Episode 426 – Q&A with Robb and Nicki #19
We’re back with Episode 426, Q&A #19, answering some of your questions!
Submit your own questions for the podcast at: https://robbwolf.com/contact/submit-a-question-for-the-podcast/
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1. Arterial Plaque Buildup
Hi Robb and Nicki!
I was wondering what your opinions were on stopping or reducing arterial plaque buildup. Isn’t that one of the big reasons were obsessed with things like cholesterol as a society? I know at one point Dr. Rocky Patel had stated he had significant reversal in his carotid artery after a few years of carb cycling (carb nite). I know this question is absolute minefield of personal variability. At age 40, and a lifetime of combining things like shitty high omega 6 oils and highly process carbs, my new goal is to enjoy retirement. My blood pressure has crept back up since falling off the low carb/carb cycling wagon at my new job. I don’t really think CVD is in too many branches of my family tree, but I always excelled at bad lifestyle choices. I would love to hear what your current thoughts are on this.
I started following you in 2011 and absolutely love your work. The more suggestions I take from you, the better my health gets!
2. Constructing A Workout Plan
New listener who absolutely loves your show so I figured I’d write in and try and get my question answered!
I’m 5’11, 180 lbs, 19% body fat (give or take), and I’m looking to improve my physique. I would describe my look as just a bit more muscular than skinny fat. I go to the gym 3 times a week for strength training, and do light cardio once or twice a week just to stay active. My goal physique would be to add a little bit of muscle and trim some fat. I don’t necessarily need peeling abs, but I’d like to look more athletic than I do now if that makes sense.
What rep ranges do you recommend for someone who just wants to look a little more toned and athletic (in my head I picture what Matthew Mcconaughey looks like)? Or do you have any recommended exercises or routines that I should follow? I know that diet is key for any kind of body composition changes, but I feel like I have that down pat. I just want to get my workouts in line with what my goals are. Maybe I’m overthinking things?
Love your show and everything you guys do!
3. Lifting From Home
Hello! I just love listening to you both. Robb, you have the most well-placed F-bombs. Anyway, I feel like I have my diet where it needs to be. I have been paleo since 2012 but keto for the past 6 months. I enjoy exercising but I do it from home. I have 5-50lb dumbells, a bench, and a pullup bar. Do you know of a good lifting-from-home program or book? I have exhausted my own expertise and would like to change it up. Thanks!
4. Fats and Protein
Hey Robb I really appreciate all that you have contributed to society. I recently finished your book Wired To Eat and I have a question in regards to fat and protein. How do I test my reactivity with different fat and protein sources? How many grams of fat or protein do I test with?
Thank you, I appreciate all that your do.
5. Can’t Reach Recommended Calories Per Day
I’m 45, 165 lbs, 6’1″. I workout 3 times a week (hand weights and HIIT). Lean frame and lean muscle which is typical for me (although I’d like to add more muscle). Minimal body fat thanks to a low-carb Paleo diet (down from 212 lbs). However, when I count up my daily calories, I’m always short of the recommended for my age/weight at around 1500 calories. I eat to satiation at three meals a day. I never feel hungry and could even skip meals with no problem. I snack on EPIC Bites, but that’s it. My question is: should I try to force myself to eat more (even though I don’t want to) to hit my calorie recommendation, or listen to my body and not worry about it?
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Download a copy of the transcript here (PDF)
Robb: Welcome back wife.
Nicki: Welcome back, hubs. Your tag is sticking up. Let me fix that for you.
Robb: Well, it’s in the back, so it doesn’t really fucking matter for this context.
Nicki: I can see it. All righty. What’s new?
Robb: Well, this is one of the interesting things about marriage and spending 15, 20 years with someone, it’s always interesting what the triage and prioritization of important things turns out to be. We’re different, which is good, which means that we have a different fresh set of eyes always available to look at a challenging scenario in a different way.
Nicki: Well, your tie wasn’t a challenging scenario. I’m just staring at it, so I just decided to tuck it in and I verbalized it, and now people get to listen to this. So-
Robb: Hey, people are always asking me about the inner workings, which I have no idea why. Like the inner workings of their own lives are probably as fucked up as ours, so.
Nicki: All righty, should we jump right into-
Robb: Or less so.
Nicki: … our questions?
Robb: Yeah, totally.
Nicki: Okay. Let’s see, our first question in this week’s episode is from Christian on arterial plaque buildup. Christian says, “Hi Robb and Nicki. I was wondering what your opinions were on stopping or reducing arterial plaque buildup. Isn’t that one of the big reasons we’re obsessed with things like cholesterol as a society? I know at one point Dr. Rocky Patel had stated he had significant reversal in his carotid artery after a few years of carb cycling. I know this question is an absolute minefield of personable variability. At age 40, and a lifetime of combining things like shitty high omega-6 oils and highly processed carbs, my new goal is to enjoy retirement.” At 40, that’s awesome, Christian.
Robb: That’s a good time to decide that you want to live, yeah.
Nicki: That’s funny. Retiring at 40, that’s awesome. “My blood pressure has crept back up since falling off the low carb, carb cycling wagon at my new job.” Okay, so maybe you’re not retired. “I don’t really think CBD is in too many branches of my family tree, but I always excelled at bad lifestyle choices. I would love to hear what your current thoughts are on this. I started following you in 2011. Absolutely love your work. The more suggestions I take from you the better my health gets.”
Robb: Awesome. That’s cool. Clearly, I wouldn’t follow any of my recommendations on relationships or spousal interaction. Man, the cardiovascular disease topic is a big deal. It’s a massive story to unpack. I sit on the board of directors of a lipidology clinic, and this is kind of like … we’re earlobe deep in this stuff all the time, and it’s … What’s crazy is billions and billions of dollars have been spent on this, and we still don’t really have a great story around it. I will diverge a little bit. I’ve been listening to the human performance outliers podcast with Zach Bitter and Sean Baker, and it’s great. They had a back to back series of shows with a couple of cardiologists, and that was outstanding.
Robb: And what’s interesting about that is if we go back and look at the efficacy of antibiotics, if you had some sort of a septic event or something like that, infection, sepsis, strep throat, a lot of these things were fatal, and so you could’ve had a benchmark of, okay, if you have this septic event, 90% of people, 95% of people are going to die. Whereas if you then intervene with antibiotics, something like 98% of people will not die.
Robb: So the efficacy was so incredibly powerful, and now we, the health care providers and the drug manufacturers, it’s still contentious, to some degree, whether or not statins really provide much of any benefit, but to the degree that they provide benefit, it’s in a tiny cross section of people. It’s kind of like a wind blowing on you, and you’re like, “Oh I think that that cooled me,” versus you’re on fire and somebody doused you with water or something.
Robb: So it’s fascinating to me that we’ve spent so much money trying to deal with this problem, and there’s some benefit that’s occurred, but without a doubt, diet and lifestyle’s kind of where the rubber hits the road on all of this. And the best understanding of cardiovascular disease, this vascular occlusion process is that it’s a multi-factorial element, like LDL, lipoproteins, LDL cholesterol clearly play a role, but Peter Attia was the first person that I heard use this point which was that it’s necessary but not sufficient for the cardiovascular disease process, and so if you didn’t have LDL lipoproteins at all, you probably couldn’t develop cardiovascular disease, the occlusive cardiovascular disease. You would die from all kinds of other stuff, but it’s a piece that needs to be in the mix, but immune stimulation, blood pressure, non-laminar flow, inflammatory status, blood sugar deltas.
Robb: So there’s a lot that’s going on there, and again, there’s so much going on that sometimes I … Occasionally, we might even break out, I might do a slide or two ahead of time on some of these things in the future. We’ll see because more people are watching these things online, so that might be helpful, but … So, on the one hand, we could have atherosclerotic progression over the course of a lifetime, but so long as we don’t have a clotting event occur, we’re not going to die from that. It’s the clot formation that you know … and it’s kind of a combination where the vascular lumen starts shrinking, so a smaller and smaller particle could-
Nicki: Could cause a clotting event.
Robb: … could cause a clotting event, but then what’s interesting within that is that there’s a pretty good case to be made that most stroke and heart attack events, when there is a clotting event, happens at the tail end of a blood sugar drop. So blood sugar goes high, presumably after a meal,…