of the deconditioning.

Typically when someone has a viral infection

or any sort of immune response or,

let’s say an autoimmune flare,

or even a cortisol response for mental emotional stress.

Accutely, their metabolisms go up.

Chronically, their metabolisms go down.

So we try to think about that

and use the framework we have to be metabolism supportive.

How many people have chronic viral infections

who don’t have a normal iron store.

Like my understanding here is that the chronic fatigue,

the chronic fatigue provincial practice shoots for a fair

10 of 100, like they’re not shooting for 50.

You know, so like I’m more conventionally there,

there are some metrics that are being used to support people.

They test vitamin D here in chronic viral infections.

They optimize for this.

and everybody comes back low.

So when someone comes in and they have been through

this kind of like torturous thing,

we can’t just say, you know, go out and exercise.

We can’t even, we don’t even really do the ramp test

because it’s, it can throw you out for a whole week.

But we do have personalized care.

We’re looking at say the most common nutrient deficiencies,

iron, vitamin D, B12.

And we’re finding that very often they’re not,

what we would call optimized.

And I’m saying optimized partially

from a conventional standpoint

because I know the program is doing certain things

with Farritin and then optimized from a basic lab standpoint,

our labs have vitamin D said our metrics are different

than yours in the States,

but the normal vitamin D is 75.

And pretty much everyone in British Columbia

who doesn’t take vitamin D is below 75.

So, you know, we always find something

that we can be working on.

We do a lot of like nutrient assessments

And yes, we find low carnitine.

Like we find it.

One of the biggest ones is the recommendations

for protein intake.

Like, you know, we have a recommendation here

of decimal eight grams per kg,

but then they want us to exercise for 150 minutes per week.

But then if we’re exercising for 150 minutes per week,

well, are we entering into more of a more

of an athletic requirement for protein?

So we’ve got the Canadian Society for Nutrition

suggesting that maybe an appropriate recommendation

might be between 1.2 and 1.6 grams per kg.

And so we’re like, well, maybe it’s glutamine.

Maybe the immune system really needs a ton of glutamine

when it’s been burdened by an infection.

So we do a ton of amino acid therapy.

Yes, we do the protein therapy.

We make plans so you know what the portion sizes are,

but that’s tough.

Like it’s kind of gross, how much protein you have

to eat sometimes to get your body back in order.

But glutamine can make a big difference.

I feel like I’m a naturopath from the 1990s.

It’s amazing.

It’s so cool.

So all of a sudden now we’re combining glutamine

and D-manos and alkarnetine

and people’s metabolism are getting better.

We do a lot of iodine tests, which is kind of wild

’cause like the main cause of hypothyroidism

in North America is Hashimoto’s disease,

but then we measure urinary iodine

and find that it’s low a lot.

And the thyroid hormones are looking pretty good,

like not too bad.

Too much iodine is terribly toxic

and make a person so sick.

But how cool is it to catch it on a test,

support it and have a person feel a lot better?

Now, I think it’s John Hopkins that says

that 50% of Americans are deficient in magnesium

and health Canada, I think they said recently

at 30% of Canadians.

If we’re not getting enough magnesium,

oh, and I looked at my own requirements for sodium,

it’s like two grams a day.

I’m in no way I’m getting two grams a day of sodium.

these requirements, there’s no way.

The food is deficient in mineral.

We’re all doing certain things with our diet

and trying to get fancy with things

and finding that, okay, maybe we’re fully deficient

in like 10 things.

So long winded answer to say that we always find something

to work on and very often working on that thing

or that group of things makes a big difference.

JANNINE: Yeah, no, I think it goes back to the title

your podcast personalized, right?

And we’ve gotten so far away from personalized.

We have all those one size fits all,

of course, in the modern medical model.

And I think a lot of us are stuck in that thought process.

So we watch different folks on Instagram.

We watch different gurus and they’re telling us

like everybody responds the same.

And I think that’s the most important takeaway.

I really want folks to think about

during this podcast is that we all have individualized

things going down.

And we all have our own different, you know,

deficiencies, different things happening.

Now, when it comes to mitochondria, you had mentioned the, you know,

training and training folks to be fitter and using that as kind of like a jumping

point. And that’s kind of one of my main jams for everybody.

I want folks to consider, okay, so you may be gaining weight.

All right, let’s take the weight out of the picture and really think about like,

Does anyone, you know, on their deathbed say, like, I really

wished I’d lost that 10 pounds, right?

No one’s going to say that.

And I’m sure you have been down this pathway with folks, you know,

I think a lot of folks would say, I really wish I enjoyed my last 10 years

of my life because I could do XYZ, right?

And so at the crux of metabolism work, the mitochondria, ultimately, at

the end of the day, you’re improving mitochondrial function and

helping folks, you know, move forward.

So I wanted to kind of loop it back to that in terms of the longevity side of

things here and why it’s so important to think beyond the,

I want to lose weight for the metabolism.

Speak to that to folks.

Help, help us spread the message of yes, weight loss is nice,

but living a really amazing life is so much better.

DR DAVID: Definitely.

So many things to pull out here.

Like the first is that I’ve taken

all those longevity supplements

and they make me starving.

I can’t, like they make me more hungry than exercise.

If I take NR, Nicketenamide, riboside or CoQ10,

I can’t stop eating.

I just can’t.

I have to keep going.

And so I feel like they’re,

they could have a place,

but for me, oh my goodness.

I don’t know if they’re just really,

I gotta measure my resting rate before and after

to see what kind of impact they’re having on.

But they make me very hungry.

So, well, you know, I come from a town

where there’s like most of our towns.

There’s lots of cancer,

there’s lots of cardiovascular disease.

I work in a practice where I try to help people

prevent those, but I see and I know a lot of people

who have been through chronic disease,

whether it be in my own family with rare cancers

or non-rare cancers, or in my practice, you know,

when people pass away from something that’s preventable, it’s torture, it’s super torture.

So what I try to talk to, what I try to speak to really when I’m making these programs is

the benefit that is that actually is possible. What can you get from this? And part of the thing

I bring it back to is the energy produced, the actual metabolism that athletes have at rest.

Their metabolic rates are higher. They’re actually making more energy. We’re measuring the byproducts.

And they feel good. And it’s difficult to stay in tune with what feeling good actually is

when you have felt bad for a very long time, or you have been sort of like what would be considered

suboptimal. I’m not saying like we’re life hacking our way here. Life hacking life away.

I’m saying like there are some things that can be done that could make a person feel really,

really good and part of that feeling is coming from improved mitochondrial function. It’s actually

mitochondrial function enhancement. And the strategies that are recommended by our

governments are actually pretty good. Like 150 minutes of moderate intensity per week

is a pretty good recommendation. Two and a half hours divided whatever way you like.

The question is, what’s moderate activity for a person? And what would be the detriment of

training less or less intense? And what would be the detriment of training more? How would that

make a physiologic difference? What would that stimulus do? And so I like to speak to those things.

Here’s how we should spend our two and a half hours right now. Let’s do it over here. Let’s

Let’s build two pounds of muscle in two months.

If we do that, you know, then in the next two months,

then we have this opportunity to improve our VO2 max

significantly through two things,

through expressing that muscle at higher intensities

and through losing a bit of weight.

Oxygen consumed per minute divided by your cagey’s body weight.

And then we know now we’re in this different group

and all we did was follow their recommendations.

We’re just dividing up this time in different ways.

If you’re trying to lose weight, walk on an incline

and eat less calories and your burning.

Okay, fine.

We should measure your resting rate afterwards.

By the way, we just had someone lose their first,

we had our first person lose 100 pounds.

JANNINE: Nice.

DR DAVID: 15 months, really cool, so proud of her.

Metabolic rate went down 250 calories, resting rate.

And so they lost 100 pounds of fat,

five pounds of muscle in 15, 15 months.

So pretty happy with that muscle loss.

That’s not bad at all.

They’re metabolic rate went down 250 calories at rest.

And that’s pretty good, you know,

to go from 1600 to 1350 for their height,

1350 is actually normal.

So, you know, I’m pretty happy with that.

Fat is not that active.

It’s not active.

Muscle is incredibly active

and it’s active for a couple of ways.

like it, it, it, you have to move it.

So your body has to make more energy to move it

’cause it’s pretty heavy and it packs in

a ton of mitochondria.

So we can, we can improve the density,

the density of mitochondria.

And when we talk about mitochondria function,

we’re really not talking about the organ systems.

We’re talking about the muscle mitochondria.

That’s really what we’re describing.

So when we think about it that way, like, okay,

the fat is not making much energy in total.

You can lose 100 pounds and your metabolism

is going to be like still normal for your height.

That’s wild.

The muscle mass is doing a lot of the lifting here.

It’s doing a lot of the actual,

it’s having a lot of the actual influence.

And so there’s two things we have to do.

We have to have a normal amount,

which we would call like above the 100th percentile,

basically is what we’re looking for.

I have an in-body scale,

but all the scales have like a normal level of muscle

that you can kind of shoot for.

And the scales at home are fine too,

as long as you’re tracking the trend.

They’re doing the lower legs only, I think.

But the trend is what’s important

if it’s going in the right direction.

Okay, it’s working.

But then, so we have that, but then we can think about

the fact that yes, we’re having to move them,

but also their actual ability to produce energy

is dependent on nutrient, but it’s also dependent

on the signaling, which is quite complex.

Oxygen to the tissues, nervous system, intent,

intending on actually making movements,

all of that comes into play.

So I just love, I love talking about this.

I love teaching about all this.

I think it’s really, really fun.

And people get a lot out of it.

So from a longevity standpoint,

we kind of bring it back to that.

We’re not all going to be athletes,

but it’s a spectrum.

It really is.

And higher VO2 max,

people with higher VO2 maxes typically feel good.

Like they feel really good at rest

and that’s ridiculously important.

So I like to speak to that as much as possible.

JANNINE: Absolutely, absolutely.

‘Cause I think we’re just,

we’re missing the boat a lot, unfortunately,

on mitochondria, on metabolism,

where we’re stuck in the wrong place

and not thinking about where, you know, as society, right?

Unfortunately, it’s all about the weight loss,

but we’re not thinking about all the other cool things

that can happen with our body to really optimize things

and what it could be like.

DR DAVID: Definitely.

You could just be fitness first

and you could be protein first.

You could be doing that.

And it doesn’t have to be meat protein.

My wife’s a vegan, my kids are vegetarian.

I’m a pescatarian.

We’re all about plant proteins.

But when we’re trying to make a change,

whether it be body composition change

or fitness change, it’s easiest if you think protein first

and then build around and then fitness first

and then track hunger and cravings and energy

and go from there.

And that’s been like, I think the biggest insight

for the people that I’ve worked with is like,

if we just keep those two things top of mind,

then it’s easier to stay on track.

JANNINE: Absolutely, absolutely.

Well, I think at this point,

we’ve given folks a really great idea

of what you’re up to in the office

and what you’re doing with metabolism school.

I would love for you to kind of explain

how folks can work with you, how they can dip their toes in.

You know, even like, do you take folks

if they come visit from out of country?

Like give us the story of how it goes and we’ll go from there.

DR DAVID: Definitely. I’m in Vancouver, British Columbia.

People come and see me from all over the world.

People come into the office because Vancouver is quite a popular city to travel to.

But if you haven’t been able to get your metabolism checked or your VO2 max checked

and you’ve got to visit booked with Vancouver, of course, you can see us.

It’s all private, primary care here in the naturopathic world.

So people come all the time and we work with them when they’re in the office here.

For education, from an educational standpoint, I teach continuing education

for the nutrition school.

But I also have my own thing online

that I’m building to try to teach these pillars.

I’m trying to teach the boxes that we need to check.

And that can be found.

The signup can be found at noblenaturopathic.com/metabolism.

So noble N-O-B-L-E, naturopathic.com/metabolism.

There’s a little signup space there

if you want to hear about how we’re going

to be helping people check these boxes,

just from an educational piece.

So that’s really cool.

And then if you want to hear more of what we’re talking about,

of course, my podcast is called Personalize.

And I interview people sort of like you and I.

JANNINE: Yeah.

Absolutely.

And that’s anywhere you can find podcasts to correct.

DR DAVID: It is.

JANNINE: OK, perfect.

I want folks to hear that as well.

Now, you know, I’m always curious, noble, naturopathic.

Where’s it?

Where’d the name come from?

Give us the scoop.

DR DAVID: Oh, we like the ring of it.

It sounds great.

But also, you know, we’re trying to be evidence-based

and we’re really good team members.

So we objective data, check the box, right?

Good team member, good listeners,

the whole group of people here are just like lovely

and very responsive and think outside the box

and are incredibly supportive and holistic.

And so we thought that it would be a good name

for the clinic.

My son’s middle name is Noble and we just,

we just like the ring and it resonates with people

in our office. We have a lot of people who choose naturopathic medicine for their primary care,

because it’s difficult to find a physician here. And people really resonate with it because we

know when to use medications and we know when not to use them. And we’re pretty good at teaching

why we made the decisions that we made. So we thought it’d be a good name to fit that kind of

approach. I like it. I like it. That’s awesome. So folks, if you’re listening to this podcast and

you’re in the Vancouver, British Columbia area. Now you know where to find a primary care

decision that aligns with your mission, but also if you’re struggling with your metabolism,

you’ve got some help here too. And sounds like the cancer care as well. So we’ve got all kinds

of things you guys are up to. And we didn’t even talk about cold laser. That’s probably got to be

another podcast for another time at this point. But these guys are doing a lot of stuff. Check

out their website and that way you’ll see more and I’ll put all the information in our podcast

notes at doctorjkrausend.com. My goodness, so much stuff. So if there is one thing, and I

think you can already set it, but I just want to reiterate it, if someone’s listening to

this and they’re like, I really want to get started on my metabolism right now and see

if I can get like, I’m a leg up before I get a professional on board, what’s one thing

they can do to get started?

DR DAVID: We test people frequently because I’m super interested in how metabolism changes. When

When you train, when you exercise on purpose for just under an hour, you’ll find that your

metabolic rate is higher for the next couple of days.

That may be, in my experience, 1-200 calories higher at rest in the following 24 hours,

maybe a little less than the 48 hours.

But it’s something to work with.

If you think your metabolism is slow, you can boost it a little bit by training every

second day for an hour.

If you get hungry from the training,

you might wanna try a different type of training.

If it’s making you overeat,

it might be something to check in with.

So exercising on purpose.

We’re not talking about the stairs in your building

or walking around.

Those are all really good and activity patterns

are super, super important.

Think about them as activity patterns,

patterns of daily living.

That’s why like competing for calorie burn

on the Apple Watch.

But purposeful exercise, on purpose,

every second day in whatever way you like,

whatever way you’ll do,

and watch your metabolism rise up a little bit.

JANNINE: Awesome.

All right, folks, you heard it here.

You know what to do to get started?

And of course, if you want to continue moving on

with your metabolism,

you can head over to noblenaturopathic.com

and then it’s forward slash metabolism.

If we wanna look at metabolism school.

DR DAVID: That’s correct.

JANNINE: Got it.

Dr. David, thank you so much for coming on.

I appreciate it. 

DR DAVID: Thank you so much for having me. What a great time and great

questions. I loved it. 

JANNINE: My pleasure. 

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