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Mitch: So maybe you've heard about it on some ads or a TV show, or maybe you got a friend who's getting really into it. It's ketosis or the keto diet. And I just have a lot of questions about whether or not it really is as magic as everyone seems to make it sound. So we're going to find out today.

This is "Who Cares About Men's Health," where we try to give you some information, some inspiration, and maybe a different interpretation about your health.

I'm Mitch, and joining us today is Scot. He is the master of BS, and manager of The Scope Radio. Hello, Scot.

Scot: I am looking forward to hearing about ketosis as well. I hear it's a state that's hard to get into, but you can burn some major fat, so I want to find out if that's true.

Mitch: And also joining us is the MD that gives us a little bit of validity. That is Dr. Troy Madsen. Hey, Troy.

Troy: Hey, Mitch. Just a little bit. Don't overstate it.

Mitch: And to answer some of these questions, we have the wonderful nutritionist. Thunder Jalili is back with us to let us know about this particular process.

Thunder: Hi, Mitch. I'm happy to be part of the crew again.

Mitch: All right. So before we get into kind of ketosis itself, how about you guys? Have you ever tried out a low carb diet before?

Troy: Mitch, I'll just jump in right here and say no. I absolutely love carbs, so I can't . . .

Mitch: Carbs are the best.

Troy: Carbs rock.

Scot: Why would you do that to yourself? No, not really. I mean, the lowest I've ever had, I was on a diet called the Zone Diet, which I've heard is a low to moderate carbohydrate . . .

Troy: Carburetor?

Scot: Yeah. I've known people who've tried low carb diets, and they're not nice to be around. That's not just a cliché. That's actual truth.

Thunder: And I have tried a low carbohydrate diet. Very, very short-term for just a couple of days just to see what it was like, what it's like to follow this. Not for any weight loss reason, just more of an experiment.

Scot: Thunder, how did it go for you? What did you learn?

Troy: Yeah, were you super grumpy? I was going to ask that.

Thunder: No, not really. I mean, I still ate a lot of vegetables. Those were my carbohydrate sources. So I probably didn't have the classically super low carbohydrate diet. I mean, I don't think I was any lower than 30%, to be honest. So it was fine. I did it, and then after a couple days, I just wanted to have beans and some other stuff, so I just stopped. But it was mostly just an exercise to see how hard is it to do this? How limited am I from a practical sense?

Troy: And did you feel limited?

Thunder: Yeah, a little bit, I did feel limited. I don't mind eating salads and vegetables, but I don't like passing up fruit. You guys know how I love my smoothies. So I don't like trying to decide, "Oh, I can't put this fruit in the smoothie," and things like that. So, yeah, I felt limited in that sense.

I don't necessarily miss rice or pasta. But it's just when you start cutting the different fruits and beans and things, that's where it starts to get tough for me.

Mitch: So why don't we start the discussion here with what is ketosis itself? For someone who has never taken a physiology course, who doesn't have a degree in nutrition, Thunder, what exactly is ketosis and what does it do to the body?

Thunder: So ketosis is the metabolic state where your body is using fat for fuel. Basically, your liver has this ability to make ketones, which is kind of like a metabolic energy substrate in the liver, makes it in the liver. It can actually do this from fatty acids. To some degree, it can also do it from amino acids, which are the building blocks of proteins.

So your liver makes these ketone bodies, and it puts it into the bloodstream. And then those ketones can be used as a fuel for all the other cell types in your body.

There are a couple of particular types of cells that really need to use glucose, and if they don't have glucose, the next best bet for them is ketones. So it's important to have that. Your muscles can use ketones for energy, as an example.

So any time you're burning some degree of fat or you're using amino acids for energy, you're producing some of these ketones.

And then the last thing is "ketosis" is thrown around so much. Really, there's a window of ketone bodies, the level you can measure in the blood. And if the amount of ketone bodies circulating in your blood falls within this window, you're said to be in ketosis.

You don't have to be in ketosis to lose weight, but a lot of times, if you're doing something from a dietary standpoint or restricting calories, you are going to be in some degree of ketosis.

And you can actually have too much ketosis where the ketone bodies in your blood are so, so high, it can be dangerous, and it can cause an acidosis and potentially cause some harm, but that's pretty rare to be in that state.

Mitch: That's interesting, because one of the things I came across was what they call the keto flu. Have you ever heard of that?

Thunder: Yeah, so that's if you're just too hardcore about it and your ketones are just really high in the blood, and it just makes you kind of feel bad. It's not really the best thing physiologically. I would say that happens in people who really take the keto to the extreme.

Mitch: Bad breath, soreness, nausea, headaches, irritability. It doesn't sound super great to me, but what are some of the health benefits, I guess, of being in ketosis or using ketones? I guess even if you're not eating a strictly low-carb diet, does the body still go into ketosis? And is there any benefit from that?

Thunder: Yeah, you don't have to be in a low carb diet to have ketosis. If you just have a low-calorie diet, you would be tapping into your fat stores and producing ketone bodies that way, too.

There's not really any great benefit or great detriment of ketosis. It's just one of those natural metabolic states that we fall into from time-to-time. And it's just that in the modern context of people trying to lose weight, people will try to use that as a goal, to be in ketosis for an extended amount of time, with the idea that that means they are burning fat. But there's no specific benefit or detriment. It's just something that happens to us.

The only detriment would be if you go too extreme and you have such high ketone levels in your blood that it leads to keto flu, like you were talking about, or other similar bad effects.

Mitch: Would this be, say, maybe a dangerous thing for someone who's maybe diabetic? Or with how low the nutrients are or how many nutrients you might be missing out on from cutting carbs completely, could it potentially lead to vitamin deficiency problems and who knows what?

Thunder: So, in general, yes to a lot of the things you touched on. I'm also going to give Troy an opening here for the diabetes question if he wants to hop in, but for diabetes especially, diabetics can develop a dangerous condition called ketoacidosis, where basically there's just too much ketones, too much acidity in their blood, and it's very dangerous. They have to be careful with that. Troy, do you want to add anything to that?

Troy: Yeah. I was going to say for diabetics, they definitely would not want to do a ketosis type diet. And I'm sure anyone who's dependent on insulin, they know that. They know their carbs, they're tracking those things, and they're adjusting their insulin doses based on that. So to go to a very low-carb diet could be very dangerous.

Number one, unless they adjust their insulin, they could really drop their blood sugar low, which would be dangerous. But like you said, Thunder, one of the things I treat in the emergency department is diabetic ketoacidosis, where patients come in, their blood sugar levels are really high, but that blood sugar is not getting into the cells, so then their body is producing ketones. And exactly like you said, Thunder, they're acidotic. They're nauseous. They're vomiting. They're confused. It can be a life-threatening condition.

So certainly people with certain medical conditions, you would not want to do any sort of a low-carb diet or really be trying to achieve any kind of ketosis.

Thunder: Yeah. Correct. And the treatment for that is a lot of insulin.

Troy: Exactly. Yeah, that's how you treat it. We start them on insulin. We give them sometimes an insulin drip. Sometimes they go to the intensive care unit. It can be a very serious condition, and something I see on a regular basis.

Scot: I'm sorry. I might have just dozed off or something. I'm a little confused. I thought ketosis . . . People do like the Atkins diet or a very low-carb diet because that puts them in the state of ketosis, which helps them burn additional body fat. Is that not true? I'm kind of getting the feeling that that's not the case.

Thunder: No. One of the ways to encourage burning body fat is to do a lower carbohydrate diet, but a lot of times lower carbohydrate diets can also be lower calorie diets. You've got to get the energy from somewhere, so you mobilize your fat stores.

One of the ways of thinking about this weight loss, fat burning, and all these different diets, there are a lot of different ways to get around the same thing, trying to produce some calorie deficit. So, really, you're not comparing the merits of a keto diet to a high protein diet or whatever other diet you want to find. It's not so much that. It's what kind of diet advice can a person follow to produce the weight loss that they want? That's really the question. Not necessarily does it have to be exactly a keto type diet or whatever else kind of diet?

But yeah, bottom line is any kind of low-calorie diet will produce some kind of ketosis because you've got to tap into your fat stores to provide the balance of energy that you're missing because you're not eating as much food. Does that make sense?

Troy: It does, yeah. And, Thunder, along the lines of weight loss, I've wondered how much weight loss . . . I know with a low-carb diet and pushing yourself toward ketosis, a lot of people do see some fairly quick results in terms of weight loss. But my understanding is that a lot of that is water weight and you get ketones in the blood.

And again, I see the extreme of this with diabetic ketoacidosis where they have these ketones in the blood that pulls fluid from the cells into the blood. That's why you often hear of people who, when they have diabetes or when they're first diagnosed with diabetes, are urinating a lot more frequently, because they're losing a lot of fluid.

And I've wondered with these low-carb diets, where you're pushing yourself toward ketosis, how much of that weight loss is truly long-term fat breakdown versus just pulling a whole lot of water out of your body and losing weight because of that water loss.

Thunder: Yeah, that's a great point. There have been feeding studies, clinical trials have been done comparing different diets over longer time periods, like a period of months, sometimes even up to a year. And a lot of times, you look at the graphs of weight loss, and they kind of look the same. There's an initial big drop in weight in the first few weeks, and then actually, the weight kind of comes up a little bit, and then it stabilizes.

So there's definitely an element of what you said, Troy, in there. You have some water loss initially, but obviously, if you stick with it for the long-term, you're going to be also losing some fat. It's just probably going to take a few weeks for it to stabilize at a certain level. You can't say what you lose in the first three days is going to be the trajectory because that's probably not accurate.

Troy: Interesting. And maybe that's kind of self-reinforcing. You say, "Wow, look at the weight I'm losing." But probably, like you said, you're not going to keep losing that amount of weight over the longer term. You're probably seeing a lot of water weight loss, and then eventually, you're going to kind of level out to where maybe it's more realistic.

Thunder: Yeah. You just kind of settle in on an amount of weight loss, and then you hit a point of diminishing returns where, in these studies, people don't necessarily lose any more weight. They just kind of stabilize at a certain level. And then if you want more weight loss to occur, you have to try something different.

Mitch: So I guess to wrap up that idea, is a keto diet worth it, or are there other ways to lose weight? Is it comparable? For me, at least, it just seems like such a lot . . . I mean, we were kind of joking, but I do love carbs. Carbs are delicious.

Thunder: Especially in the form of cookies.

Troy: Sure.

Mitch: Oh, cookies, whatever, sure. But is it worth that amount of . . . are the benefits, the increased potential for weight loss, etc., enough of a difference that would make cutting all those things out worth it, in your opinion?

Thunder: I think with any kind of change in food behavior, you have to land on something that you can stick with. So, yes, you can lose weight following this keto diet. But the question you have to ask yourself is, "Is this something you can stick with for the next 40 years or whatever?" Forty or 50 years. And if you can't, then it's going to be something you do temporarily, and then you're going to stop and then maybe fall back into old habits.

So I'm not a fan of extreme diets of any kind for exactly that reason, because I'm afraid that this is something that people just can't stick with long-term. It's like a short-term fix.

Troy: Yeah, I agree. And again, it's a theme that seems to come up again and again as we talk about diet and exercise and all that. In my mind, too, it's all about sustainability and not just that short-term fix and getting ready for swimsuit season or whatever it is. It's like, "Hey, can you do this for the next 40 years and enjoy it and have this lifestyle that's rewarding for you?"

And I guess if ketosis is, if a low-carb diet works for you, and you're good with that, you enjoy it, then great. If it's something you're doing just to try and lose the weight and looking at as a short-term fix, it just doesn't seem like a great approach.

Mitch: So why do you guys think that the keto diet is so popular, then? I mean, some of the numbers that I was able to kind of pull up were saying that in the last year, 24.5 million Google searches were trying to figure out whether or not keto was right for them. It continues to have more and more people being a part of it. Why keto? Why cutting out all carbs? Why is that the diet of the time?

Thunder: That's a complex question to answer, but I think maybe some of the themes that are involved there are people are looking for some sort of program that they can easily follow that has noticeable quick results.

People are looking for any kind of crutch or help. A lot of times, if an individual is overweight and wants to lose weight, they don't feel great about it and they may be approaching it from a place of desperation. So if they can latch on to something that they see has worked for other people, and they're like, "Oh, all I have to do is cut out carbs. I can do that," I think that has a pretty powerful element.

And then there's also the element of marketing. I mean, not that there's a specific company marketing keto, but there are a lot of lifestyle-, nutrition-, exercise-based websites that market keto is the way to go. So you have also that marketing that's out there in the ethos that is always promoting keto. So that gets people to try it.

And then the last thing I'll say to that is keto diets have definitely been studied. Low-carb diets have definitely been studied in clinical trials. And the general conclusion is they don't work really any better for weight loss than any other diet. But a lot of times, people will see medical research like that and they will rationalize and say, "Well, that's the averages, but I think it'll work for me." And then they're willing to take the plunge that way anyway because they figure there's no harm in trying.

So that's my personal take of some of the things that are involved in keeping keto popular and really any other kind of fad diet or supplement that comes around.

Scot: Hey, Troy, what about the medical benefits of keto diets? I remember on thescoperadio.com one time we did an interview with a doctor that said there was some evidence that showed that for young children that had epileptic seizures, some of them responded really well to low carbohydrate diets that put them in that state, that ketogenic state.

Are there other health benefits that you're aware of? I mean, you'll see it on the web. People will claim diabetes, cancer, epilepsy, Alzheimer's disease. What do you know about that?

Troy: I'll say, in my opinion, and this is purely my opinion, I think the detrimental effects of a low-carb diet are probably greater than the health benefits. And the reason I say that is because I think a lot of low-carb diets lead to higher meat consumption, and primarily a lot of red meat consumption. So, right there, you have the detrimental effects there.

When we talked about that before, there are those rare exceptions where being in a state of ketosis does help maybe some children with seizure disorders.

Certainly, if you have weight loss, and it's a decent amount of weight loss, and you're able to maintain that that's going to help with potentially reversing diabetes, like a type 2 diabetes, and potentially helping with some of those long-term effects of being overweight. But again, in my mind, the sustainability of a low-carb diet I think is just a challenging thing for probably most of us.

And again, I think probably a lot of the protein intake in the form of meat . . . At least a lot of people I know who are on low-carb diets, they tell me they are eating a lot of meat. It's often a lot of red meat. And I think the health effects of that there, you're talking about increased risk of colon cancer, other types of cancers, certainly increased risk of heart disease, vascular disease, leading to risk of stroke, all those sorts of things. So I think it's kind of a mixed bag, quite honestly.

Thunder: Yeah. And if I could just add on to what Troy was saying, too, I think there are certain medical conditions, like you mentioned epilepsy, where this type of very high-fat, ketogenic-type diet may be required. Sometimes people have inborn errors of metabolism and they have to do kind of crazy special diets. Sometimes these patients are backed into a corner, so to speak, because they just may have to do that to move on.

But for most of us who are not in that camp of medical conditions that require it, then I would agree with Troy that the risks are probably outweighing the short-term weight loss benefits.

Troy: Yeah. And I will say anytime anyone asks me, "What kind of diet should I do?" and we say this again and again, I say the Mediterranean diet. The reason I say it is because there are so many good studies out there looking at long-term health effect impacts on heart disease risk, cancer risk, stroke risk, weight loss, and it does the trick.

And certainly, I don't consider it a fad diet. It's a very, I think, manageable, sustainable long-term diet. And it's certainly not a low-carb diet either.

So, in terms of just scientific evidence, that's the one diet that just seems again and again to come up over many years, lots of really good studies published in very strong reputable journals that really show beneficial health effects.

Thunder: Yeah, 100% agree with Troy. And also it's more of a moderate carb diet, and it's delicious because you get to eat a lot of delicious foods.

Troy: Yeah, exactly.

Mitch: Well, thank you so much for joining us, Thunder, and kind of enlightening us a little bit about keto and what it can and cannot do. I guess keto isn't really magic. So thank you so much, Thunder, and thank you for caring about men's health.

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This content was originally created for audio. Some elements such as tone, sound effects, and music can be hard to translate to text. As such, the following is a summary of the episode and has been edited for clarity. For the full experience, we encourage you to subscribe and listen— it's more fun that way.

Scot: Mitch mentioned that he was using a product named Huel to Troy, and Troy and I went, "What?" We had no idea what he was talking about.

Troy: No idea.

Scot: Yeah. And he explained it to us a little bit and then had some questions that we couldn't answer about it, so we thought, "Well, let's get our nutritionist Thunder Jalili on the show."

So this is "Who Cares About Men's Health," providing information, inspiration, and a different interpretation about men and men's health. We've got a good crew here. I love this crew. I love this crew right here. I provide the BS. My name is Scot Singpiel. He provides the MD. His name is Dr. Troy Madsen.

Troy: Thanks, Scot. We love you too.

Scot: And then we have Ph.D. Thunder Jalili. He knows so much about nutrition and how the body processes nutrition and does its nutrition thing. And I know I completely just undersold what you've spent your whole career doing, but let me just say Thunder is really smart about this stuff.

Thunder: That was a great introduction. I'll take it.

Scot: Okay. Yeah, you're great. And then we have Mitch.

Mitch: Hey.

Scot: He's a Hueligan, apparently, I've come to find out.

Mitch: Yeah. There's a t-shirt even that they sent me. It's a whole thing.

Scot: Yeah. So you ordered some of these Huel meal replacement products. Are they meal replacement products? What are they, Mitch?

Mitch: So you hear about them sometimes on podcasts, on some of the tech blogs that I read all the time. They were definitely invented by Silicon Valley tech bros for tech bros. All of the branding and everything is very, very much, "It is the world's number one complete food." It's not a meal replacement. It is a food.

And the kind of concept is that, "In this busy world that we're all in, you don't have time to think about your nutrition, your macros, what you're going to eat. So we have created a product that is a 'nutritionally complete meal' with an exact amount of calories, an exact perfect amount of," according to them, "macro distribution." It's vegetarian. There's supposed to be a ton of nutrients in it. It's all super foods. Who knows what's in it?

And it's okay. It's not the most delicious thing in the whole wide world, but it's okay. I don't know. I just was curious, how much of this is all hype to repackage the old SlimFast-style meal replacements of the '90s to today's tech culture? So I'm glad that we have Thunder on to kind of talk me through this.

Troy: Mitch, I'm curious. Do they market it as this is all you eat? Or you're on the go, you need a quick meal, you eat your Huel? Or is it just, "This is your food. This will sustain you and you will eat nothing else"?

Mitch: So there are a couple of brands out there that are not Huel that I have not tried that do market it as, "This is all you eat." You eat three shakes a day and you're perfect. All the nutrition your body needs. I couldn't really get behind that particular brand because the idea of just drinking a kind of earthy-tasting protein powder . . . It was like protein powder plus dirt plus a little bit of chocolate. Eating that three times a day, slurping that down was not my idea of a good time.

So the Huel and the reason I hopped on the Huel train was they have what is called their . . .

Scot: Is this your next t-shirt, the Huel Train?

Mitch: Choo-choo, all aboard.

Scot: He's in deep, guys. He's in deep. Intervention.

Mitch: Yes. But what I liked about the kind of marketing for the Huel is that they market it as, "This is a healthy lunch to have." They talk about how you can have their breakfast shake and their lunch and then have whatever you want for dinner. It's this idea of, "Don't go for fast food. Have this instead." And I appreciated that more than thinking I was joining some group of people who just don't like food anymore. I do like food. I don't know. I don't get it.

Troy: Well, I've got to tell you, Mitch, and I mentioned this to Scot off the air here, that I used to do a lot of cholesterol testing on people as part of a job I had. And this one guy, he was a tech guy, and I checked his numbers and I was blown away. I had never seen cholesterol numbers like he had. Crazy, crazy low LDL, crazy high HDL. I was like, "What do you eat?" He said, "Soylent. All I'll eat is Soylent." He said, "Totally on a Soylent diet." It was crazy.

Mitch: So he was doing the goop? He was doing the goop all day, and it was . . . Oh, my God.

Troy: Yeah. He was doing it all day, every day. That was all he ate. So he was not doing Huel like you're talking about it where it's like, "Hey, this is your healthy lunch and you can eat whatever you want for dinner." He was going all in. It sounds like some of these are marketing where it's just like, "24/7 this is all you eat." But the numbers were impressive. I will say that.

Mitch: That's crazy. Okay.

Thunder: That sounds like such a boring food culture.

Troy: It sounds horrendous, but . . .

Thunder: I know. It's like the Russian Gulag of eating.

Troy: Exactly. It's just like, "Eat your porridge."

Scot: I knew that Thunder was going to . . . Thunder is very pro-real food just because I think he enjoys the experience of eating real food.

Thunder: And it tastes good. You can make it taste good too. Isn't that a bonus?

Troy: I was going to say Thunder has already referred to me as the metronome of eating. These guys take it to a whole new level.

Thunder: That's right. You can set your watch by the way Troy eats.

Troy: That's right. But these guys, this was something else, the Soylent diet. And it sounds like probably some of these people that are doing Huel 24/7. That's a whole other level.

Scot: Thunder, what's your take on this? To me, my initial reaction is this probably is not good. I don't know. But then I hear what Troy just said. So what's your take?

Thunder: Like you guys, I am kind of a novice to the whole world of Huel and I tried to educate myself a little bit about it. I don't think they're doing anything new, as Mitch mentioned.

Over decades, there have always been food substitutes, meal substitutes, and they're always marketed with the same sort of thing. "You're too busy to make food, so eat this," or, "You want something healthy and you don't know how, eat this." etc.

So my take on it, this is probably not a terrible thing if you want to do it sometimes. I think, overall, the danger . . . I don't know if danger is the right word, but the problem with this sort of thing, in my opinion, is that it gets you really used to reaching for a convenience product to get your meal out of the way and move on to the next phase of the rat race.

I don't know. To me, it sounds restrictive. I've never tasted it, so I don't know if it's delicious or if it tastes like crappy camp food. But that's one of the things that I would wonder about. Would it get boring? I mean, you're all excited, you do it for a few weeks or a month, and then you're totally sick of eating all these lunches because you're rotating between the same five options.

I don't know, but maybe we'll find out because Mitchell is doing the experiment for us. So we'll get some information about it.

Troy: Along those lines, Thunder, too, I wonder . . . There probably are some beneficial health effects. I don't doubt that. I just wonder about the psychology of eating that way 24/7 and what the long-term effects of that are. Is it like being in the desert with just a small amount of water and then you get to the oasis and when you finally get a chance to drink water, you just overdo it and kill yourself? Do you just break down at some point and just go crazy and just eat tons of fast food? I don't know.

Thunder: Yeah, that's a great point. The health thing and then do you just totally go off the deep end because you can't take it anymore with the monotony?

I will say, regarding the health aspect of it, I'm split in my mindset of that. Just glancing at some of the ingredients and nutrition labels, it doesn't look like it's bad from a health standpoint at all. It's just that I wonder if you become reliant on it, does that prevent you from going out and seeking whole foods on your own? Do you get so used to the convenience that then the meals you do on your own tend not to be great because you've kind of fallen off the wagon of cooking and finding whole foods and going down the classic nutrition route?

Mitch: That's interesting because that was the big thing that I was wondering about. We talk a lot about whole foods. We talk a lot about they're the best possible version. But we've also said like, "Eh, if it's frozen, it's okay. It's still pretty nutritious." And this flash dried or whatever it is. It's 100% like camp food. It tastes . . .

Thunder: Yeah, freeze-dried

Mitch: . . . like camp food, but maybe a little bit better. I don't know. Maybe I'm just biased. But ultimately, is the processing or anything problematic for the foods that are in it, the ingredients? Is the nutritional value impacted by the way that it's formulated and shipped and packaged?

Thunder: I mean, the general answer is probably some, but it's hard to answer specifically without taking the ingredients in their natural state before they're freeze-dried or whatever and comparing them to the rehydrated version.

So we're going to guess that, yeah, there's going to be some degradation of some of the vitamins. But who knows exactly how much? Hopefully, you make it up with other parts of your diet as well, or maybe by just eating enough Huel that if the levels are lower, you eat enough volume to make up for it.

Scot: Hey, question for you Thunder. One of the things that you talked about one time was the food matrix that the nutrients reside in, and that makes a difference, right?

Thunder: It does make a difference, but this does seem to be like whole food. So I've got to give them credit for that. They're taking whole ingredients, not just powderized this or that. They're incorporating whole foods, which theoretically would address the food matrix issue.

Scot: All right. So, Mitch, I'm confused. I thought these were shakes.

Mitch: They do make shakes. That is an option you can have. I found them to be gross. That is a personal . . . That is not an official stance for this podcast or our organization. That is just a Mitch Sears opinion. Kind of gross.

Thunder: They taste like wallpaper paste.

Mitch: No, more like . . .

Scot: And that is a Thunder Jalili opinion. Not necessarily . . .

Mitch: Not the podcast.

Thunder: A completely uninformed opinion because I've never even tasted it.

Mitch: Sure. No, it's more along the lines of . . . Have you guys ever had the taste of pea-based protein powder? That weird veggie taste? You mix that with the smell of dirt and you mix it up with some almond milk and that's . . .

Thunder: My mouth is watering.

Scot: Again, why are you doing this?

Mitch: But I don't eat that. I eat the fancy hot and savory stuff. It's like a mac and cheese. And it's got quinoa-based noodles and a yeast-based cheese sauce, right? Or a Mexican chili that's full of lentils and beans and whatever. So it's 100% like the camp food you'd get at an REI or something like that, the kind of freeze-dried, rehydrate type stuff.

Scot: And do they amp up other nutritional stuff by adding additional things to it?

Mitch: That's what they say. They say they're able to increase the amount of plant-based protein. There are 27 vitamins and minerals. It's high in fiber because it's all lentil- and veggie-based.

Troy: Mitch, it sounds like you're going to do this.

Mitch: What? What am I doing? I just have it sometimes.

Troy: Are you doing Huel? I thought you were . . .

Mitch: I'm doing it.

Troy: I thought you were going all in on it. You're doing it. You're actively doing it.

Mitch: Oh, no. I am currently eating some Huel for lunches and I have another one that is some fancy oats that I have in the morning, high-protein oats. It's a similar concept. But it's not like I'm doing it every single day every, single meal.

Troy: Okay.

Mitch: I just mix it in there when I know I'm going to have a busy day or something like that. So I just do that rather than go get a gas station taquito.

Troy: Okay. So it's going to . . .

Thunder: The infamous roller food.

Troy: Yeah, it beats the alternative.

Scot: Yeah. I guess in comparison to that, it's pretty good stuff, right?

Troy: No, it really sounds like it is.

Thunder: In the application that Mitch is using, it's probably fine because he is not living off it. It's not the staple of his diet. Yeah, I don't really see any problem with it.

I think in the grand scheme of things, if you look across the spectrum of people that would be interested in this, maybe you'll get some people who want to make this their meal all the time. And that could have some issues.

I mean, for one, it's probably really expensive, and for two, it probably gets them away from exploring what they could get out of real foods and just gets them locked into this particular panel of meals.

And then as Troy was saying earlier, what if you just get to a point where you're like, "I can't take it anymore," and you just fall off the wagon and just will eat anything because you need a different taste?

Troy: And along those lines too, you mentioned cost, Thunder. Mitch, what are you finding in terms of how much you're paying for a meal?

Mitch: So it ends up being about $3 per meal.

Troy: That's pretty cheap.

Mitch: Maybe a touch more than that.

Scot: That's way cheap.

Mitch: So that's kind of more . . .

Troy: That's really cheap.

Mitch: Yes. They give you a bunch of bags. You have to order a certain amount, so there is a bit of an upfront cost. But yeah, for me to have just a couple of bags in the back, just on-hand, emergency replacement food, it's been nice. It's been nice to have that. I do worry that this feels processed. This feels like a trap. This feels like it's all snake oil or something like that. So I wanted to figure out.

Thunder: Technically, Mitch, it is processed because it's dehydrated and you have to reconstitute it.

Mitch: Yes. But is it killing the nutritional value? That kind of stuff.

Thunder: Yeah. And again, that's difficult to say. There's probably a little bit of a hit with the nutrients, with the vitamins and the phytochemicals, but it's impossible to say how much.

I have a couple of technical questions about the Huel. So you add water and you just throw it in the microwave. Is that how you prep these?

Mitch: Yeah. You put two scoops. They have these little special measuring scoops. If you want to get real technical about it, they give you the exact weight measurements, and then you put a couple of scoops of water, throw it in the microwave for two minutes.

Thunder: So how much food does this make? Are you full? Are you satiated from eating that?

Mitch: Yeah. It's a big bowl.

Thunder: Okay.

Troy: I'm just confused, Mitch. Yeah, I'm just trying to figure out what these meals are, because my initial thought when I heard about this, I thought of Soylent. With Soylent, you're just drinking soybeans. I mean, it's just like a soybean paste and that's what you're drinking.

It sounds like, though, here you're talking about different varieties. They are like camp food, but some have a pasta sort of consistency to it. Others are just protein drinks. So it sounds like there at least is some variety both in the texture and the flavor of it.

Mitch: Oh, yeah. And I think that's kind of what drew me to it. They've got chilis, they've got Cajun dishes, they've got curries, they've got a chicken and mushroom. And they always spell it a little different because there's no meat in any of their products. A tomato and herb. A sweet and sour if you're feeling like you need a little bit of takeout Asian-type food. It's a good mix. They're okay. They're all pretty okay.

Troy: Yeah. For me, for someone who's certainly not a nutritionist, the way you're doing it seems to make sense where you're using them to substitute certain meals. It's not like it's overly expensive. It sure beats some of the alternatives for fast food or quick meals.

And it sounds like, from what Thunder is saying, there's definite nutritional value there. It's not like the freeze-drying process is necessarily causing it to lose a lot of that. So it seems like a pretty good approach.

And talking about it and just looking at their website here, I'm actually intrigued and maybe this will make it into my food metronome. We'll see.

Mitch: Oh, sure.

Thunder: Hey, I'm looking at the offerings, the hot and savory offerings. There are nine. They're advertised on the website. And I think it'd be neat just to real quick look at some of these ingredients, because they do emphasize the whole food thing.

I'm looking at yellow coconut curry because I actually like coconut curry. So they have dried grains, which consist of brown rice and quinoa, pea proteins, flaxseed, coconut milk powder, raisins, desiccated coconut, which just means dried up coconut, yellow coconut curry. So these are all pretty much whole ingredients that you would use if you're making coconut curry.

And then at the end, they have all the other things they add to it to bump up the nutritional content. And what I mean by that is ascorbic acid, which is vitamin C, nicotinamide. Is that in cigarettes? Nicotine? No, that's actually a vitamin.

Troy: No, I don't think it's the same thing. Yeah, nicotine is in cigarettes, but I don't think nicotinamide makes it in there.

Thunder: But it's funny. People will look at ingredients and they have no idea what some of these are because we're not used to seeing these added to food. They have alpha-tocopherol, which is vitamin E, lutein, which is a carotenoid, a vitamin A derivative, calcium, zinc, retinol acetate. So you guys get the idea.

Troy: Interesting.

Thunder: They're basically putting a multivitamin in these products. And every one has basically elements of a multivitamin added to it.

Troy: Yeah, that's interesting to hear that because as I was scanning over it, I got the impression it's a lot of, like you said, whole foods and you're getting the nutrition from that. It sounds like it has that certain component, which is the bulk of it, but then they're adding a whole lot to it as well to get those vitamins in there.

Thunder: Yeah. That's good for the label.

Mitch: I was so sure that there was going to be an "Oh, Mitch, you're ruining everything" episode. This is awesome.

Scot: I'm actually a little surprised too. And this feels like it's becoming an ad for this product, which it certainly is not, right? I'm still skeptical. I don't know why. I find that to be interesting. It doesn't sound like it's expensive. I figured it would be. It sounds like it tastes okay. It sounds like Thunder is reading the label and he is like, "Yeah, this seems all right." Troy is all like, "If you're just using it as a once in a while meal replacement, that'd be fine."

Thunder: Yeah, and I think that's the take-home message. Once in a while meal replacement, this is okay. You could do a lot worse.

I think what Troy and I agree on is that you don't want this to be the foundation of your diet all the time because while you could get by strictly from a nutrition standpoint, I think you miss out on other things. You miss out on trying new foods, trying new sources of nutrients, and the element of extra nutrition you get from fresh things, farmer's market products and so forth. But as a once in a while meal supplement, I think go for it, Mitch.

Mitch: Cool.

Thunder: I can't even really ding them for too much sodium. That's the low hanging fruit. You always bash on frozen foods or processed foods. "Oh, it has too much sodium." It doesn't really have a lot of sodium either. Yeah, as far as meal replacements go, it doesn't look like it's bad.

Scot: All right, Mitch.

Thunder: For me, it would really come down to taste, if I can stomach it or not.

Scot: Why don't you invite us over for a Huel dinner and we could do some taste testing?

Troy: Yeah. Speaking of inviting people for meals, why don't you serve us up a Huel buffet? We can try all sorts of different Huels.

Scot: We could all sit down at the table and then you can get up and you could put it in the bowl and we can watch you use the specially designed scoop to put two scoops of water in your food and then put it in the microwave and you can bring it out. That'd be great.

Thunder: It could be like a bonding food preparation experience like we talk about except with powder.

Mitch: It just feels like a joke on some sci-fi show of some sort where it's like, "Oh, yes, let me reconstitute the meal."

Scot: Who knows? That may be the way of the future. So I think this episode was all about Mitch wanting permission that this is okay.

Troy: Yeah.

Mitch: Yeah, basically.

Scot: Am I getting it correct that you guys are giving him permission?

Thunder: Yes. Mitch, you have permission to have occasional Huel.

Scot: All right, Mitch. Permission granted.

Mitch: Yes.

Scot: Can we wrap up the episode?

Mitch: Absolutely.

Scot: Okay. Thank you for listening and thank you for caring about men's health.

This content was originally created for audio. Some elements such as tone, sound effects, and music can be hard to translate to text. As such, the following is a summary of the episode and has been edited for clarity. For the full experience, we encourage you to subscribe and listen— it's more fun that way.

Scot: Hey, this is Scot from "Who Cares About Men's Health." The episode you're about to listen to developed into two different themes. It was a very organic conversation, but I think it applies to a lot of men. And I want to be sure that you hang out long enough in case you are the second situation that we talk about today.

So this is about two different guys who are trying to lose some body fat. One has made some poor decisions over the past six months, had some stress in his life, that would be me, and had some questions for nutritionist Thunder Jalili, who we have on the show, and also Dr. Troy Madsen.

And then Mitch, who is producer of the podcast, has a different situation. He's been doing the right things lately, but he is struggling to lose his body fat and he's getting very frustrated and wants to know what he should do.

So we talk about both of those things in this episode. Without further ado, here is this episode of "Who Cares About Men's Health," and I hope you find it useful.

You're listening to "Who Cares About Men's Health," bringing information, inspiration, and a different interpretation of men and men's health. Got a good crew here today. My name is Scot. I bring the BS. The MD to my BS is Dr. Troy Madsen. We've got Mitch, and then we also have nutritionist Thunder Jalili. Thanks for coming together today, guys.

This show is about my fatness. I've gotten to a point . . . I don't know if this has ever happened to you guys, ever. Not Troy. It never happens to Troy. It seems like Troy has always got . . .

Troy: Yeah. Right.

Scot: But I don't know. I was a really good weight and then the last semester of my master's came in January and my exercise, my diet fell apart. I was stress eating Reese's Peanut Butter Cups and just anything hand over fist. I got the minis. I don't know if you've ever done this. I got the minis because I thought it's not as much Reese's Peanut Butter Cup as if I get the full-size one, except for then eat the whole bag of minis, which is more than . . . Yeah.

Troy: So how much weight are we talking here, Scot?

Scot: I'm 15 pounds up since January.

Thunder: Wow. That's impressive.

Troy: That's respectable.

Scot: Well, this is how guys are supposed to talk about it. Not like, "Oh, that's concerning, Scot." It's like, "Whoa."

Thunder: You're all man.

Scot: "Good for you." And this is another weird thing about it too. I knew that my weight was creeping up, but then all of a sudden one day, it just slaps you in the face with how bad it's become. And it could be different things. For me, it was putting on a particular pair of pants that I apparently hadn't worn in a while. I'm like, "What's going on here?" I got stuff hanging out.

Troy, do you have something like that that's . . . Have you had an experience like that where all of a sudden you're like, "Wow, this has gotten out of control"?

Troy: Yeah, I have. I've talked about it before. I had a stretch where I did put on a decent amount of weight. From where I am now, it was about 15 pounds more. And it was that kind of thing too, where the pants started feeling tighter. And you just start to realize . . . I was convinced that it was muscle weight, but then it became very clear that it was not muscle weight.

Scot: No, it's not muscle weight.

Thunder: Focused around your thick, muscular core.

Troy: Exactly. That's right.

Scot: That's spilling out like a muffin.

Troy: Yeah, exactly.

Scot: For me, I noticed it was coming on, but all of a sudden, one day, it almost, and I hate to say this, snuck up on me. It didn't, but it did. Can anybody relate to that? Mitch? Thunder?

Thunder: Yeah, absolutely. I went through something like that a few years ago too. Not quite 15 pounds, but I probably put about 5 pounds on and I'm not a big person. I'm somewhat lean, so five pounds was very apparent. And it did sneak up on me. It's the same experience, shorts and pants fitting tighter. And I did the eye test in the mirror and I thought, "Yep, it's not muscle."

Scot: What's the eye test in the mirror? Looking at yourself?

Thunder: When my stomach is starting to come over my belt in different places.

Scot: Yeah. So I just got back from a road trip too, and that was another kind of indicator. I put on this pair of jeans to go on this road trip, and they were just tight and things were hanging over and I was uncomfortable just standing. I'm like, "You know what? I'm punishing myself. These are my punishment pants. You're going to wear this on this 600-mile drive today."

Mitch: Oh, no.

Thunder: Wow.

Scot: "And you're going to live with it. You put yourself here. You're going to live with it." So I drove 1,200 miles total with my punishment pants on.

Troy: Wow. You should have just worn a corset or something. Just go all in. Just pull everything in and just hurt.

Scot: Yeah. Anyway, I'm putting together a plan to get rid of this and I thought, "You know what? I've learned a lot over the couple years we've done this podcast." This has happened to me before. I've yo-yoed in my weight before. It's kind of an ongoing thing.

Thunder: Hey, can I ask a question, Scot?

Scot: Yeah, absolutely. Ask as many as you want. It probably could make it more entertaining.

Thunder: So you mentioned your weight has yo-yoed in the past. Is the 15 pounds within the realm of previous yo-yoing, or is it new territory?

Scot: I am not the heaviest I've ever been. I'm still 10 pounds shy of that.

Thunder: Okay.

Scot: There was one point where I was . . . I'm 6'1". I was 190. I'm a skinny fat guy, so people don't notice it, but I have a disproportionate amount of body fat. And I worked really hard to get that down, and I was down to 165, and it snuck up again on me.

For the most part, if I put on some weight or lose some weight, it's a little less of a swing, but I'm constantly exercising and then not exercising, paying attention to what I'm eating and then not paying attention to what I'm eating. This has been a recurring thing in my life.

Thunder: Well, I would say right off the bat that you're not alone. This is something everybody deals with from time to time. So I don't think there's any stigma against it. It's just that it happens and then you deal with it. So I think you're doing the right thing.

Mitch: Scot, I am so glad that you're bringing this up because I am in a very similar boat and . . .

Scot: Hopefully we're not in that boat together because it ain't floating long.

Mitch: Oh my god.

Troy: It's taking on water.

Mitch: I know. Yeah, I am at this moment in time heavier than I've been in maybe four years, and it's not great. It's not great. And I think it's interesting that everyone assumed it was putting on muscle. I just assumed my dryer wasn't working or overheating my clothes.

Thunder: Defective washing machine.

Mitch: Yeah. Go make sure that the heat settings were correct and that's not . . . Anyway. But it's interesting because the struggle I had was very similar where I've been having a lot of fatigue issues and been going to the doctor's for the last year, working on all this stuff. And we got it under control. But during the rough times, both mentally, physically, etc., I've been putting on the pounds. I eat pretty healthy, but I need to get it off. So I'm excited to hear what your plan is.

Scot: Yeah. Well, I haven't eaten healthy, so that's going to be part of the plan.

Thunder: That's Step 1.

Scot: Yeah. I've maintained some of my healthy habits. My breakfast that I eat has a ton of vegetables. I still eat fruits. My problem, I think, truly was beer, sweets, Reese's Peanut Butter Cups, and everything else. I think I was using it to get myself through that difficult time of doing my master's project. Exercise completely fell by the wayside. So that's where I'm at.

Now, the first thing, Thunder, is during this podcast and just some of the readings that I've done, eating is really the key to this, right? Exercise can play a component, but really, losing 15 pounds of fat, it's diet. Am I correct on that? That's where my focus should be?

Thunder: I'm going to say just partially correct, because exercise is still very important. One of the things you want to do . . . Most people, to lose weight, if they're just looking at the food side of things, are going to try some way of cutting calories. And that's great, but if you cut calories without really exercising, you run the risk of losing some lean body mass. So to avoid that, it's good to exercise and focus on the diet side at the same time.

Scot: Okay. And when you say exercise, you mean some sort of resistance or strength training?

Thunder: I would say all of the above. Obviously, whatever you can do in the context of your work and life balance and all that, and what you enjoy, but all the above. Walking, running, strength training, mixing and matching.

Scot: All right. So this is a mix of what I've learned on the podcast and what I've seen out in the real world. I should come up with a better term than that. I should say on the internet, right?

Thunder: Yeah. That's the real world.

Scot: Instagram, Facebook. That's as far from the real world as it gets. So I've seen this. I've seen that you cannot gain muscle mass when you're in a caloric deficit. My first step to losing some of this body mass is to go into a caloric deficit, right? Below my base metabolic rate. Would you agree with that or not?

Thunder: Well, I would say below what you've been eating, because I would think you're probably eating more calories than you've needed for the last five, six months. And that's one reason why you have some of the weight gain. So first let's target what are your caloric needs and eat to that. And then adding the exercise just to make sure you're preserving lean body mass.

And then there's probably a third component I would add to that. I remember you were a proponent of time-restricted feeding to a certain degree, right?

Scot: Yeah.

Thunder: Have you been doing that the last five, six months, or did that go out the window as well?

Scot: That went out the window. Yep, absolutely.

Thunder: Okay. So I would say bring that back as well. I think with the combination of the three you're going to see some pretty rapid changes, because your body knows what it's like to be leaner as well.

Scot: Okay. So there's a memory thing going on there?

Thunder: Yeah. And you're used to it. Psychologically you're used to it. We're not asking you to do something that's brand new. You know what it is to eat healthy. You've done it before. Psychologically you're comfortable with it. You're comfortable with exercise and you're comfortable with time-restricted feeding. Those are all things you've done in the past. So I think that makes your job easier. It's maybe a little harder if someone has not done any of those things and we're asking them to totally turn their lifestyle upside down.

Troy: And the good thing, Scot, it seems like you've got some pretty easy targets here. Like you said, you've identified you've been eating more sweets than you should. And the time-restricted eating has gone out the window. So yeah, I agree. I don't think you'd want to go below your caloric needs, but it seems like you could definitely cut some calories down to those needs.

Scot: Sure. So let me clarify. I had a BOD POD done one time, which is that thing that they put you in and they check your body fat. And one of the numbers you get back with that is your base metabolic rate. So mine is about 1,700 calories a day, according to that.

My interpretation of what to do with that information is that is the amount of calories my body burns if I did absolutely nothing. That's just to survive if I sat in a chair for 24 hours a day. If I start adding some activity in, then that calorie level goes up.

It was always my impression that to lose weight, what you want to do is you want to have a little bit less than that base metabolic rate. You want to consume fewer calories than that. Thunder, is that true or not? Or really, truly for what I've done, it's just eliminate what I've been doing that's got me here?

Thunder: Yeah. I wouldn't go below your basal metabolic rate or your resting metabolic rate recommendation of calories. I would first focus on reducing the beer intake and the Reese's Peanut Butter Cup intake and things like that that are easy targets. That's low-hanging fruit.

Scot: All right. And why would you not want to go below a base metabolic rate? Is there some reason for that?

Thunder: Yeah, there is. There's actually a good metabolic reason for that. If you cut your calories too much, your body can also defend against that calorie loss and it can reduce your metabolic rate even further, which would make it more difficult to lose weight. So, to avoid that, you don't want to cut your calories too much. You just want to cut out the offending things.

And if you cut out the offending things, you are going to be reducing your calorie intake. It's just not going to go to a level that's low enough that we would worry about it interfering with resetting your BMR, your basal metabolic rate.

Scot: And as a nutritionist, would you also not recommend taking that base metabolic rate, figuring out . . . Because also, on that BOD POD, it tells you, "If you're moderately active, this is probably how many calories you're burning." And that number might go up from my 1,700 to 2,000 or 2,100 calories a day.

Thunder: Right. It all depends on your activity level.

Scot: Would you recommend trying to find that level and eating just below it or . . .

Thunder: That's a good place to start, but again, I guess what I would just focus on if I were you is I wouldn't go out of my way to cut out calories. I'd just cut out the things that I know are bad. Again, doing that in itself may cut 1,000 calories a week out of your diet.

Let's say you have five beers a week. That's like 1,000 calories right there. Let's say you have a bag of Reese's Peanut Butter Cups a week. A week. I'm not saying in a day, right? I'm giving you credit.

Scot: Yeah, you are. A day would probably be closer to accurate, but . . .

Thunder: Do you know what I mean? If you do the math, maybe that's another 2,000 calories. So if in a week's time you're reducing your caloric intake by 2,000 or 3,000 calories because you're not eating the bad stuff, that's calorie reduction.

And then you add to that the time-restricted feeding part of it . . . Maybe let's try to get all the calories in, in a 10-hour period or 11-hour period, and then start off on an exercise program. Give that a couple of weeks, give it two or three weeks, and see how things work out, because that may already get the weight loss going and you don't have to make any additional sacrifices. And I know you won't be messing with your metabolic rate either.

What I think is worse is to say, "Slam on the dietary breaks. I'm eating 1,200 calories a day, and I'm going to hit the gym," and blah, blah, blah. It's like, "Well, how hard do you think you can hit the gym if you're in a semi-starvation state?" And what's that going to do to your metabolic rate?

Scot: Is that a common mistake that people make, what we just outlined there, what I was heading towards?

Thunder: Yeah. I think that crash, aggressive-type, rapid diet is a common mistake. People do it either on their own by just deciding to cut calories like crazy, or maybe they get sucked into some sort of diet plan from a book they read or a website they came across or something that advocates restriction of what you can eat and how much you can eat and things like that. So yeah, that's been for decades or centuries, people have been doing that.

Troy: Yeah. And it seems too, Scot, like Thunder said, if it's so difficult . . . I can't imagine just trying to drop down calories, just a low caloric intake like that. And again, you could maybe do it short-term and then see some dramatic results, but certainly, it's not sustainable. Again, we've talked a lot about sustainability and it seems like it would just make sense just to say, "Hey, this is what I can do. I feel good doing this. I can keep doing it." And I'm sure you'll see results.

Scot: Yeah. I think part of the danger, too, could be if you go a little too drastic, that might only last a couple of weeks. It might be just like, "I can't do this anymore." So you don't get that consistency, which is so important that we've talked about on the show, whether that's what you eat or your exercise. That consistency is super important.

I have another question. So this is a thing I see on Instagram a lot, Thunder, and it comes back to this notion that you cannot lose body fat and gain muscle mass at the same time. And it says that, however, that is possible if you up your protein intake during a caloric deficit.

I think we've already decided I'm not going into a caloric deficit, but I'm curious about that logic. What I read was if you up your protein intake to 0.8 grams per pound, then you can eat less calories than you're burning and you would not lose and you could actually gain muscle mass. Have you ever heard that before?

Thunder: Yeah, I have heard that. There is some truth to it because to gain muscle mass involves resistance training or exercise. And if you're going to do resistance training, you do need a higher protein intake. That's known. So there is an element of truth to that.

So most of the time for people who do resistance training, depending on the intensity and the frequency and all that, we'll recommend maybe they increase their protein intake by 50% or something.

The other part of it, though, is it's hard to reduce your calorie intake that much and still gain muscle mass because you do need energy, you need calories to fuel the muscle, to fuel the process of muscle protein synthesis. So there's definitely a balance of all that. You need insulin to stimulate muscle protein synthesis.

So I would say, going back to your situation, attacking that healthy diet by definition would also make sure that you're getting enough protein. And if you want to increase it a little bit, that's totally fine. That's going to address making sure you're getting quality protein, but at the same time, you're cutting out the crap, the sugar, and stuff, but you're still getting enough calories to allow your body to build muscle in response to that resistance exercise. So cutting too much would probably get in the way of that.

Scot: So we've talked in the past what the average person needs for protein. Refresh my memory what that was.

Thunder: Yeah. So, in terms of kilograms . . . and 1 kilogram is 2.2 pounds, so you can figure out the math . . . 0.8 grams of protein for a kilogram of body weight is the general recommendation for an average adult who has an average activity level, a lower activity level.

And if you add exercise into the mix, then that recommendation progressively increases. So, for example, for resistance training, maybe 1.2 grams of protein per kilogram of body weight is a good goal.

So there's no specific hard and fast rule, but it would be looking at your own personal exercise situation and then picking a target accordingly.

Scot: For me, the downside, though, is trying to get in that amount of protein. It requires you to eat a lot of food that's just like, "How many chicken breasts can I eat?"

Mitch: Ugh.

Scot: And then as a result, if you're eating more protein, you can't eat as many fruits and vegetables or carbohydrates as easily. So that there is a downside for me. I don't necessarily always think about optimizing, but I'd like to optimize that because it's hard consuming large amounts of protein.

Troy: Scot, I've struggled with this as well. Obviously, being a vegetarian, I don't get meat sources of protein, but it seems . . . Thunder, you can help us out here too. There are a lot of other sources you can get. For me, I do eat a protein bar every day and I do have a protein drink, so I'm getting some protein there. But I eat eggs and there's a decent amount of protein there.

I'm taking you up, Thunder, on the smoothie thing. I am a convert to the smoothie now, man. And using the non-fat Greek yogurt in that, that's a great source. So that's where I'm getting my protein now, and I find that provides a decent amount of variety. Yeah, it seems to work.

Thunder: Troy, you hit on so many good suggestions for Scot. Yeah, you can eat chicken breast Scot. Actually, chicken breast has a lot of protein. It has, depending on the size of your chicken breasts, maybe 40 to 55 grams of protein. So that's a lot. If you weigh 80 kilos and you're shooting for 1.5 grams of protein per kilo of body weight, you're looking at 120 grams of protein a day. You may get 50 out of that 120 grams from just a chicken breast, right? So it's not always as much as you think.

And then Troy had so many great suggestions of other ways to incorporate it. And I would, again, harp on the smoothie. You can put a scoop of your favorite protein powder and some Greek yogurt in a smoothie, and that would probably give you 30 grams of protein right there.

Scot: So I hear it's 0.8 per pound, right? That's what I hear on the internet. Not per kilogram. And that's a huge difference because 0.8 per pound is 144 grams of protein, and that is hard to achieve.

Thunder: Yeah, that's hard to achieve. But the 1.2, which is about 100 grams of protein, that's really not that tough.

Scot: Yeah. When you do the kilograms, it makes all the difference in the world. Now I can consider doing a vegetarian diet. I don't have to eat chicken breast all the time. That's an achievable number.

Thunder: Yeah. And also, if you can spread out your protein intake across your meals, that's also beneficial. So that's something to keep in mind. If we're going to shoot for . . . if 25 grams of protein is the amount we're going for in each meal, that would mean if you're looking to gain muscle mass and you want to do that through exercise, you want to have four meals in a day with 25 grams in each meal.

Now, for your purposes, if you're trying to lose weight and you're not maybe necessarily looking for maximal muscle building, you just want to preserve what you have, then maybe you don't have to worry about it as much.

So I would say in the context of time-restricted feeding, shoot for 10 hours of eating, shoot for three meals, try to get around 30 or so grams of protein in each meal, and incorporate your exercise routine.

And I'm assuming, saying that, your exercise routine is not going to be hammering in the gym for three hours a day six days a week lifting weights.

Scot: I think that's another mistake people can make too. And I'm not making that mistake because I don't want to work out three hours a day.

Plus, also, we go in the gym and we're like, "Oh, I've got to lose this weight, so I've got to really pound the weights." And then that's not sustainable because it's not fun for me. I've tried to lift the heavy weight and then I feel terrible and I actually start getting weaker, and I just decided that's not what I'm after anymore. I'm just after doing this to stay healthy, right? I'm not after it to look like Arnold anymore.

Troy: Well, we've got to hear from Mitch. Mitch, you said you're in the same boat. Is any of this hitting home? Is this just stuff relevant to Scot? Scot, I know you love numbers. I know you love counting calories. I'm curious, Mitch.

Mitch: As someone who has consistently struggled with their weight his entire life . . . I was a little chunkier when I was younger. I thinned out when I got tall and then got fat again when I was in a relationship where breakfast in bed was going to Dunkin' Donuts, Starbucks, and a Beto's burrito. Who knew that you could go to multiple fast food chains if you wanted the perfect breakfast?

Troy: That sounds awesome.

Mitch: I know it sounds awesome. But no, it was a bad habit. I'm glad I'm out of that relationship.

But when I hear that kind of stuff, it's weird to me because I have been doing a lot of big changes to my diet. I have counted calories in the past. I do meal prep. I do everything I possibly can and I still can't lose the weight.

The question I wanted to ask earlier, Thunder, was when you said as someone who has been there before, you're telling Scot one piece of advice. For someone like me, who's never really . . . I have been trying to get down to 180 my entire life, right? And it's still a struggle. If someone is doing okay with most of everything, but still not losing weight, what do you tell to them?

Thunder: Well, I would try to look at the bigger picture for one thing, because the main reason why health professionals like Troy and others would say, "You have to control your body weight. Don't get too fat," the main reason is to prevent chronic disease.

Now, from a societal psychological standpoint, we have other reasons we like to be skinny. We think it looks good and it's attractive and all that. But the main biological reason is avoiding chronic disease.

Now, having said that, there is a weight range that's associated with reduced risk of chronic disease. And you can actually find this in different height and weight tables and charts and things like that.

So it's a long-winded way of getting back to your question and saying if your body weight falls within that realm of reduced risk of chronic disease, I would say that the main box is checked. You're in a lower risk category for diabetes and other obesity-related diseases.

What you're really looking for is more that societal acceptance of body weight, and that's tougher, but it's not medically harmful. Do you understand where I'm going with that, Mitch?

Mitch: Yes. But I guess that's the thing. Let me do the math real quick.

Thunder: And you probably don't want to hear that, but . . .

Mitch: I hear all of that, Thunder, but that's my question. I get all of these tests done. I really interact with my health more than I ever have in my entire life. I'm getting my cholesterol checked. I'm getting everything checked, but . . . But, but, but. My current BMI is 30.3.

Thunder: Okay. So you're in the range where it's a health thing potentially.

Mitch: Yes. And that is what is very . . .

Troy: Are you sure you calculated that correctly, Mitch?

Mitch: Sure did. I triple-checked it.

Troy: What's your height?

Mitch: 6'1".

Troy: And your weight is 180?

Mitch: 230.

Troy: 230. Okay.

Thunder: That sounds about right.

Scot: Troy just committed the number one sin. He tried to guess somebody's weight. "Your weight is 180?" "230."

Troy: I heard 180, but you're trying to get down to 180. I'm sorry.

Mitch: I'm trying to get down to 180.

Troy: Yeah.

Scot: "How old is she? Sixty-eight? Forty-two."

Troy: You just don't guess. Yeah.

Mitch: So I guess that's the thing. All the tests are saying that my cholesterol levels and everything are just fine, but every single doctor visit I go to, the little system automatically lets the doctor know to remind me, "You should probably lose some weight."

But I'm eating, I haven't been exercising as much as I did in the past, but I am getting back into it. Am I really unhealthy or am I just fat?

Thunder: So right now, you're a fairly young man. As you get older, the weight will be more of an issue when it comes to those numbers. You're talking about cholesterol, sugar, and so forth. So, yeah, I guess it is best to get ahead of it and try to lose the weight now.

Some things I would point you towards we also talked about with Scot. Have you tried the time-restricted feeding approach? That would be one thing.

Mitch: Okay.

Thunder: And if you haven't tried that, I would try that. And then I guess I would also look at . . . it'd be nice to do a dietary analysis on you to see exactly what your average intake is. How many calories are you eating? What is your nutrient status? How many grams of carbs and so forth are you eating? That would be the place to start.

Mitch: I'll just send you my last four weeks of calorie counting that I've been doing. And we can explore as to why I'm still putting weight on.

Troy: So you've been keeping a journal, a calorie journal on what you've been eating?

Mitch: For months.

Troy: For months? Wow.

Thunder: Well, what I would actually say, Mitch, have you ever done a dietary analysis, like using software to analyze your diet?

Mitch: No, I haven't. Just the calorie counting and the macro factoring.

Thunder: So since you're already into keeping a log of what you eat in calories, doing an analysis is actually pretty simple. What you do is you just keep a journal of all the food and beverages you consume, and you have to make sure you get your portions correct. And then, say, keep a four-day dietary record or something or a five-day dietary record.

Then use diet analysis software. You enter in all those foods and the amounts, and it'll spit out your average daily calorie intake, the amount of all the different nutrients you're eating, the grams of fat, grams of carb, grams of protein, grams of added sugar, etc. Very detailed analysis.

We do these in some of the classes I teach, but I think there's also online diet analysis software as well that you could access.

So I would say that would be a great starting point. Let's really see what your intake is instead of just guessing that it's good or that it's bad.

Mitch: Sure.

Troy: Do you have an idea of your sugar intake per day, added sugars?

Mitch: It's super-duper low.

Troy: It's super low? Wow.

Mitch: I make all my foods these days.

Troy: Wow.

Mitch: Yeah, I know. I don't know. It's one of the things that I have trouble with when I see things online and sometimes when we have these types of discussions and stuff. It's like I guess I'm obese. I don't think I look obese. Is BMI real or whatever? And then it's like I'm . . .

Maybe the analysis is what I need to do, but I've weighed my food to make sure my portions are right. I've switched to different lower versions of one thing or another. I'm trying and I don't seem to be making much progress.

Thunder: Mitch, have you ever done a body composition test?

Mitch: No. I keep putting off getting in one of those BOD PODs.

Thunder: I think you need to do that as well. The BMI is a reflection of body weight for your height, for your stature. It doesn't really discriminate if that extra body weight is muscle or fat.

And it goes back to what we were joking about. "You mean it's not muscle?" But joking aside, there are some people that just naturally are more muscular for their stature. So why don't we do a body composition to see where you're at with that as part of the overall assessment?

Mitch: Okay. I can do that. I think it would be important to know. I think I need to . . . Something is not working.

Scot: And you sound super frustrated.

Mitch: Well, yeah, and I feel like I'm now taking over the episode. It's, "Scot is feeling fat," and then it's like, "No."

Scot: Yeah, you did. It was supposed to be about me today, but Mitch made it about himself.

Mitch: No, I didn't mean to.

Troy: Well, Scot, yours sounds like you've got some low-hanging fruit. You've got some easy stuff. Hearing Mitch's story, I'm frustrated too. I'm just like, "Wow. What do you do?"

Scot: I know. Yeah, exactly.

Troy: But the dietary analysis, something with a dietician, like Thunder said, the BOD POD, those all sound like great ways to go next. And I think we probably have people listening who are in both boats, who are like, "Yeah, I'm eating too much sugar. I could cut that." And then people maybe who are in your situation, Mitch, where it's just like, "Hey, I'm doing it. I'm doing time-restricted eating. I'm not taking in extra sugars," and they're still just not losing the weight. So it's nice to know where to go from there.

Scot: And is there a troubleshooting kind of . . . It's not called troubleshooting, I don't think, but is there a process, Thunder, that you would then go through for somebody who's in a situation like Mitch? The next step does sound like to do a nutrition analysis and get a BOD POD. With that information, where would you go from there?

Thunder: Yeah, there's definitely a process. A good dietician could take you through that. At the University of Utah, we have Peak Health and Fitness that also does fitness testing and BOD POD, and they can recommend you do a dietician. They help people get this sort of data so a plan can be crafted to let them meet their goals.

So, yeah, there's a process, but you find out what's your nutrient intake, what's your requirements, what's your basal metabolic rate, what's your body composition, and then you go from there.

Scot: I have one last question for you, Thunder. And this is for people like me that have an idea of how many carbs they might be consuming or fat. Is there a percentage of my calories that you would recommend be carbs? Or just eat the number of grams of protein I need and then fill in the rest with good fats and carbohydrates? What should that breakdown look like?

Thunder: I'm just going to give you some super general carbohydrate windows, and there are a lot of customizations that can be built into it depending on your exercise and your preferences and all that.

If half of your calories come from carbs, that's plenty. The others you can fill in from fats and proteins. If less than half come from carbs, 40%, 45% is totally fine also.

And I will add . . . I wanted to give one other thought just to keep in mind, for you, especially, Scot, because you're in a situation where you've had this gradual weight gain and now you're all ready to lose it.

Scot: Oh, yeah.

Thunder: Gaining weight took a while, right? It didn't happen in three or four weeks. It took five, six months, right?

Scot: I'm not falling for your Jedi mind trick. I know where this is going.

Thunder: Yes. I'm saying patience, young Jedi. You're not going to lose all the weight you want in three weeks, right?

Scot: All right.

Thunder: It was fun to gain weight. You took your time with it. Everyone had a great time. Now you've got to be patient with the weight loss. It may take a couple or three months.

Scot: All right. I'll be patient. Do you have any final questions, Mitch? Any final thoughts, reflections?

Mitch: Maybe, just maybe the general approach and advice is not working for me, and I need to go talk to someone who knows stuff and get tested and figure it out. I need to get over the idea that I can just fix it myself, and maybe I need a little bit of help.

Scot: All right. Well, we'll follow up, Mitch, you and I.

Mitch: Yeah. We can do this.

Scot: It sounds like we have two different situations.

Mitch: Sure.

Scot: In a few weeks, I'll report back and let you know how things went. I'm going to take the balanced approach that Thunder suggested. I'm not going to go into some sort of caloric deficit, which I think is the natural reaction any time people want to lose weight. I'm going to admit that it takes some time.

I'm also being kind that I ate a lot of Reese's, as you like to say, Thunder. I think that's cute that you call them Reese's instead of Reese's. I ate a lot of those, and sometimes coming off sugar can be really hard, right? So the first couple weeks, eat generally healthy and if I have a couple of those, that's fine. Some people might not work that way. They might have to just cut it out completely. But I'll take that balanced approach. I'll try to exercise every day and we'll see where I end up.

Thunder: Yeah. And if you have any extra beer in the house you want to get rid of, just send it to me.

Scot: Okay. Well. Thank you so much for listening, and Thunder especially, you're just such a big-hearted guy to help me out like that. Thanks for caring about men's health.

Thunder: Great talking to you guys. Thanks for talking about men's health too.

This content was originally created for audio. Some elements such as tone, sound effects, and music can be hard to translate to text. As such, the following is a summary of the episode and has been edited for clarity. For the full experience, we encourage you to subscribe and listen— it's more fun that way.

Scot S: Time for a Listener Scot update. We met Scot back in July. He said he was a little bit overweight. His blood pressure was a little bit high. He felt like he was active enough, but he wanted to get things a little bit more under control, so he asked us what we thought. And boy, did we tell him what we thought.

So, today, it's our Scot update episode. How is Scot doing, and are there some lessons that anyone trying to get a little bit more healthy, lose a little bit of weight, or try to affect those numbers can learn?

This is "Who Cares about Men's Health," providing information, inspiration, and a different interpretation about men's health. I am Scot Singpiel. The MD to my B.S. is co-host Dr. Troy Madsen.

Troy: I'm here.

Scot S: You sound so happy about it too.

Troy: Present.

Scot S: Producer Mitch is in the mix.

Mitch: Hey there.

Scot S: We've got Thunder Jalili, who is our guy that has a PhD in eatology. He's a nutritionist extraordinaire.

Thunder: Hi, everyone. I'm happy to be here, unlike Troy.

Scot S: Good.

Troy: Thanks, Thunder.

Scot S: And our guest today is Listener Scot. How you doing today, Scot?

Scot: I'm doing all right. I'm glad to be here.

Scot S: All right. So, Scot, when we left off back in July, which was when we talked to you, what was the plan of action that you took away from our conversation so you could work on your weight and your blood pressure, which was just a little bit high?

Scot: So the primary takeaways that I had were, one, I really need more minutes of exercise per week, hopefully getting up there towards 30 minutes a day, as well as go talk to a dietitian. So those were the two big things.

There was another one of like, "As you're doing your desk job, make sure you get up and do some exercises. Sit on an exercise ball, if you can get one, for a couple hours a day." So there were those ancillary things as well, but that was my main "This is what I can do at this time."

Scot S: All right. And how did it go on any of those things?

Scot: So, with the exercising, I did quite a bit more as far as more frequently, as well as different things. So I did a lot of running and biking before, and I tried to do more inside cardio. Not really weightlifting, because I don't really have big weights or anything. My body is heavy enough. But that didn't last too long because I just hurt all day every day, and realized that, at very least at this time, I cannot maintain that frequency and duration of exercising. And so I cut it back. I am currently more than I was when we originally talked, but not as much as 210 minutes a week.

Scot S: Okay, so 210 minutes. So you were doing consistently 30 minutes a day at that point?

Scot: I sure was trying. It certainly felt like 210 minutes. And it might have been "instructions unclear" type thing, where I was under the impression that it was 30 minutes of sweating. So a casual walk down the street wouldn't have counted towards my 30 minutes. And maybe that's one of the places where I went wrong.

Thunder: I would actually think that 30 minutes of sweating is a good guide. And you can sweat when you walk as well. It depends on how fast you walk, or whether you're walking uphill, so it doesn't necessarily mean you're maybe out there sprinting for 30 minutes.

Troy: But it sounds like doing that, though, you were feeling it. You're talking sore muscles? Are you talking injuries? Or what did you experience exactly?

Scot: So mostly sore muscles, kind of sore joints. I did notice that the more strength training that I did, the less my knee bothered me as far as, "Hey, if you do a bunch of squats, when you go running, your knee won't hurt you as much." And so I did notice that that improved. It did not go away, but it did improve considerably.

Troy: Interesting. But it sounds like at this point, though, at least you're doing more than you were doing before that.

Scot: Yeah, that's kind of what the exercising happened with. The big things are my weight has gone down. So I was almost consistently like 180 every morning. Well, every morning that I measured. And now I'm generally down somewhere around 177, but it's kind of plateaued there for the last three weeks or so. So it's been an improvement. It went down a little bit more than that when I was exercising a ton, but I just couldn't maintain that.

Scot S: Hey, Thunder and Troy, one of the words that Scot did not mention when he talked about his 30 minutes a day is intensity. And it sounds like maybe the intensity was a little too much too fast. What do you guys think of that?

Thunder: Yeah, I think that's maybe one of the factors. The other thing I was trying to get a sense of, Scot, how long did you give it the 30 minutes of sweating a day before you felt that you were too sore and you can't keep it up? Was that a couple of weeks? How long did that happen?

Scot: Yeah, it was probably about three weeks.

Troy: And remind me again, what exactly were you doing? You said biking, maybe some running?

Scot: Yeah, mostly biking, running, and then kind of strength training. There were definitely some days when heavy yard work would have counted, things like that. But generally, it was sweating. And when I went running and when I went biking, it wasn't really like, "Okay, I'm going to sprint. I'm really going to work hard." It's like, "No, I just want to actually run. I don't want to do the slow foot shuffle."

Troy: So it sounds like intensity was pretty high, and it sounds like . . . Did you ramp up pretty quickly to 7 days a week, 210 minutes a week?

Scot: More or less immediately. I mean, that might have been part of the problem, but . . .

Troy: Yeah, that might have been a part of it.

Thunder: Yeah, I think so. I see where Troy is going with this, and I kind of agree with that. Maybe you started a little bit too fast. There is definitely a little bit of ramping up. Makes it easier to stick to things.

Scot: That might be a part of it. I have noticed throughout my life that recovery from exercise has generally taken longer than it seems to take my peers, which might come up again in part of my dietitian story.

Thunder: So just real quick, one of the things I see fairly commonly in the gym with my friends and other people who start working out is sometimes they'll start out pretty hard, have a bunch of exercises they're going to do, they do three sets, they don't think about their weights. They do that, and then the next day and maybe the next few days, they're crippled.

So there is something to be said for starting slow. And to be honest, if you're going to do a weightlifting routine, it may take you actually the full three weeks to start slow and build up to the point where you're doing three sets of something with the weight that you want to try.

Scot S: It might even be longer than that, Thunder. I mean, I've lifted weights before too. It's amazing how easy it is to get sore if you're not careful when you're first starting out. It could be a couple of months of just doing some easy weight training exercise with some light weights before you start ramping up. I know that makes a huge difference for me, because I've done that, what you said your friends have done in the past, and then it just comes to a screeching halt because I don't want to do it anymore.

Thunder: Yeah, exactly. And that's the downside, is jumping in too fast becomes a disincentive because now you're like, "Oh, I'm hurting all the time. I'm sore. I'm tired. This sucks."

So I guess bottom line is I would say don't give up on it, Scot. Try to incorporate some of that stuff in there. It's totally okay to kind of start easy and slow for a few weeks so you don't go through that disincentive of being too tired or too sore.

Scot: How much does that apply? Before we talked the first time, I was already running a 5k or an equivalent to a 5k two to three times a week. And then it was like, "Okay, I want to try and do six to seven times a week." It's not like I was a couch potato to 210 minutes a week.

Thunder: If you were adding weight training in there, maybe you run three days a week, and you do three days a week of weight training. But those three days you do the weight training has to be a very slow onboarding process, so to speak.

Maybe it should take you three, four weeks to get to the point where you're doing . . . If you have five exercises you want to do in the gym, and you're doing three sets of each, it'll maybe take you three weeks to get to the point where you're doing three sets of each, if that makes sense. And you keep your running, but just two, three times a week. Doing both every day will take more than 30 minutes and you'll definitely be sore.

Scot: Yeah.

Troy: And if you look at it, too, essentially you more than doubled what you were doing. So you said you were doing two to three times a week, and you went up to, it sounds like, seven days a week. So that's a big jump.

Scot S: Yeah, it is.

Troy: And maybe a 20% increase, and then you give it a month and see where you are, and another 20% increase. Again, the great news is you're better off now than you were then. You've lost some weight. You're exercising more. What's your minutes per week right now?

Scot: Probably around 100, 120 of solid sweating, not counting the leisurely bike rides, walking, mowing the lawn, stuff like that.

Thunder: Well, I think leisurely bike rides should count also because . . .

Troy: I do too, yeah.

Thunder: . . . you may not know you're sweating, Scot, because if the breeze is blowing on you, that sweat is evaporating, so you don't really know.

Scot: Well, sweet.

Thunder: Now, what are we up to? What are the minutes?

Scot: That easily adds another 60 minutes, easily.

Troy: Nice. I was going to say I love it. You've truly embraced the Matthew McConaughey Rule. You're going for the sweat. It may be 15 degrees out, but you're going for the sweat. So maybe the better rule is just getting your heart rate up. And sometimes that old Matthew McConaughey thing, he's like, "Yeah, I just break a sweat every day." But I'm sure he has personal trainers, and dieticians, and all that.

Thunder: Troy, it's a lot easier to do when you live in Texas.

Troy: Sure is. He just walks outside and he breaks a sweat. But yeah, I think maybe just looking more stuff to get your heart rate up. And a bike ride, that's going to get your heart rate up, pushing a lawnmower around, things like that. So I would definitely give yourself credit for that time you're investing as well. That's all definitely stuff that's . . . That's exercise, no doubt.

Thunder: You mentioned, Scot, you lost a few pounds, but you kind of seemed to downplay it, like maybe it's only about three pounds, or four pounds, or something. I think that does make a big difference, especially if that's weight that's come off of the abdominal area. If you're thinking about long-term chronic disease risk, that's what increases risk for people, is weight around the abdominal area. So think about that. And maybe three or four pounds has been a really positive change in that regard.

Scot: Yeah, every little bit counts. And I have noticed that my exercise shorts have more of a tendency to low-ride now versus in the beginning. So something has happened.

Troy: Something has changed.

Scot S: Yeah, I think sometimes we can get this twisted perception of what success and progress is. I know for a while on my Facebook feed, I had numerous people that were way overweight, like I'm talking 100 pounds or more overweight, and they're losing 5, 6 pounds a week. Everybody is talking about how great they look. And it was always really frustrating, because I'm a skinny fat guy, so I could lose five pounds, it could be pretty significant, but nobody had ever noticed. Nobody had ever celebrated. And that's just as much of a win for me as five or six pounds was for somebody else a week.

So I think sometimes we get a little bit of a skewed . . . the shows like "The Biggest Loser." You think you have to have these huge changes so fast. That's just not necessarily always the reality, and those little small ones should be celebrated.

And then you also went to a dietitian. What was the goal of going to a dietician, and how did that play out for you?

Scot: So that story is a little bit longer. But the goal of the dietitian was really to see how foods might be hindering me from reaching my optimal goals. If there's something that's fairly easy to cut out, let's do it.

And so I went to a dietitian. For what it's worth, I was able to get my insurance to cover it. All I needed was a note from my doctor that said, "Yes, the last time he was in here, his BMI was over 25." And that referral was enough. I don't know if that's valid for everyone, but it worked for me.

Thunder: That's a really great thing to bring up, because I think that's a message a lot of people need to hear. Sometimes people don't want to pay for that counseling out of their own pocket. So to have it covered with insurance is fantastic.

Scot: Yeah. Well, one of the things that made a lot of sense . . . So I met with the dietician three times, and the first time, they said,"It's interesting that people are willing to go to the dentist every year, but not to a dietitian." And that made a lot of sense to me as far as like, "Hey, check in." We usually go to the dentist, and all it is, is, "Yep, your teeth aren't falling out yet, and you still aren't flossing." The dietitian could be more or less the same thing.

So from first appointment, we sat there and kind of discussed what am I wanting out of this, a little bit of weight, a little bit of blood pressure. And so we talked about four different possibilities. Essentially, there might be some food that is mildly irritating to my body.

The four things that we discussed were cutting out gluten, cutting out dairy, cutting out eggs, and then adding a bunch of probiotics. And so I sat around for a couple days and thought, "Which one of those would be easiest to do?" And we decided to try gluten. So I did a two-week no gluten thing, and essentially nothing changed.

But while I was doing the gluten thing, I kind of realized, "You know what? Maybe there are more things that I need to talk about with the dietician because my digestive health could be a little bit better." So I went back said, "Hey, the gluten thing didn't work out. My digestion hasn't been great, so let's try the probiotics next," and we talked about it.

So I went out. I did a little bit of kefir with breakfast and dinner or dessert, and then some sauerkraut with lunch. Did that for two and a half weeks, and there was a little bit of difference with the digestive health, but generally nothing else seemed to change.

Troy: And help me out here, Scot, when you're talking digestive health, are you talking your stomach feeling unsettled, or are you talking just having regular bowel movements? What exactly were they going for there? I'm just curious what led to that.

Scot: Stool consistency was kind of what I was going for, or regularity.

Troy: So you were kind of feeling constipated, and they said, "Let's try something and see if this helps out," and trying probiotics, that sort of thing?

Scot: Yes, except I'm generally on the other end of the spectrum.

Troy: Oh, okay. So maybe a little too frequently?

Scot: Yeah.

Troy: Frequent visits? No shame in that. I'll readily admit I've had issues with that as well.

Scot: But like everything else, it isn't terrible. Everything that I have is perfectly livable. But I've realized, "Oh, let's talk about it. Maybe this is something else."

Troy: Good.

Scot: And so it's kind of the theme here, that there's some idea of, "Hey, go to the dietician." "Oh, I'd never thought about that." "Try the gluten." And while I'm doing the gluten, I realized, "Oh, wait, maybe I should be considering more than just weight and blood pressure. Maybe digestion too," and kind of opened up the scope of what I'm considering for "What are my measures of health? What is affecting my quality of life?"

Troy: That's an interesting approach, probably different than . . . when we mentioned the dietitian, I think we were thinking more some of those hidden sugars, things like that. But you were really going to them more targeting that, and just trying to feel better digestion-wise, where maybe your stomach didn't feel so unsettled, or you weren't having such frequent trips to the restroom, things like that.

Scot: Yeah, but that was the second thing. I tried the gluten first, which was supposed to be the blood pressure and whatever. But while it was doing the probiotics, I was sitting there thinking, again, about, "Huh, I wonder what is the power of dietitians and whatnot?"

And I had seen somewhere that sugars can affect mood. And so my scope creep opened up a little bit more of, "You know what? My mood could be better." I find that I tend to ruminate. Another thing with sugars can be associated with soreness after exercising. And so I'm like, "Okay, whatever. I'm going to try that."

Because of scheduling conflicts, I wasn't able to see the dietician right after the probiotics thing, so I decided just by myself, "You know what? I'm going to try and cut out everything sweet," including maple syrups. Essentially anything that is sweet and easy to cut out so I'd do it. So my pancakes were peanut butter and bananas, which is not as satiating as butter and syrup and everything.

But I found out that that has almost completely removed all of my rumination. If something negative happens to me, or I find some bad news or something, it doesn't ruin the rest of my day. I mean, it's still bad, I'm still sad, or whatever about it, but I'm able to be like, "Okay, that's great," and move on, which is a really surprising outcome from our original conversation. It might not be correlated. It might be because I've been exercising so much more or whatever, but currently, that is what I am experiencing, which is surprising.

Thunder: That is also an exercise effect, because regular exercise is known to be one of those things that helps people deal with stress and improve their mood. One thing I would ask, Scot, is how long have you been doing the low sugar/no sugar diet?

Scot: So I cut out the sugary cereals before we talked. I did the math, and low-balling it, I was probably consuming as much sugar as is in half a can of soda every morning just in cereal. So that probably had an effect. But the actual cessation of sugar was about a week and a half, close to two weeks ago, and I noticed the rumination benefits within a couple days of stopping.

Troy: Have you seen a tie in there, Thunder, with sugar and maybe some of the mental health benefits, or some of those things he's mentioning?

Thunder: I don't really know what exact ties are maybe in sugar consumption. Like everything else, it's probably related to the amount you're consuming. I mean, I'm not discounting what Scot is saying at all. Just right now on the spot, I'm having trouble kind of drawing a pathway in my mind to try to explain it, if that makes sense.

Scot: So I did talk with my dietician yesterday. That was my last appointment. I brought it up, and she more or less said, "That's great. I have read that high sugar has been associated with depression, and so maybe this is kind of the same thing. I don't know. But if you're seeing benefits, hey, that's great."

Thunder: High sugar is associated with so many negative things, but the key is how do you define high sugar? What level is high sugar? Scot, I'm not sure really how much sugar you had. I mean, it sounds like in breakfast, you would probably have about 20 grams of added sugar or more. Yeah, it's a fair amount. But I don't know in general, your diet, how high was it?

There are tons of studies that show if you feed high sugar, where you get to the point of 10% of your calories to 20% of your calories, that does have specific physiological problems that develop.

I'll give you just one example. If you give someone's calories, say, 10% to 20% of their calories in the form of sugar, their LDL levels go up. LDL is the bad form of cholesterol that's in your blood. And not only that, the type of LDL that's produced is the more atherogenic type. In other words, the type that's worse for heart disease. But that happens with 10% to 20% of your calories coming from sugar.

So taking it back to you, I don't know where you would fall into that scheme, because I haven't seen your diet. And I'm sure there are other connections as well with sugar. I'm just more familiar with the heart disease and obesity issues around it, and also the blood pressure issue. That's another thing. Sugar is known to increase blood pressure and increased risk of cardiovascular disease.

Scot: Yeah. I mean, this is all a great big experiment on myself. I know that I'm probably similar to most people, but I'm also unique in my own ways. And I still need to find out if all of this is just coincidence, or if it's actually correlated, because there are quite a few nights that I'll be laying in bed and tell my partner, "I really just want a cake."

Thunder: Join the club.

Troy: I hear you.

Scot: Not a piece of cake. I want the whole cake.

Troy: "I want a cake." I get it.

Scot S: All the cake.

Troy: Just bring it.

Thunder: Well, everything that's positive that's been happening, it's great. But I think all of us can't fall into the mistake of trying to put the finger on one thing. Because you know what? A lot of this comes back to basically healthy lifestyle. What's part of healthy lifestyle? Trying to get some exercise, trying to find a way of dealing with your stress, trying to eat healthier.

So we may not have to identify one specific dietary change, but the fact that you're changing multiple things and you're having a positive benefit, that's the important take-home message.

Scot: Yep. And that is similar to what the dietitian was saying, of every time we cut out something for a couple of weeks, we gain information. You gain the information of, "If I don't eat this, I see these benefits." And if at any point in time those benefits are worth cutting it out, go for it. That's kind of how I viewed everything, and will go forward under that of, "Let's see how much sugar I can eat while still maintaining these benefits."

Or maybe it's exercise-related. I don't know. But I'm certain when Christmas comes around, there will be plenty of sugars that I eat, and no exercising that will be done, and we'll find out.

Troy: Give yourself some credit. We know you can do it. You can resist and you can keep exercising. It's a challenge.

Scot S: I think, too, the other the other takeaway is you're doing a great job cutting out stuff, but I hear words like "all" or "as much as you can." Everything in moderation, right, Thunder? Every once in a while, you can have a little reward. It's just more of what choices are you making on a regular basis? Would you agree with that, Thunder?

Thunder: Yeah, I totally agree with that. It is really hard to be super militant all the time. And you don't want to fall into the trap of having a piece of cake and then just throwing your hands up in the air and saying, "It's over. Just give me the rest of the cake." It's okay to have stuff like that once in a while.

You have other levers you can operate, right? One of those is the exercise lever. So maybe if you have a little bit of a tougher time with some of your dietary approach, Scot, maybe you try to just ramp up a little bit more exercise for that week, or that day, or something. So I would use all the tools at my disposal as you move forward.

Scot: Definitely. I guess for some context, at least for the dietician that I went to . . . and we're talking about excluding things from the diet to gain information. It is important for two weeks to be very militant about, "You do not eat any gluten," to figure out is it actually bad. I have no intention of living this way for the rest of my life. But for the two-week experiment phase, that's kind of how it has to be.

Scot S: Thunder, what's your take? When I read that Scot went to a dietician and that they went down the route of gluten sensitivity and just different food sensitivity diagnosis, I kind of rolled my eyes a little bit. I feel like that happens a lot, but I don't know that . . . It seems like a little bit . . . I don't know. It's not witchcraft, but I'm like, "Really? That's the first thing, huh?" What's your take on that?

Thunder: It does happen a lot, it seems like. I guess it's one of those trendy things. Everybody wants to immediately talk about gluten.

So the reality is some people are definitely gluten-sensitive and it has a lot of big problems as it relates to their digestive health, and their body weight, and things like that. But you don't really know who is gluten-sensitive, so this is one of the approaches.

If you're faced with somebody who has some of those issues that could raise the flag of gluten sensitivity, then it's an easy thing to try. Go on your gluten-free diet for one or two weeks and see what happens. I think that's part of the reason why it's so popular.

But obviously, not everyone is gluten-sensitive. So in Scot's case, it didn't really make much of a difference one way or the other.

And there are other examples, though, of this in nutrition as well. Salt is another one. If someone has high blood pressure, one of the first knee jerk things that's done is you tell that patient, "Oh, just eat less salt. Reduce your sodium intake. Let's see if we can reduce your blood pressure." There are some people that do respond to that, but not everyone does. But people try it anyway just to see if it works. If it doesn't work, put it aside and move on to a different approach.

So that's my take on gluten sensitivity. I think it's in that paradigm.

Scot S: Mitch, you've been quiet. Do you want to jump in with anything?

Mitch: So the thing that I keep thinking about a lot when it comes to, say, even my own health . . . I've slipped up a little bit recently, but it's that idea of finding what works for you, right? And that's a big problem I think that happens when we talk men's health, and you see the magazines, and you look on Reddit, etc. Everyone swears they found the one way to lose weight, or the one way to drop your blood pressure, one way to lose whatever, when actually there are maybe 50 different ways that could maybe work for you.

And so it's very inspiring, Scot, to hear that in the six weeks you've made a lot of progress, but on top of that, you're trying things. You're taking an active role in your health, in getting yourself to that next level, rather than just, "Oh, I'm good enough."

So trying things out, and trying the elimination stuff, and just getting to know yourself better in your body, in your health, I think that's really the takeaway for me as someone by the sideline who's trying to also improve his own health.

Scot: My partner is very grateful to you, that you . . . "you" meaning the whole podcast family I guess . . . have been the kick in the pants I needed to actually try some of these things that she's been advocating for, of like, "Hey, we eat too much sugar. We should try decreasing that. We should do this." It has been a long time coming, and I guess this was the stimulus that I needed. And she really appreciates it.

Troy: And that's probably the biggest thing. It's not so much what you're doing, it's that you're doing it. Like Mitch said, you're trying stuff. The thing that makes me happiest to hear is you're better off than you were six weeks ago, and you're very comfortable with that. It sounds like what you're doing now is very sustainable and you're happy with it. And I think that's the greatest thing. So I think you've got something you're comfortable with, you're doing well, and you can just keep building on it.

Scot: I absolutely agree.

Scot S: Moving forward, Scot, what's your next plan of action? How are you going to continue this great progress that you've got so far?

Scot: I'm definitely planning on trying to continue to increase the activity level as far as strength training, as well as cardio type stuff, so head in that direction. Hopefully, I can get up to closer to 210 minutes a week. But I'm also going to cut myself some slack as far as leisurely bike rides and stuff like that. So that will make it a lot easier to get up there.

Other than that, I'm planning on playing with this sugar idea a little bit more. So maybe another half week or a week of being serious about it, and then slowly introducing it back to see if symptoms return.

If nothing happens with that, I am planning on trying a dairy cessation for two weeks, and an egg-cessation at some point. Not immediately. I'm kind of getting overwhelmed with all of that. But it would be interesting to see what happens.

I still want to get a personal trainer for a couple of sessions to help me with my gait or techniques when I do squats or something like that. I think that having that feedback would be very important. It just didn't happen over the last handful of weeks.

So that's kind of where I'm going. Kind of more of the same, more of this experimentation, and trying to get a professional to give me personalized feedback.

Scot S: Very cool. Troy, do you have any last thoughts?

Troy: Like I said before, I love what you're doing. Again, I think it's more that you're doing it, and you're trying stuff, and you're finding stuff that works. Just keep it up. I'll be excited to hear where you are in another six weeks.

Scot S: Thunder?

Thunder: Yeah, I agree with Troy. You're making the changes. You're trying different things. Keep it up. It'll take a little while before you land on something that exactly works for you consistently that you can live with, but this is all part of the journey. So, yeah, good for you.

Scot S: And I'm going to tell you, Scot, you actually inspired me. After we talked, that initial episode, I decided I needed to get back into the gym doing some weight training again. So as a result of our conversation, our interaction, and that whole deal, I've been fairly consistent, at least two times a week, which for me is pretty good, if not three times a week, of getting in and doing some strength training.

And it's taken about a month, six weeks, but now I'm starting to notice some benefits. I'm definitely noticing that I'm getting a little bit stronger, and clothes are fitting a little bit differently.

So I wanted to thank you for caring about your health to the extent that it made me care about mine again. Being in the gym was something I hadn't done for a while. And I actually kind of do like weight training in the gym, even though Troy doesn't. So thank you, Scot. I appreciate that.

Scot: You're very welcome. And thank you for being a positive impact on my life.

Scot S: Scot, it's been a pleasure. We look forward to checking in again. And if you have any questions, feel free to reach out anytime, all right?

Scot: Okay. Thank you.

Scot S: Oh, it was so awesome hearing from Listener Scot. He's making some progress. Things are going well. It just takes time. It takes some trial and error, figuring things out, especially finding a type of health that's going to work for you and work for your goals. It doesn't have to always be about being big and buff, and being able to do extreme stuff. So we'll check back in with Scot at a later date.

By the way, if you have any questions or if you'd like to talk to the "Who Cares About Men's Health" crew, a couple ways you can do that. You can email us, hello@thescoperadio.com. You can call and leave a voicemail at 601-55SCOPE. Or you can go to our Facebook page, facebook.com/whocaresmenshealth, and you can send a message there, or make a post on our wall.

Thank you for listening. And by the way, if there's somebody else you think might find this useful that could be inspired by Scot's story or any of the things we talk about to start their health journey, by all means, please share this with them. That's the best way to get this podcast out to as many men as possible.

Thanks for listening. Thanks for caring about men's health.

This week's recipe is Zesty Lentil Salad. If you make it, tell us how it was and post your pictures on our Facebook page.

This content was originally created for audio. Some elements such as tone, sound effects, and music can be hard to translate to text. As such, the following is a summary of the episode and has been edited for clarity. For the full experience, we encourage you to subscribe and listen— it's more fun that way.

Scot: Tasty and easy-to-make man meals you can eat all week. Today, it's a very manly review of last week's recipes, stuffed spaghetti squash and the other optional recipe, the no-bake chewy granola bars. Then we'll also have a recipe for next week as well.

And by the way, hit the kitchen with us and share your story and photos at facebook.com/whocaresmenshealth. These recipes are there. You can find links to them. Get in the kitchen, see what you think, see if you like them, see what we can do to improve them. That would be awesome.

I'm Scot Singpiel from thescoperadio.com. I'm learning I enjoy making food, so that's cool. Here's today's crew. We've got co-host, Dr. Troy Madsen. He's the MD to my BS.

Troy: That's right.

Scot: And the guy my wife told me that he should talk more on the podcast, it's Producer Mitch in the mix.

Mitch: I'm here.

Troy: Just keep talking, Mitch. Just keep talking.

Mitch: All right.

Scot: And both of our guests today are from the Department of Nutrition and Integrative Physiology at University of Utah's College of Health. We've got kitchen daredevil Thunder Jalili.

Thunder: Hi, everyone.

Scot: And the person who has the hardest job on the show teaching the rest of us how to cook, it's registered dietician and culinary coach Theresa D.

Theresa: Hello, hello.

Scot: You have just a cool last name. Now, it's just an initial. It's not even your whole name. That's how you know you've made it.

Theresa: I just read an article too about cooking therapists, and I think I should be a cooking therapist. I think that would work with this group.

Troy: Does this mean you are therapy for those who do not know how to cook, or use cooking to provide therapy for other things?

Theresa: I think it could go both ways, but mostly anxiety in the kitchen.

Troy: Oh, sign me up. Since you brought that up, Theresa.

Theresa: I'll call you later.

Troy: I hope you don't mind me starting this out with an analogy. My wife once invited me to a Zumba class, and I went to the Zumba class.

Thunder: I can just picture it now.

Troy: I had never been to a Zumba class before. We were on the back row, but there was a mirror on the front so people could see other people. At the end of the class when it was over, my wife asked me, "Were you making fun of the class, or were you actually trying?"

And I will say that is how I felt last week talking about my experience in the kitchen. Everyone here knows what they're doing. I am clueless. And that's how I felt in the Zumba class. I did not go back to Zumba after that. I have come back here.

Theresa: Yes.

Troy: So I'm still with you.

Theresa: Win.

Troy: I came for my second Zumba class. I'm still here.

Scot: All right. I think you're going to find though, Troy, the more you do this, the better it's going to feel. I think you are.

Troy: I will say that's the case already. Yeah.

Thunder: It couldn't get worse.

Troy: It could not get worse. You're right. Technically, it could. This whole parchment paper thing, as I'm putting this in the oven, I'm like, "Is this going to catch on fire? Is this going to be the next episode about my oven fire?" It could get worse, but it didn't.

Theresa: That's great.

Scot: Thunder is always there for some support.

Troy: Exactly.

Scot: Back-handed support in a way.

Thunder: I'm here for you.

Troy: Thanks, man.

Scot: All right. So let's go ahead and we'll start with a review of the stuffed spaghetti squash. We'll go ahead and start with Mitch. Any thoughts on that? Did you like it?

Mitch: I did. And I think the thing that I was the most surprised about was just how much food it actually made. The spaghetti squash looks small, but when you start to scoop things up and fill it up, I think we ended up getting almost six meals out of the recipe.

Scot: Wow. It's cool too because the spaghetti squash, you can scrape that thing to the shell. You can use every little bit in there. That's pretty awesome.

Troy, how'd it go for you?

Troy: It was great. I am now a fan of spaghetti squash. And this, again, pushed me a little bit. I had to find someone in the store and ask them, "What is a spaghetti squash?"

Theresa: Yes. I love it.

Troy: I did. I had to.

Thunder: Is it in the pasta section?

Troy: "Is it next to the pasta?" So this nice lady in the store then, who works there, of course, she had a couple of smaller ones. She's like, "Oh, let me go get you a good one." So she went to the back room and brought a nice big spaghetti squash out for me. And it's cool. This is cool. It's fun to eat.

Scot: Wow. Special treatment there. I like that.

Troy: Yeah.

Theresa: Troy, did you find the olive bar?

Troy: I did. Our olive bar, though, it's still not an open olive bar. They have an olive bar with everything packaged so they don't have it all exposed, but I did find the olive bar.

I'll tell you the way this happened if you're interested. I went to the store for something else and then I said to myself, "I am really overthinking this cooking stuff. Why am I doing this?" And so I tried to pull up the recipe on my phone and I couldn't get a connection in the store, and I'm like, "I remember what to get." I remember Thunder talking about the olive bar. So I went there. I found olives. They did not have sun-dried tomatoes, but I remembered that. I found that. I remembered the spaghetti squash, so I'm like, "Hey, I can do this."

And so I found most of the stuff. Just remembered what we talked about. I tried not to overthink it and got everything together, and it was much less stressful. It was like, "I can do this." I got the nice spaghetti squash. It was not the cheap stuff. It was in a glass bottle, and so . . .

Scot: The spaghetti squash was in a glass bottle?

Theresa: The sauce.

Troy: I wish the spaghetti squash was in a glass bottle. I just gave it away. No, the spaghetti sauce was in a glass bottle.

Scot: Got it. Sorry.

Troy: Yeah. I think in multiple levels I was just like, "I'm just going to do this. I'm overthinking it." And overall, it was a good experience in that sense. Just not stressing about it, just like, "Hey, I can do this. I remember what I need. I can make this happen." And found the stuff and it all worked out.

Theresa: That's great.

Scot: Hey, Theresa, you teach a lot of cooking classes to people probably at all levels. I think what Troy is discovering is it's really hard to screw things up in the kitchen.

Theresa: Yeah. We can try and take a step back, and a lot of this is this analysis paralysis. We're trying to overthink it. We're trying to be that Food Network chef, that Instagram influencer, or what have you. And we really just need to . . . especially when we're starting out, you need to take that step back and remember those basics.

And if we think about some of the basics that these recipes have introduced us to, sautéeing, chopping things, roasting, buying pre-prepared and then adding a bunch of fresh stuff to it, it can be a lot easier than what we're holding ourselves to these unrealistic expectations.

Scot: Yeah. And even if it doesn't turn out, it's still good. I had a little botch story I'll tell here today, but it still turned out good.

Theresa: That's right. And at least you know that, "Most of the time, well, I know that it may not be amazing, it may not be a Michelin restaurant caliber, but all of the ingredients are good. I followed food safety. It's cooked through. I don't have raw beef in here or something of the sort, and it's probably going to taste better the next time I make it." So learning experience.

Scot: The spaghetti squash. So I've got just a few questions here, and then if anybody else has any questions or comments that they want to dive a little more deeply into.

Theresa, these are just rapid fire. Okay? So how does spaghetti squash freeze? It seems like it's really full of a lot of water. Is it going to not be good if I freeze this?

Theresa: No. Don't freeze it. Awful.

Scot: Okay. So this is one of those ones you've got to . . .

Theresa: Yeah.

Scot: Okay.

Theresa: Do it fresh. You can save the squash. You could save it and not prepare it until earlier or think about your different steps, but don't make this dish and then put it in the freezer.

Scot: Okay. And when a recipe says two cups of spinach, chopped, does that mean I take two cups of pre-chopped spinach and then chop that, or am I supposed to chop up the spinach until I get two chopped cups?

Theresa: I love this. This is so what I was going to talk about during this episode. In the recipe that we're going to make, it has some of this recipe jargon that is helpful to know. It's not the end of the world. Again, it's still going to taste really good if you mix it up, but it makes a little bit of a difference in the taste and quality.

So, for example, the recipe today will call for "one cup parsley, chopped," or if the recipe were to say one cup chopped parsley. So it's a matter of when you measure it. If it says "one cup of parsley, chopped," then you start with one cup of loose leaves and chop that up. But if it's saying one cup of chopped parsley, then you want to chop until you fill up a cup.

Scot: Got it.

Theresa: A full cup of parsley.

Mitch: When do you learn that in your life? Is it just right now or is it . . .

Theresa: Right now is when you learn it, Mitch.

Mitch: Because I've cooked for a long time in my life and I'm just like, "Wait, what?"

Theresa: It's just like algebra. What do you do first?

Troy: It's the order it's in.

Theresa: Is it parentheses? Is it addition or multiplication? That's all. There you go.

Scot: All right. Yes. So, in the squash recipe, it's "two cups baby spinach, chopped." So I take two cups of whole leaves and then chop those up.

Theresa: Correct.

Scot: All right. Yeah. We're rocking and rolling.

Theresa: You would just have a little extra spinach. It probably wouldn't equate to all that much extra, but in some things like parsley or herbs that really chop down fine, it would make a strong difference.

Scot: Yeah, it would make a flavor difference. With spinach, it's just kind of . . . It was a really tasty recipe. I got a ton of leftovers. I looked up how many calories and carbs spaghetti squash has. Literally none. I think one cup is nine grams of carbohydrate and one and one-half of that is fiber. The beans in there have more carbohydrates than the spaghetti squash.

So it was really, really filling and really, really good. I ate it cold today from my leftover and it was great cold.

Theresa: I was just going to ask how did you guys think about repurposing it? Or did you just eat it as was for leftovers?

Troy: I ate it for leftovers. I heated it up in the microwave last night. And it's funny, I just left the whole . . . I didn't scrape it all out. I just left the quarter spaghetti squash there. So I've got a couple of those in the fridge. But I heated it up. The outside of the spaghetti squash really heated up. When I touched it, it was really hot, and the inside of it wasn't super warm, but it was still good though. I enjoyed it.

I will ask something that Mitch wanted me to ask but was too embarrassed to ask. Does spaghetti squash give you gas?

Mitch: It's a legitimate question.

Troy: This was on our group text. Mitch brought it up, if anyone else might have experienced a little bit of upset.

Theresa: I would say no, but it's always possible because there's lots of . . . Do you have issues with other carbohydrates?

Mitch: Not typically. No.

Theresa: Okay.

Thunder: Maybe it was just a bigger fiber load than you're used to eating at one time, Mitch.

Mitch: That could have been it. Sure.

Scot: Because those beans . . . the spaghetti squash has fiber, but those beans also have a lot of fiber in them.

Thunder: Yes, they do.

Theresa: It's true.

Troy: I'll admit too . . . I kind of put Mitch on the spot, but I did feel a little bit of stomach unsettling maybe two or three hours afterwards as well. So I wondered if maybe there's just a lot of fiber content in there, but it sounds like there probably is.

Theresa: That would be my guess, is the fiber piece. If you think about . . . the sun-dried tomatoes are really condensed from a fresh tomato.

Troy: That's probably what did it.

Theresa: The olives, similar thing. The beans, the spaghetti squash, certainly. The greens, depending on how much spinach you put in. It's certainly high on the fiber content from your typical roller food.

Troy: Higher than the taquitos.

Theresa: I have to. Every week, I've got to bring it in, Mitch.

Mitch: That's fine.

Troy: That makes sense.

Mitch: So it's not like anything is wrong. It's just fiber is good for you.

Theresa: Yep. And as you get used to higher fiber content in your meals, that should decrease.

Mitch: Okay.

Theresa: You're training your gut.

Mitch: I guess one of the things that I was wondering was . . . it seemed like I had a bit of sticker shock as I was scanning one jar after another. It just seemed like it was a bit pricier than I was used to.

Theresa: Very valid. And this is where looking at where and how we buy our items and then reusing them . . . So this is sometimes challenging when we're trying a recipe for the first time and we don't know if we're going to like it. So if you're buying jars of these items, it's quite possible that you had some left in that jar. You didn't use the entire jar.

And this is where maybe some of those grocery stores that have an olive bar where you can just purchase the amount that you need for the recipe . . . So if you only needed a half a cup, that's all you have to buy instead of needing to buy the one to two cups' worth that's in the jar.

Look at other store options as well. Trader Joe's does some of these items less expensive. Those kinds of things are a great way to look at some of these alternatives.

So certainly, it's a valid question, valid concern with this particular recipe. I would also argue, though, at the same time when you think about the quantity that it made . . . It gave Troy six meals' worth for one or two. That's a significant amount of food that it made. So pricing it out per meal, hopefully, would be considerably less. Yes, the initial purchase can sometimes be a bit of a shock.

Troy: And I will say I priced mine out, because I'm curious about this too. I priced mine at about $20 for everything. And admittedly, I did forget to get the artichoke hearts. I would have liked to have had those and I didn't remember until I got home. I was like, "Ugh, artichoke hearts." So that probably would have added on another $5.

But you're right. I think if you look at $20 and you spread it over four or five meals, it's not crazy high. But it seems like there are variations you could do on that. Maybe you don't do the sun-dried tomatoes and maybe you just do the olives or something. Because I found . . .

Thunder: Oh, sun-dried tomatoes are the best part.

Troy: Okay.

Theresa: Or if you didn't like the olives . . .

Troy: You're right. They are the best part. Maybe you don't do the olives.

Theresa: Or doing canned olives. You could do canned olives. Artichokes, there are frozen artichokes and those are fantastic as well.

Troy is exactly right. You could certainly modify this and make it a little bit less expensive of an initial punch.

Troy: You're right, Thunder. That was my mistake. I would not remove the sun-dried tomatoes. Those were amazing. So maybe the olives . . .

Thunder: I'm glad you're a convert to the tomatoes now.

Troy: Yeah. Big fan.

Scot: All right. Let's move on to the granola bars. The official title . . . what was this?

Theresa: No-bake chewy granola bars.

Scot: All right. Yeah. How did that go for you guys? Let's start with Troy.

Troy: I did not make it to recipe number two, unfortunately.

Scot: I've got to tell you, it was pretty easy. So if you want to try it at some point, it doesn't take that long and it was pretty simple.

Troy: I would like to, yeah.

Scot: How about you, Thunder? Did you do the granola bars?

Thunder: Yeah. So, actually, like the good parent I am, I delegated and had my daughter do it.

Troy: Nice.

Scot: That's not the point. The point is us make them.

Thunder: Well, I was in the kitchen at the time in a supervisory capacity.

Theresa: And what were you drinking, Thunder?

Troy: Love it.

Thunder: We had one modification. We didn't do the brown sugar. I think it actually turned out really, really good. And we used a special kind of chocolate chip that my wife found that I guess are some sort of baking chocolate chip, but that ended up being one of the good parts of the recipe.

So bottom line is I think it was a bit more crumbly because we didn't add the brown sugar, but I thought they tasted great. And as long as we ate them chilled, they were fantastic.

Scot: I've got to say Mitch's picture of his look like it was straight out of a food magazine compared to how mine turned out. Mitch, talk to us about the granola bars.

Mitch: I find these suspiciously delicious. The question I have, because I don't have it readily available . . . We ended up swapping . . . we did some Kashi Go rather than puffed rice to make it a little more protein-rich. What is the caloric density of these things? I've had to run up to the hospital a time or two. I've been grabbing them just as a quick lunch.

Thunder: It's high.

Mitch: They are so tasty, though. I'm just concerned. I'm very concerned.

Theresa: And especially with putting in the Kashi Go, it's certainly upped it from what it was. So if you just made one batch and cut it into the, I believe, nine servings that it was allotted for, which would be a fairly good size bar, they're about 300 calories.

Mitch: Okay. That's like a meal replacement.

Theresa: So then with the Kashi Go, I'd probably add another . . . probably if you did that fully instead of the puffed rice, it's probably another 25 to 50 calories. So it's a very dense snack, yes.

Thunder: Mitch, did you cut them into . . . did you actually make nine bars or did you cut them into smaller bars?

Mitch: I cut them into nine, and I just . . .

Theresa: Portion control on this one.

Thunder: So you didn't have just one big bar.

Mitch: So one of the things I think I run into a lot with my own nutrition is I get into that health food blindness where I'm like, "These are healthy. Theresa told me I could eat as many carbs as I wanted." And then I have two of these and then it's like, "Oh, no."

Scot: I don't think she said you could eat as many carbs as you wanted. I think she said you could eat the rice, but I don't believe she . . .

Mitch: Yes. All right.

Thunder: Well, one thing to think about is we actually made them into smaller pieces when we did them. They're like bite-sized pieces, so maybe about an inch or inch and a half or something.

Theresa: And also, if you're thinking about having it as a snack, but realizing that you're eating a lot of them, certainly think about how many you portion and take with you. Another thing to think about is that I have something else alongside it. So maybe I have a low-fat plain yogurt.

Thunder: Like an exercise bike?

Theresa: An exercise bike. Hopefully, you're walking around work. Or an apple. Something fresh along with it.

Mitch: I have been having an apple with a full-size bar, so I need to re-evaluate my life. Okay. Cool.

Scot: Well, I don't know if . . .

Mitch: Good to know.

Thunder: Nothing wrong with a full-size bar in the right circumstance. But I think if you're just popping them as a snack, it's probably a bit much as a snack. So maybe half a bar, a third of a bar, or something.

Mitch: Okay.

Scot: I'm treating it as a dessert, really. Just a little something afterwards. And mine didn't come out in bar form. I think where I made the mistake was I put the liquid part in the microwave. It came out bubbly and hot. And then I think I waited a little too long and it hardened up, so it didn't mix very well. So I need to work on my kitchen technique, but they were good. This is one of those cases, Troy, where it didn't come out like . . . it wouldn't be something I'd want to take to a party because they look terrible, but they taste great.

Troy: They tasted good.

Scot: So even though it was a little bit of a failure, it was not a failure because they are absolutely delicious. And I could even see maybe taking these and putting these in the bottom of a bowl, just a few of the crumbles, because mine really crumbled up, and put a little ice cream on top of them. That would be a good little dessert.

Theresa: I was thinking yogurt, but yeah, ice cream works too.

Scot: Yogurt is even better because then you get the protein in the yogurt and the fat in yogurt to help slow down the sweetness in the granola bars. That's brilliant.

All right. On to next week's recipe. It looks really, really good. It looks light and summery. I can't wait to learn more about it. Theresa, what are we making next week?

Theresa: Zesty lentil salad.

Scot: What do you think, guys? Zesty lentil salad.

Troy: I'm already intrigued.

Thunder: It sounds great.

Troy: I like all three of those words.

Theresa: Nothing from Mitch.

Mitch: You like lentils?

Theresa: Mitch, hold on to me. Hold on, Mitch.

Mitch: I'm here.

Theresa: Because it's a salad. However, I don't want you to cringe too much because it's not a salad in the sense that lettuce and iceberg is your base.

Mitch: Yeah. Okay.

Theresa: So hold with me. It's a warm salad. And I use salad a bit loosely because we're essentially just mixing things together like you would, say, a fruit salad. Well, there's no lettuce in there, but we still call it a salad. So we're mixing things together in a giant bowl.

So we had talked I believe the first week about wants or goals or desires of this class and something of this conversation was talking about lentils. And so here is an awesome lentil recipe for you guys to try. And talk about having leftovers. This one is going to give you leftovers. So this is going to be a great combination of lentils and bulgur and some nice fresh veggies as well as a homemade dressing that you'll put on the top.

Troy: So you just said a word there I've never heard before. What was that?

Thunder: Bulgur?

Scot: Bulgur.

Theresa: Bulgur?

Scot: Yeah. It sounds like somebody that was in "He-Man and the Masters of the Universe."

Troy: Exactly. Who's Bulgur and where do I find him?

Scot: Bulgur. Bulgur smash.

Troy: Exactly. What is that? I have no idea.

Theresa: So it's wheat. It comes from wheat.

Troy: Okay.

Theresa: And it is considered a whole grain, less processed than if you were to, say, have wheat pasta, or wheat bread, or something of that sort. But you can find quick-cooking bulgur and it'll cook up in about 10 minutes. It's a two-to-one ratio similar to rice, two cups of water to one cup of bulgur. And it's a really great addition to your grain repertoire. A lot of people think about quinoa or rice or couscous. I put pull bulgur in there as well. It has a nice nutty, roast-y flavor to it without adding a whole lot.

Troy: Where does one find bulgur?

Theresa: You'll find it with the other grains. So Bob's Red Mill makes a really great one. So if you're in either the baking aisle or in sometimes the Italian pasta aisle where maybe they have cornmeal or polenta or packaged quinoa, things of that sort, it should be there. It can sometimes be in the cereals, though, too.

Thunder: I was going to mention, don't give Troy any hints. It'd be more entertaining to watch him try to find it.

Troy: I know. I have learned my lesson.

Thunder: All the places you mentioned I don't think he could find anyway.

Troy: Yeah. Well, number one . . .

Theresa: This could be one that you find that produce lady and say, "Hey . . ."

Troy: Yeah, I need to find that nice lady again.

Theresa: Or look at your store app. If you're at a store that does have an app function, this would be a great thing because you can put in bulgur and it'll tell you exactly where in the grocery store it's located.

Troy: Intrigued.

Scot: I bought the ingredients for this while I was buying the ingredients for the spaghetti squash thing and I had a hard time finding the bulgur. One store I went to, I couldn't find it anywhere. The other store, I found it in their . . . not the health food aisle, but the natural foods aisle is where I ended up finding it.

Troy, like Theresa said, look for the Bob's Mill brand and you're going to look around quinoa and that sort of thing. So it could be in two or three different places just depending on your grocery store.

Troy: Sounds like an adventure. We'll see.

Scot: Yeah.

Troy: We'll see how this . . . Are there any alternatives? Let me ask you that first. Are there any alternatives to bulgur? Rice?

Theresa: Sure. You could do rice. I would more so suggest something like quinoa or couscous.

Troy: Okay.

Thunder: I was thinking couscous would be a good alternative.

Theresa: Or if you really want to go out, millet would be a . . . But that'd be probably just as hard for you to find as bulgur.

Troy: So get wheat and . . .

Scot: No, you're not milling anything, Troy. Millet is a thing you buy. You're not going to go down to the creek where the mill is with the big mill wheel.

Troy: I swear you said, "Mill it." But now I understand what you said. I get it. I thought you were just seeing how far I was going to go with this, but I get it.

Scot: So is this going to be a main course then, or is this a side, or what's your recommendation on that, Theresa?

Theresa: It's both. You'll see on the recipe I have that it makes 6 main courses or entrees and 10 sides. So this is a really great one that you can really multipurpose. So it's great the first night that you make it. Maybe eat it warm if that works with your timing, because it's really yummy warm. But then for lunch the next day, it's awesome cold as well, or putting it into a pita and having more of a sandwich-type or a wrap or something like that would be really great too.

Scot: And if you're using it as a side, what would be a good type of food to eat with this then?

Theresa: Oh, I would do grilled chicken. I could do some sockeye salmon. It's summertime, so throw something out on the grill. That would be really awesome with it for sure. Thunder's sautéed tofu would be a good topper. It's nice and zesty and kind of Mediterranean, Eastern, Middle Eastern, and so you could think about any of those poultries. A lighter poultry or fish would be really great.

Scot: Let's go around the room here. Troy, let's start with you because you have the most questions normally, so maybe we'll get everybody else's questions. Do you have any questions? Any concerns? You got the recipe there?

Troy: I think I'm ready to try it.

Scot: Do you know what an English cucumber is?

Troy: I will probably find an American cucumber, but . . .

Scot: Do you know how to tell the difference between English cucumbers and American cucumbers?

Thunder: Is it the accent?

Scot: Well, yeah. You go, "Hello, governor," and if it goes, "Hello, how are you?"

Troy: Yes. That will be me talking to the cucumbers.

Scot: "Mighty cheeky today, aren't you, Dr. Madsen?" Then it's an English cucumber.

Troy: If it's wearing a top hat, I'll purchase it. What am I supposed to look for?

Theresa: If it's wrapped in plastic, long and wrapped in plastic, it's an English cucumber most of the time.

Troy: Okay.

Scot: All right.

Theresa: They tend to have fewer seeds, they have a lower water content, and so they work really well for something like this. If you were using a traditional cucumber, say, that you were harvesting out of your garden maybe, or your typical American cucumber from the grocery store, they tend to be really waxy. So I would suggest peeling it as well as scraping out a lot of the seeds in the middle, or it's going to make the salad really watery. Find that produce lady.

Troy: I will find the lady. I've got to find her.

Theresa. Or gentleman. There are plenty of good produce men as well.

Troy: I'm sure there are.

Thunder: So my question about this recipe . . . when I was looking at it, it looks like it's going to create a massive volume of food, and I'm pretty sure I can't freeze it. Would it be okay to cut everything in half, and could I still mix everything?

Theresa: Yes, certainly. This one fairly easily could go in half, yes.

Thunder: Okay. Good.

Scot: Mitch?

Mitch: We'll see. I have suspicions also about lentils, but we'll see how this comes together. Troy, the thing that I've been doing lately is that I've just been doing the pickup, the grocery pickup. So I don't even need to hunt in the store to find things.

Theresa: Nice.

Troy: Oh, you just put everything on there and someone finds it for you.

Thunder: That's like cheating.

Troy: It is cheating.

Mitch: Yes, her name is Mary. It's been every Wednesday for the last month. I know her. We chitchat. It's great. So she's like, "Oh, getting something different this week." And I'm like, "Yes, I am." So I will . . .

Theresa: You should share the recipes with her.

Mitch: I might have to, but that's just it. So that's how I've been skipping the "Where on earth is this item in the store?" So that's my tip.

Troy: That's a really good strategy. I didn't even think about that. That's actually a good idea. I may do that. I think I can find most of the stuff.

Thunder: Troy, it's part of the adventure.

Troy: I know. It is part of the adventure. I have to say it is, and I have found some new things I hadn't really found before. So this looks pretty straightforward though. The bulgur, that really threw me off, but everything else on here . . . The English cucumber, now that you've described it, I think I can find that. Everything else looks pretty straightforward.

Scot: All right. Can't wait to try zesty lentil salad. We'll talk about it next week along with another brand new recipe from Theresa. And we would love it if you'd join us in the kitchen. Try these recipes out. You can find them at facebook.com/whocaresmenshealth. We're posting the recipes there. You can post your comments and pictures there. We'd love to have you just be a part of this and let us know what you think in the kitchen along with us with "Who Cares About Men's Health."

This content was originally created for audio. Some elements such as tone, sound effects, and music can be hard to translate to text. As such, the following is a summary of the episode and has been edited for clarity. For the full experience, we encourage you to subscribe and listen— it's more fun that way.

Scot S: Today's episode of "Who Cares About Men's Health" is for guys who are doing pretty well with their health but maybe would like to do a little bit better and have been struggling to make progress. Who do you go see? Who can help you accomplish your goal? Is it a primary care physician? A nutritionist? A fitness bro with a YouTube channel?

This is "Who Cares About Men's Health," providing information, inspiration, and a different interpretation about men's health. We've got a great cast here today. First of all, he is the man that brings the MD. It's my co-host from the emergency, Dr. Troy Madsen.

Troy: I'm trying to think of something that rhymes with "C," but I don't have anything, Scot. But yeah, it's me.

Scot S: All right, and I'm Scot Singpiel. I bring the BS and ask the dumb questions so you don't have to. Producer Mitch is in the mix. Hey, Producer Mitch.

Mitch: Hey there.

Scot S: All right. Then we've got our all-around baller shot-caller with a PhD in eatology. It's Thunder Jalili.

Thunder: Hey, guys.

Scot S: And our guest today is a listener. He sent in a listener email and had some questions, so we're going to try to answer them as good as we can. It's an interesting situation that Scot has. Scot, how are you doing so far? Doing all right?

Scot: I'm doing all right. Glad to be here.

Scot S: Scot, tell us a little bit about what your situation was so we can set the stage for the conversation.

Scot: So my situation is I'm a mid-30s male. I'm in pretty decent health. I'm able to go running once or twice a week. I can run five kilometers at a time. They're not terribly fast, but they're not terribly slow. I do some biking. Back in the before times, I would go swimming. Two years ago, I did a sprint triathlon and I finished it, which was my goal. So things are going pretty well.

But I have a knee that doesn't really behave much beyond five kilometers. I weigh a little too much. Just kind of a lot of things that are a little bit off. My blood pressure is always up a little bit, no matter how much I exercise it seems. So just kind of everything is a little bit off.

And when I went and talked to my primary care physician about it, he pretty much just said, "If I bothered every person that came in here with a BMI of 26, that's all I would do every day," and kind of pushed me out the door. And so I sent in the question wondering, "Well, if it's not my primary care physician, who should I go see? Is it a physical therapist or whatever?" And now I'm here.

Scot S: All right. Fantastic. Hey, Troy, do you want to give the synopsis à la medical style like you would?

Troy: That's right. This is like residents when they see a patient that they come and present to me, and I would basically present Scot's case as a male in his mid-30s. He has a BMI of 26.6, which is a little overweight, with a BMI of 25 being that overweight category. Reports a blood pressure of 128 over 75, which that top number maybe a little on the high side by NIH standards. It's a little bit above 120, so maybe a little bit elevated. He sounds like he exercises fairly regularly, runs a 5k once or twice a week. He bikes. He says he can do five pull-ups.

Scot S: That's pretty impressive actually. Maybe we spend the rest of the episode talking about that.

Troy: Seriously. Yeah, five pull-ups.

Mitch: When I first read the email, I'm like, "Scot, it is the same story with me." Even down to the little bit of BMI, the running, whatever. But when it said five pull-ups, I'm like, "That's not me."

Troy: That's right. Mitch, similar to you, he does report some knee pain if he tries to run a little bit farther than 7k. So I know you've had some knee pain. You've had some ankle issues as well.

Well, I guess, Scot, is there . . . I think the first question is for you. Was there something that prompted you to really say, "Hey, okay, this is all right, but I want things to be better"? What was it that made you think this and start asking these questions?

Scot: I guess it's just kind of been over 10 to 15 years of adult life nothing has really changed. My weight has stayed at about 180. Sometimes it goes down a little, sometimes it goes up a little, but it kind of tends towards the mean.

Some thoughts of, "I'm getting older, and if I could get this under control now it might make life easier in the future instead of trying to be 55 or 60 and like, 'Oh, no, retirement is coming up and I'm going to be on the beach every day. I'd better start working on that.'" I don't think it would work. So it was really just a "nothing really seems to be working."

I guess I should state that as far as diets and exercise and stuff goes, I haven't tried anything extreme. So I haven't tried any of the "cut out all of the carbs" or "cut out all of the meat" or "only eat smoothies." I haven't done any crazy exercise regimes just because . . . It's important, but I don't want it to become my personality.

Scot S: Thunder, what's your take on that?

Thunder: Actually, I had just a couple of questions about the diet/exercise component of what you were doing. I have a general sense of it kind of in broad strokes, but could you give me a little bit of color? When you exercise . . . so it sounds like you run a couple of times a week. Is that the main thing you do? Or what else do you do to kind of burn calories, so to speak?

Scot: So that really is the main thing. I'm an office worker, so I do a lot of sitting, like exclusively sitting. So there's playing with kids and exercise. Before the pandemic, before I was working at home, I would walk to work, which was about a kilometer there and a kilometer back, which was nice.

That's pretty much it as far as . . . The exercise is the real thing. Other than that, it's just kind of walking around if we happen to go for a walk or do some yard work or whatever. It's just kind of incidental caloric burn.

Scot S: So are you going to put him on some extreme exercise program now and diet, Thunder?

Thunder: Yeah, we're going to start with the weighted vest for 24 hours a day.

Troy: But I think . . . yeah, go ahead, Thunder.

Thunder: Thank you for sharing that. One thing you mentioned that I think is great is you said you try to play with kids and walk around and do some of this kind of ancillary exercise. People don't consider that exercise, but actually, it is activity, and all that stuff counts.

So my other question is about the diet side of things. You mentioned you haven't tried anything extreme, but how would you characterize your diet in terms of variety of foods? Do you kind eat like a little everything, or are there things you don't like? And how do you feel about it? How much processed foods or fast foods do you typically have in your diet?

Scot: So I feel like we do pretty well. We generally don't have any sodas, just kind of as a matter of course. Throughout the day, it's pretty varied. However, we do lean much more towards the pasta and carbohydrate side of the spectrum than meat-heavy, but that's not to say . . . We usually end up getting a serving of meat in per day. We like eggs, so there's a decent amount of eggs involved.

Breakfasts are probably an . . . well, it's a guilty pleasure essentially because I don't really like waking up, so it's just "get up, get a bowl of sugary cereal, and be done." But that's more out of convenience than anything else.

Thunder: And are you a snacker?

Scot: So throughout the day, no, but it's not uncommon for me to have a snack with my young kids in the morning or the afternoon, but generally not both. It's apples and the goldfish crackers and a little bit of that.

Troy: What about sodas? I know, Thunder, you've talked about this before. Do you drink a lot of sodas or how does that factor into your diet?

Scot: Essentially next to none. Sometimes for birthdays or whatever it's nice to grab a ginger beer or something like that, some sort of fancy soda. So it's like a bottle or two a year.

Troy: You're doing great there.

Thunder: Yeah, great.

Scot S: And that was one of Scot's frustrations, is that he feels like he's kind of done those easy things. Not to say that you shouldn't ask about those easy things, but cutting out soda, that sort of stuff, and still not seeing . . .

Troy: Yeah, the obvious stuff is . . . he's really taken care of it.

Thunder Before we get into it, just as a little encouragement, it sounds like you eat fairly well. You try to exercise. You're really not that overweight. So don't get too down on yourself, right?

Now, having said that, a couple of things that I would think about if I were you. One is maybe some different kinds of exercise. It doesn't necessarily have to take more time out of your day, but it could be perhaps more efficient and maybe more targeted towards building strength and burning calories.

If you have any interest at all in ever going to a gym, and some people don't and that's totally fine, it'd be a great idea to hire a personal trainer for a couple of sessions. They're really good about giving you ideas of what kinds of exercises to do, how to use certain machinery, and just doing things that are maybe different, instead of just going to the gym like most guys and bench pressing and doing arm curls or something. But resistance exercise actually is good for your whole body. So that's one thought.

If you don't like that, then there are other ways to incorporate more exercise into what you do. Recognizing your knee limitation, I don't know if you can run more than twice a week, but that would be one option. Biking is actually a great alternative to that because, obviously, it's low impact and it can take about the same amount of time as running.

Scot S: How many minutes of exercise do you think you get a week?

Scot: Somewhere between 90 and 120, so an hour and a half to two hours.

Scot S: That's kind of in the ballpark, isn't it, Thunder?

Thunder: I think . . .

Scot S: A little higher?

Thunder: I think if it would be higher, it would be better just in terms of what I've learned about your weight goals and your health goals. I think if you did a little more, it'd be better.

Scot S: And that would be maybe just short-term to kind of get the extra weight off and then you could go back to a maintenance? I know time is important. He doesn't really want to invest a ton more time.

Thunder: I know. See, this is the tough part. I'll be honest with you, Scot. The way human beings are built . . . you look at the human being of 10,000 years ago, even 5,000 years ago, even now, primitive cultures, they spend a lot of physical activity, a lot of calorie expenditure, in the effort to procure and prepare food. That may take hours, right? And so they don't exercise per se, but just the act of getting food is a tremendous amount of exercise.

Now you fast forward to a modern society where we don't have to do that. We can just go to a store or go to a restaurant and we're just handed something. We cut out all that other stuff.

So when you try to incorporate exercise kind of in the modern sense, you've got to try to make up a little bit for all that lost calorie expenditure that we had in the past that we don't have to do anymore.

So having said that, probably you want to shoot for more than that 90 minutes or two hours a week. If you don't, it's just going to be harder to maintain your body weight.

Scot S: What's the number you're looking at? 210? Is it 30 minutes a day?

Thunder: Yeah, I would say 30 minutes a day is what I would recommend, just the baseline. It doesn't have to be every day. You could take a couple of days off and maybe do an hour five days a week, something like that. But the reality is you have to just have a little bit more of that activity in there, because we're just not built to maintain body weight on just a little bit of activity.

Scot: So when you're talking about activity, what are we really looking at? So when I was giving you the minutes, I was meaning . . . not really counting in the warm up, cool down, get done running and now walk for 10 minutes to cool down.

And when you're talking about other exercises, what should I really be looking for? Is it really just the fact that I am exercising? Or if we're talking about a pulse, are we wanting to get the pulse up above a certain level? Because my pulse is a lot higher when I'm running versus when I'm biking, but is a minute of running and a minute of biking comparable?

Troy: Scot, I'm going to give the quote that I know everyone loves. This is the Matthew McConaughey rule. I've quoted Matthew McConaughey before. His rule of thumb, which I love, is he says just do something every day that makes you sweat. And he doesn't . . . obviously, I'm sure he has a personal trainer and all kinds of other things, but there's something to be said for that, about not worrying about metrics and pulse and this and that.

I think if you can do something every day for 30 minutes, whether it's biking or running or a vigorous walk, or maybe it's, like Thunder said, doing some resistance training. Maybe you don't like going to the gym. So maybe if there's a way you can stand and do just some free weights or something while you're working. I think anything you can do just once a day that's incorporating it to get your heart rate up a bit, I think that makes a huge difference.

Scot S: Let me also throw in there too. So I have two or three kettlebells in my office, and every 50 minutes . . . Do you try to stand up every hour? I mean, I try to stand up every 50 minutes, every 55 minutes. But I take that 5 or 10 minutes and I'll do some push-ups or I'll grab those kettlebells, and it's called the rack position and I'll do some squats or something, some of those big muscle exercises.

Troy, you can tell me if I'm making this up, but I thought that there was some research out there that said exercise doesn't have to be the continual 30 minutes. You can do little exercise snacks. You could have a little five-minute session where you do some squats and deadlifts, some overhead presses with those kettlebells, and then go back to work. I find it gets my brain going again. It wakes me up and I'm better equipped to take that next hour or so.

Thunder: Can I add a couple of other perhaps easy things?

Scot: Sure.

Thunder: Scot, you like to go on after-dinner walks? That's an easy thing to do.

Scot: I do like to do that. Sometimes it's difficult with the little kids because we're all kind of getting tired and grumpy, but yes, we do like doing that.

Thunder: Yeah, so that's an easy one. I always encourage people to maybe do some of their own chores around the house. I mean, I know in my neighborhood everybody hires someone to do their lawn. I'm like the only one in a five-mile area that actually does his own lawn, but it makes me sweat, getting to Troy's point. So things like that, because it does add up.

Troy: And I think a great thing too . . . A couple of points here. Thunder, you talked about be sure and give yourself credit. You really are doing a good job. Obviously, you want to optimize things, but you're doing very well. You're doing a lot of exercise. It sounds like you've really focused on some of the big things on diet.

But I think it's really important . . . you mentioned, "I haven't done any crazy diets. I'm not doing any super extreme exercise stuff." And I worry sometimes that we feel like we have to do those things to really get healthy. But I think if you can just say, "Hey, this is where I am. What can I do to just do something every day?" Right now, you're doing stuff a few times a week. Is there a way you can incorporate stuff into just your daily routine, anything just to get 20 to 30 minutes of getting your heart rate up a bit just once a day every day? I'm sure after a month of doing that you'll start to see some returns from that.

Scot: Okay, that sounds good. I mean, while we were talking about it, I was worrying like, "Okay, this kind of sounds like, 'Do a little bit more and you'll see essentially more of the same.'" But I hope that there can be differences after a month or two of more consistent activity through the day.

Troy: Yeah, and I think that's important too, because a lot of times we jump in and we want to do something and we want to see results fairly quickly. But I think if you just say, "Hey, I'm going to do this, and I'm going to do something now every day where I've been doing something a few times a week, and I'm going to give it four weeks, and then I'm going to reevaluate and see where things are," I think it's important to do that just to make that commitment, that four-week commitment.

And again, just looking at where you are now, looking at how successful you've been to this point, and then just thinking adding that little more. You figure if you can do something every day you're going to increase your . . . at least those times your heart rate is up, you're going to increase that by at least 50% a week in terms of total time. I'm sure you're going to see some results with that.

Scot S: So I feel like we've talked about the physical part of the equation. Thunder, is there a nutritional part that you would like to explore a little bit further? And then I want both of you gentlemen to think about if there's anything else.

Thunder: Thanks, Scot. So yeah, there are a couple of things with nutrition that come to mind. One thing that I ask people to evaluate in their own diet, and I haven't obviously seen your diet in detail. I just kind of know the broad strokes. But what are your portion sizes? Think about that. Are they just right? Are they a little much? Are they chronically too low? That actually can be a bad thing, because if you're always kind of semi-starving yourself you're actually reducing your metabolic rate and it'll make it easier to gain weight and harder to lose weight. So portion size is one thing to consider.

And the other thing to consider is how much meat and animal products you eat. Now, I'm not telling you that you have to be a complete vegan or anything, but people who eat less meat also tend to have a little easier time maintaining their body weight.

And actually, I know Troy has had some personal experiences with this, so he can perhaps share a personal story. But I know when I went to a lower meat diet, I think I lost like a couple of pounds, which doesn't sound like a lot, but on me a couple of pounds is a lot, and right away. And it never really came back as I kind of kept that vegetarian or semi-vegetarian approach. So that's another thing to think about as you look at your own diet.

Then the last thing is think about visiting a dietitian. And I'm saying this because one of the things you were kind of a little disgruntled with is, "I don't have any time to talk to my physician. I don't know where to go for some of this information." If you talk with a dietician, if you book an appointment with a dietitian, they will give you half an hour or an hour as part of your appointment and you can just talk. You can ask them questions. You can tell them about your diet. You can get their opinion. That time is there for you.

I think that's something that you just don't find in the modern medical system, because a doctor may only have 10 or 15 minutes or whatever to see you, or 20 minutes, and then he has to move on to the next patient who perhaps is much sicker than you and actually needs the attention. So I would consider the dietitian.

Scot: I have a question about the first point that you brought up as far as portion sizes. I haven't done calorie counting or anything like that, because it's kind of hard when you're preparing your own food. I mean, if it comes from a box, it's pretty easy to look on the box and say, "I ate this much." So as far as portion sizes, I just try and make it so that I stop eating before I'm full, and that's kind of just been how I've been doing it. But I do recognize I could probably eat a little bit less without starving myself, which is probably something that needs to happen.

Thunder: That's a very intelligent way of going about it, stopping to eat before you're completely full. And another trick is perhaps try to eat a little slower. Again, I have no idea if you're a slow eater or a fast eater, but that's another approach that I know people have used.

Scot S: And smaller plates too. I use a smaller plate. You get those big dinner plates. I take the next size down and I find that . . . Because you see the big plate, and you want to fill that plate with food. Otherwise, it doesn't look right. So that might be another thing.

I know that some of the stuff we're talking about kind of . . . What's your honest opinion of it, Scot? Do you just kind of feel like it's more of the same? Or do you feel like, "Oh, these are dumb. These things won't work. They're too easy"? Where are you at?

Scot: I was expecting a little bit more of like a cheerleader type thing of, "Yeah, you can totally do it." Whereas I feel like we've touched several times about, "Yeah, you should just be chill. You should be happy for where you're at right now."

But it is nice to sit here and talk and have people say, "Hey, when you get up from your chair while you're working, if you just do some push-ups, grab some weights, do something, get your heart rate up for a couple of minutes, you might actually see some changes." That is something that I have not really tried. And so I'm excited to try that out.

Troy: Yeah, I guarantee you'll see differences here, Scot. And it doesn't have to be a dramatic effort. Thunder kind of alluded to this a little bit, and I've talked a little bit about my experience previously. My big issue was my cholesterol. My cholesterol levels were surprisingly high when I got them checked. And so I tried a vegetarian diet, which I've continued now for many years, and that definitely helped.

And then I got to a point where I just started . . . you said you're doing a 5k a few times a week. I just said, "I'm going to try and run just two miles a day." So just two miles a day every day. And I said, "I'm going to do that every day because then I don't have an excuse not to do it," because I'm like, "Well, I do it every day." And I found that just made such a big difference doing that and just trying to incorporate that. Then it allowed me to look and say, "Well, this is where I am. Can I increase this?" and then kind of build from there.

But I think these small changes . . . again, looking where you are now and just making a small change to increase that to every day, something to get your heart rate up, something to make you sweat, get working out a little bit, I definitely think you're going to see a difference with that.

Like Thunder talked about, maybe some things with your diet as well you can look at there and maybe portion size, maybe not eating until you're completely full, things like that.

And again, in your situation, we're kind of talking about fine-tuning things. Again, I know your primary care physician said you're doing well, and I think you are doing really well, but I also see exactly where you're coming from and I think this will help you get more to optimizing things.

Thunder: Hey, Scot. In full honesty, I actually exercise every day like Troy. Six to seven days a week I'll do something. So like I said, there's sometimes no substitute for volume because our bodies are kind of meant for a lot more activity. It's just that our context of our modern society makes it kind of tough. So that's something to consider.

But really talking with a dietitian, you'll get a lot more of what we're doing here and really a chance to explore the nuances of your diet that I don't think we could do on a show, because I'm not looking at your five-day food diary or anything to have specifics to kind of jump on.

Scot S: Hey, Troy. I got a question for you. So if Scot tries to amp the activity up to 30 minutes a day and then goes to a dietician and finds a few little small changes in the diet, is that going to help the blood pressure? I mean, I think we all can agree those types of changes could eventually help the BMI and the cholesterol, as Thunder said, but what about the blood pressure?

Thunder: Before Troy answers that, let me just say one thing. Blood pressure taken in a doctor's office, as Troy can probably attest to, is not always the most accurate because there's . . . some people are nervous and their pressure is a little high. So I would say if you had your blood pressure checked a lot and it's always around there, then it's legit. If that's just one measurement you've done and that's what it happened to be, I wouldn't put too much stock in it.

Troy: Agreed. Yeah, I always tell people that, especially in the ER. I say, "Do not base anything on what your blood pressure is here." You really need readings over months and months, and usually at home while you're relaxed, home blood pressure cuff. And if there's any concern, usually your doctor will do that.

So honestly, as I see your blood pressure, I'm not really concerned. I can see you're concerned with BMI being a little high, cholesterol being a little bit high.

But I think the answer to your question, Scot, is absolutely. I think you're going to see differences across the board. As your weight comes down a little bit, maybe you lose 5 to 10 pounds, I think you'll probably see your blood pressure come down a bit as well probably as a response also to just the regular exercise. I think that's going to make a big difference there.

And before you get your cholesterol checked, I'd give it six months in a new routine and see these other things come down, and I think at the six-month mark you'll get your cholesterol checked and I think you'll see improvements there as well.

Scot: How important is it to have variety in your exercise life? I can't remember who it was. It was probably Troy that said that he went running two miles every day. Is it better just "variety and the spice of life" sort of way? Or does our body really care that much? Thirty minutes of sweating is 30 minutes of sweating.

Troy: The big thing I'd encourage is try to bring in some resistance training. I think just from what you're telling us, that's one thing you could really do right now, and just bring that into your routine while you're working with some free weights, just some dumbbells or kettlebells or whatever you like, and do that along with what you're doing with the running. Then maybe throw in some biking or, like Thunder mentioned, maybe an evening walk, things like that that are easy enough to add on.

Scot S: Hey, Troy. Do physical therapists, physical therapy places you go for that, do they teach any strength training, like resistant-band training if that's what Scot wanted to try, or anything like that?

Troy: I think a physical therapist . . . I think, Scot, if you went to someone for your knee specifically, and some of the joint issues you've had, that might be helpful. Typically, I think most physical therapists are going to focus on weak areas and pain that you're having. So I'm sure they could talk to you about that.

And if that's a limitation in terms of what you're able to do cardiovascular-wise, whether it's running or whatever else you're trying to do at this point, that may be a consideration. I think if you just went in there and generally said, "Well, I want resistance training, etc.," I don't know that they would be the best person for that. But for some of these chronic issues, I think they could be helpful.

Thunder: And one other kind of plug for the personal trainer. If you find a good trainer, the other thing that they'll do, Scot, is they'll kind of try to evaluate where you're at with your current condition.

I'll tell you right now most men in their 30s and beyond have weak hamstrings. They have weak low back muscles. They have kind of weak core muscles. So those types of areas can be augmented with resistance training, right? So that's another reason to seek out other kinds of help.

Now, a physical therapist would be a great trainer. It's just you'd have to go through the medical route to get that, and as Troy said, it would be kind of targeted towards maybe an area that's injured that needs to be rehabilitated. And I think part of what we're trying to get you to think about is not just dealing with your injury, but going forward, increasing your whole-body resistance training not only to burn calories, but to also keep you strong as you go forward in years.

Troy: Scot, originally when we got your email and we talked about this, we thought, "Wow, that is certainly a common dilemma of really trying to optimize where do you really go in the healthcare system to get that." And yeah, you can try on self-education and reading and all that, but there are different health systems that will have certain programs set up that incorporate so many of these different factors.

The University of Utah has PEAK Fitness that has different things, like Thunder talked about, a dietitian. They do the BOD POD testing. They have other specialists you can consult with, personal trainers, all those sorts of things. Intermountain Health also has a similar thing through their LiVe Well centers. So depending on your insurance, that may be something to look into.

Usually with these, there is an out-of-pocket fee, but they can also offer a lot of these people who can help really look at where you are and help give you this advice. And like Thunder said, you can really pick their brain and try and learn from them.

Thunder: I think this is why we have so many people now who market themselves as health coaches and nutritionists and trainers and wellness coaches and so on and so forth, because they're trying to address the gap that's existing now in the healthcare system.

Scot S: Going to try to wrap this episode up. So through the process of communication, we are trying to kind of come up with solutions and solve problems. Unfortunately, sometimes that can get a little overwhelming. I'm overwhelmed for you, Scot, and I have a fairly decent understanding of all the issues here.

So I want to ask you . . . Now, I've been taking notes so I'm prepared to give a summary, but I want to ask you what you think your steps forward might be, keeping in mind that it doesn't need to be a wholesale change. It's just those small little things. Are there a couple of small things you think you could do now consistently that you heard today? What do you think?

Scot: I think that some of the low-hanging fruit would be having some sort of weights, some sort of resistance training that when I stand up periodically, do something. I mean, there's bodyweight training, like push-ups and sit-ups, whatever. So I think that that's something that I could definitely do.

Maybe eating a little bit less. I am planning on contacting a dietitian. That seems like something that I would be able to do pretty easily. It wouldn't require much face-to-face stuff, or only once or twice, versus a personal trainer-type situation.

But I am very interested in getting a personal trainer. I think that if I tried to get more minutes of exercise in the week and then go and meet with a personal trainer once a week for a month, and then see where I can go from there.

I feel like there are a lot of directions to go. And I feel like this has been a very helpful conversation, I guess, to wrap it all up.

Scot S: And you don't feel overwhelmed right now?

Scot: Oh, yeah, definitely.

Troy: Well, let me just wrap it up then, Scot, because I think the big point I want you to understand is you're doing great. I mean, that's the bottom line. You really are doing well. Your numbers are, it sounds like, just a little bit off. Certainly give yourself credit for everything you've done. Again, it sounds like you've got some very specific things you can do. I think it's important to implement those things. Give it a month. Commit, give it a month, and then reevaluate. But it sounds like you're on the right track.

Scot S: You're talking about small changes, right? Because like Troy said, you're close to where you want to be. So just the fact you want a small change, that just requires small change. It's not like you're completely in terrible health and it's going to be a complete lifestyle overhaul. So I think those small changes would really make a difference. Consistency, we hear time and time again, is cool. And don't do anything crazy. You don't have to do anything crazy with your diet.

Scot: I'm so glad to hear that.

Scot S: Hey, Scot, we would like to check back in with you maybe in four weeks, six weeks, eight weeks, and see where you're at.

Scot: I'm okay checking back in, in a couple of weeks. Honestly, the pressure of needing to come back onto a podcast and tell them, "Hey, there's been progress," is probably one of the most effective tools that . . .

Troy: Yeah, the accountability. It really does make a difference. Well, let's do it. Let's have you back on. And like I said, you want to give it enough time to really get a chance to do it. So maybe six weeks.

Thunder: I think that six weeks would probably be a decent indicator that there should be some movement on one of these dials by then.

Scot S: And I think you hit at the very end of the conversation another component that we could've talked about, and that is having somebody that you're accountable to, have an accountability partner. When I used to work out with a partner, there were days I didn't want to go but I would go for that partner. We're kind of your accountability partners right now.

So that might be something else somebody is listening might find benefit. If you've got a couple of people you got running with and you're accountable to them, then that can make a huge difference.

Scot, we look forward to talking to you in six weeks. Send us any emails along the way. If you have questions, feel free to let us know. If you just even want to check in via email if you have any questions, that would be awesome. And thanks for caring about men's health, Scot.

Scot: Oh, thank you for caring about men's health. I really appreciate it.

Scot S: I wanted to thank Dr. Madsen and Thunder coming with some great advice today. Hopefully Scot got a little something out of that conversation. Hopefully you did too.

So if you're kind of in a similar situation, maybe a couple of your tests from the doctor came back a little high, whether it's cholesterol or blood sugar, or blood pressure, a couple small changes, if otherwise you're doing pretty good, can make a big huge difference. It certainly worked for Troy. So hopefully you picked something out that you could work on as well.

If you did, or if you'd like to give some advice to Scot, you can hit us up on our Facebook page. It's facebook.com/whocaresmenshealth. Go ahead and DM us there or put a post up on the wall. You can also email us hello@thescoperadio.com. And you can leave a voicemail message too if you call 601-55-SCOPE.

And the most important thing, I should've put this first but I put it last, is if you found value in this podcast and you know somebody else in your life that would find this episode useful, sharing it goes a long way to help us get word out about our podcast.

Thanks for listening. Thanks for caring about men's health.

Scot S: Mitch, Scot, Troy, can you hear me?

Scot: Yes.

Troy: I can hear you.

Scot S: All right. Great. All right. Hey, Scot, I just need to get this recorded too. I just want to confirm that that was your signature on the release form that you emailed me.

Scot: That is correct. That is my signature.

Scot S: Okay, great. And I also need to run this disclaimer. This conversation does not constitute a physician-patient relationship. It's for informational purposes only, to be more informed, and then we encourage you to seek out a provider for advice specific to your situation.

Scot: I understand.

Scot S: Great. Cool. Here we go.

Scot: All right. We're back with Thunder Jalili. He's our resident nutrition expert. And we're going to throw out another one of these things you might see on the internet, or some of this common sense, or, you know, something that you've believed for a long time. And we're going to find out if it's truth or if Thunder is going to debunk it on "Truth or Thunder-Debunked." Thunder, are you ready for your challenge today?

Thunder: I hope so.

Scot:: All right. Does eating at night really cause weight gains? Because there's this kind of, I think, this wisdom that you eat late at night and that's what's going to cause weight gains if you're eating like right before bed or something like that. So is that truth, or are you going to Thunder-debunk it today?

Thunder: No, I actually think there's truth to that.

Scot: What?

Thunder: Yeah.

Troy: Good, I was going to say don't tell me this is not true, because my whole takeaway from all our discussions is that this is true.

Scot: All right. Well, go ahead and explain.

Thunder: We talked in earlier podcasts about kind of the length of time that you eat, in terms of like what time do you eat in the morning when you wake up and then kind of when in the day you stop eating. And as we eat, our insulin levels go up, and that's kind of the hormone to store nutrients like fat.

So people that do that late-night snacking, you know, they've got to have something at, you know, 10:00, 11:00, 12:00 at night, maybe even later, they're kind of extending that whole time that they're putting calories into their system, and their insulin levels are high. So that's a recipe for, you know, storing fat.

So one of the ways that we would, like, advise somebody if they want to try to lose weight, you know, what are some easy steps I can think about, well, one of the easy steps is try not to eat after dinner, you know. Then you kind of have a longer time period where your body can go into that natural fasting state overnight and that helps us control our weight.

Troy: See, I'm so glad you said that, Thunder, because I have now, after all of these discussions we've had about this, I now watch the clock. I don't eat after 8:00, and sometimes it is a rush to get calories in before 8:00 p.m. I admit it's a little weird, but sometimes I am just like, okay, gotta eat, gotta eat, gotta eat. Okay, it's 8:00, I'm done.

Scot: So if you do work later, though, let's say you don't start eating until 6:00 p.m. and you shut it down at midnight. You're eating at night. Is that going to cause weight gains? Is there something about the night, or is it really just about that time of eating and not eating?

Thunder: It's not . . . there's nothing special about night. It's about the time period.

Troy: So maybe it was Thunder-debunked then. So it's nothing about the night in general. It's more just that period between when you last ate and when you eat again.

Thunder: Yeah. Oh, that's true. I guess in that sense it could be debunked. I guess I was assuming most people, you know, do have kind of a more regular schedule of having, you know, three meals, more or less, a day and then throwing snacks in there. So the night snacking, when I hear that, I assume that the person is, you know, kind of doing that normal, three-meals-a-day thing. But, yeah, to your point, if that's not you, if your first meal doesn't come until 4:00 in the afternoon, then, by all means, eat at 10:00.

This content was originally created for audio. Some elements such as tone, sound effects, and music can be hard to translate to text. As such, the following is a summary of the episode and has been edited for clarity. For the full experience, we encourage you to subscribe and listen— it's more fun that way.

Scot: Great. Yeah, Mitch is our producer, and he doesn't even listen to the podcast. What hope . . .

Mitch: I'm listening to the podcast right now.

Troy: What hope do we have?

Scot: What hope do we have beyond the walls of these microphones?

Mitch: I'm sorry I didn't remember what you were . . . okay.

Scot: I love how frustrated you get, Mitch. That cracks me up every single time. "Okay, fine. Yeah. Right. We're doing this now. Okay."

Helping provide the inspiration and the information to care about your health, this is "Who Cares About Men's Health." My name is Scot Singpiel, I am the manager of thescoperadio.com, and I care about men's health.

Troy: And I'm Dr. Troy Madsen. I'm an emergency physician at the University of Utah, and I care about men's health.

Scot: All right. Today, we're going to talk to Troy about five things that you figure are common-sense medical things, but they really aren't true. So, Troy, how long have you been an emergency room physician?

Troy: Scot, I graduated from medical school in 2003, so I started residency in emergency medicine 17 years ago. Man, I say that and it makes me feel really old, but it's been 17 years of emergency medicine. Fourteen years since I finished my emergency medicine residency training, so it's been a little while.

Scot: What's the average career expectancy of somebody in emergency medicine? Because I'd imagine it's not like just being a family physician. I'd imagine that burnout is higher, or maybe not.

Troy: It is a bit higher. Yeah. Studies have been done and it used to be they'd look at burnout in emergency medicine and say, "Well, it's because it's a lot of people who didn't train in emergency medicine," but I think since then we've seen that yes, there is, unfortunately, a higher rate of burnout in the ER.

So you don't see a lot of really old ER doctors. That's why I think I'm starting to feel old. You don't see a lot of white-haired guys going around talking about the old days 40 years ago. It's not something you see in the ER.

Scot: Yeah. And all the ER docs talking about the old days 14 years ago, so . . .

Troy: That's right. I feel like the old guy now. There are guys older than me, trust me, but I'm starting to feel the years.

Scot: So point being you've been doing medicine for a long time and emergency doctors sometimes see a lot and hear a lot and experience a lot, some that might make most of us shake our heads, probably make you shake your head as well.

And today, Troy came up with a topic that I just absolutely love, and I would love it if you'd share this with us. So "Common Sense That Doesn't Make Sense." So in your experience as an ER doc, these are five things that you have seen and heard from people and patients that think are common sense medical things, but aren't really true.

Troy: That's right. These are things that I grew up believing. And maybe even in medical school, I still thought, "Yeah, this makes sense to me. It's common sense." These are things maybe your mom told you as a kid, like you need to do this if this happens, or it's just stuff your friends have told you. Maybe even a doctor told you at some point.

But from my perspective as an emergency physician who deals with certain things and sees these things, it's just, from my practice, it doesn't make sense. These are things I've heard, and then I've heard them again after years of experience. I'm like, "Wait a sec. I believed that at one point, but it doesn't make any sense." It's not something you really need to know or you really need to pay a lot of attention to.

Scot: All right. So we're going to run down through this list right here. And some of them, I'm like, "Really, that's not true?" Number one here, for example. Number one, putting rubbing alcohol to clean wounds is on Troy's Madsen's . . .

Troy: Yeah. It's something you always hear.

Scot: Yeah, common sense that don't make sense. So that's not true? That's what I did all the time. That's what my mom did all the time.

Troy: Oh, I know. Me too. Do you put rubbing alcohol on your wounds now still? I mean, is that something you do?

Scot: I don't live a life that I end up with a lot of wounds.

Troy: You don't have a lot of wounds on your regular wounds?

Scot: But if I was to get one, I would come home, I'd get a cotton swab or a cotton pad, I'd probably put rubbing alcohol on it, and I'd try to clean it up.

Troy: Yeah. I mean, it makes sense. You've got to get that wound clean and that's what you're thinking. Like, what better thing to do than pour some rubbing alcohol on it and just scrub that thing out? You think back as a kid, just the pain and agony from that. Your mom grabbing some rubbing alcohol and rubbing it on your wound or that sort of thing. It's like, "Well, you've got to get it clean." Or even soap, just getting a bar of soap and rubbing it on a cut or just scrubbing it in there. It's not something we do.

And it's not only not something we do in the ER. It's something I tell people not to do. Let's say you get a wound on your hand. And there have been a lot of great studies done on this. All you have to do is run that wound under some kind of lukewarm tap water for five minutes. That does a great job. It washes it out. It gets it clean.

If you do have a lot of debris and dirt and rock stuck in the skin, maybe you do have to get a little scrubbing brush or something really that's not going to tear the tissue apart, but something to kind of rub that stuff out. But you don't want to use rubbing alcohol.

And the reason I say that is because rubbing alcohol or a lot of these things kills a lot of that healthy tissue in there. So that can actually affect the wound healing and even make things worse than if you just did nothing.

Just putting that rubbing alcohol in there can do some damage, so I tell people don't put rubbing alcohol on. Just run it under some nice lukewarm water for five minutes. Just get things irrigated really well with that. It doesn't have to be sterile water. You don't have to boil the water on the stove for five minutes. Just tap water is perfectly fine. It's going to clean the wound out great and keep that healthy tissue there.

Scot: All right. And cleaning out the debris, you just want to be gentle, it sounds to me. You don't want to get in there and really make sure . . . better to have a little debris. I mean, is that damaging the tissue as well if you get in there and, even without rubbing alcohol, just really scrub?

Troy: Yeah. It's a tough balance because you've got debris in there and you've got maybe some chewed-up tissue that's just going to die off anyway. But you don't want to just get in there and really scrub it super hard. I mean, that sometimes is just going to tear things apart and damage the healthy tissue you've got there.

Scot: All right. "Common Sense That Doesn't Make Sense." This is five things you figure are common sense from a medical standpoint, but they aren't true. Troy has encountered people that still believe that they are true. He even believes some of this stuff. I even believe of this stuff.

Number two, know your blood type. I have a memory that back in the day didn't they have blood type bracelets?

Troy: Yeah. You can have cards you carry in your wallet. Because you know your blood type, right?

Scot: Yeah. I'm A-positive.

Troy: I know you know that because you say you have special baby blood or something like that.

Scot: Yeah. Well, first of all, I know my blood type because I donate blood, but I also have baby-saving blood because apparently. I don't have some virus or something that most adults have. I don't know what it is. I'm pure.

Troy: You're pure.

Scot: Yeah, I'm pure apparently.

Troy: You don't have the coronavirus. You are pure.

Scot: Yeah. But the average person doesn't need to know their blood type. That's not something I'm going to be asked if I'm in an accident. "Hey, what's your blood type?"

Troy: The reality is if you come to the ER and you need a blood transfusion, there is absolutely no way I would ever trust you to tell me your blood type, and then I would give you the blood. Scot comes in and he's like, "A-plus." "Okay, let's order up some A-positive blood for Scot." Because if I gave you the wrong blood and you told me, "I'm A-positive," and you're not A-positive, you're B-positive or AB-positive or AB-negative, and I gave you the wrong blood, I could kill you. That would be a really, really bad thing.

So the reality is you don't need to know your blood type. You're never going to get a blood transfusion based on what you say your blood type is. We're either going to give you blood that's what we call universal donor blood that's essentially the blood type that is okay for anyone to receive, or if it's not an emergent thing and we've got time, we'll do cross-matched blood. What that means is we just test your blood, tell what type it is, and then we get you that type right then.

So, again, like I said, it just always kept . . . I can't say it kept me up at night, but it worried me as a young boy to know I didn't know my blood type. "What's going to happen?"

Scot: Well, that's interesting. All right. And it makes total sense too. "Common Sense That Doesn't Make Sense." Number three, speaking of the ER, this was a favorite one of moms everywhere, including my mom. "You better wear clean underwear in case you end up in the ER." I always thought this was just a vanity thing. Did other people have the impression it's a health thing, or was it always just a vanity thing?

Troy: It's a vanity thing, but it's one of . . . yeah, you always hear it too. "You better wear clean underwear because if you end up in the ER and you've got dirty underwear on, it's like . . ."

Scot: "Sorry. Can't help you."

Troy: Sorry. But it's this idea that you're just going to be absolutely humiliated going in the ER and like, "Oh, I haven't changed my underwear in three days," and you're going to have nurses pointing their finger at you, like, "Look at this dirty little kid," or something. But no one cares. I mean, honestly, no one cares.

Number one, no one is going to look at your underwear. But the only time we ever see anyone's underwear is if they come in as a critical patient or a trauma patient, and there, I'm not looking at their underwear. If they're a trauma patient, we've got these scissors, trauma shears, and we're just cutting their clothes off all in one fell swoop, and everything just gets bundled up and tossed in a bag. I don't care. Like I said, it all gets bundled up.

Scot: Not on your list of concerns.

Troy: It's not. No one is going to look at your underwear or judge you for your underwear, whether it's clean or not.

Scot: All right. That was a fun one. Number four, getting a little bit back more to the seriousness. "You should go to the ER if you have high blood pressure so you don't have a stroke." Now, I can't say that I believe this. So I'm hard-pressed to believe what situation this arises in. So maybe you could shed some light on that.

Troy: Well, have you ever checked your blood pressure? Like, just gone to the grocery store or at a pharmacy and sat down on one of those machines and it squeezes on your arm and tells you your blood pressure? Is that something you ever do?

Scot: Yeah. Usually screwing around, but . . .

Troy: Yeah, like, "Hey, what's my blood pressure today?" It is not at all uncommon for us to have people come into the ER who have done that exact thing, and they checked their blood pressure and they got a high reading.

The reality is, number one, we don't base a whole lot off a single blood pressure reading. People's blood pressures fluctuate when you're exercising. If you've been kind of worked up, like you walked in from outside and it was hot outside, maybe that raised your blood pressure.

But the other reality is that you're not going to have a stroke from just high blood pressure like that. It's not going to just somehow cause you to rupture an aneurysm necessarily or do something like that. It's one of those things where the body tends to respond pretty well to fluctuations in blood pressure.

And unless you're having other symptoms with high blood pressure, like chest pain or stroke-like symptoms, like numbness, weakness, difficulty speaking, anything like that, just a single blood pressure reading at a grocery store or a pharmacy or home blood pressure cuff, it's not a reason you have to rush to the ER.

You could call your doctor. You could see them in a week or two. They may check your blood pressure there. And even then, they're probably going to say, "Well, let's see what your blood pressure does over the next three months. We're not going to start you on medication. Let's just keep an eye on it, and then we'll see what it does over the next few months and then kind of make some decisions from there."

Scot: So without the symptoms, if your blood pressure comes back a little high, don't worry about it too much. Maybe check it again a little bit later if it's a home cuff.

Troy: Exactly.

Scot: Okay. That's good advice.

Troy: And you know what happens 90% of the time? When people come in with high blood pressure and maybe they're in the waiting room, as they're getting triaged, they do have a high blood pressure. We get them back to the room, turn the lights down, let them relax, check their blood pressure 30 minutes to an hour later, and it's come down. And it's kind of like, "Well, we don't need to start medication. Don't need to rush to do anything. Sometimes just different things make our blood pressure fluctuate."

So, like I said, it's one of those things where we see it often enough that it's . . . certainly, I think people worry about that, but no reason to rush right in to get things checked out.

Scot: Is there a number that I should be concerned about?

Troy: No. I'm not going to say any number.

Scot: All right. Fair enough. The no other symptoms part, that's the key there.

Troy: That's the important piece, yes. As long as no other symptoms.

Scot: Five things you figure are common medical sense, but they aren't really true. This is "Common Sense That Doesn't Make Sense." And we are up to number five on Troy's list. "Get an annual physical to get a clean bill of health."

Yeah, I've heard this before, but that's not true. That's going to make a lot of guys feel good because we don't necessarily want to go in every year, do we? I mean, does that mean we don't have to go in every year?

Troy: Well, I think the "common sense that doesn't make sense" piece of this is this whole idea of a clean bill of health. Occasionally, I'll see people in the ER who are coming in with chest pain and they say, "Well, I just saw my doctor last month and he gave me a clean bill of health."

Scot: "So this couldn't be a heart attack."

Troy: So it's kind of this idea of I saw my doctor, he listened to my lungs and my heart, maybe did a little bit of blood work. You've got a clean bill of health. It's a funny term because you think about that and you're like, "Wow, that sounds really reassuring. It means everything is good. It means I must be healthy. There are no impending heart attacks or strokes." But there's no way of predicting those things.

You could go to your doctor and get your annual physical and get whatever you might consider a clean bill of health. They say everything checked out, and your blood work looked okay. You could still walk out the door and have a heart attack. Nothing about their testing is going to be enough to predict whether or not you could have a heart attack within the next hour or two hours or week or month or whatever it is.

So I guess kind of the point of that isn't to say don't get an annual physical. It's more to say this whole idea of a clean bill of health really doesn't hold a lot of weight.

Scot: Got you.

Troy: Basically, what it's telling you is during the visit things looked okay, your vital signs look good, everything checked out. Stuff can still go wrong. You could still have strokes, heart attacks, etc. So still a reason to take those symptoms seriously if you do have those, even if you just saw your doctor a week ago.

Scot: Got you. So the danger for the average person is "I was with my doctor a month ago. He said I had a clean bill of health." Now, somebody has these symptoms and they're like, "Well, it can't be anything. I have a clean bill of health. It's written right here. It says on this piece of paper."

Troy: "It says I have a clean bill of health, so I must be fine."

Scot: So then people will ignore those symptoms to their detriment.

Troy: Yeah. They ignore those. It may create a false sense of reassurance.

Scot: And get that annual physical. Sure, it might not predict that you could become sick a week or two from now, but a lot of times those numbers that they get can actually start to recognize a trend that you can turn around, as in Troy's case with cholesterol, and my case with my higher blood sugar.

Troy: Yeah. And I want to be careful there in saying, "The common sense that doesn't make sense." The annual physical makes sense. I think you want to do that to predict stuff and prevent stuff down the road and potentially uncover issues. But if it doesn't uncover an issue, stuff can still go wrong.

Scot: All right. There you go. Five things that you figure are common medical sense, but really aren't true. "Common Sense That Doesn't Make Sense" according to emergency room physician Dr. Troy Madsen.

Any final thoughts as we wrap up this segment of the show on "Who Cares About Men's Health"?

Troy: Like I said, these are all things that are just funny thoughts I've had over the years of stuff that I've just thought, "This used to be a really big deal for me. I used to think a lot about this and now I realize it's not worth worrying about it. It doesn't make any sense."

So maybe you've had some other ideas, other questions that you've wondered about, like, "Is this really something I should worry about? Is this sort of a medical myth?" Feel free always to contact us at hello@thescoperadio.com or reach out to us on Facebook. I'd love to get your questions and explore some more of these things as well.

I would sing it, but I . . .

Scot: Na-na-na-na-na. Thunder. Thunder. Troy, do the honors of singing, "You've been Thunder debunked."

Troy: I can't do that, Scot. Come on.

Scot: Thunder debunked.

Troy: I have to maintain some sense of dignity.

Scot: Thunder debunked.

Troy: I'm sorry. I can't . . . I think you already did it.

Scot: All right, Troy. Excited again to have Thunder. Thunder is back. We love it when Thunder comes on the show. He's our resident nutritionist here at "Who Cares About Men's Health." Thunder Jalili on the show.

Troy: Yeah, Thunder.

Thunder: Thank you.

Troy: Thanks for being here.

Scot: Where else do you go in life that people applaud you like that when you show up?

Thunder: I'm pretty sure you two are the only ones.

Scot: Yeah. Well, me. I mean, Troy, he never claps for anybody.

Thunder: He didn't even applaud? Okay, it's only you, Scot.

Troy: It was just Scot, but I was clapping in my heart for you, Thunder.

Scot: All right. We have a listener question. That's why he brought Thunder on the episode today. So how can you gradually improve your eating habits? That is one of the questions that we got. There are a lot of ways to contact us, which we'll give you at the end of the podcast, but this individual is interested in improving their eating habits, just doesn't quite know where to start. Where do you start? Do you just the next day decide, "Oh, I'm eating healthy. Let's go"? Is that what you do?

Thunder: No. I think it's really hard to do anything cold turkey like that. We are kind of creatures of habit, so really, what we have to look at is how do we build new habits? And that requires maybe making some smaller changes and going from there.

So what would I tell someone who wants to try to improve their eating habits? First, I would say take a look at how much natural versus processed foods you consume, and how many beverages that may contain sugar you consume, and pick a couple of the low-hanging fruit, easy things to modify, and go with that. And then build on that over time a little bit.

Because it is really hard, especially if you're not sure how to eat well, to just wake up one day and say, "It's all over. I'm going to the store and all I'm buying is quinoa and green beans." You have to build up into it. So that would be my advice.

I find that when people start doing that, and they get kind of used to maybe a different way of shopping, a different way of preparing food, then they can . . . it's like a snowball rolling effect. They can kind of build on it and it increases over time. But it is daunting if you just try to go all-in in one day, because you don't even know what to buy, how to cook, when to eat, everything.

Troy: Yeah, cold turkey never seems to work well, that 0-to-60 thing. Same thing of someone going out like, "I'm going to run a marathon," so they go and run 10 miles and they're injured and then they're just done. It seems like the same thing happens with diet. You're just like, "I'm just going to go cold turkey and eat great." It seems like people are miserable. It just doesn't go well.

Scot: Interesting take. At first, it's just getting rid of some of the stuff that's not optimal. Just one or two of the things. You don't have to all of a sudden get rid of all of it, but maybe you just decide, "All right. A couple of meals this week, I'm going to try to get rid of some of this suboptimal stuff and replace it with something that's a little bit better."

I'm going to also say, Thunder, at least from my experience, you've got to be kind to yourself. Because at first, you're not going to get it right. You're going to have setbacks. You're going to have moments of weaknesses. So don't beat yourself up. Just go, "All right. Well, try again next time."

Thunder: Yeah. If I could give a quick concrete example too, because this is something I've talked to people about. There's a bigger push, I guess, in society that maybe we should eat less meat, some of the health effects associated with meat intake.

I've had people say, "Well, I'm not really sure. If I don't eat meat, what do I eat? I don't know what kind of foods to eat." And I tell them, "Well, why don't you try to pick one meal in one day and make that a vegetarian meal? And if that works out, then try to pick one day and make that your vegetarian day. And this just gives you time to think about it and practice a little bit and buy some different foods and build into it, and you can just keep adding days."

So I think that is a good way to go, because if you tell somebody, using the meat example, "You're going to go vegetarian starting in an hour," you're like, "Okay, the only thing I can figure out is I'm going to have cereal for every meal of the day."

Troy: Right. When I went vegetarian, I just tried to replace everything that was meat with non-meat. So I used to eat turkey sandwiches every day, grilled turkey sandwiches. So I bought about all this Tofurky, this soy turkey, and that was disgusting. It often doesn't go well. You're right.

Scot: Time for "Just Going To Leave This Here." It might have something to do with health or it could be something completely random.

Just going to leave this here. I've been kind of into sayings lately, Troy, so I'm going to throw another saying down for "Just Going To Leave This Here." It might be a new paradigm to look at something if you've recently found yourself kind of at square one again on a project. For a lot of people, COVID has kind of put them back.

I like this. It says, "Don't be afraid to start over again. This time, you're not starting from scratch. You're starting from experience." So I like that. Just try to think about you're in a different place when you start something over again, and that different place is actually going to help you make the next part better. So I like that and wanted to share it. Hopefully, it helps somebody out that's listening.

Troy: Scot, I'm just going to leave this here. I mentioned recently on our podcast that we have a pull-up bar outside the ER. It sits outside the ER right there in the ambulance bay. I have been very intimidated to go out there and try and do pull-ups on it, but I've taken a couple of steps in my life recently, Scot.

Step 1 was during shifts, if I just kind of hit that lull halfway through the shift, I go out there and I do a few pull-ups. Fortunately, none of the EMTs have been out there who are generally pretty big guys.

Scot: They make it look easy, right?

Troy: Yeah, exactly. So, fortunately, none of them have been out there to laugh at me and no ambulances have pulled up while I'm doing it. But the other thing I've done, Scot, is I actually got a pull-up bar. So I'm now doing pull-ups at home too.

Scot: I want to know more about that. Is that one of those indoor pull-up bars, or where is it?

Troy: It's indoors. It goes over the doorframe. It's got a wide pull-up . . . kind of your arms wide and then a handle for closer arms. And you definitely find doing this, when you do the wide arms, those are tough. When your hands are in closer together, it's a little bit easier doing the pull-up. But I've been doing it now for a couple of weeks. I like it.

Scot: Does the pull-up bar feel safe and secure, the one that you put in between the doorway?

Troy: It does. Yeah, it does feel safe and secure. I was a little concerned about that, but the way it's set up, it loops up over the doorframe and it's got these pads. So as long as you have it set up correctly and it shows you the diagram to make sure it's safe and it's not going to flip off the doorframe or something, it's been fine for me. And I've been using it for a couple of weeks. I haven't had any issues.

Scot: I've been thinking about getting one of those pull-up bars, because you talk to just about anybody that knows stuff about exercise and doing resistance training, that is kind of one of the big exercises, the king of back exercises, because you're using so many of those back muscles.

Troy: Yeah, it's great. I'm enjoying it. I would be embarrassed to tell you the number of pull-ups I can do, but I'm enjoying it. You definitely feel like you've had a workout in a very short time. So I kind of like that.

Scot: All right. Time to say the things that you say at the end of podcasts because we are at the end of ours. First of all, if you want to get in touch with us, you can do it in a lot of different ways. The way that would be kind of cool is if you called 601-55SCOPE. That's 601-55SCOPE. And leave us a voicemail with your message, your question, your feedback, whatever. But there are other methods as well.

Troy: You can contact us, hello@thescoperadio.com. We're on Facebook, facebook.com/WhoCaresMensHealth. Our website is whocaresmenshealth.com. Also, subscribe anywhere you get your podcasts. We're on Apple, Google Play, Spotify, Stitcher, Pocket Casts, whatever works for you.

Scot: Thank you for listening. Thank you for caring about men's health.

This content was originally created for audio. Some elements such as tone, sound effects, and music can be hard to translate to text. As such, the following is a summary of the episode and has been edited for clarity. For the full experience, we encourage you to subscribe and listen— it's more fun that way.

Scot: All right, Troy, this is your show. Go ahead. I'm just kidding.

Troy: Don't put me on the spot like that, man. You know I don't know what to say.

Scot: All right. Here we go. "Who Cares About Men's Health," providing information, inspiration, and motivation to better understand and engage in your health so you feel better today and in the future.

Got some guys here that care about our health. We're proud to say it too. My name is Scot Singpiel. I am the manager of thescoperadio.com, and I care about men's health.

Troy: And I'm Dr. Troy Madsen. I'm an emergency physician at the University of Utah and I care about men's health.

Thunder: I'm Thunder Jalili. I'm a professor in the Department of Nutrition and Integrative physiology, and I care about men's health.

Scot: All right. Today on the show, what's wrong with a few extra pounds? Is that a bad thing or not? We're going to talk about your diet, your nutrition, that extra weight you may be carrying around, and how that could impact your health today and in the future as well.

So, right after the holidays, and you tune in to your favorite podcast, "Who Cares About Men's Health," and boom, this is the topic we choose. I'm sure you're like, "Thanks, guys. I just got done gluttonizing from Halloween through New Year's and this is when we're going to talk about a few extra pounds?"

So, Thunder, from a nutrition standpoint . . . we talk about proper nutrition and exercise in the core for health now and later. And one of those reasons is to keep your weight within a healthy range. But why does that matter? We've learned that knowing why we do things is important for us to actually follow through on those things, so what's wrong with extra pounds?

Thunder: Well, there are several health risks associated with extra pounds. I think the one that most people know about is the fact that it increases your risk for diabetes. And it's actually the weight gain that happens around the middle, so around the belly. That's kind of the worst kind in terms of increasing diabetes risk.

And that happens to affect men more than women. So as a guy, when you see the belly start to get bigger, which happens after the holidays, that's not always a good thing.

With women, the risk is a little less, they tend to gain weight in different places, more around the extremities and the legs and the rear end. And that's not as bad as far as diabetes risk. So that's the main one.

And then the other one that has been getting more attention lately is actually the fact that obesity is related to cancer risk. So it turns out that that's another risk factor for cancer, is obesity.

And there's now some work that's actually being done in our department trying to also establish a link between metabolic syndrome, which is what happens when people gain weight, and having that be the link to increased cancer risk.

Troy: So, when we talk about a few extra pounds, Thunder, are we talking like, "I just did not do super well eating over the holidays. I put on five pounds"? Are we talking 10 pounds, 20 pounds, or we're talking BMI, looking at that? Anything that you can put there in terms of a cutoff where you really see that risk?

Thunder: Yeah, so if you want to just take the straight clinical approach, BMI, the cutoff where you start to see increased health risks is a BMI of 25. Twenty-five to like 29.9, that is the range that is called overweight. That's where you see these health risks go up. Obviously, the greater the BMI, the more those health risks go up.

To translate that into pounds, what does that mean? Because most people are not quite sure how to make a connection between, say, a BMI of 27 and extra pounds. It's an easy calculation to do. There are lots of online calculators that can help you do that if you want to go in and type in your body weight and your height and it can spit out your BMI. But in general, if somebody is probably 15 to 20 pounds over their ideal body weight, their BMI is going to be in a range that's going to be around that kind of mid-27 or so. And that's where the health risks are going to increase.

But I encourage everyone to go online, find one of those BMI calculators, and try it out. It's good to know where you're at.

Scot: So I'm standing in front of the mirror right now looking . . .

Thunder: Always a bad idea.

Scot: Well . . . I'm looking at my stomach. Is it just the front part of my stomach or the love handles/muffin top? Does that count? What are we talking here?

Thunder: Yeah. It's all there. It's everything.

Scot: Okay. Allow me to put my shirt back on and back away from the mirror slowly now at this point.

Thunder: And mostly the abdominal obesity that is the subject of concern, that is kind of the front, like as your belly protrudes out. Love handles are a bit more subcutaneous, and that's not quite as bad. If you think about like the anatomy of the body, the fat that's packed in around the intestines and the organs, that's the kind that is more associated with diabetes risk.

Scot: So you talked about metabolic . . . what did you call it? Metabolic disease?

Thunder: Metabolic syndrome. Metabolic syndrome is three out of the following five conditions. Either somebody has kind of high blood pressure. Maybe not the blood pressure that we would classify as classic high blood pressure, but that borderline high blood pressure. They may have slightly elevated cholesterol. Again, on its own, maybe it wouldn't be the first thing of concern, but it's elevated more than normal. They may have slightly higher blood glucose levels, which is indicative of pre-diabetes. And they probably have extra weight around the middle, around the belly that we were talking about. And they may have more fat, which we call triglycerides, in their bloodstream.

So, if somebody has three out of those conditions I described, or more, then we would say they have metabolic syndrome.

If somebody has this undiagnosed hypertension, maybe they're running around with a blood pressure that's 5 or 10 points above what we would classify as normal and that would maybe fly under the radar when they would go get a health screening or whatever, but over time, that can increase risk.

Scot: Is the fat the cause of these things starting to happen, or is the fat the indication these things are going to happen? Does that make sense? Because the fat is an indication of a lifestyle that somebody has maybe been doing that is not the healthiest.

Thunder: Yeah. I would say the fat is an indication of the lifestyle that can affect some of those factors, because we know lifestyle is involved with cholesterol or hypertension or, obviously, blood sugar. So, if somebody is gaining weight, for me, and Troy can chime in on this, that's the first kind of warning sign, "Let's take a closer look and see what else happens to be there."

Troy: Yeah, exactly. And I think you're right, Scot, and obviously, Thunder. Yeah, it's one of those things where is it a chicken and egg thing? Is it because these other things are going on? But my understanding is they're all interrelated. Yeah, one may cause the other, but then the other is there, and then it feeds into the other thing.

So I do think that putting on that extra weight, and obesity is going to make you more likely to have that blood sugar that's going to be a little bit too high. And then often, once you get into more of the diabetic issues, then you're going to see more high blood pressure with it and heart disease and all that as well.

So, yeah, it's hard to say if one is definitely the thing that precipitates everything else. But I think definitely the obesity is something that really gets that ball rolling, especially if you've got any sort of genetic tendency toward these things or any sort of just mild underlying issue. It's really going to push that forward to where it gets much more severe.

Scot: It sounds like those video games where you have to string together moves, and you get times two, times three, times four, times five. It sounds kind of like that's what this is, except for not in a good way.

Troy: Yeah. Exactly. If you're already struggling with your genetics, and then you have a tendency toward high cholesterol or toward high blood pressure or diabetes, and then you throw in obesity, you're right. It just makes that snowball and take off.

Scot: What is the turnaround for somebody that has found themselves in a range that's concerning? They've gone online, they did the calculator, they figured out their BMI. How do you start to turn that around? Is it just exercise? Is that what it is?

Thunder: Oh, it's the whole package. It's exercise, and it's what you eat. It's really difficult to use only exercise to control your weight. Unless you're young and you exercise like crazy, then you can probably do it. But if you're a middle-aged guy and you're looking to control your weight or lose weight, you're going to have to bring nutrition into it as well.

Troy: Thunder, what about long-term risk? I've got this BMI calculator up on my computer, and I'm putting in the weight I was five years ago when I was living in California, just living the life of convenience. And every day, there were snacks in the break room, and I was eating snacks, and my BMI was in the 25 to 29 range. How does that compute to longer-term risk? Is my risk dropping immediately as I lose that weight? Or does that time at that range put me at risk of a heart attack in 10 years? Or any idea in terms of what that means longer term?

Thunder: Yeah, I would guess that your risk does drop fairly quickly after you assume a normal body weight or healthy body weight, I should say. So there shouldn't be any reason to say, "Oh, I've already been overweight, so what's the point? The damage is done." I would always try to go towards healthy weight because your risk can always be reduced.

Troy: Again, I was actually a little surprised to put that in. I think at the time, I didn't really realize exactly where I was in terms of BMI, or maybe I justified it or something and I was telling myself it was muscle mass, which it wasn't.

But I'm hoping it's kind of like some of these ads and some of these graphs you see about quitting smoking, about how you may not think that it's making a big difference, but one month after you quit smoking, your risk is dropping. Then you look at that risk drop a year, and then two years out, and it's a pretty dramatic drop in your risk, just with that change. And I imagine the same thing would apply to weight loss as well.

Thunder: Yeah. There have been human studies and animal studies that have found that, where you take an obese animal or human and weight loss occurs, and then you find that their bodily function improved, like their endothelial function in their blood vessels is better, and their insulin sensitivity gets better, and things like that. Yeah, we do have a fair amount of evidence that shows weight loss always results in some sort of improvement.

Scot: I'd like to jump in and say, Troy, at no point have I ever thought that you would have been pushing a BMI that was unhealthy. I need to also confess I had at point . . . maybe now again. Who knows? I had been pushing a BMI that is not healthy, because I would not have considered you overweight. So I think it's good, even if you don't realize, I think your story is really great to maybe check that number out just to make sure, because it can make a big difference.

Troy: It's eye opening. Like I said, I'd never really thought about it until we were just talking now and I thought, "Wow, I wonder . . . well, where am I now? Okay, good." I thought, "Well, where was I five years ago?" And I put it in there and was like, "Wow, I would definitely was in the overweight range."

And it wasn't one of those things where anyone ever necessarily told me, "Hey, you're overweight." People aren't really going to tell you that anyway, hopefully. But I certainly did not think of myself as overweight. So it's a little bit eye opening when you actually plug those numbers in there and see what the results say.

Thunder: Hey, can I add two quick things, as long as we're on the topic of BMI? The thing is, there are so many people in our society who are overweight. Now, I'm making a distinction between overweight and obese. Being overweight is almost normal, really. So the thing is people will say, "Oh, he looks pretty good. Maybe his belly is a little big," but it doesn't register because that's what you see all the time. So that kind of desensitizes us to what overweight actually is.

And then the second point I'll make about BMI is it is just considering your overall body weight. It doesn't discriminate whether that weight is from fat mass or muscle mass. And in the classes I teach, we always do BMI and I come across a fair number of young men who will have kind of a higher . . . like a BMI of 26 or 27, which is in that overweight range, but they're not overweight at all. They're just more muscular than the average person. So you have to keep that in mind, that that can affect BMI, but not in a negative way.

Troy: And like I said, that's how I justified it in my mind, but it was not the case.

Scot: I think you know.

Thunder: Yeah, you know. You can borrow Scot's mirror.

Scot: Yeah, it might be 28 and you can tell yourself it's muscle, but I think if it's muscle, you know.

All right. Hey, Troy, since you've got the BMI thing up, why don't you walk us through what that looks like so we all have a better idea of what we'd be getting into?

Troy: I just Googled "calculate BMI" and it took me to the NHLBI, National Heart, Lung, and Blood Institute, to their BMI calculator. I just put my numbers in here. There's a standard and there's metric. We're going to use standard just because we're using feet, inches, and pounds. My height is five feet, and I'm going to put 9.5 inches. Sometimes I will say 5'10", but it's 5 feet, 9.5.

Thunder: Come on. Go for it.

Scot: COVID has gotten Troy down a half an inch.

Troy: I'll be honest here and type 5 feet, 9.5 inches. My current weight it's about 153 pounds. So that puts my BMI at 22.3. The normal range it gives me on here as a normal weight is 18.5 to 24.9. So I'm within that range.

But then I thought back, "Okay, where was I five years ago?" And I peaked out there at 175 pounds. My height was the same. It hadn't changed. Still, 5 feet, 9.5 inches. That's a 22-pound difference. And at that point, my BMI was 25.5. Overweight is 25 to 20 29.9. Although I did not realize it at that time, I was at that time in that overweight range. Surprising for me to think about that because I certainly didn't think of myself as overweight.

Scot: Thunder, let's go ahead and wrap this up. So we've discussed that this is not a healthy thing, that you should try to get back to more of a healthy weight. Exercise is definitely a part of that equation or activity. You should be getting that 30 minutes every day. But unless you're young and exercising a lot, that's not the only thing. So you're going to have to take control of some of the things you're eating.

I think a lot of us realize we're not probably eating the healthiest, and we can make some adjustments. But what are some of the things that you think could make the biggest impact right off the bat? What are some changes that could be made right away that can make a difference?

Thunder: So what I recommend to people, the first thing they should look at is their sugar intake. The reason why I pick on that is because there's a lot of hidden sugar in foods that we don't really suspect. Between drinks, like iced teas and obviously sodas and juices and snacks and things like that, it's just easy to have a lot of that in there.

Scot: All right. So sugars would be one of the first things, the obvious sugars in the sodas, and then the hidden sugars and stuff like sweetened yogurt. Any sort of flavored yogurt that's not a plain Greek yogurt is going to have hidden sugars. Get rid of those. What would be a good Step 2 then?

Thunder: A good Step 2, I would say, is look at the timing of your eating. When do you eat? When do you snack? Things like that. Sometimes people are grazers. They'll tend to kind of nibble and munch the whole day, and that basically puts them in a position where their insulin levels are always high. Insulin is the hormone that's needed to make fat and to store nutrients. So looking at your food habits, your behavioral habits is another way. Maybe instead of eating 18 hours out of a 24-hour cycle, try to eat 8 or 10 hours. That's a great tool to use.

Scot: If you find yourself overweight and you're trying to lose that weight, is that something that you should go to a health professional and should be done under the supervision of a health professional? Or is this something that a person can do on their own safely? What is both of your guys' take on that? Thunder first.

Thunder: I would say if you're just trying to lose 10, 20 pounds, something like that, then just do it on your own. If someone is very obese, with a BMI of over 40, and they're in a position where they have life-threatening conditions, they need to lose 100 pounds or 200 pounds, at that point I would recommend those people get involved with the physician because they need a more drastic weight loss program.

Troy: And it's also worth thinking . . . Scot, you mentioned working with a healthcare professional. If you have just struggled and you can't get the weight off and you're morbidly obese, consider gastric bypass. Consider bariatric surgery. It's been proven it works. It's successful. Most of the time, people are able to lose weight. They're able to keep the weight off long term. Obviously, we want to talk about diet and exercise and everything there. But if this is about really trying to reduce your long-term risk of heart disease, and diabetes, and everything else, and just nothing has worked for you, talk to your doctor. That's something to consider. And for some people, that's what they need and it does the job.

Thunder: Yeah, and I think it's important to make a distinction between someone that's trying to lose 15, 20 pounds versus someone who is 75, 80, 90 pounds overweight, and they have pre-diabetes and maybe they have high blood pressure. So they have documented medical reasons that they need to lose weight to improve those conditions. What we're talking about in contrast is someone who is slightly somewhat overweight, 20 pounds, and they know if they can stay on that road, in 10 years, you're going to have an increased risk of various ailments.

Troy: Exactly.

Thunder: I think that's important for listeners to keep that in mind.

Troy: Yeah, we're not talking about getting in swimsuit shape and getting gastric bypass for that. This is about taking a surgical step to reduce your long-term, very real risk of heart disease and stroke and everything else and serious medical issues, and someone who's been struggling with long-term morbid obesity.

Yeah, this is not really what we're talking about, but, again, getting back to that question of when do you talk to your doctor, when do you think about medically supervised things, I think that's probably more where you may want to look into that.

Scot: Some good lessons. Fat is an indicator that you might have some other health issues down the road. So even if it's just a little bit more than you'd like, perhaps start turning that thing around sooner than later before it becomes much more difficult, because as we've learned today, that extra fat can impact your health in a lot of different ways, including diabetes, and heart disease, and cancer.

Thanks, Thunder, for that great information today, and thank you for caring about men's health.

Troy, are you ready for a new segment idea we're going just kind of float out there and see how it works?

Troy: Yeah, let's do it. Let's start something new.

Scot: All right. As guys, I think . . . at least I can only speak for myself, but I like this feeling of being prepared to handle situations that come up. So, if a situation comes up and I'm out in the world, I'm like, "I know how to help with that."

This is "Who Cares About Men's Health." You are an emergency room physician. So these are going to be a little bit more serious things, but I think I want to call the segment "How Do You Handle It?"

Troy: "How Do You Handle It?" I like it.

Scot: "How Do You Handle It?" We're going to talk about some things that might happen out in the world, and hopefully, you are going to be able to give us some advice on if this happens, how we could be helpful and useful in that moment so we know how to handle it.

Today, I thought it might be fun to do frostbite. Not fun to get frostbite, fun to do frostbite. You think you've had frostbite at one point in your life.

Troy: Oh, yeah.

Scot: Didn't you tell that story?

Troy: It was awful. Yeah. I was nervous. It was bad. It was one of those things. I was out on a long snowshoe run in the middle of winter, and it's like eight degrees out and my feet are covered in snow the whole time, just in powder. And I get up to the point where I'm turning around to come back down, and I think, "Wow, I can't feel my feet, but my feeling will come back as I get closer to home in lower elevation and as things warm up a little bit."

I get home, and I take my shoes off, and I still can't feel my feet. Right now, as I'm talking about it, I still have that sensation. Just thinking to myself, "From the ankle down, I can't feel my feet. This is the weirdest thing."

I peeled my socks off and my socks were pretty much stuck to my feet because they were frozen on my feet. I looked at my feet and it looked like textbook pictures of frostbite. My feet were just white. And I touched my feet and I could not feel anything. I started to feel very nervous. It was scary.

Yeah, I did experience at least some mild frostbite. Fortunately, I recovered from it. But we can talk a little bit more about that process of what I did to treat that and how you do that. But it was a scary experience.

Scot: When you saw that, was there a little bit of a denial? You're like, "I know I'm a doctor. I know I've studied this. I know what it looks like. I'm seeing it on myself. No, that can't be frostbite."

Troy: I usually go one of the two extremes. I'm usually in complete denial, or I go all in and I'm like, "Wow, I have frostbite, I'm going to die, and I'm going to lose my feet." And that's kind of extreme I went to. It was more like, "Wow, should I call 911?"

Yeah, I was nervous. It was one of those things where it was a combination both of being like, "Okay," and then there was a lot of pain following that time. So it was both that pain and then also definitely a high sense of anxiety associated with that.

Scot: Painful. Your feet are white. Those are some of the things to look for. You said there are different degrees of frostbite. So how do you handle it? Cover some of that for us.

Troy: I think one of the important things about handling frostbite is, first of all, if you're in a situation . . . let's say I were up there at the top of my run, and I'm at 9,000 feet, and my feet are in the snow, and I think to myself, "I think I have frostbite." I should not make a fire there and boil water and try and get water hot and try and rewarm my feet because my feet are going to get cold again. You don't want to thaw it out and then have it freeze again. That's the number one goal.

Scot: That's the worst thing?

Troy: Yeah. Don't thaw it out. Do not treat frostbite unless you're in a situation where your feet can stay thawed out. So, if you're up there in that scenario, and you're like, "Wow, I have frostbite," just deal with it and get to a point where you can then be in a safe place and treat the frostbite and not have it refreeze, because that's when really bad damage can happen. That's probably the number one take-home of it.

Scot: All right.

Troy: But then once you get to a point where you can thaw your feet out, or your hands or whatever it is . . . feet, fingertips, toes, those are the most common sites where we see frostbite. The way you want to do it is get a warm bath, about 100 degrees. Something that feels warm to you. You put your hand in the water, and it's like, "Okay, this is warm. It's not crazy hot where it's burning my hand, but it definitely feels warm." And you want to re-warm your feet in that.

Basically, what I did was I took our bathtub, I filled it up, just started running some warm water in there, and I put my feet in there and it hurt like crazy. So as that blood started coming back into my feet and the tissue started to re-warm, it hurt like crazy and it itched. I just wanted to scratch at my feet. It was very uncomfortable.

And that's the biggest thing with re-warming frostbite, is it does hurt. If we see it in the emergency department, sometimes we have to give pain medications with it to help people tolerate that. But you want to just have warm water where you're circulating that water through there. Maybe get the bath full to a certain point and then just keep running some more water in there and go through that process. For me, I did that for about 15 minutes.

Then I looked at my feet after I had re-warmed it, and I actually sent a picture to Laura, my wife, at that point. I said, "I'm a little bit nervous," because it just had this funky, weird appearance like my feet were all bruised as that tissue was re-warming and blood was trying to work its way back in. It was kind of scary looking.

That's often where the damage happens in frostbite. It's not the freezing piece. Usually, the freezing doesn't cause the tissue damage. It's during that re-warming process that it can get damaged.

But I tried just to do what I would normally do with any sort of patient and just say, "Okay, we're going to go through a re-warming process now." I took some pain medication with it too. I took a Tylenol to help with some of the pain I was experiencing.

And after I'd done that first 15 minutes, I kind of took 10 minutes off and said, "Okay, we're getting there. I'm still nervous about this, but let's do another re-warming trial in the bath and see how things go." And then I went through that, and after that second 15 minutes of re-warming my feet, things weren't back completely to normal, but I was getting some feeling back in my feet. At that point, the tissue was looking a little more normal, not really that crazy, weird bruise look to it. It's the same process I'd recommend someone go through if this happens to them.

Scot: If you're in a situation where you are at the top or wherever of the 9,000-foot peak, or wherever you might happen to be, is there a point where you just make it your priority that I'm going to stay here until somebody can come get me and I'm going to start re-warming stuff right now?

Troy: No, I wouldn't. Because then you've got hypothermia and everything else you've got to deal with.

Scot: Oh, right.

Troy: If I'd stayed up there . . . like I said, the high that day was in the single digits. And if I'd stayed up there and I'd stopped moving altogether, then I'm risking hypothermia. Then you're risking not only loss of limb, but loss of life. You want to just keep moving. This is going to happen probably when you're somewhere in the backcountry on a hike or snowshoeing or . . .

Scot: Snowmobiling.

Troy: Yes, snowmobiling or something like that. Yeah, don't stay put. Just work your way back and work your way back calmly and recognize that, yeah, you've got some frostbite, but you can deal with it and you can work through it and get things back to normal.

Scot: So the protocol that you would follow in the ER is literally what you described that you did at home You don't have any secret weapon?

Troy: No secret weapon. The treatment for frostbite is re-warming. And it really just comes down to trying to get it re-warmed as soon as you can. You just want to keep re-warming until that tissue no longer feels like a block of ice, that crazy feeling that I felt as I touched my feet where it felt like ice. You want to get it re-warmed to where it feels like normal tissue.

Scot: All right. "How Would You Handle It?" Our very first one on frostbite. How are you feeling about that?

Troy: Feeling good. It's something I think that's very relevant right now. We're going to see, I think, a lot more of these things this winter. Frostbite, potentially avalanche injuries, things like this, stuff that happens in the backcountry because my guess is we're going to see a whole lot more people getting out in the backcountry this winter, just with COVID and everything else. So this is one thing to keep in mind. Know what frostbite is, know how to deal with it, be prepared for it, know what to do if it happens.

Scot: Time for "Just Going To Leave This Here." It might have something to do with health or it could be a random thought that we have.

Just going to leave this here. Troy, do you ever run on the treadmill?

Troy: I do.

Scot: You ever get on that thing and think, "Oh, man, this is a form of punishment"?

Troy: Oh, absolutely. That's why I run outside.

Scot: So I found an article in "The New York Times." The treadmill was once a criminal sentence.

Troy: That doesn't surprise me.

Scot: And there's a picture that shows prisoners on a treadmill in London around 1850. Yeah, the treadmill used to be . . .

Troy: Is a form of punishment.

Scot: It was a form of punishment.

Troy: Probably would be considered cruel and unusual punishment. That's why it doesn't exist anymore. You can't do that to prisoners now.

Scot: You're right, and you shouldn't. If you throw golf on the TV while you have them on the treadmill, that's cruel and unusual. That's like the worst.

Troy: That's awful. Well, Scot, I'm just going to leave this here. I ran across an interesting website recently. It opened my eyes to some very fascinating pedestrian laws. I am very attuned to pedestrian laws because I am often a pedestrian. And when you're a pedestrian, you really feel like your kind of putting yourself out there. I've been in some places as a pedestrian on the road where it's downright scary.

But let me ask you about this, Scot. You've got kind of the crosswalks that are just the two lines going across the road. And then you've got the crosswalks that are like those thick things that look like railroad ties going across the road. Do you know what the difference is in the law with those things?

Scot: I didn't know there was a legal difference. No.

Troy: There is a legal difference. If someone is in a crosswalk when there's just the two stripes going across the road, you just have to wait until they're not on your side of the road and then you can go. If you're at a crosswalk with those big railroad tie looking things, and those are usually school zones, you have to wait until the person is completely off the crosswalk before you can go. Interesting.

Scot: I didn't know that difference. At one point in my life, I had heard that here in Salt Lake, if the pedestrian was in the crosswalk, but they were on the other side of traffic, not my area, even then you were supposed to let them completely clear the crosswalk. But there are actually visual indicators. That's interesting. That's good to know.

Troy: Scot, this came up on a website. Actually, the state of Utah put it together. Some of this may be different state to state, but the website is drivermyths.utah.gov. It kind of goes through some of these things. And some of these are a little tricky. It was a little bit surprising to see what laws are specific to pedestrians in crosswalks and what we really need to be aware of.

Scot: All right. Time to say the things that you say at the end of podcasts because we are at the end of ours. First of all, if you want to get in touch with us, you can do it in a lot of different ways. The way that would be kind of cool is if you called 601-55SCOPE. That's 601-55SCOPE, and leave us a voicemail with your message, your question, your feedback, whatever. But there are other methods as well.

Troy: You can contact us, hello@thescoperadio.com. We're on Facebook, facebook.com/WhoCaresMensHealth. Our website is whocaresmenshealth.com. Also, subscribe anywhere you get your podcasts. We're on Apple, Google Play, Spotify, Stitcher, Pocket Casts, whatever works for you.

Scot: Thank you for listening. Thank you for caring about men's health.

This content was originally created for audio. Some elements such as tone, sound effects, and music can be hard to translate to text. As such, the following is a summary of the episode and has been edited for clarity. For the full experience, we encourage you to subscribe and listen— it's more fun that way.

Scot: What are you getting in Taco Bell that you're paying $20 for?

Troy: Sometimes it's just $20. We got me, we got Laura, and we got three dogs in the car. Come on.

Scot: What do the dogs get at Taco Bell?

Troy: They all get a side of steak.

Scot: Do they really?

Troy: You can order a side of steak. They will give you steak in a little cup. They each get their little cup of steak, and they love it.

Scot: Wow. As a dog owner, do you get stuff for dogs at other drive-thrus?

Troy: Unfortunately, yes.

Scot: What are the other things?

Troy: In McDonald's, they get a cheeseburger, no onions, no pickles. We have stopped giving them the bun with it. They just get the meat. At Arby's, Arby's roast beef sliders. They love roast beef sliders. Yeah, it's not good. I'm not recommending this to other dog owners. This is what they get. This is our spoiled dogs here.

Scot: That's fabulous. Anything else?

Troy: Oh, and then there's, in Heber . . . I don't know if you ever go down to Heber, but there's the place on Main Street there. It's called Dairy Keen. It's a place they've got great shakes and stuff. There, they get corn dogs.

And so what happens is when they see dogs in your car at that place, they're like, "Oh, would your dogs like a treat?" And we're like, "Sure." And so they hand us these little dog biscuits. We hand them to the dogs, and they just kind of sit there with it in their mouth or they spit it out, because then they're just waiting for their corndogs. I'm just like, "These dogs are so spoiled."

Scot: "Who Cares About Men's Health" provides information, inspiration, and motivation to better understand and engage in your health so you feel better today and in the future. Plus, it's a place where we can talk about health as men. There are not a lot of those opportunities out there. We kind of get a bad rap for not wanting to talk about it, but it's something we should talk about and that's why we do it here.

My name is Scot. And I like to proclaim loud and proud I care about men's health.

Troy: And I'm Troy and I am also proud that I care about men's health.

Scot: Thank you for joining us on the first show of 2021. Fingers crossed for a better 2021. I went up to that little New Year's baby. You know the visual, right? The old guy wearing the old year sash, the baby wearing the new year, and I just whispered in its ear, I just said, "You better be better than this."

Troy: Like, "Come on, baby."

Scot: Yeah, I'm like threatening 2021 already. 2021 is barely a week old and I'm up in its face saying, "You better be better than this."

Troy: 2021 hasn't even learned to speak yet and you're threatening it. That's what it's come to. That's how desperate we are.

Scot: All right. So today's show is talking about a concept called cognitive load. Heh-heh-heh. I totally said cognitive load.

Troy: You totally said cognitive load.

Scot: Yeah. I don't know if you've run into this. So this is what this is all about, difficulty concentrating on something. Maybe you used to be an avid reader and you pick up a book and you can barely get through a page because you find yourself totally distracted, or you find yourself totally distracted in your work or your personal life. You can't focus on one thing for any amount of time. There could be an explanation for that, and cognitive load will help us find what that explanation is.

Troy: Is that Beavis or Butt-Head?

Scot: That's like the one impersonation I can do, is those two guys.

Troy: But which guy is it that laughs like that? That's Butt-Head, right?

Scot: That's Butt-Head.

Troy: That's Butt-Head. Okay. This is like a total '90s flashback.

Scot: "Heh-heh-heh, you said cognitive load." "Cognitive load. It rules." Anyway.

Troy: Was this like your '90s, doing Beavis and Butt-Head impersonations? I like it. Total throwback. I've got to give a shoutout to James Maynard and Barry Coles here, two my friends from my youth. And that just reminded me of watching "Beavis and Butt-Head" with them. So thanks for that, Scot.

Scot: You're welcome. All right. So I digress. Anyway.

Troy: Anyway.

Scot: This is perfect. This perfectly explains what I'm trying to talk about, trouble focusing, trouble staying on task.

Troy: Exactly. I was going to say, does podcasting count here too? Because clearly, we're distracted.

Scot: So this whole concept is if you've been having a hard time focusing, or just even getting things done, paying attention, you feel more mentally exhausted than normal, it could be because of COVID-19. And we're going to use this concept of cognitive load to explain that.

So, during the past year, a lot of people's routines, many of us, that they've had for years have been significantly disrupted. The power of routine can actually help save mental energy. So all these new routines means more cognitive load. And what that means is you start experiencing these symptoms of concentrating or feeling more exhausted or you can't focus on a book.

And you probably have other things in your life that used to be routine and it seems pretty simple the new way that you have to do it, but it still takes over that working memory. That's tiring, always thinking about, "How am I going to do this? How am I going to do that?" That's why we have habit and routine.

So thing number one is if you have a lot of new routines in your life, and you find yourself having the troubles that we talked about at the top of the episode, we'll talk about how to solve that, but that could be one of the reasons why you're experiencing some of that mental fatigue or inability to concentrate.

Troy: Scot, I think one thing we always used to complain about, but I think we all miss now is commuting. I mean, that was a time in the day that was a part of our routine. And you've mentioned it before, how it was sort of like your separation, like moving from home life to work life, and then the return to home life and leaving work behind. Well, that commute is now gone.

And that was just something, I think, for so many of us . . . that drive is second nature, or that bus ride, or train ride or whatever. And you just kind of turn your brain off, and you'll listen to a podcast, like "Who Cares About Men's Health," or you listen to an audiobook, or music, or whatever. And that's gone. Just having that piece of routine out of our lives, I think, has also contributed a little bit to that mental load.

Scot: Number two, emotions can also interfere with your working memory, that precious resource that we've talked about. Lord knows we've been through ups and downs with emotions, and research has supported this. So, if something stressful is going on in your life, it can make it hard to concentrate because that memory that you want to reserve for solving problems, that working memory, can be impacted by your emotions.

So there's a lot that's stressful right now. COVID, how we're approaching life with COVID, what's going on in the government. Some people got new pets, and as rewarding as those are, those also can be stressful and interfere with that.

So emotions can also interfere with that working memory capacity. And I think a great example of that is if you've ever had a fight with your significant other before you've gone into work. It just kind of sits and chills in your brain and you can't get it out. That distracts you. That impacts your ability to use that memory for what it's meant to do, which is solve problems.

Troy: Yeah. And I think that's a reality we really need to acknowledge, that just being in such close proximity to so many family members, where before there was work life and there was home life. I think that's impacted a lot of people.

It's so funny. I got a holiday card from one of my friends from med school, from his wife. She'd clearly written it because she's pretty funny. But she said something about days in quarantine with her two boys, X number of days, days, homeschool with the two boys, X number of days, 76 days in home isolation with the boys, priceless. It's just like really priceless.

This is what we've been dealing with, whether you've got your kids at home or whatever. A whole lot of emotions come with family. And that family time has, in many cases, tripled or quadrupled when you really look at the waking hours in a day spent with family members, and that comes with a lot of emotion. A lot of those are great emotions. A lot of those are not so great. So that's, I think, been a big factor in the cognitive loading.

Scot: And, of course, all the other emotions that have come with this whole situation. So that can that can really impact your ability to concentrate and solve problems as well.

And another thing that can impact that working memory, that memory that's so important to thinking and reasoning through stuff and really being able to focus, is stuff that's not relevant to what you're currently working on. And they call this extraneous cognitive load.

I'm going to use my table saw analogy to this. One time, I was out working on a table saw cutting a piece of wood. I got done, I looked down at the saw, I saw where my fingers were, and they were dangerously close to the blade.

Troy: That is the number one source of severed fingers, by the way, Scot. But anyway, go on.

Scot: Is it?

Troy: Yes. Number one that I see, yes.

Scot: Anyway, it terrified me and I'm like, "How did this happen? How was I not paying attention?" And what it was, was I had a bunch of other stuff going on in my brain at the same time. So, when I cut that next piece of wood, I'm like, "All right. I've got to focus on that blade. There is nothing else in my world other than that blade right now." And I'll tell you, I had a moment of Zen and peace that I've never had in my life when I shut everything else off and I just focused on the blade.

All that other stuff that's not relevant that's constantly running in the background, whether we realize it or not, was finally shut off. And my brain was like, "Ahh." It was probably only working at about 10% capacity, that working memory.

So thinking about the next project or the next thing on the to-do list while you're doing something else is stuff that's not relevant to what you're currently working on. And when you do that, it impacts your ability to concentrate and focus. It impacts that working memory.

Wondering what the dog is doing in the other room. Normally, you're at work, so that's not a concern, but when you're at home, it could be a concern. Those are distractions we didn't have at the office. Or thinking about the news of the day or your future. So, if there's stuff that's not relevant to what you're currently working on, that takes up some of that cognitive capacity as well.

How do you find that impacts you, Troy, that stuff that's not relevant to what you're currently working on?

Troy: Well, I was going to say, Scot, my takeaway from your story is that I should really be doing very dangerous tasks because it requires my undivided attention and I can put all that other stuff away.

Scot: Well, it's the power of mindfulness really.

Troy: It really is.

Scot: I learned mindfulness through that almost accident.

Troy: Yeah, I was going to say it's mindfulness out of necessity.

Scot: Exactly.

Troy: You have to become very focused in that moment so you don't take your finger off. Because like I said, we see a lot of severed fingers from table saws.

Scot: What do you catch yourself thinking about that's not relevant to what you're currently working on? Do you have an example of that?

Troy: Well, let's see, Scot. I have four dogs and how many cats. I just lose track of the cats, but . . .

Scot: At the end of the day, you're doing a cat hunt to track them all down.

Troy: Trying to find cats. Yeah, like one day, you're working from home and it's windy outside and the front door hasn't closed completely and the door blows open. And I go downstairs just taking a break from doing some stuff on my computer, and I look, and one of the kittens is just sitting there at a wide-open door looking outside.

Laura's home and I yelled to Laura, "Laura, the door is open. Count the cats." And so I run around counting cats to make sure no one escaped. And I immediately went outside to do a quick search to see if any of the kittens ran outside, and it's freezing cold outside. So that's one of my distractions working from home. When you've got pets . . .

Scot: Stuff that's not relevant.

Troy: Yeah, it's the stuff that's not relevant, that then becomes relevant that would not have happened otherwise. Because if you would have been at work, the front door would have been locked, the wind would not have blown the door open. But because you're home, the wind blows the door open and cats are looking out the door wondering, "Maybe I should go explore out there. That's where all those cool birds are I've been watching out the window." You're just like, "Oh, great. Now I'm going to lose a bunch of cats."

So, yeah, those are, I think, the inevitable distractions if you have pets, or you have kids, or whatever else. It's just everything you could kind of just put on the back burner and not think about, it's there with you 24/7 now.

Scot: Right. It's taking up that precious, precious working memory capacity and our ability to focus, and it's also making us mentally fatigued.

What are some of the solutions? Here are some of the solutions.

By the way, I have to give credit to Christian Jarrett from bbc.com, who actually wrote the article that this conversation is based on. We'll put a link to the article in our show notes.

But the solutions. The article goes on to say, "Normally, we adapt well to new situations, but these aren't normal times because there are so many things that are new. There are so many extraneous distractions and emotions are running high." So what can you do?

One of the solutions was start to create consistency where you can and eliminate the other factors that impact our working memory. So double down on the routines. If your routines have been blown up and you haven't developed a new routine, every time you have to think about what you're doing if you don't have a routine, you're using some of that cognitive . . . you're experiencing cognitive load. So sit down and develop some new routines. It could take some upfront work, but it could help get your life more back on autopilot.

Number two, stress management. We're going to tie right back into the core four on this one, Troy. So you've got to manage that stress to control those emotions. Eating well, exercise, and a bedtime routine, if you've kind of abandoned your bedtime routine. It's always great to see even when somebody else is giving us advice how it comes back to the core four.

And I'm going to add build in a time where you give your brain a break from the world and what's going on. I think you need to build in those times in your day. I think at work we used to have them. It was called going to a co-worker's office and shooting the shit, but we don't have that anymore.

So that's my thought on stress management. Do you have anything you'd like to throw into stress management?

Troy: Yeah. I have come to value routines more and more. And what I do . . . we've joked about my little day planner before, but I will try and write out my day, and I will try and at least have some structure to it. I say, "Okay, this is when I'm going to go running. This is when I'm kind of prepping for the day. This is when I'm going to work on this project. This is when I'm working on this project," just so there's some of that routine and that structure. So I'm kind of taking it off my mind, that cognitive load of, "Okay, I've got three hours now to work on stuff. What am I going to do?"

And it also helps, too, to offload my mind when I have things that I just keep thinking about and I just keep thinking about, like, "I need to do this. I need to do this." I just write it down. I'm like, "Okay, I'm not going to worry about it today. This is something I'm going to deal with on Wednesday. I'm going to send this email to this person and address this," or do this task, or whatever. I think that helps me.

I think the bedtime routine has become a little more important to me where now I'm kind of like, "Okay, at this time, I want to start winding down," and then have a little time just to sit in bed and read a book before falling asleep just to incorporate even more of a routine into that.

So that'd be my advice. Anything you can do to structure your day, writing things down, writing tasks down so it's not always on your mind, moving that off so you're not thinking about it. That's taking up some of that cognitive load.

And then like you said, Scot, the routines either at bedtime or morning or wherever you can have some sort of routine, some sort of structure that, again, sort of puts you on autopilot and relieves some of that cognitive load you're experiencing.

Scot: How about for stress management? What's your solution there? Eating well? Exercise?

Troy: Stress management, again, we talk so much about exercise on here. I think, Scot, we're probably a little biased toward exercise, because I think we both lean heavily on that for stress management.

But you may have found other stuff that works for you, too. Whether it's just gaming, or watching sports, or talking with your spouse, or just taking your dogs for a walk, or just watching "Friends," streaming it for the 40th time on Netflix, or whatever. Whatever it is, do not feel guilty about taking that time and working that into the day. I think that's essential now more than ever, just in terms of relieving that cognitive load and just turning your brain off for a while.

Scot: And take a look at your diet as well. I take a look at my diet and that's a big part of stress management, is eating that nutritious food. I probably could work on that.

Troy: Yeah, it's challenging because sometimes that becomes stressful in itself because there's the guilt of not eating well and then . . . I don't know. But I agree. I feel less stressed when I'm eating healthy. I just feel better. My body feels better. I think that just contributes to an overall sense of wellness.

Scot: And number three, solution number three on how to control your cognitive load, is tune out that extraneous cognitive load. So put a little bit more effort into organizing your time. Troy talked about routine already, but if you put a little effort into organizing your time, then you've got your dedicated times to do the things you want to do during that dedicated time.

I'm going to give you a goofy little thing I discovered that helps me. I have a timer I set for 15 minutes, and I have these 15-minute blocks that I work in. I start the timer, and during those 15 minutes, I tell myself, "This is what you're focusing on." And if I catch my mind wandering to something else, I gently say, "No, we're focusing on this." In the next 15 minutes, what can I do to move this thing forward so I feel like I've accomplished something at the end of the 15 minutes?

It keeps me from getting distracted, to want to go to Facebook or Amazon.com. And when the alarm goes off, then I've got five minutes that I can do something else, whether that's a little bit of exercise or whatever.

But it's very Pavlovian. I hear the beep of the timer. Listen to this. I hear this and I know it's work time. That means, "Brain, it's time to focus on this one thing." And when it goes off, then it's cool to focus on something else.

So that's what I do to try to tune out that extraneous cognitive load to really just focus on the one thing, just to do one thing at a time. Email time is email time, and then even beyond that, when it's time to be interacting with the dog, or if you have kids, you then put the phone down and it's kids time.

So just really try to be, I think, cognizant of, "What am I doing with this time right now? I'm going to be mindful in the moment and dedicate my time to this thing right now."

Troy: And for me, it's not just creating that time but also creating that space. That was a big adjustment for me, again, just with the distractions at home and Laura working from home as well.

Right now, I'm recording up in a little bedroom, a little spare bedroom we have. I'm not recording in my office because my office is downstairs near the TV and I can hear everything going on down there when I'm recording there. But this has become my workspace.

I've got a little desk here, a little fold-up desk. You should have seen the setup I had here for months. I finally gave in and I said, "I'm going be doing this for a while longer. I might as well buy a decent desk." But I had like a little patio table that I had in here and a chair I'd set up and some pillows I was setting stuff on so it was sitting high enough. So it's kind of a makeshift arrangement, but I think having that space also away from the distractions where you can focus . . .

And when you go in that room . . . for me, when I come in this room, it's like, "Okay, this is where I do work. This is my workroom." And the door is shut. I don't have pets in here or anything. I'm just working on stuff, and that seems to help as well.

Scot: So, at the end of it all, if you or you know somebody and at the end of the day, somebody in your life says, "Oh, I'm just so tired. I'm so mentally exhausted and I don't even know why," these are some of those hidden things that you might not realize.

So routines. Do you have routines in place or have they been disrupted, and are you constantly needing to manage those things that you do as opposed to being able to put them on autopilot? Have you had a particularly emotional day for one reason or another? That can cause that mental fatigue or lack of focus if you hear somebody say that you think that yourself. Are you trying to do too many things at once? Do you have that extraneous cognitive load?

If you hear yourself saying, "I'm distracted. I'm mentally tired," those are the places to look, at least according to this article by Christian Jarrett at bbc.com. And the link to that will be in the show notes.

Final thoughts?

Troy: I think the takeaway from this, too, is just to recognize that this is a burden. This is something that we're all experiencing. And if you're feeling distracted, there's a good reason for it. If you're feeling mental fatigue, there's a very good reason for it. And these are some ways to potentially address it, but the first step, I think, is just acknowledging that this is real and it's something so many of us are experiencing and don't feel guilty about it.

I loved that Dr. Ben Chan talked a lot about this about a month ago on our podcast, just about giving yourself some slack. Cut yourself some slack. Cut other people some slack. Recognize what they're going through, that they're experiencing the same cognitive load and cognitive fatigue as a result of their routines being disrupted. So I think that's a big takeaway too.

Scot: I think at the end of it all, us guys aren't very good at necessarily recognizing these types of things. So I think just becoming aware of it is the first step. Hopefully, this gave you some information into the workings of some stuff you might not have even realized existed that is impacting your mental health, your ability to concentrate, your ability to focus, your ability to just even feel well. So . . .

Yeah, that's how you end a segment. You just go, "So," and then you play a sounder.

Troy: I was waiting for a "Beavis and Butt-Head" impersonation to end it.

Scot: Oh, that's a good idea. So there you go. That's all you need to know about cognitive load. Heh-heh-heh.

Troy: See, I can't do it. I can't do as well as you can, Scot.

Scot: I think you're a probably better Beavis than Butt-Head, really.

Troy: I don't know what I am.

Scot: Let's hear your Beavis.

Troy: Heh-heh-heh.

Scot: Yeah, you're a better Beavis.

Troy: I'm a better Beavis than a Butt-Head. I'm not sure what that says about us. I'm sure there's some sort of online quiz. "Are you a Beavis or a Butt-Head?" And I don't know what it tells you about yourself, but whatever it is, I'm a better Beavis.

Scot: I think I'm pretty good at both actually. "Yeah, you are. You're really good."

Troy: But personality-wise, who are you more? Or is there a real difference in their personality?

Scot: Wow, this is getting deep.

Troy: They seem pretty similar to me. Beavis just seems kind of frantic and all over the place where Butt-Head is maybe a little more cerebral than Beavis. Beavis is your friend that would just be like . . . you kind of like hanging out with him because they were just hilarious and you never knew what they were going to do, but they kind of scared you too. Butt-Head, I think I'd be a little more comfortable hanging out with him.

Scot: He's a little more chill.

Troy: He's a little more chill.

Scot: Good Lord. This is a disaster.

Troy: It's a total train wreck. See, this is the proof of everything we talked about. We can't even focus long enough to talk about cognitive load, because we don't have enough cognitive space to talk about it.

Scot: I think it also highlights the necessity to being able to offload some of that and take time out to just let it deprogram.

Troy: To do a Beavis and Butt-Head impersonation. To just go with it. I'm thoroughly enjoying this. My mind is back to 1992 hanging out with James Maynard and Barry Coles and watching "Beavis and Butt-Head." That's where my mind is right now, and that's a good place. That's cool. I like it.

I would sing it, but I . . .

Scot: Na-na-na-na-na.

Troy: Thunder!

Scot: Troy, do the honors of singing "You've been Thunder debunked."

Troy: I can't do that, Scot. Come on.

Scot: Thunder debunked!

Troy: I have to maintain some sense of dignity.

Scot: Thunder debunked!

Troy: I'm sorry. I think you already did it.

Scot: All right. We're back with Thunder Jalili. He's our resident nutrition experts, and we're going to throw out another one of these things you might see on the internet or something that's common sense or something that you've believed for a long time, and we're going to find out if it's truth or if Thunder is going to debunk it on "Truth or Thunder Debunked?"

Thunder, are you ready for your challenge today?

Thunder: I hope so.

Scot: All right. Does eating at night really cause weight gains? Because there's I think this wisdom that you eat late at night and that's what's going to cause weight gains, if you're eating like right before bed or something like that. So is that truth or are you going to Thunder debunk it today?

Thunder: No, I actually think there's truth to that.

Scot: What?

Troy: Good. I was going to say don't tell me this is not true because my whole takeaway from all our discussions is this is true.

Scot: All right. Well, go ahead and explain.

Thunder: We talked in earlier podcasts about kind of the length of time that you eat in terms of what time do you eat in the morning when you wake up, and then kind of when in the day you stop eating. And as we eat, our insulin levels go up and that's kind of the hormone to store nutrients like fat.

So people that do that late-night snacking, they've got to have something at 10:00, 11:00, 12:00 at night, maybe even later, they're kind of extending that whole time that they're putting calories into their system, and their insulin levels are high. So that's a recipe for storing fat.

One of the ways that we would advise somebody if they want to try to lose weight . . . what are some easy steps I can think about? Well, one of these steps is try not to eat after dinner. Then you kind of have a longer time period where your body can go into that natural fasting state overnight and that helps us control our weight.

Troy: See, I'm so glad you said that Thunder because I have now . . . after all of these discussions we've had about this, I now watch the clock. I don't eat after 8:00 and sometimes it is a rush to get calories in before 8:00 p.m. It's a little weird, but sometimes I am just like, "Okay, I've got to eat. I've got to eat. Okay, it's 8:00. I'm done."

Thunder: It all depends on your work schedule too. I know some people work later, so you've got to balance all that stuff. But yeah, just try to shut it down after dinner.

Scot: So, if you do work later, though . . . let's say you don't start eating until 6:00 pm and you shut it down at midnight. Your eating at night, is that going to cause weight gains? Is there something about the night, or is it really just about that time of eating/not eating?

Thunder: There's nothing special about night. It's about the time period.

Troy: So maybe it was Thunder debunked then. It's nothing about the night in general. It's more just that period between when you last ate and when you eat again.

Thunder: Yeah. Oh, that's true. I guess in that sense it could be debunked. I guess I was assuming people were snacking at night.

Scot: Boom, I Thunder Debunked a Thunder Debunker.

Thunder: Yeah, this is an embarrassing day for me.

Troy: So it really is . . . that has been debunked. Let's say you work just a late schedule, or you're a night owl, and you like to have a midnight snack, but you sleep in or you just don't eat in the morning. You get up you exercise and you don't eat until lunch, then that's 12 hours between eating periods right there.

Thunder: Yeah. Your timetable definitely makes a difference whether the night thing is an issue or not.

Now, if I can defend myself for a moment, though, most people do have kind of a more regular schedule of having three meals more or less a day and then throwing snacks in there. So the night snacking . . . when I hear that, I assume that the person is kind of doing that normal three-meals-a-day thing.

But yeah, to your point, if that's not you, if your first meal doesn't come until 4:00 in the afternoon, then by all means, eat at 10:00.

Scot: All right. Well, that was that was a fun one to work through. It started out as truth, but then kind of turned into Thunder Debunked. There's nothing special about late-night eating that is bad for you. It's more about are you keeping your eating within certain time limits. Like, are you eating only 8 out of 24 hours, or 12 out of 24 hours? That's what makes the difference there.

All right, Thunder. Thank you very much for another great edition of "Truth or Thunder Debunked?"

Time for "Just Going To Leave This Here." It might have something to do with health or it might be something totally random. Troy, why don't you go ahead and start off the first "Just Going To Leave This Here" of 2021?

Troy: Scot, I texted you about this experience, but I'm just going to leave this here about the bizarre experience I had the other evening. I had to run into the store, into the grocery store, and it was in the evening. I ran in there and I'm going in there just grabbing a few things. I'd been in the store about five minutes. There weren't a lot of people there.

I get to the self-checkout area, and I realized I have gone through the entire store and collected everything I'm buying, six or seven items, and I didn't have a mask on. It was the most bizarre feeling. I was suddenly just so embarrassed and ashamed.

And there were some other people there and I noticed the looks from them. I hadn't even thought about it up to that point. I'm embarrassed even to mention this. Here I am, a physician, we've got masks and all this, "We should be masking," and I just I walked in there. I didn't even realize I didn't have a mask on.

It was like the equivalent of . . . I don't know if you've ever had these dreams, Scot, where you're out in public and you realize you forgot to put your pants on. It is like the 2020 equivalent of the stress dream about being in public and you don't have pants on, and what do you do? And I seriously had that thought, "Well, do I pull my shirt up over my face? Do I put my arm over my face? What do I do?"

I just scanned everything as fast as I could. I didn't even put it in bags. I just scanned it, threw in my cart, and busted out of there. It was kind of a bizarre experience.

Scot: Yeah, it's like do you cover your hand with your mouth?

Troy: Yeah. Well, that's what it was.

Scot: Do you grab one of the plastic bags and put that over your head?

Troy: I thought about it. I was like, "Well, there's a plastic bag. I can put that on my mouth." And I thought, "Well, that's not a good idea. I won't be able to breathe, but at least I won't be spreading COVID." That's too funny.

Scot: Too funny. Wow.

Troy: Yeah, it was weird.

Scot: Just going to leave this here. I told you the last "Just Going To Leave This Here" for 2020 was I have gotten into puzzling, and I finally completed that puzzle.

Troy: Oh, well done.

Scot: I really enjoyed it. I'm just really bummed out, Troy, that you don't enjoy puzzles more because . . .

Troy: I don't. Did want me to join you for puzzling? Is that what you're trying to say?

Scot: No, you don't have to join me for puzzling, but I just wanted to say I finished it. I enjoyed it. The last part I didn't finish pretty, if it was like the World Puzzling Championship. It wasn't like I was looking at the pieces and putting them all together. It's a beautiful mine style.

I'm down to, like, 25 pieces that all kind of look the same. So one by one, I'd find an area on the puzzle and I'd go, "This way? No. This way? No. This way? Nope. This way? No." And I'd put it off to the side and I'd go to puzzle piece number 24. "This way? This way?" And that's how I finished the puzzle.

Troy: Scot, I was going to say when I don't do a pretty job of finishing a puzzle, it usually means I'm just taking pieces and shoving them in places where they don't actually go. Maybe trimming the edge a little bit, being like, "Okay, that works. Okay, that's good enough."

Scot: Where's the hammer? Just hammer them in.

Troy: Just put it in. Yeah, we're done. That's my way of finishing a puzzle and not doing it very nicely.

Scot: All right. Time to say the things you say at the end of podcasts because we are at the end of our podcast. First of all, please subscribe. We're on all the popular podcatchers, including iTunes, Spotify, Podbean.

Troy: Podbean? That's a new one for me.

Scot: I don't know. I don't even know if that's a podcatcher.

Troy: Did you just make that one up?

Scot: No, it's a thing. I just don't know if that's the place where people listen.

Troy: Stitcher. I've got to throw out Pocket Casts every time. I'm going to throw it every time, Scot, because I know you hate it, but Pocket Casts.

Scot: Yeah, wherever you listen, you can get us. That's what I'm trying to say.

And if you want to reach out to us . . .

Troy: You can contact us at hello@thescoperadio.com. Also, give us a call on our listener line, 601-55SCOPE. We'd love to hear from you and get your questions.

Thanks for listening and thanks for caring about men's health.

This content was originally created for audio. Some elements such as tone, sound effects, and music can be hard to translate to text. As such, the following is a summary of the episode and has been edited for clarity. For the full experience, we encourage you to subscribe and listen— it's more fun that way.

Troy: It got interesting.

Thunder: That's a visual.

Scot: "Who Cares About Men's Health," providing information, inspiration, and motivation to better understand and engage in your health so you feel better today and also it's an investment in your future health.

My name is Scot Singpiel. I am the manager of thescoperadio.com, and I care about men's health.

Troy: And I'm Dr. Troy Madsen. I'm an emergency physician at the University of Utah, and I care about men's health.

Thunder: Hi, I'm Dr. Thunder, Jalili. I'm a Professor in the Department of Nutrition and Integrated Physiology, and I care about men's health.

Scot: And Thunder's back. We love it when Thunder Jalili comes on the show. So good to have you.

Troy: Thunder is back, and, Scot, we're back too.

Scot: We are.

Troy: We're not doing reruns. I know everyone enjoyed our recycled episodes for the last two months, but we are back in person. And this is not something we recorded pre-COVID. This is happening now.

Scot: By the way, are you doing okay, Thunder? Is everything all right with the pandemic and whatnot? Your life okay?

Thunder: Yeah. Yes, it's fine. I mean, the short of it is my lifestyle has not really been affected that much, even though that may sound crazy, other than the fact that I'm working from home. But I like to do outdoor stuff I like to bike ride. I don't go to bars. I'm not a big theater or restaurant person. So I'm curious, have you guys gained weight in the last few months through this?

Troy: I haven't. No.

Scot: I've actually lost weight.

Troy: Have you? That's great.

Scot: Yeah. Although I don't know what my body composition is. I'm afraid that it's muscle because I don't weight-train anymore like I used to.

Troy: I heard the statistic somewhere that the average weight gain over this whole thing has been about 15 pounds. So I'd have to look that up, but I don't know if that's true.

Scot: You've heard of the Freshmen 15. This is the COVID 19.

Troy: Yeah, the COVID 19. There you go.

Scot: How about you, Thunder? What's your weight done since this thing?

Thunder: I've actually lost three pounds probably because I've been biking like a maniac. I'm trying to do some more strength training and to kind of moderate that, but I'm lucky I have a gym that I can do that here because I can go at odd times when there's literally nobody there and do a workout and then come home.

Troy: Well, have any of you actually been COVID tested, like had the test?

Thunder: Not the nasal test, but I've had the antibody test, yeah.

Troy: I had the nasal test last week because I was going to the dentist. They required it. It's horrible. It really is bad as people say it is. And I knew what to expect because I've ordered it on so many people and I've seen it done so many times and it was awful. So don't get it if you can avoid it.

Thunder: It serves you right.

Troy: It serves me right. I know. It really does. They say a doctor should have every procedure done to them that they order and I'm just like, "No." That's where I draw the line.

Thunder: Including regular prostate exams.

Troy: Including prostate exams and full-length catheters. No.

Thunder: Full-length catheters.

Troy: That's where I draw the line.

Scot: I sense a fun game. COVID test or catheter? Troy, go. What would you rather?

Troy: I'll take the COVID test over the catheter.

Scot: Troy, as an ER doc, you've never had . . . you don't insert the catheter. That's what a nurse does, right?

Troy: They do, fortunately. I have done it though, and I did it as a med student because that was just part of my training. And I have had to do it or attempt it on difficult patients. Yeah, it's a grueling thing to have to go through. I mean, sometimes it goes pretty smoothly. It depends on the circumstance, but not something I want done.

Scot: And by circumstance, you mean . . .

Troy: I mean, do you have a large prostate? If you have a large prostate, that makes it difficult. And those people tend to experience a lot of pain with insertion, and sometimes we have to use special tools to get it in there and sometimes we have to call a urologist. So yeah, it really depends.

Scot: So it's not the initial part that's going to hurt. It's when it gets up in there a bit. That's when the real pain can start to come.

Troy: I think everything hurts. I think the entire process is uncomfortable. They can numb things up before with lidocaine. So it depends how quickly you need the catheter in. If it's in a trauma situation or an emergent thing, you're not going to get lidocaine, so that's going to hurt. So yeah, it depends on the circumstance.

Thunder: I think I would need general anesthesia.

Troy: Exactly. That's what I love. When you're going to do something light, people are like, "Can you just put me out?" Well, technically I can't really. Hard to justify, but yeah.

Scot: Every time Thunder's on, he just kind of blows our minds about nutrition a little bit. And we've had the macro series. So we've already talked about carbs, we've talked about protein, and we learned that you don't need to have bread guilt because carbs aren't bad. We learned that you don't need to shovel down 16 chicken breasts because you need all this protein, like the muscle guys on Reddit tell us.

Today, we're going to learn a little bit more about fat. The episode is called "Don't Fear the Fat." And really, it should be the easiest show of the season if you believe what the internet says because the internet says, "Fat is evil. Fat will make you fat. It increases your cholesterol. It causes heart disease. You shouldn't eat it. You should go get the low-fat and fat-free foods instead." But that might not necessarily be the truth.

So, first of all, Troy, what's your relationship with fat?

Troy: Scot, everything you just said there is everything I believed before we started talking to Thunder on the podcast. And Thunder has kind of alluded to this in the past and we've touched on this a bit, and my whole perspective on fat has changed.

So I used to think everything you thought, everything . . . I would look on the label. "How much fat is there is in this food? Wow, there's a lot of fat. I am not eating it." And it's kind of changed since then. So I honestly don't even look at fat now, but we're going to defer to Thunder for his thoughts on this.

Scot: Yeah. And we'll get the differences. Is there a good fat? Is there bad fat? Is there fat that you should eat or shouldn't eat? We're going to answer all of those questions.

But, Thunder, I'm hoping that you're thinking the same thing I am as far as when fat got a bad rap. Didn't that happen back in about the '70s, when low fat became the fad?

Thunder: Yeah, exactly. It actually happened even actually before that. In the 1950s, there was a famous physiologist named Ancel Keys who started a series of studies. He kind of actually invented epidemiology in a way, nutritional epidemiology. And he was interested in finding an association between fat that you eat and fat in the blood, like cholesterol, and also heart disease.

And so, between the '50s and the late '60s, he kind of accumulated enough data in his studies where he made a connection that said, "Yes, dietary fat is related to heart disease." And he was a pretty powerful voice. He was articulate, very persuasive.

And over the years, he pretty much persuaded the NIH and the American Heart Association to see it his way, even though there were a lot of detractors at the time. And then even going back and looking at Keys' initial research and finding some problems with the way he did his studies and some of the methodology he used.

Scot: But then this low-fat craze then created some other nutritional problems, if I understand correctly, and that comes along in the form of you take the fat out of something, it doesn't taste good anymore, so you've got to put something into it. And that something was sugar.

Thunder: Exactly right. It was a practical matter. Food companies, they had to kind of respond to the market demand coming from the public where the public wanted low-fat foods because they were told fat is the spawn of Satan and they have to avoid it at all costs. So they're responding to the market. Yeah, when they make low-fat products, they have to put in something else so the food you buy doesn't taste like cardboard, and so they would add sugar in there.

Troy: And I love seeing that in some of the marketing, you'll walk down the candy aisle and see like licorice that says, "It's a low-fat treat," and, "Zero fat." You're like, "Hey, it must be healthy." Obviously, they're still using that in marketing, but it's interesting that, like you said, it was really replaced by sugar and that then became a huge part of our diets.

Scot: But that sugar . . . am I correct, Thunder? So low-fat comes along, lots of sugar gets added to food, and now we've actually got a different health problem that starts emerging as a result of all of that.

Thunder: Yeah. Well, we kind of have the same health problem in a way because, yeah, maybe sugar promotes obesity, so we have that side of it. But really, a high sugar intake still will raise cholesterol levels and will raise triglyceride levels. And so what you think you're avoiding by not eating fat and then not caring about sugar and eating sugar is still going to drive up your blood lipid levels.

Scot: Let's circle back here. In this macro series, we've kind of focused on some of the basics. We got the backstory of fat, how it became vilified if you will. Let's get to "What is fat?" What does it do for my body? I mean, I know protein helps build those structures, carbs provide energy. What does fat do?

Thunder: Okay. So fat really centers around the fact that it's a fuel. So our cells in our bodies can use fat directly as fuel. In times of fasting, we can take stored fat, we can use it as fuel. We can take that fat, we can process it, and eventually make ketones out of it for other tissues in our body to use as fuel during times of fasting or starvation.

There is a certain amount of fat that we need in the form of essential fatty acids for normal physiological function. We use some kinds of fats to maintain our hormone balance. So we have these hormones that live a very short amount of time, maybe just a few seconds, before they're degraded. They're called eicosanoid. They're made from fat, so we need fat for that. These hormones control blood pressure and inflammation and blood clotting and important stuff. So that's one purpose of it.

There are certain kinds of fats that benefit our eye anatomy, our retinas, and are used in the retina. Fats that make it helpful for our immune system to function properly. So we do have some kind of baseline need of fat.

Now having said that, you don't need to have like 20% of your calories coming from fat for the things I just mentioned. Maybe just a few percent of your calories coming from fat, as long as they're from essential fatty acids, can cover your physiological needs.

Scot: Let's go over the different types of fats, because sometimes you hear people talk about good fat or bad fat. You already talked about trans fats, saturated fats. How many different fats are there?

Thunder: Well, there's classically kind of two camps of fats -- fats that are saturated and fats that are unsaturated. And then if we take it back to food, we tend to find more unsaturated fats in plant products and more saturated fats in animal products, but that is not exclusive. There are some plant products that have saturated fats and there are some animal products that have unsaturated fats.

But just the majority, in general, of fats in animal products tends to be more often saturated fats, and then in plants it tends to be more often unsaturated fats.

Scot: All right. I want you to pretend you're looking out, because I know you teach as well, and you see your student Scot in the middle of one of the rows.

Thunder: Is he on his phone again?

Scot: No, he's not, but he's like, "Saturated? Polysaturated?" Make it simple for me.

Troy: What's good and what's bad? Keep it simple. There you go.

Thunder: It's so hard to say what's good and what's bad because a lot of the effects of fat are going to depend on the context of what you're eating in general.

Take saturated fat, for example. So, if you look at ground beef, which is a source of saturated fat, most people say, "Hamburgers have saturated fat." True. There are different kinds of saturated fat in there. There's one kind that has been shown experimentally that it could raise your LDL. It could also raise your HDL, which is good. But there's another kind of saturated fat in that same ground beef that doesn't raise your LDL at all. So it's kind of hard to say, "This is all good. This is all evil," because of those subtle differences.

Now having said that, to make the simple version, the fats you get from plants tend to be more healthy. The fats we get from animals tend to be more unhealthy, especially when it's in the context of fast food.

So the same saturated fat that's in fast food, if I have a little bit of it and it's maybe as part of meat or chicken and there are a lot of vegetables that I'm eating with it, it may not be a bad thing. But then when I take that fat and I put it like in a super-size meal, now it's with all this other stuff that as a package can make it bad.

So I guess two rules. Let me try to summarize this simply. Fat that's in its natural state with unprocessed foods is not that bad. And when we take saturated fat and we put it in the context of processed foods, so think bacon, think fast food, stuff like that, that is bad. So that's the simple version of it.

Troy: So I guess the big question I have for you then, Thunder, is when you're eating or if you're looking at options to eat, do you even look at the fat? Do you even care, or are you just thinking more in those terms like you just mentioned, like, "Unprocessed, vegetable-based, and that's great. I don't care what the fat is"?

Thunder: Exactly. That's basically my guiding principle. If it's an unprocessed food or a food that I prepare at home, I don't really care that much about the fat. But if I'm out and I'm getting food at a restaurant or at a fast food place, then I'm thinking about it. Then I'll be more careful.

Troy: Yeah. And like I mentioned, I've kind of cheated in the sense that I've been able to hear you say a lot of these things before on previous episodes. So hearing this now, I used to look at stuff . . . You talk about nuts, like peanuts, things like that. Like, "Wow, there's a lot of fat in there." Or peanut butter, like, "Wow, that sure has a lot of fat in it." I would avoid those things because of that fat content.

But I think my diet has changed just in the sense that I'm not even looking at fat now. Hopefully trying to follow your rule of thumb of eating more plant-based and simple things and just not worry about the fat.

Thunder: Yeah, I think that's a good approach. And if I could just throw out a few examples since we're talking about high-fat foods. Yogurt, full-fat yogurt is pretty healthy and it has a lot of fat. If you've ever picked up the full-fat yogurt and looked at the nutrition label, it may have 8 grams, 10 grams, 15 grams of fat in there in one serving, but that's fine because the fat in that yogurt, in that food matrix, has not been found to be associated with heart disease or any mortality.

An avocado is another example. An avocado has a lot of fat, but no problems with the fat in avocado. It's a plant-based fat. Even though some of it is saturated, it doesn't really have any negative effect on cholesterol levels or heart disease.

So we can look around and we can find items like that. You mentioned nuts and you mentioned peanut butter. Those are all okay.

Scot: Let me throw out eggs. I used to just eat exclusively egg whites because I wanted to avoid the fat in the yolk.

Thunder: Yeah. So eggs really . . . most people, if they did what you did, Scot, they're avoiding eggs or specifically the egg yolks. The rationale for that is probably based on the fact that you're thinking the fat in the egg yolk is going to increase my risk for higher cholesterol and hence heart disease, right?

Scot: Yes.

Thunder: Has that relationship been shown to be true? The answer is no. Eggs consumed in some moderation really have no bearing on cholesterol levels or heart disease.

Now, if you have six eggs a day, I don't know. Maybe that's something that should be looked at. But if you're the kind of person that has six eggs a week, eight eggs a week, I don't think that really makes any difference. And the studies that have looked at that really haven't found any changes. So we can eat eggs.

And there's also protein in that yolk, by the way. It's not just fat. So when you eat the egg whites, you're missing out on a little bit of a protein from that yolk as well.

Troy: So what about milk? Since we're talking about any kind of animal products here, I grew up and everything I ever learned was drink skim milk. That's what you want to drink. Is that still something you'd recommend?

Thunder: Not really. If you choose to drink milk, there's really no rationale for drinking skim milk. If you like milk, you kind of owe it to yourself to have 2% or whole milk and enjoy it.

Troy: I love it. So forget it. Quit drinking that white watery stuff. Drink the whole milk. Drink the whole cream.

Scot: It looks like dishwater.

Troy: That's what I grew up . . . yeah, on my sugary cereal. I would pour in skim milk. This is my youth in the '80s.

Scot: So one of the things we learned in the carb episode is you don't have to fear bread, right? Bread is fine, like a loaf of sourdough bread. What about if I put some butter on it? Is that okay? I mean, that butter is fatty, right, but it's a natural fat, so I'm going to go with "Thunder says it's cool."

Thunder: Oh, god forbid, butter. I think it's better for you to have butter than margarine. But butter in moderation I don't think really makes a big difference.

Now, remember, this is again in the context of processed versus unprocessed. If you have a high sugar diet, a higher simple carb diet, and you're adding butter to that, that could be a bad combination. But if you have a fairly healthy, unprocessed food diet, and sometimes you're having some butter, whether it's putting it on broccoli, like I like to do, or some other context like that, I don't think it really makes that much of a difference.

So there have been a lot of studies that have looked at saturated fat in that context and haven't really found that it's a major player.

Troy: Well, olive oil. Dip bread in olive oil. That has a lot of fat. I mean, it sounds like though you're saying olive oil is probably okay.

Scot: I'll take this one.

Troy: You're going to take this one, Scot?

Scot: I got this one.

Troy: I'll just give you a softball to hit out of the park here, Scot.

Scot: Olive oil is great for you. Next.

Troy: Okay. There we go. That seems like that's the perfect example of a high-fat food that's been shown again and again to have significant health benefits.

Thunder: Right. It's the centerpiece of the Mediterranean diet. The Mediterranean diet can be a very high-fat diet because people that adhere to that use a lot of olive oil. And Mediterranean diet has been shown to pretty much be great for everything.

Scot: And also I understand fat satiates. It's a satiating appetite suppressant. So when you eat those types of foods, then you're less likely to want to reach for the chip bag a little bit later or some of those other choices.

Thunder: Exactly. One of the bonuses of fat, and fiber also falls into that category, protein falls in that category. So things that help keep us full.

Scot: We are going to wrap up here with one last thought. So we've already talked about the health notions that kind of gave fat a bad rap, but what about "When I eat a lot of fat, it's going to make me fat?" Is that true?

Thunder: That is not necessarily true. It kind of depends on how long you're eating and how much you're eating, but generally not true.

So I think the biggest driver of what makes you fat is the number of calories and, probably even bigger than that, the time that you spend eating, regardless of whether it's fat or other stuff.

What I mean by time, and maybe it's a topic of another podcast, is if you eat in a shorter amount of time and have a longer period of fasting, you're more resistant to weight gain. But if you eat for a longer period of time in a 24-hour cycle, and it doesn't matter if you're having fat in there, protein, carbs, sugar, or whatever, a longer period of time eating in a 24-hour cycle, it makes it easier to gain weight. So that, I think, is a more important determinant than the macronutrient itself.

Scot: Thunder, every time you're on here, you change our paradigms and you make me feel a little less guilty about the foods that I'm eating, and I so much appreciate that. And you make it simple. You make it super simple. Just eat natural foods. Stay away from processed foods as much as possible. Once in a while is fine. And that is the cornerstone to a healthy diet.

Troy: And incorporate regular fasting. I'm glad you brought that up again, too, because that's the other piece of the simplicity. If you can do that intermittent fasting and then throw in just eat healthy, non-processed foods, it's very simple.

Thunder: Yeah. Great summary. I enjoy being on and talking with you guys about nutrition and health. I think they're important topics, and it's great to have interested people to bounce ideas off of.

Troy: Well, Thunder, you'd be happy to know we all went through our favorite episodes of the past year. We did this back in June, and you made all of our lists.

Thunder: Holy crap. That's awesome. Who would have thought?

Troy: You were on there.

Thunder: Thank you.

Scot: Don't expect a certificate or a ribbon or anything.

Troy: Clearly, there were no monetary awards associated with that.

Thunder: Wait, when is my bronze plaque coming in the mail?

Troy: Yeah. We'll get you a trophy,

Scot: But you were definitely a favorite, and it's always great having you on the show. Thank you for caring about men's health.

Time for "Odds and Ends" on "Who Cares About Men's Health." We've got three things to talk about. First of all, a brand-new listener line. Second of all, a brand-new podcast on thescoperadio.com. And third, an upcoming episode that we could use your help with.

So the first thing I'm going to talk about is . . . this is going to actually be out of order, but I want to talk about a brand new podcast. It's part of thescoperadio.com, The Scope Presents Network, that producer Mitch, the producer on this show, is also helping to produce, called "Clinical."

And I've got to tell you, you and Stephen Dark are doing some amazing storytelling with "Clinical," and I just can't say enough good things about it. Tell the listeners a little bit what it's about.

Mitch: Well, thanks. So the show itself is focused on looking at the people that make a hospital a hospital. It's not just the doctors. It's the nurses. It's the EVs workers. It's the translators. It's everyone else that makes the whole thing run.

And right now, we are focusing, like hyper-focusing on a story about the MICU and the nurses and the all the people that are on the frontlines in the medical intensive care unit who are treating COVID-19 and how the virus is affecting them. And it's some of the most rewarding work I've done in a really long time.

Scot: It's awesome. I'll find myself . . . I'll listen and I'll look at the time and I'll think, "I've only been listening for two or three minutes," and I'm 17, 18 minutes into your stories. That right there, I think, is just absolutely amazing, to make them so compelling that I've lost track of time.

So you can check out "Clinical" if you go to thescoperadio.com. That was item number one.

Item number two, we have a brand-new listener line. This is exciting because now it's a new way to interact with us at thescoperadio.com. And the listener line phone number is 601-55SCOPE.

And this is what it'll sound like if you call the listener line.

Voicemail: Hello, you've reached The Scope Radio listener line. We love when our listeners call in and can't wait to hear what you've got to share with us. In your message, be sure to tell us your name as well as which podcast you're calling in for. If you would you like to remain anonymous, feel free to provide an alias. Without further ado, here comes the beep.

Scot: There it is. You will not find any more sincere message leaver than Mitch.

Troy: That was Mitch.

Scot: He was so sincere. "We love it when our listeners call."

Mitch: I believe I recorded that message at like 2:00 in the morning three weeks ago.

Scot: "We just love it."

Troy: "Thanks for calling."

Voicemail: We love when our listeners call in and can't wait . . .

Scot: "We love when our listeners call in and leave their messages."

Mitch: All right.

Troy: All right, Mitch. It's better than anything I could have done.

Scot: I don't know what line I just called. I'm checking the number at this point.

Troy: Am I getting charged for this call?

Scot: So please call the listener line. Thank you very much, producer Mitch, for setting it up. We do appreciate it.

Mitch: You're welcome.

Troy: It really does sound great and welcoming. It sounds very welcoming.

Scot: Exactly. I mean, if I was recorded there, I don't have an ounce of empathy or . . .

Troy: I'd just be like, "Say what you want to say. Beep."

Scot: I'm probably a little jealous that Mitch has those traits, so that's probably why I'm making fun of him.

All right. Number three, upcoming episode. Next episode, we're going to have a urologist on the podcast, which is awesome because a lot of times guys have questions for urologists because they might not be able to access one, get an appointment, maybe feel a little shy or embarrassed, don't want to actually go in and talk.

So we are collecting your questions, whether you call the listener line, whether you go to our Facebook page, whether you just send an email to hello@thescoperadio.com. You can use a fake name if you want. You can say your name is John Doe, or you can say your name is John Smith. You can say you're asking for a friend, but just get those questions in and we'll have them answered in next week's episode.

Anybody else have anything they want to throw into "Odds and Ends"?

Troy: Use the listener line. Obviously, it's a great way to interact with us and, as Mitch said, we love when you call in.

Mitch: Oh my god.

Scot: Do you love when listeners call in, Troy? I just love when listeners call in.

Mitch: I am still trying to find my NPR voice. Give me a break.

Troy: I love when listeners call in.

Scot: The worst part about that is that Mitch really was the one pushing for the listener line. He brought this up so many times, and he did all the work to make it happen. And what do I do?

Troy: You just make fun of it. Just tear it apart. The poor listener line.

Mitch: It's working, though. People are calling.

Scot: Just make fun of it. Well, it's because we have such a sincere message.

Troy: That's why. It's probably just wrong numbers and people hear that and they just say something, like, "Well, I should probably ask a question."

Scot: "Yeah. I mean, I don't want to disappoint this guy. It sounds like this might be the only thing going on in his world."

Troy: "This might be the only call he's ever gotten."

Scot: Oh, boy. Oh, that's good podcasting right there, folks.

Troy: Yeah, it is. This is the quality. This is why we get paid the big bucks, Scot.

Scot: Sure.

Troy: This is it.

Scot: Time for "Just Going to Leave This Here." That's our random thoughts or it could be health-related. It's just whatever happens to be on our mind.

I'm going to go ahead and kick things off with just a brief, kind of an observation. I want to get into kettlebells for a workout. I've looked at some videos. I think a kettlebell workout would be a nice full-body workout. It works the posterior chain nicely. But you know how hard it is to find kettlebells nowadays?

Troy: Probably incredibly difficult.

Scot: Nobody has them. You can't order them online because they're all sold out. I've gone to some fitness stores here in town. They either have really, really light ones or really, really heavy ones. I'm going to have to either get a lot stronger or just work out a lot lighter. But anyway, I hope to have a future episode maybe where we talk about . . . Have you guys done kettlebells ever? Either one of you two?

Troy: I have never done kettlebells.

Mitch: I have. They're fun.

Scot: Yeah?

Mitch: Yeah.

Scot: What weight kettlebell did you use when you did? Do you remember?

Mitch: Is that what we're doing right now? We're measuring things? That's cool. Whatever. I was doing a weight that felt comfortable and safe to me.

Scot: That's the right answer. Very good.

Mitch: I know how to do this podcast.

Scot: Actually, that was a great answer, Mitch. We're going to move to Troy's "Just Going to Leave This Here."

Troy: Well, I'm just going to leave this here, Scot. I know you're very focused on your diet. You measure out everything you eat and you know exactly what your carb/protein intake is. What's your water intake?

Scot: Enough. I drink the amount of water . . .

Troy: That makes you feel safe? I'm just curious.

Scot: I don't know. I probably drink a half or three-quarters of a gallon a day.

Troy: How many glasses is that?

Scot: I don't know because I have one of these big 32-ounce deals and I fill it up two or three times throughout the day.

Troy: Okay. So that's a decent amount. I now know how much water I drink a day. And the reason I know this is because I got these water . . . I mean, I'm filling up water stuff too, and I've never really looked at it. I knew I drank a lot of water. It's recommended you drink eight glasses of water a day. I'm drinking at least 20 to 30 glasses a day easily, probably closer to 30. That's a lot of water.

I don't know why I drink that much. I've wondered, "Maybe I have . . ." I don't know. I hope I don't have any underlying health issues. I just saw my doctor and he did a bunch of labs and everything looked okay.

Scot: Did your doctor have any concerns about the amount other than just health? I mean, I've heard if you drink too much, it can start leaching vitamins and stuff out of your body. This is a question we should ask somebody.

Troy: It is. I'm really curious now.

Scot: As I'm saying it out loud, it's sounding like it's a bunch of crap really.

Troy: I don't know. I've wondered that same thing too. I've wondered because I know I've seen patients in the ER who drink copious amounts of water and it can drop your sodium level. But I had all my labs checked a month ago, everything was okay, but I had that thought as well. I knew I drank a lot of water. I just like drinking water for whatever reason, but things are okay.

Scot: All right, Troy. Cheers. I'm taking a drink of water in honor to you.

Troy: Thank you. I appreciate it. I heard it. Nice.

Scot: All right. Time to say the things that you say at the end of podcasts because we're at the end of ours. Go ahead, Troy. Why don't you start this off?

Troy: Well, thanks for listening. If you want to get in touch with us, you can interact with us on Facebook, facebook.com/whocaresmenhealth. You can also contact us by email at hello@thescoperadio.com.

Scot: And we have a brand-new listener line. That number is 601-55SCOPE. And as always, if you like the podcast, be sure to subscribe. If you can leave a review, that definitely helps other people that might like this podcast find it as well. Thank you for listening and thank you for caring about men's health.

This content was originally created for audio. Some elements such as tone, sound effects, and music can be hard to translate to text. As such, the following is a summary of the episode and has been edited for clarity. For the full experience, we encourage you to subscribe and listen— it's more fun that way.

Consuming too much sugar can be quite detrimental to your health. While they may taste good, refined sugars add no nutrients but a lot of calories to the feed we eat. They can lead to packing on extra pounds, impact your cardiovascular health, and increase your risk of diabetes.

According to the American Heart Association, men should have no more than 9 teaspoons or 36 grams of added sugar a day (6 teaspoons and 25 grams for women). That may sound like a lot of sugar in a day and seem pretty easy to avoid, but you may be surprised at how much added sugar is in the food you eat every day.

Nutritionist Thunder Jalili, PhD, explains that even in the food that is "healthy" there can be a shocking amount of added sugar you don't realize you're consuming. For example:

• 2 slices of white bread - 3g or 1 teaspoon of sugar
• Fast food bean burrito - 3g or 1 teaspoon of sugar
• A small cup of flavored yogurt - 10g or 2.5 teaspoons of sugar
• One Packet of flavored instant oatmeal - 18g or 4.5 teaspoons of sugar
• Name brand energy bar - 31g or 8 teaspoons of sugar

All of these items may seem like pretty normal items to consume every day. Some foods may even be bought on the health food aisle. It wouldn't be strange for a person to eat all of these in a single day. But when you add up the hidden added sugars it comes to 66 grams or 16 teaspoons of sugar in a single day. Nearly double what the AHA recommends. Summer Plans During COVID-19

As the weather turns warmer and we get deeper into summer, we're all yearning for summer activities and vacations. But with the outbreak of COVID-19, a lot of summer plans have been canceled. Plus, with the risk of the virus still present, how can we still enjoy the summer while keeping ourselves and others safe?

First, consider risk. How much risk are you personally willing to tolerate? How does your home or work situation impact your risk toleration? Who are the people in your life that will be impacted by your decisions?

After you have a good handle on what you're comfortable with risk wise, you can then assess the riskiness of an activity based on these three values:

• Time - How long will you be in close contact with another person?
• Proximity - How close will you be to other people? How many people will be present?
• PPE (Personal Protective Equipment) - If you can't maintain physical distance, do you have equipment like masks to help reduce the risk of infection?

Analyze your summer activities to deem how risky they will be. It may not be a good idea to do a multi-day river rafting trip with a group of strangers, but a camping road trip to some of the more remote places of the country would be safer.

Get creative on how you can manipulate time, proximity, and PPE this summer to get out and have some fun while staying safe. Odds and Ends - The 5k is this Saturday

The Who Cares About Men's Health 5K is this Saturday, June 20. We encourage anyone who wants to join this virtual race and show support for Mitch as he gets closer to his goal of going from couch to 5K. The virtual race can be completed any way you'd like, whether it be running, biking, walking, skipping, whatever you can do to get in your physical activity that day. Just Going to Leave This Here

On this episode's Just Going to Leave This Here, Scot really appreciates Brad Stulberg (@BStulberg) on Twitter and his simple, holisitic approach to health. Troy is so desperate for sports that he has begun watching bowling and NASCAR. Talk to Us

If you have any questions, comments, or thoughts, email us at hello@thescoperadio.com.

This content was originally created for audio. Some elements such as tone, sound effects, and music can be hard to translate to text. As such, the following is a summary of the episode and has been edited for clarity. For the full experience, we encourage you to subscribe and listen— it's more fun that way.

It seems like everyone is trying to cut carbohydrates in their diet. Yet, carbohydrates are one of the three major macronutrients the body needs every single day. Are carbs really the enemy to your nutrition goal? Nutrition expert Thunder Jalili is back to clear up the myths about carbs.

Carbs are a category of macronutrients that are built around glucose, starch, and other naturally occurring sugar compounds. They are used by the body as an energy source. These compounds are fundamentally the same whether you get the carb from an apple or a soft drink, but they differ in their potential benefits and how the body can use them.

Thunder breaks carbs down into two categories: natural, plant-based carbohydrates, and refined carbohydrates that are added during food processing. He wanted to make it clear that this is not the typical "good" versus "bad" dichotomy that a lot of fad diets try to create. Think of Carbohydrates Like a Drug Dosage

"Think of it kinda like a drug dosage," explains Thunder. Compare the carbs contained in a sweet potato versus a big gulp soda. First, when looking at the form the carbohydrate takes, the sweet potato's carbs are in a food matrix that slows the body's absorption. The highly processed sugar in the soda absorbs much faster and produces a much more robust insulin response.

Secondly, consider the concentration in these two carb sources. Besides being a quickly absorbed form of carbohydrate, the amount of sugar contained in a large soda can be as high as 30-40 teaspoons. To get a similar amount of sugar from a plant-based source like an apple, you would need to eat five whole apples. Most people wouldn't sit down and plow through five apples in a sitting, but sucking down a large soda over 30 minutes is not unheard of. It's much easier to "overdose," or consume too many carbs (and calories) from highly processed sources and foods with added sugar.

Finally, it's important to take into account the other "good stuff" that the unprocessed sources of carbohydrates have in them. Fruits, vegetables, beans, and even whole-grain bread and pasta have fiber, phytochemicals, and micronutrients that are part of a healthy diet. Processed carbs like Pop-Tarts provide very little nutritional value beyond their high dosage of carbohydrates. Carbs Are Best in Moderation

It can be easy to get too many calories or sugar from non-natural sources. High sugar and high caloric diets can lead to weight gain, obesity, and other cardiovascular diseases. In fact, some research studies have shown evidence that high sugar diets can lead to higher cholesterol and cancer metastasis.

On the other hand, extremely low-carb diets have their own dangers. A diet with no carbs often lacks those important micronutrients and fiber that makes for a healthy body. Additionally, most low carb diets contain more meats and fats, and there are plenty of potential health complications that can come from high meat and high-fat diets.

The rule of thumb is for carbohydrates to make up 40-60% of your daily caloric intake. But Thunder says worry less about the number of carbohydrates you're consuming daily. Instead, focus on the type of carbs you are eating and the rest should figure itself out.

The simple rule is to "live on the fringe" when shopping. In the grocery store, most carbs on the outside edges of the store will be better for you than the refined carbs from the snacks and candy aisles in the middle. Odds and Ends

We broke 1000 likes on our Facebook page. Our community is growing and we want to thank all of our listeners for being a part of it. If you like the show and how we approach the topic of health, please share it with someone you think may appreciate it.

The Who Cares About Men's Health 5K has been moved to June 20. We encourage anyone who wants to join this virtual race and show support for Mitch as he gets closer to his goal of going from couch to 5K. The virtual race can be completed any way you'd like, whether it be running, biking, walking, skipping, whatever you can do to get in your physical activity that day. Stay tuned for our updates for the event.

This week you can visit our Facebook to get your 5k race bib. Download and print the file so you're ready for race day. Take a photo of yourself in the bib and post them to the Who Cares Facebook page or using the hashtag #WCAMH5k to show your support. Just Going to Leave This Here

With all these Zoom meetings, Scot finds himself looking at himself a lot more often. It's making him pretty self-conscious about his posture

Troy is dealing with a new kind of goatee that has been bubbling up with his new constant use of face masks at the hospital. Talk to Us

If you have any questions, comments, or thoughts, email us at hello@thescoperadio.com.

This content was originally created for audio. Some elements such as tone, sound effects, and music can be hard to translate to text. As such, the following is a summary of the episode and has been edited for clarity. For the full experience, we encourage you to subscribe and listen— it's more fun that way.

Macronutrients or "macros" as you may have heard online are the compounds in our foods that we need to eat a large amount of every day. These macros are fats, carbs, and protein. There are a lot of misconceptions about macronutrients. There are plenty of articles out there making claims about these three macros and how much you should or should not be eating. To help us sort through all the noise, we've brought back nutrition specialist Thunder Jalili to speak about each of these macros in a series we're calling Get to Know Your Macros.

In this episode, we're focusing on protein. What it is, and what it does for your body.

Let's start with the basics. When we eat protein, our digestive system breaks proteins into amino acids. Amino acids are the basic building blocks your cells use to assemble all sorts of compounds and proteins the body needs. For example, amino acids make up connective tissue, muscle fibers, antibodies, as well as enzymes and hormones. You Don't Need to Eat That Much Protein

As men, it seems like every muscle building diet plan you find online focuses heavily on getting a lot of protein every day. Producer Mitch was even doing a plan last summer he found online that was having him eat well over 300 grams of protein every day to help him grow muscle.

According to Thunder, the average person needs a whole lot less protein than that to be healthy and grow muscle. He shares a simple equation he uses for everyone except the most elite of athletes.

(Body weight (in pounds) / 2.2) x 1.2 grams = the number of grams of daily protein

For example, Troy is a pretty active guy and he weighs 155 pounds. According to Thunder's math, Troy only needs around 85 grams of protein every day.

85 grams of protein is a whole lot easier to consume than the amount Mitch was trying to choke down on the plan he found on Reddit. While he was seeing some results, he felt miserable and his food budget was expensive. More Protein Doesn't Mean More Muscle

In spite of the diet plans you see online, eating extra protein every day does not mean that protein goes directly into more muscle growth. In fact, eating extra protein may set you back in your fitness goals. Consuming a large excess of protein increases the total amount of calories you consume in a day, and your body does have a mechanism to turn all that unused protein into fat if conditions are right.

Even a high functioning competitive tri-athlete may need only 2 grams per kilogram of body weight every day during training. But for guys like that, it only comes out to about 140-180 grams of protein a day, not the 300+ grams some forums insist on using. Protein is Protein, but Plant Sources Have Bonus Benefits

According to Thunder, there is no fundamental difference in the way your body utilizes the protein found in animal products or plant sources. One the protein is broken down in the gut, your body will use those amino acids in the same way.

However, it's important to keep in mind that research has shown that a diet very high in animal-based protein may lead to a bevvy of chronic diseases. Meanwhile, plant-based protein sources have the added benefit of containing additional micronutrients and fiber that the animal protein does not. Housekeeping - Who Cares About Mitch's Health 5k

The Who Cares About Mitch's Health Mid-May 5K has started. Morning of May 23rd at Sugarhouse park. Feel free to download a couch to 5k event and join the movement. Just Going to Leave This Here

On this episode's Just Going to Leave This Here, Scot realizes how hard it is to leave the house without his phone and trendsetter Troy starts to wear workout clothes to work. Talk to Us

If you have any questions, comments, or thoughts, email us at hello@thescoperadio.com.

This content was originally created for audio. Some elements such as tone, sound effects, and music can be hard to translate to text. As such, the following is a summary of the episode and has been edited for clarity. For the full experience, we encourage you to subscribe and listen— it's more fun that way.

vitamin and supplement industry is big business in the United States. According to the Journal of nutrition there are around 90,000 different dietary supplement products on U.S. store shelves, making up a $30 billion dollar industry.

These supplements make vague, yet bold health claims, including improving ‘heart health,' ‘promoting muscle growth,' and ‘boost vitality.' Men seeking out these benefits in a pill have grown throughout the years, with around 73% of U.S. men taking a supplement daily.

But do these supplements actually work or do they just make your urine quite expensive?

We asked our nutrition specialist Dr. Thunder Jalili. He works with the University of Utah Department of Nutrition and Integrative Physiology and he has the answers to our supplement questions. Research On Supplements is Unclear at Best

So what supplements does Dr. Jalili take? Vitamin D, fish oil, and a baby aspirin. But he admits that he does so even though the science is not clear that these supplements are actually effective.

According to Dr. Jalili, if you look at the research, a majority of supplements have very little effect on your health and just pass through the body. Considering the cost of most of these pills, they're mostly "making your pee expensive."

When it comes to supplement and vitamin research, there are very few reliable, repeatable, and conclusive studies available. In fact, a lot of the findings between studies can be contradictory.

For example, it's a fallacy to assume getting 10,000 percent of your daily suggested dose of Vitamin C will provide any extra benefit than just getting the recommended amount. There is no clear scientific evidence to correlate a super high dose of vitamin C with a reduction of cold symptoms or prevention of illness.

Luckily a high dose of vitamin C is not likely to cause any physical harm. So there's no immediate need to stop taking it, but it's probably providing little health benefit. It's Best to Get Your Micronutrients from Food

"It's really a crutch to help support a poor diet," says Dr. Jalili in regards to vitamins.

He discourages his patients from relying on supplements to make them healthy. It's important to focus on getting the macronutrients and micronutrients your body needs from a healthy diet. Adopting a healthy diet is the most effective, tasty, and safer method of getting vitamins, minerals, and other micronutrients into your body.

In fact, Dr. Jalili tells people not to take multivitamin. While a daily multivitamin may seem like a great way to help ensure you're getting enough minerals every day, they can not only be ineffective, but potentially dangerous.

Some studies assert that multivitamins provide no benefit in the minerals it provides. Other studies have shown a potential link to the regular consumption of multivitamins and an increase in developing cancer. Interestingly, consuming the same dosage of these minerals from food does not show the same cancer risk. There is No Such Thing as a Magic Pill

Out of the 90,000 supplements available, Dr. Jalili suggests there are two that may be worth taking:

• Fish oil - Early research into fish oil supplements has shown it may help reduce a person's risk of primary cardiovascular events.

• Vitamin D - Low levels of vitamin D can lead to a lack of energy and heart disease. It's common for vitamin D levels to drop in people as they age, do older patients may need to take a supplement.

For both of these supplements, recent research has shown that these pills provide only a minimal benefit. Neither present any serious adverse effects. With the low risk and small potential benefit in mind, Dr. Jalili takes both supplements.

It's important to keep in mind that no supplement will completely fix the health effects of a bad diet. The one good rule is: "Eat healthy foods that are good for you."

"Eating unprocessed, plant based foods is good for you. We can all agree on that," says Dr. Jalili, "It's everything beyond that we have to be open minded and objective about. And be prepared to change our mind if the facts change." Workout Supplements Are Best for Elite Athletes

When it comes to performance enhancing workout supplements, Dr. Jalili admits that there are some potential benefits to taking some of the compounds, but they are really only effective for elite athletes.

For example, creatine can be useful in building muscle. It can provide a small increase in performance when used in part of a systematic strength training routine. But the change is relatively minimal and the supplement itself is quite expensive.

Dr. Jalili suggests asking yourself what your goals are before spending the money on creating. Are you an elite athlete that needs gains for a specific athletic performance? Or are you a regular guy trying to get healthy? Do those small expensive differences a supplement may make really matter to you and your health goals? Is it beyond important for you to be able to lift 10 more pounds within a month?

If you do choose to take creatine, be sure to increase your hydration. Creatine has the potential to cause issues with kidneys and increase the chance of developing kidney stones if you drink enough water Your Doctor is Not the Best Resource for Nutrition

If you have questions related to anything about your nutrition - supplementation included - your doctor probably isn't the best to contact. Most doctors in the U.S. receive minimal nutritional training in medical school. Your doctor will only have knowledge of nutrition if they are self-motivated and self-educated.

For questions about diet, food, and supplements, it's best to go to a certified nutritionist.

Otherwise, Dr. Jalili suggests a few good online sources about supplements:

• Academy of Nutrition and Dietetics

Remember not to look for hope in a pill. Your diet, sleep and exercise will have more of an impact than any sort of supplementation. 23andMe May Have Used Your DNA to Develop a New Medication

Did your genetic data help develop a new treatment for psoriasis? The direct to consumer genetic testing company 23andMe recently announced that their genetic library had been sold to and used by a South American company to develop a new drug that may help a lot of people suffering from psoriasis.

It's exciting news, but individuals whose genetic information was used were not compensated, and many didn't even realize their DNA would be used like this.

The Who Cares team discusses what implications this new breakthrough means for research, big data, and ultimately patients that choose to have their DNA tested. Housekeeping - Who Cares About Their DNA Giveaway

Last week we posted a video of Troy and Scot doing a pushup challenge in the studio with Dr. Ernie Rimer. The challenge was inspired by recent research that suggests men who can perform 40 pushups have a 96% less chance of suffering from a cardiac event.

Check out the video on our Facebook and take a listen to the episode to learn how to improve your pushup form and how you can work up to 40 pushups.

Second, Troy has been recovering from a significant running injury he had last year. He's been working hard on getting back to normal. After months of rehabilitation and perseverance, he's running long distances again. In fact, Troy recently ran a race with a good enough time he was able to qualify for the Boston Marathon. Just Going to Leave This Here

On this episode's Just Going to Leave This Here, learn how Scot accidentally got dog poop in his nose. Troy has serious questions for the designers of men's urinals. Talk to Us

If you have any questions, comments, or thoughts, email us at hello@thescoperadio.com.