The Belly Fat Effect: Linking Leptin, Microbes and Metabolism

 

Mike Mutzel: I am grateful that you made it on today. Super excited for all your support and encouragement. I’m going to let Bettina do a quick introduction, and we’ll start rolling.

 

Bettina Newman: Okay. Thank you everyone for joining us this evening. I’m Bettina Newman, Technical Support. I’m a registered dietician. I work as technical support and a writer for Xymogen. It is a great pleasure this evening to introduce my webinar mate and leptin guru, Mike Mutzel. Mike has been in the nutrition field since 2006. He earned his Bachelor of Science Degree from Western Washington University, and a Master of Science Degree in Clinical Nutrition from the University of Bridgeport. He’s also a graduate of IFM AFMCP. Mike has been a competitive athlete and a personal trainer, and has spent that same degree of energy into his nutrition research, Xymogen customer education, and caring for his lovely family including his wife and their adorable little girl and pet dog. I’m honored to be the first, to be among the first if not the first, to introduce Mike Mutzel as an author. Mike’s book and his labor of love was published last week and the title is, The Belly Fat Effect: The Real Secret about How Your Diet, Intestinal Health, and Gut Bacteria Help You Burn Fat, available on Amazon.com in paperback or Kindle.

Mike Mutzel: I’m super excited to share this with you, and you know, I’m a lifelong student just like many of you, and so I’m here to share my knowledge. I spent the last five years in putting this together and everything, and hope to answer some of the questions that may be you and your patients have, and hopefully you’ll be better equipped to help patients out with weight-loss related issues and metabolic challenges, and fitness and health, and nutritional…

Bettina Newman: I have to admit that I did take a sneak peek of your slides this evening. I was really excited to see how many tips that you’ll share with us. I actually employed with weight management clients during my 40 years as a dietician, working with the late Dr. Robert Atkins who we actually lost in April in 2003. It’s hard to believe so many years have gone by. Also, I was in private practice. What I found most amusing is now we know why what I observed in to be important work so well for patients helping them to achieve and maintain their healthy weight. So Mike, I know you want to talk to us about what I guess we can even call the “Seven Wonders of the Diet World,” and the first one’s a real biggie. If you want to put to that, that’s the one that says, “Diets don’t work.”

 

Mike Mutzel: Right.

Bettina Newman: And I remember the very first page is advertised when I ever ran into my private practice; there’s a big header that said the very same thing. Yet here we are four decades later and people still think that diets do work or at least we should. I used to tell my clients that diet stands for, “Did I eat fat?”

Mike Mutzel: Right.

Bettina Newman: And that’s exactly what happened to his diet. They try to stick to them closely, then they eat something that they know that wasn’t on their plan, and immediately they feel guilty, feel disappointed on themselves and often end up talking out the diet. What were you thinking about when you selected, “Diets don’t work” as your No. 1 reason?

Mike Mutzel: Yeah. It’s along those same lines. I really appreciate you trying to get in and giving us that feedback and stuff. And please, if anything further comes up, definitely we want to hear about it. But most of the stuff here, as you mentioned, it’s not new in the sense that practitioners have been doing it for a long time and people know it works. In the fitness and nutrition industry, everything that I’m going to tell you – everyone knows it works. But now we have the concrete double-blind randomized placebo-controlled trials to prove and to illustrate the mechanisms as to why they’re working. To me, that’s really important because it’s no longer voodoo; it’s no longer empirical or objective – I’m sorry, it’s more empirical, not objective – and so, I think we’re going to enable people to get better results, and then help so many Americans. Before we talk about the diet thing, this is something that I’ve mentioned to you guys before. A recent study published by Eric Braverman and one of his colleagues there, Dr. Shah in New York, when they did DEXA scanning in 13,000 individuals, 64% of them were obese.

So, what you see, what you hear all the time on TV and literature this week or whatever, “The obesity is prominent in America,” it’s really under-represented. The American media will say, “Well, close to 70% of Americans are overweight,” but it’s really going to be much higher than that. So, there are a lot of people with the same problem. And I think, as Bettina just said, what we’re going to talk about tonight is really nothing new, but it really does work. It has worked for clinicians and fitness people and athletes for years, and I really hope that this concrete science will give you more confidence in implementing these different strategies, but Bettina, why do I say “diets don’t work”? Well, I saw them in clinical practice. Obviously, I wasn’t in practice for 40 years like yourself, but I worked with Dr. Gerard Guillory in Denver and doing nutrition for his prediabetic patients and overweight patients. I was a personal trainer in college and I met him through the nutrition industry, and we really clicked and he said, “Hey, why don’t you come in here and work once a week?” and then it turned to two days a week, and then two and a half days a week, and so forth. It was really a great experience for me because you’re having the fitness background and then getting in all these advanced nutrition through functional medicine and IFM and A4M, ACAM and all that. I could really put all the pieces to puzzle together.

Like you said, Bettina, “Diet’s don’t work.” All these people that were overweight were trying to diet, and it wasn’t working for them. I didn’t know this at the time back in 2007, but real reason, or at least one of the main reasons that diets do not work, is they suppress the gastrointestinal hormones from the gut, and so you have about 25 different hormones that are released from the small intestine itself that regulate appetite; they regulate satiety; they regulate insulin signaling. We talked about chromium and vanadium, magnesium, cinnamon, and all these things that affect insulin sensitivity, but many people don’t know that up to 40% of insulin’s action is governed by the release of these hormones. So, let me say that alternatively. If you do not have proper release of the gastrointestinal incretin hormones, which is the category that these hormones are bucketed into, you’re going to be insulin-resistant.

So, what is really unique is these gut-dried hormones are responsible, as I mentioned, for most of insulin sensitivity and activity, but also these hormones and their upregulation are the main reason why people lose weight after bariatric surgery. Contrary to proper belief, so many practitioners and patients really ask them, “How does bariatric surgery work?” I know there are different subtypes of bariatric surgery – there’s Roux-en-Y, lap band and all that – but just in general, one of the main modes of action of bariatric surgery is manipulating, number 1, the gastrointestinal microflora and the gut bacteria, which we’ll talk about, but also beneficially increasing these incretin hormones; the ones that are most notable are the GLP ones and the CCK – so GLP-1 (glucagon-like peptide-1) and cholecystokinin. So, big pharmaceutical companies are no dummies; they’re actually going after these targets. If you look at the total additional research on diabetic medications – at present, there are 168 diabetic medications available right now. Of those 168, about 45 are new in the pipeline, and most of those – about 90% of those 45 new diabetic medications – guess what? They’re incretin hormone mimetics, or they are enzymatic inhibitors of the enzymes that break down the incretin hormones. So either they kind of whip the dead horse, if you will, they whip the gut and tell the gut to release more hormones or they prevent the enzymes in the gut from breaking down the hormone. Either way they’re designed to increase the relative activity of these gut hormones. If we go back to this diet thing, that the problem is when you go on a low-calorie diet, you suppress these hormones for up to one year.

Belly Fat Effect: The Real Secret About How Your Diet, Intestinal Health, and Gut Bacteria Help You Burn Fat

This was a study in the New England Journal of Medicine. What they found was just a 10-week diet, and the low-calorie diet, I think they’re going after 14,000 calories a day or something like that, which in the most traditional dietitians and doctors and things would probably suggest the low-calorie diet such as this. Well, the problem is these people not only gain their weight back, but they gain more weight back than when they started, and their hormones in the gut were still suppressed. They had more insulin resistance than when they started. They had more hunger cravings than when they started, and they had worse fat burning when they started. So, we need to keep the gut in mind not only for GI disorders, not just for autoimmunity, but for metabolic restoration and fat loss as a whole. Again, we’ve already mentioned this, but I do want to show you that the GLP-1 and the CCK and these incretin hormones, they’re not only affecting the gut, they affect many different biological tissues in the body – the heart, the brain, the liver, muscle, tissue, and so on. When there is a malfunction in the gut, we know the saying, right? You’re going to have “Death begins in the colon;” you’re going to have systemic abnormalities and so, it’s very important. We’ll talk about ways that you can increase these gut-derived hormones, but this is No. 1 in terms of where to begin with the dietary metabolic restoration program or weight management program is make sure that these gut-derived hormones are functioning optimally. My favorite for this are phytochemicals, and that’s the one secret ingredient.

What is that one thing that you’re going to tell people that you need to include in every meal? And it’s phytochemicals (phytonutrients).

Here’s the reason why. We tend to think about cumin, garlic, berberine, resveratrol, blueberry polyphenols, green tea – all these things that we know to be beneficial, we know they’re “antioxidants.” We know they’re healthy, but how are they healthy? How are they working? Well, it turns out there’s a twofold effect on fat burning. They not only bind to these docking receptors in the small intestine and increase the secretion or release of these gastrointestinal hormones that are just referenced, but they also selectively increase the proliferation of good guy bacteria. I’m saying it again because this is so, so important. I have a slide on it, but I want to say this a million times so that this really sticks. Polyphenolic compounds are only metabolized by beneficial bacteria.

So, just by eating a diet that’s rich in polyphenols – the greens and spinach and kale, the oranges and bell peppers, and so forth, the purples and blueberries, and the purple kale – all these things – they can only be broken down by good guy bacteria. The bad guy bacteria literally do not have the enzymatic capacity to break them down. So, just by eating a diet rich in fruits and vegetables, and polyphenols, and drinking tea, looking at herbs and spices, you’re not going to affect your metabolism and your so-called increased antioxidants in your body, but you’re going to selectively proliferate good bacteria; they’re almost like prebiotics in that sense. That’s huge, and it makes a lot of sense. We need to really change the way that we look at diet and think about the gut first, think about the bacteria that reside between them. Also, medium-chained fats, such as coconuts, walnuts, macadamia nuts and so forth – these fatty acids also stimulate the release of these gastrointestinal hormones. So, that’s really huge. I summarized this right here. Pea protein is another protein that’s why Xymogen made a switch about I think three years ago, to get rid of this rice protein. Not only other’s proteins not very clean from heavy metal, genetically modified standpoint, but these proteins also don’t stimulate these satiety receptors like pea protein does. That’s really unique. There are some studies from a research I do that has shown that pea protein, but not rice, not soy – pea and whey actually – whey protein is a good stimulator of these gut hormones, is beneficial. Eating in a calm relaxed state, chewing your food – I’m going to talk about rate of eating and such. Regular activation – that would be your meditation; your prayer; your heart math, which I’m a huge fan of.

This is the slide that shows one of the many studies on pea protein showing that it upregulates the release of cholecystokinin and GLP-1. One of the studies was comparing oral ingestion of pea protein versus intraduodenal administration, and interestingly, when you do this intraduodenal administration, you increase these hormone levels a little bit higher, more dramatically, but that’s not really practical for our patient and your patient’s population or ourselves. So, just eat the pea protein mindfully, and it’s going to be beneficial for you.

Big Lesson No. 2: It ties in to all these, but eating while stressed, rapid chewing, mindless eating – we’re all victims of this at some point or another – when we’re driving and eating, when we’re talking on the phone, when we’re doing Facebook and eating – whatever – watching TV – we have kids running around. We all have to work on this all the time. It’s not just overweight people that need to worry about; it’s lean, healthy people. This is something that’s just like a part of human nature; it’s really hard. So, that’s why eating with friends, eating with family, eating with other people and talking while you chew – the science specifically states that eating about 42s per bite is beneficial. They’ve done (no kidding) laboratory studies to prove that. Also, there have been laboratory studies to show that rapid eaters have elevated levels of dyslipidemia, hyperlipidemia, greater hypertension, greater visceral adipose tissue, and so on. So, it’s not just like – Bettina and I were talking about – just diet; it’s not only what you eat, but how you eat it – what’s your physiologic state while you’re eating? This is huge, and I think it’s something that’s commonly neglected.

I talked about this a lot in the book Belly Fat Effect; it really get people to think differently about that like, “Oh, how many calories?” You know there are so many practitioners that even look at the protein product, “Oh, my gosh. It has 180 calories. I can’t recommend that to my patients.” 180 calories is not a lot – no. 1 – but no. 2 – if we’re really not picking calories, are you making sure that you’re talking about what sort of physiologic state? Are you recommending to your patients to get into a parasympathetic state before they eat? Are you recommending heart math and prayer before meals, before dinner? What times of the day are they eating? Like all these things. If we’re going to nit-pick calories, then let’s make sure we definitely nit-pick all these things first. Once we did that, I don’t think we need to worry about 180 calories or 140 calories or whatever because we’re doing all these other things that in my opinion, are more effective, and I will prove that to you shortly.

When you’re stressed out, you’re going to crave bad food; we all know that. So, try to recommend for yourselves and your patients – if you’re stressed, try to calm down before you eat because you’re going to choose high-fat and high-sugar food. This was an interesting study when they gave a milkshake to individuals, and individuals that are high-stressed had a dramatic release of dopamine in their amygdala. So, there’s an interesting link – not only just from like appetite satiety – but literally a correlation between bad food, and the amygdala, as you know, is one of the regents in the brain involved in the stress response.

Let’s see. So, this was another study – awesome study – that looked at all the different… I just summarized everything I’ve told you like mindful eating, chewing your food, and then the proper release of all these gastrointestinal hormones, and then what did they do well that improves blood glucose and lipid homeostasis, which is good.

Bettina, any comments so far?

Bettina Newman: On the timing, I just think people can use the timer for 20 minutes and pace themselves until 20 minutes after the first one. It’s a very easy simple thing, but just as you say, people would generally find and they would eat within a 5- to 10-minute period, and just getting them to extend that time would usually make a difference.

Mike Mutzel: That’s really good. That’s super easy. I mean, get a kitchen timer. Now, the iPhone has a timer on it.

Bettina Newman: Yep. There you go.

Mike Mutzel: Yeah. That’s cool. And the other thing, too – the mindless eating. I read a book; I think it was called “Mindless Eating,” but using smaller plates and only eating on plates. I’m so guilty of this. My wife gets mad at me. When you come home from the gym or whatever, it’s so easy to stand and snack. You know, you just stand and you just eat gluten-free rice chips or whatever and you eat fruit. So, we really have no perception or understanding of how much rice you’re eating when we’re eating mindlessly. So, it’s so easy just to over consume a lot of – even nuts, even seemingly healthy foods – you can overconsume if you’re not mindful. Obviously, if you’re not mindful, then your gut is not going to be prepared to receive the food, so it’s not going to postprandial process that like you would want to. So, what I’ve been doing, just because I was guilty of this, is putting what I’m going to eat on a plate so I know I’ve had a plate of whatever – whether a fruit or nuts or whatever it is – and then I put that plate down. That’s my serving, that portion control – because people are always worried about that – but I think that has been a very useful thing, but I’ll start using that timer like you said. I think that’s a great idea.

Bettina Newman: Yes. On a plate, on a placemat, and using a smaller fork to go along with the smaller plate, keep everything in proportion so they don’t feel like you have a small plate, and then just creating a little world of your own by using a placemat to set out your territory and always sitting down with the placemat and with the plate.

Mike Mutzel: I like that. This small fork – I haven’t heard ever used before, but that’s a good idea. I’ve been using chopsticks.

Bettina Newman: Oh, even better.

Mike Mutzel: Yeah, it’s fun.

Bettina Newman: Or a spoon with a hole in it.

Mike Mutzel: That’s a good idea. Wow, all kinds of good stuff. That’s cool. When Dr. Hussey and Dr. Bridget and I were in Korea, it’s just amazing how slow… I mean, the only overweight people were Americans that were there, or Europeans. But just how long meals are consumed and the chopsticks and coincidentally, they have fermented foods, which I’m going to get into, but the prebiotic component of the live bacteria before and after pretty much every major meal. So, everything we’re talking about – it’s been proven out of science, and is part of Asian cultures and part of their way of living, which is really unique.

So, skipping breakfast – this is a huge, huge thing that I think a lot of people have this misconception on. We know that mild calorie restriction is beneficial, which we call the different mitochondrial pathways, the molecular switches that ignite fat burning, the PGC-1 alpha, MPK, nerf-2 – all these beneficial things are increased when we mildly restrict our calories, which is great, but if you’re going to restrict your calories, don’t skip breakfast. That’s part of the problem. My wife is huge in the blogosphere, paleo and CrossFit, and we have some respectful debates on this topic that the people that say that the best thing that you can do is not eating breakfast, eating large lunch and stuff like that – it’s just that it doesn’t go with the science unfortunately. I’m open to any and all ideas as long as there is something scientific you can hang your hand on. When we discuss the circadian clock system very shortly, it just does not make sense because when we wake up in the morning, it’s called “break the fast” for a reason, but not only that, the minute that the sunlight hits your retina, your brain is interpreting that signal, in a region of your brain called the “suprachiasmatic nucleus” (or SCN) – that transmits that light signal to all the different tissues on your body – your heart tissue, your liver tissue, the gut, the adrenals – that’s why your adrenals fire in the morning, and then you have cortisol release to get you up and going, to go forward for food, eat food, and so the gut starts to churn and is most active in the early part of the day, not in the evening. The gut peristalsis and digestive capacity really slows down at night, which I will explain why it’s a problem if you do eat large meals at night very shortly. The big take-home here is you got to eat breakfast. People that I worked with in Dr. Guillory’s clinic, they were overweight – I say 90% of them didn’t eat breakfast and they would say, “Well, I’m just not hungry in the morning. I don’t know what to do, Mike.”

The simple solution to that is if you’re not hungry in the morning, don’t eat dinner. Just to kick the cycle, kick the body in the high gear – you might be a little hungry, have some whey protein or pea protein at night – but if you don’t eat dinner, you will be hungry in the morning. I know because sometimes I do it, and I’m starving like I can’t go very long without eating food in the morning. That’s how you want to be. It’s really a good feeling when you wake up hungry. And I find that my energy levels for the rest of the day if I wake up hungry and eat a nice meal, most of the carbohydrates that I do eat in the morning or at lunch – I pretty much stop carbohydrates after that. There are clinical studies to support this. I’m going to bring up bodybuilders and fitness models. I know that you guys aren’t trying to be a bodybuilder; you’re not trying to get your patients to be a bodybuilder – but if we can appreciate bodybuilders for what they’ve been able to do in a sense that for these people that do these sorts of events, they can reliably get their body fat down to 4 or 5%.

How do they do that? Well, they do large breakfast, and they go from 15 or 20% body fat down to 4. They do cardiovascular exercises on empty stomach; they eat a large breakfast; they eat a large lunch; and they eat minimal calories, just proteins and vegetables in the evening. That’s how you lose weight. The science is showing that, but we know in the fitness world that that’s what’s been done since the 80s, and it works, and it’s continuously working. So, when you go away from that and you do these weird calorie restrictions and you don’t eat breakfast and all that, it’s not going to get you anywhere. If you have trouble getting into the rhythm of eating breakfast (I’m going to show you how you can do that), but don’t eat dinner, take melatonin, get a good night sleep, then that should kick in the cycle. If you do that repetitively three or four days at most, that will get you in the cycle and retrain your circadian clock system and retrain your gut, and I guarantee you you’ll lose belly fat, you’ll lose weight, and you’ll improve your metabolism. So the bottom line – there are many studies here. I’m not going to get through all these studies; you can find them and read them on your own, but pretty much every single study that has looked at breakfast and body fat breakfast, metabolism breakfast, and metabolic syndrome, breakfast eaters, and blood sugar – it all shows that eating breakfast is beneficial. We’re going to talk about the circadian…

Bettina Newman: There was a question that came in that’s relevant. Somebody wants to know how you feel about eating three times a day versus five.

Mike Mutzel: That’s a really good question. What I’m going to say on that is it depends how active someone is. If you’re really active, I think the idea of eating five times a day is good – and what I mean by that is if you’re doing CrossFit (which I’m a huge fan of), if you’re doing Olympic-type lifting (which I’m a huge fan of), you’re doing burst training, circuit training, you’re getting out moving – I think eating smaller meals more frequently is very beneficial. But if you’re relatively sedentary – not too big into exercise for time constraints or injury or reduced mobility – I think then three small meals a day is just fine. I say that because eating is pro-inflammatory. Every time you eat, you create oxidative stress, and you have food sitting in your gut for a long period of time, and a few hours moving and you’re burning through it and all that – I think it’s decent and you’re going to need to eat three times a day because you’re going to be hungry. If you’re not super active, I don’t think people should be eating that much. It’s just my personal opinion; people can argue with me. In Ayurvedic medicine – some practitioners there are very versed on that. They’re totally against the idea of eating multiple meals a day. They think it’s too much of a burning in the GI tract, and that you need some bowel rest. I don’t know – I think you got to play with that one a little bit and see where people are at. What do you think, Bettina?

Bettina Newman: I think the constitution of the meals is important. So, if you’re snacking carbohydrates in between and raising blood sugar during that time versus if you’re having a handful of nuts in between, protein and fat (which have lower glycemic index), it wouldn’t be as inflammatory, and I think that would be a better choice. So, it’s what you eat in the five meals.

Mike Mutzel: Yeah. I would definitely agree. A lot of people think as snack is like coke and a muffin or coffee (cappuccino with milk and sweeteners) and a muffin, but obviously, like what you said Bettina, that wouldn’t be ideal. So, snack of light nuts and a little protein shake – I think that’s good, especially for people that are active.

Another huge lesson is poor sleep hygiene. Pretty much everyone that I’ve worked with that’s overweight has sleep issues, and they were these people that have to be at work 5 in the morning, have to be at work and leave the house at 3:30 or whatever. They would barely sleep and have sleep hacking. They want a CPAP machine, they have to sleep in different rooms from their spouses because they snore, and all these different things. I just thought, “Gosh. That sucks.” I would hate to have that kind of lifestyle, but I did not realize that it was probably contributing in a large percentage to their condition, to their insulin resistance, to their obesity, to their poor dietary habits and such. Sleep is huge. As I mentioned earlier, the minute light hits your retina in the morning, you’re driving this circadian clock. I believe I have a slide here that shows this circadian clock, and if you didn’t catch the webinar on January 7^th, I believe we dove into this. This is the latest thing in metabolic science and obesity – the circadian clock genes and all that.

It sounds kind of voodoo to think that there are molecular clocks inside our cells, but it really makes sense. I mean, why would you want to test your patient’s testosterone in the males first thing in the morning? Why do you want to do an adrenal salivary index first thing in the morning? Because everything oscillates with the rise and fall of the sun, and that’s how it’s supposed to function. If you look at the female hormonal system, it’s very predictable in the 28- to 31-day cycle, or at least it should be. People that don’t have these rhythms working properly – they have low testosterone in the morning or low cortisol in the morning or whatever or no appetite in the morning – that’s a clinical indication that they have circadian clock destruction. So, getting them back on track – turning out the lights at night and measuring melatonin, getting regular consistent sleep. Sleep hygiene – it’s not just 8 hours; from one day 10-6, and another day 12-8, and then 9-5; it needs to be very consistent. Just because you sleep 8 hours, but if it’s in different times every night, that’s going to confuse the body and further perturb the so-called circadian clock system, which is illustrated here. Sleep is very, very, very important – not just for body composition, but for detoxification, for hormone balance, for neurologic function, for cardiovascular function. If you look at the epidemiological data on when heart attacks occur, about 60% of most fatal heart attacks occur in the morning. There’s no surprise there. That’s a whole another topic.

But this circadian clock system, I just want you all to know, is very, very real. This isn’t voodoo; this isn’t weird nutritional medicine. This has been validated, and from the clinical standpoint, we need to start being conscious enough and talk about not only meal timing, nutrient timing, but also supplement timing. Individuals become more insulin-resistant as the day progresses.  It makes no sense to have pasta for dinner because you’re pretty much insulin-resistant by dinner, so it doesn’t make sense to have a lot of sugar or a lot of carbohydrates, especially refined carbohydrates in the evening. If you’re going or if your patients are going to have these things – these carbohydrates and the rice and the pastas or whatever – if they personally can’t live without them – at least convince them to eat it in the morning, and then convince them to have lean protein fish or grass-fed beef or myosin or what have you and some vegetables in the evening, and just cut the carbohydrates down. So, this is huge. Your folks have the adrenal salivary index tests that are off – I mean cortisol are peaky at night or it’s flat line or whatever. Yeah, support their adrenals.

You can give them ashwagandha or whatever else, but we also need to get them back into rhythm – get them sleep in consistent times, get them corrected with melatonin. I don’t really review these studies here; that was the previous webinar, but melatonin is so critical for – the term is called “in training” – in training someone’s circadian clock; so, getting their clock back on the predictable pattern that is commensurate with the rise and fall of the sun. Their clocks are these maestros, metabolic maestros. They do so much and all that. I want to talk about this slide – just this illustration from an article here. Incidentally, we actually burn fat most effectively at night. When we’re sleeping, our mitochondria are very active; they’re burning lipids, the so-called “oxidative phosphorylation,” beta oxidation of fatty acid occurs at night – your carnitine, you alpha lipoic acid (ALA), the different mitochondrial supportive agents would be beneficial for you to have very first thing in the morning or later in the evening because that’s really when the mitochondria are most active. Conversely, your blood sugar supportive agents would most likely be best administered in the afternoon and the later part of the evening when we become more insulin-resistant. Also, exercise. We talked about cardiovascular training, aerobics – if people are doing aerobics – running, walking – I’m a fan of walking and burst training, and all that. I’d like to do that first thing in the morning on empty stomach because you’re going to ride the coat tails of those mitochondrial pathways where you’re burning lipids, you’re burning fat, and so on. So, it’s really beneficial to consider this aspect of metabolism – this so-called “circadian clock system.”

I mentioned this earlier – that light is hitting your retina. And so if you’re up late at night on your computer, you got all the lights in your house on, you watch the TV – your body is confused; it thinks it’s daytime. If you ever go camping, there’s no light. Once the campfire’s out, it’s like pitch black. That’s how humans live for a very long time and so now, we’re on a society where everything is lit up. You can’t even get away from the lights. In some cities, you can’t even see the stars because there’s so much light. This is very, very important. Encourage your patients to use black-out lights and things like that – shades, turn off the TV, turn off the computer, just do some light reading on a Kindle or whatever in the evening hours – and they’ll sleep so much better. My wife and I recently moved. We used to live in this house; it was a nice house, but our bedroom was on the second floor and there’s always road noise and lights kept going by and by, and I didn’t realize that I got used to it. I never slept well there. I always felt tired when I woke up and not restful, just kind of out of it and made a coffee.

I just assumed it was my life working and whatever, and then we moved into this new place; our room is on the bottom floor, it’s nearly in the ground. That’s how the house is built in beside of the hill – it’s completely pitch black. We both sleep 8 hours no problem. Whenever I wake up, I feel amazing. I mean, it’s just so incredible – that’s just small difference. I bet a lot of your patients are in that – they don’t even know that they’re not sleeping well. They don’t even really realize that they’ll leave the door open and the kid’s bedroom’s has the light on or a night light or whatever, the TV’s left on while they’re sleeping. I know of some friends and family that watch TV and fall to bed, and go to sleep and the TV’s splattering all night, and there’s a median light. That is going to be a problem; that’s going to create metabolic disturbances and chronic diseases, potentially cancer and autoimmunity, and so we really need to pretend like we’re almost camping in a sense. We want it that dark; we want it black.

The reason why that’s really bad to you at night, not only that – I shouldn’t say, “eat at all.” It’s good to eat dinner, but eat a lot of food, a lot of refined fats and carbohydrates and a lot of calories at night is because the GI tract is really not very active. It’s kind of stagnant. It’s ready to go to sleep. You should have eaten most of your calories during the day. And that’s going to prolong the time that your food is interacting with gut bacteria, and that’s problematic because gut bacteria can actually extract more calories from food than you eat. And so you may eat – let’s just make it an arbitrary number, and I hate to count calories here, but just to give you an example. Let’s just say you eat a 1,000-calorie meal. If you’re going to eat that meal when the gut is very active, it’s not going to be in contact with the gut microflora for very long, but if you eat that meal, for example, at 11 pm at night and you go to bed at midnight, your gut peristalsis and digestive capacity’s going to be diminished.

So, that food is going to spend a lot of time interacting with your gut microflora. Your gut microflora is going to ferment things, create secondary metabolites, and they’re going to have more time to extract nutrients from that food. Remember, our gut microflora outnumbers a number of human cells in the body 100 times; it’s 150 times larger than our own DNA; there’s 7,000 different strains and so on.  So, this is really something that we need to consider. Meal timing – not only it can be very problematic, so definitely eat your most calorie meals in the morning; it’s the bottom line here. We talked about the microflora a lot of times, but we always need to keep in mind how the things that we eat influence the gut microflora. And along those lines, I mentioned earlier – “polyphenolic compounds” – the beneficial bacteria have the enzymatic capacity and the capacity to really break down polyphenols and thrive on polyphenols – you know these complex what they call “aromatic-type compounds” are hard to break down, and not all bacteria compounds or not all bacteria species are able to metabolize these things.

Coincidentally, the benefits of bacteria of the world and other beneficial gut bacteria have the enzymatic capacity to break them down. Conversely, more pathogenic-type strains of bacteria do not have the enzymatic capacity to metabolize polyphenols, and so they don’t thrive in a high-polyphenol rich environment. So, in addition to probiotics, in addition to prebiotics and immunoglobulin-rich colostrum, and all these things, the polyphenols are huge for supporting homeostasis in the GI tract. So every single meal – that’s the secret – if you can include polyphenolic compounds in every meal. I know Bettina – you probably recommend this – but you want your plate like a rainbow. That’s something that’s been known in our grandmother’s, but now we can explain this with hard science. The mechanism of action is really improving the composition of the gut microflora.

This is some great pictures that I took while in Korea in November.  Like I said, with every meal – we had kimchi before and after – and polyphenol-like rich fruits, fermented vegetables; the rice that we ate was colored rice. It was amazing. Again, there was very little of any overweight people. We ate with chopsticks; we ate big breakfasts or dinners – everything that I’m telling you that the science is showing, and we did – the group of practitioners that I was with had an amazing time and just really impacted my life and showed me a huge part of what we’re missing here in America and in Western culture. The gut microflora link with dysmetabolism, with obesity is slightly more complicated than just the fermentation that I was talking to you about and just the selective proliferation and selective growth of good and bad bacteria. The bacteria strains – the gram-negative bacteria – harbor a compound on their cell well-called “endotoxin,” which is also known as “lipopolysaccharides” or “LPS” for short. Many, many studies, as I’m going to show you, link endotoxin with visceral fat, link endotoxin with blood pressure, and most importantly, with inflammation and insulin resistance. So, a high-phytochemical, high-fiber, plant-based diet with some lean protein and good healthy fats is a low endotoxin diet. Over the week, when we move away from that, there’s a type of a genre or categorization of bacteria – the gram-negative bacteria tend to harbor what’s known as endotoxin or lipopolysaccharide (LPS); it’s known as LPS for short.

Belly Fat Effect: The Real Secret About How Your Diet, Intestinal Health, and Gut Bacteria Help You Burn Fat

Basically, this is just an appendage that resides on the cell membrane of different bacteria – gram-negative type bacteria, which include e-coli and a couple of others – these guys are very pro-inflammatory – so the huge lesson is get people into a low endotoxin diet.  A low endotoxin diet is a high-fiber rich diet; it’s a high-phytochemical rich diet; and it’s low in processed fats and lipids. I’m not going to talk about all these studies, but this is one of the most medically validated kind of link with diet and gut bacteria, and what’s known as “metabolic endotoxemia.” This is huge. I bring this up because I want you all to look at blood lipids and to look at blood glucose. When you see these things rising, just know that there’s a strong correlation between elevations and LDL cholesterol, elevations and triglycerides, and elevations and blood glucose with metabolic endotoxemia. So, instead of that just major reaction, we need chromium or vanadium or whatever it is. We need to think, “There’s probably some gut dysbiosis going on.” You probably have some leakage of bacterial endotoxin from your gut, which is causing insulin resistance, which is causing your visceral fat, which is causing that.

When you have elevated LDL cholesterol – I’m going to show you the next slide. LDL cholesterol is an endotoxin sponge, and so instead of just major reaction to statins – you’ll think about, “Why is this occurring?” Could it be a protective mechanism of the body? LDL cholesterols soak up all this endotoxin that is fleeting around in bloodstream, and if it was me working with the patient or that client, I would say, “Absolutely.” We most likely have some low-grade bacteria leakage from the gut and the natural response to the body is to increase blood lipids and so on as a protective mechanism. So, instead of just driving down those lipids with pharmacologic agents, even though those agents may have additional health properties, we should also be looking at the diet in the gut. There’s ample data showing that the LDL cholesterol, in particular, is an endotoxin sponge. About 68% of the LPS are bound up in these lipoprotein particles. I’m a huge fan of advanced lipoprotein particle testing – looking at the size and shape of these particles and it makes sense. If you have a lot of small dense LDL, you’re increasing the surface area of LDL, and you’re increasing the ability of the body to bind the different bacterial endotoxin in the systemic circulation. So instead of, again, using pharmacologic agents, nutraceuticals agents, we need to get to the source of the problem, and the source of the problem is probably gut bacteria imbalances and gut permeability, gut immune imbalances. So instead of looking at this major reaction of the postprandial effects, we have a colorful three-dimensional model of how diet interacts with our intestinal barrier, with our gut microflora, and then affects systemic metabolic parameters from fat burning, insulin resistance, and so on.

The best clinical tools – how can you modulate this as a practitioner or in your own life? Prebiotic fiber – I know the SIBO people would just cover their ears if I say “prebiotics” because prebiotics can really cause havoc in certain individuals. But I’m a huge fan of prebiotics, personally. I don’t have a problem with them. From historical human history, we’ve eaten a lot of prebiotic-rich foods, and you travel to different countries and there’s a lot of prebiotics foods consumed. So, I’m a huge fan of them. They also incidentally can downregulate gram-negative bacteria. Saccharomyces boulardii – the probiotic keys – I know some people only use this for like C-diff, only use this for diarrhea – but there’s a really good data showing Saccharomyces boulardii have some nice therapeutic effects for modulating the gut bacteria in a beneficial way and reducing endotoxin. Bifido bacterium genre and species – there’s many different strains and so forth of bifido – but bifido, in general, is very protective. Lactobacilli – yeah, there’s some really good lactobacilli strains, but bifido, in general, time and time again in published research has been shown, to modulate endotoxins. So, I’m a huge fan of that.

Bovine colostrum – there’s a lot of good data here. We’re really excited; we have a new version of the IgG 2000, which is going to be great. We’ll let you know about that more next week. But this is a whey protein colostrum. Immunoglobulin – just tons of research on it – and I’m very excited about that.

I put pumpkin seeds here twice maybe because I like them so much. Pumpkin seeds can liberate alkaline phosphatase from the gut. Alkaline phosphatase helps to break down endotoxin. That’s very beneficial.

Supporting the gut barrier – you guys already know this. You think about Crohn’s, colitis, and autoimmunity, but leaky gut is also linked with fat – belly fat. And that’s so-called “zonulin” molecule – the so-called “brick and mortar;” it’s inside the gut that’s keeping the adjacent enterocytes linked together. Increased zonulin signaling is linked with insulin resistance; it’s linked with belly fat. It’s no longer just the gut disorder – leaky gut is linked with pretty much metabolic syndrome – and there’s more and more studies suggesting this. So again, just going after calories, just going after chromium, vanadium, and green coffee bean extracts is a wrong approach. We need to look at the immune system; we need to look at the gut microflora; and we need to balance the gut barrier because it’s very, very hard to lose weight if you have intestinal barrier dysfunction and you have bacterial particulate coming across stimulating the immune system and reducing fat burning and so on. So, it’s huge, and I talk about this a lot in the book, “Belly Fat.”

Another big lesson and it ties in to what I was just talking about. We can’t forget about modulating the immune system. A key to this is tolerance at barriers. Michael Ash has really been instrumental; he’s a doctor in the U.K., but he talks a lot about mucosal immune tolerance and the regulatory cells. In the context of atopy and even autism and various things, but this is huge from metabolic challenges as well. When you have loss of immune tolerance, you’re going to have insulin resistance; you’re going to have impaired fat burning. It’s really kind of a selfish response of the immune system to shift the body into an insulin-resistance state so as to increase the available sugar for its own use. Remember that insulin – it’s like a delivery boy; it’s putting stuff in the cells, and as the immune system is upregulated because you have loss of tolerance and it’s reacting to everything in its sight – these CD40 helper, type-1 cells, or Th17 cells, macrophages or mass cells – whatever the cell type it is – it thrives on sugar – and so if your muscle tissue’s absorbing all the sugar because it’s insulin-sensitive and your fat tissue’s absorbing the sugar, and your liver’s absorbing the sugar, the immune system doesn’t really have any feel to go wreak havoc in the body, and so what does it do? Well, these pro-inflammatory immune cells release things like interleukin-1 beta, TNF-alpha, interleukin-6, interleukin-17 – and we know these to be pro-inflammatory – but they’re also bifunctional; they antagonize insulin signaling and that’s why they were named early on in the 60s “cachectin” because they cause cachectin; they oppose insulin signaling. So, if you have inflammation or your patients have inflammation, then they’re going to have insulin resistance. It’s that simple. So, we can’t just focus on the chromium, vanadium and all the blood sugar stuff, we also have to simultaneously support the immune system. That’s that take-home message here. I don’t want to bore you guys with a lot of details.

Instead of looking at this model where fat tissues are kind of in a storage tank, it’s really a metabolic-reactive immune organ. Fat tissue, particularly in overweight individuals, there’s a large influx of many types of immune cells, from mass cells and T-helper cells, macrophages, and all that. So, we really need to modulate the immune system so we can burn fat because when we have all these sugar-hungry immune cells, it’s hard to burn lipids because there’s a state of localized insulin resistance. If you’re insulin resistant, you just can’t burn fat. You need to be insulin-sensitive, so we need to calm down the inflammation.

One of the best ways to modulate this – one of the best molecules I should suggest to target is leptin. Leptin is just more than just that energy sensor that’s been relegated. There are so many people – if you Google “leptin resistance,” you’ll hear about appetite and satiety – but leptin does so, so much more. That’s where we’re going to end because we don’t have enough time. But really, what I want to give you guys an option to learn more about leptin, to learn more about how it modulates the immune system, I made a 90-minute video all on leptin – I mean literally we went to like 60 studies on that, and I can send that to you. But here’s how you’re going to get access to that and how you can review that and everything else. If you go on Amazon and you purchase “Belly Fat Effect,” here’s a link – you can go to bit.ly/bellyfateffectbook.com. Either the Kindle or the paperback, fire me an email with the receipt, and I’ll send you my advanced leptin, what I call, “The Leptin Blueprint,” and it’s a more in-depth training. No one that I know – I go to all the same seminars you guys go to – IFM, A4M, ACAM – all that. No one, to my knowledge, is talking about leptin in this way. It’s really been relegated as the satiety hormone and molecule, but there’s so much more. I think a lot of practitioners can benefit from this; a lot of patients can benefit if they understand this. Here’s how you can get access to it again: Just go to Amazon, get the book or Kindle, forward me that info at mikemutzel.com, and we’ll have a member from our team fire you over the video, and you can learn everything and more about leptin. Also, in the book, there’s a whole chapter about leptin and T-regulatory cells, and fat burning and sugar burning. So, that’s one way. You can read the book, too. You don’t have to watch the video, but the video is nice because you can get into a little bit more detail and commentary.

That’s it for tonight. I really apologize for the technical issues, and I had no idea. I was just sitting here talking to myself and Bettina had to call me. I apologize about that. We have about 65 questions here and a couple of people have their hand raised, so we want to get to those folks. And here’s the special. Bettina, thank you for your great commentary. I really do appreciate that – all your support and all you do for us, so thank you.

Bettina Newman: You’re welcome. My pleasure. Thank you.

Mike Mutzel: For the folks that have their hands raised, maybe we can get to their questions first and then address maybe some of the questions that are out there.

Bettina Newman: Okay. You show me how to get to those people. I haven’t done it before.

Mike Mutzel: Yeah. No, it’s fine. Maybe I could just… Let’s see here.

Bettina Newman: Okay. I see “click to use hands as raised.” Okay.

Mike Mutzel: Jeff, do you have a question?

Jeff: Yeah, I have submitted it. A lot of Asian people consume a lot of rice, and I presume it’s white rice, correct?

Mike Mutzel: Yes.

Jeff: So how come they don’t have the same problems as we do here in America – getting fat from that?

Mike Mutzel: That’s a really good question. From what I’ve seen in my limited exploration of Asia, their breakfast is consumed. They're very active working and walking. At least, this is just from limited my observation of South Korea. There’s fermented foods being consumed at pretty much in every single meal. There’s literally a kimchi index – believe it or not. So, when cabbage supply or demand fluctuates, people freak out, and so there was no kidding, and I think when we were there – we’re reading in the newspapers – there were some things going on with kimchi. If you look, though, there’s lot of influx and Western businesses and McDonald’s and processed foods, and instead of making their own kimchi, they’re eating kimchi from Target or something like that. It’s just not the same and you’re seeing these children are now trying to become overweight. I think rice is not necessarily a staple. For a lot of people, it’s part of meals and such, but there’s also a lot of fish and a lot of fermented vegetables, pickled vegetables, and so forth. So, that’s my own opinion. I’m sure there’s other that’s trying to study and get into more detail on that. That’s where I’m coming from.

Jeff: Thanks.

Mike Mutzel: Yeah, we can now.

Bernarda Zenker: I just want to ask – I’m looking at the different products, and I’m wondering clinically the products that – just this Leptin Manager – where does it fit in the scheme of controlling leptin?

Mike Mutzel: That’s a really good question. That’s a proprietary blend of glycosaminoglycans and hyaluronic acid. It’s a raw material that comes from they call the Bioiberica in Spain. The mechanism of action of this product is that it actually blocks adipocyte differentiation at the stem cell level. So, they’re going to aim this video that I was alluding to – this 90-minute presentation – that I get into some studies that show that just 8 weeks of eating high-sugar meals causes like kind of 18 pounds of weight gain. But no kidding, for every pound of body weight gain, it’s something like 1.6 billion new fat cells. So, there’s a huge – if you think about people gain about five to 10 pounds a year or whatever – there’s a lot of new fat cells being created when someone’s not eating right, when they’re not sleeping right, when they’re stressed out – and what this product, “Leptin Manager” really unique at doing is at the stem-cell level, it blocks the adipocyte differentiation and pushes those stem cells to become chondrocytes, and as chondrocytes are involved in joint function and joint activity and other more structural related aspects of the body, so by reducing the number of total adipocytes, you’re going to reduce serum leptin levels. At least this is what’s been shown in some of the research, and so that would be used for individuals that have high body fat percentage.

Bernarda Zenker: Okay. Thank you.

Mike Mutzel: We have 70 questions here. I don’t know if we’re going to be able to get through this. Bettina, I know you’re ahead of me. I’m in Central time now. What would you like to do with all these questions? What do you think?

Bettina Newman: I don’t know. I think we can copy and paste them, and you can get to them via email or we can stay on and record them because we have to leave.

Mike Mutzel: It is getting late and we still have 200+ people here with us. We do appreciate all of you hanging on the line. There’s a ton of questions here. Just no offense – we really appreciate that – but I don’t think we will be able to get through it. So, what I can do is make a recording and send it out to you guys, and go through these questions. I would really like to address your questions. We like your feedback and input, and we want to help you out. Bettina and I can help you work with that on you to get that over to you guys.

Bettina Newman: Are you able to save the questions?

Mike Mutzel: Yes.

Bettina Newman: Okay. Or we have to work with it via email.

Mike Mutzel: Yeah. Okay, I think that’s good for tonight. Again Bettina, I really appreciate your help and all your great questions. I want to thank all the people that came on and everyone that supports what we do and has been participating. It’s been really great.

Bettina Newman: No, thank you. Thank you everyone.

Mike Mutzel: Alright. Have a good night, all.

Bettina Newman: Have a good night.