#24 Introduction to Functional Medicine with Dr. Callum Cowan

Introduction Of Podcast

Functional medicine & naturopathy has been an area of multiple debates for over decades now. In this episode, we’re joined by Dr. Callum Cowan, who’s an expert in naturopathy. He elaborates the benefits of getting better by adopting functional medicine and optimizing your life for the better. Tune in.

Timestamps

(00:00 – 01:48) – Introduction
(02:10 – 04:31) – Dr. Cowan’s Life Story
(04:32 – 06:15) – Functional Medicine vs Traditional Medicine
(06:17 – 12:08) – Dr. Cowan On Nutrition Controversies
(12:09 – 17:06) – Challenges In Working With High Performance Athletes
(17:19 – 20:40) – Health Tech Products Having Potential
(20:56 – 34:22) – Perspective on Upcoming Biomarkers
(34:25 – 36:20) – Dr. Cowan On PhenomDoc
(36:21 – 39:38) – Top 3 Advice For Health Optimisation

Key Takeaways – Transcripts

Intro (Mohit): In today’s episode, we are joined by Dr. Callum Cowan. He’s a board certified Naturopathic doctor and a functional medicine practitioner, who focuses on high performance and has also founded his company, PhenomDoc. Over the past few years, Dr. Cowan has worked exclusively with the top initial players UFC champions, Olympic gold medalists, elite executives, millionaire entrepreneurs, and Fortune 500 companies. Functional medicine, if you look at it, has received a lot of criticism, especially from the traditional medicine folks. But there’s always two sides to every approach. And today, with Dr. Cowan, who has had a wonderful record of successfully working with top athletes, uncover what functional medicine is and how it’s different from traditional medicine. You might be on any side, but nutrition has always been an area where folks are at loggerheads. Dr. Cowan shares his stake on nutrition and how one should ideally approach it. The fun thing about nutrition is the fact that even though it’s an area of conflict, it’s very easy to try and test a particular strategy on your own body and figure out what really works for you. Dr. Cowan has also worked with USA Fighters and NHL teams. He shares the challenges working with such high performing athletes and what it takes to train them. We then delve deep into top two or three biomarkers that Dr. Cowan feels have great potential and which ones have caught his attention. We also discuss what PhenomDoc, Dr. Cowan’s company is all about and how he trains his athletes and clients. Lastly, Dr. Cowan shares his choice of top three foundations of health that people can focus and get started on. So, let’s do this. 

Question (Mohit): It’s a pleasure to have you here, Dr. Cowan. Of course, I’ve been hearing a lot about your work and about PhenomDoc and here. Would love to talk more and know more about the work that you have been up to, tell you a little bit more about in context of what we are doing as well. And I’ll look forward to a really interesting chat today. So before I begin, you have such an amazing background and such a diverse set of things that you’ve done in this space in the space of health, fitness, and performance. I’d love to really begin with your life story. So what got you here? Was that a personal story or something else or would not really understand Like, how did you end up here?

Answer (Callum): Yeah, that’s a good question. Actually, I was planning on going into dentistry. That was my original plan, and I had gone into dental school and realized that it wasn’t having the level of impact that I wanted to have. So I wanted to work with a team or be a team dentist or here in Canada, hockey is very popular. So I was thinking of maybe working in the hockey area with dentistry. And a friend of mine had been working with the national team, the basketball team, and he had been studying naturopathic medicine and functional medicine. And I had just sort of had a conversation with him and explaining some different things. And I read a few books after that in terms of getting to the root cause and how to optimize people from a deeper level, from more of a foundational level And I quickly realized that this was the space I wanted to be in in terms of having a big impact on people. How can we maximize health, how can we maximize performance as a result of that? And then for the past ten years, I’ve just been working with high performers. So Olympic athletes, many professional athletes, developing athletes. I also have a clinic where we treat the general population. I have a team of doctors there as well that we sort of use our same methodology there. But ever since the beginning, it was sort of how can we optimize people was the mindset from the beginning. And then my first few patients were professional athletes that I had sort of known indirectly. And I had about two months to optimize them in an off season. So I quickly realized what matters and what doesn’t matter and what markers to look at and what to assess. And now my methodology is primarily a lab testing based, evidence based practice. And I’m the nutrition and high performance specialist for an NHL team right now and also an OHL team, which is sort of the one level down like a junior team. So, yeah, it’s always been a performance focus for me.

Question (Mohit):  And to understand this further, you mentioned functional medicine there and would love to understand functional medicine compared to traditional streams of medicine. How is that different or unique in terms of the approach?

Answer (Callum):  Yeah, so functional medicine is very similar to naturopathic medicine in the sense that the approach is looking for one of the underlying causes of things, where things going wrong behind the scenes. And a lot of times with conventional practice, you’re not seeing differences in terms of lab testing until something that’s at an end stage. So we’re really looking for what are the issues before they become issues? How can we optimize things quickly before they become issues? Like, we don’t want to be waiting around until something becomes a problem if we can identify it quicker. And then also the strategies are more in line with correcting the underlying issues as opposed to dealing with the symptom picture. So we’re looking deeper. And the other advantage too, is when you look deeper, you can get improvements all the way out instead of starting out and working back. If you start at a deeper level, you can improve everything, right? For example, something like gut health or hormone health, you want to fix it at the root cause to get that area to improve. But when you’re doing that, you also get a number of other improvements as a result, right? I would say the approach is the big difference. And then also the way of thinking. Like, your thinking is different. You’re not just trying to patch work over an issue, you’re trying to resolve it.

Question (Mohit):  That’s a fundamental difference, I think, and this is a fundamentally new approach in the medicine space. One can look at the traditional medicine methods and find them to be more preventable. But I think this is a modern take on evidence based. It is more preventive in nature. And that’s the most interesting part because it’s sort of like surrounded with controversies all around, like whatever you touch here, there is a controversy here, especially in the field of nutrition. It’s almost like a war zone, almost always, where people talk about diets being better than the other. And there’s no, like, larger alignment on one type of approach and one type of method and scientific communities fighting each other and not sort of like constructively building this. How does one like, even if the company or an individual or a functional medicine practitioner, how does one approach this? And I’m asking this more from a perspective of how do you do this mentally, right? Given that there are so many controversies around nutrition? And even if you approach it with evidence, you can say that the larger industry today still optimizes for quick fixes that are not probably the right answer in the longer run.

Answer (Callum): Yeah, I think for us anyways, everything is personalized, everything is individualized, and it’s all tied into what you’re trying to accomplish. So if you’re a professional hockey player, we need you to be eating a certain way based on your sport, and you need to be fuelling yourself a certain way. You need to have sort of a general picture which will be different from an endurance athlete or different from purely power athletes, a little bit different hockey sort of in between. And then once you have that base in terms of nutrition, this is what it should look like, then we can go in and customize it for the individual. In terms of what foods work best for you, what foods might be causing low grade chronic inflammation, what kind of things are optimal for you. So I think the answer is sort of two parts. You always need to be personalizing, but also need to be applying it to what you’re trying to do. And then within that, there is no real best diet. We always say the best diet is the one that suits you and is easy for you to do and the one that you can follow and the one you enjoy and you can stick to. Obviously, that’s in line with your goals. I mean, there’s some evidence on Mediterranean diet being superior and there’s some evidence on lower carb for longevity and things like that. But I do think that if you start getting to eliminating some of the big macronutrients, I think that can cause some problems. And I think that we’ve seen it all that’s the other thing. There’s a lot of things that are out there in theory and also in practice. You can say XYZ is great in the literature, but apply that to real people and see so we have so many patients at our clinic, we can actually see that, right? So if you put someone on Ketogenic or low carb or Paleo, regardless of what the theory says, we can see what the outcomes are with real people in real time. 

(Mohit): I think this is really fascinating because what you’re also saying, and what we have seen on the platform largely, is that as you generate more data, it becomes clear that all humans are not the same. We are probably the same species, but you can say maybe 10,000 different types of species, maybe a million different types of species, depending on our stress levels, gut microbiome genetically all into on.

(Callum):  even along those same lines, like 95% of our DNA is similar between human beings, but only 5% of your gut bacteria is similar between human beings. Wow. So that right there will show you the diversity that people would require. And the more that we find out about microbiome right now is extremely hot right now in research. But in terms of fibre intake and diversity of bacterial strains, the diversity is important. But also your genetic makeup helps provide the base for that.

(Mohit): Wow. It’s such an amazing rabbit hole because a lot of microbiome science is emerging as we speak. It’s getting built while we’re talking. And it’s another war zone, though. Like, a lot of people don’t believe in the microbiome science. I think a lot of people do strongly believe in it, but there is definitely a lot of discovery, there’s a lot of discovery there to be made in this field. A lot of discoveries are yet to be made. And I think it’ll fundamentally revolutionize how we think about human health because what we think as human might turn out to be a microbial colony eventually.

(Callum): Yeah. And the research is coming in. I think, probably next year. It’s going to be so strong that people aren’t going to be able to ignore it in terms of microbiome.

(Mohit): Yeah, that’s very cool. And what I also loved is the fact that functional medicine, as you mentioned, is starting with the performance layer, and it’s almost test by fire approach, which is like, if I can make it work for the top 0.001%, that’s the best evidence that you actually need, because the top 0.001% will never stick to your advice. If they don’t see micro improvements and they’re optimizing for the last mile, they’re optimizing for the last 4 or 5%. They’re not optimizing for directional improvement. So it’s very precision oriented. 

(Callum): Yeah. And we’ve had a few of those light bulb moments where we’ve worked with Olympic gold medalists, for example, who are classified as the top of their field. If you want a gold medal in your discipline, you’re definitely at the top of your field and we’ve had those athletes come back to us and say, well, I can’t believe how much better I feel from using your methodology, like working with you. Right? So if you can optimize, like you said, someone like that who’s at their peak, then everybody else could also benefit because they’re right there within the top of the top, right? So that was sort of a light bulb moment for us years ago when we had a few gold medalists that we said, okay, they’re coming back to us saying this is the best I’ve ever felt. So everyone else could also benefit below that. 

Question (Mohit): How challenging is that? Like working with a top performer in this space, how is that different from working with somebody who’s seeking general health? I know that the margins are very different. Like somebody looking at the top performer, looking at improvement, might already be at 95% and they’re looking to get to 99%. But how challenging is that? Give me one example that I can relate to and something that I can think about.

Answer (Callum): Yeah, I don’t think it’s that challenging because the way that we’re approaching things, we’re looking at those big foundational systems, we’re looking at hormone function, gut health and detox liver function as sort of a base for everything else. So of a lot athletes, you’d be surprised, even at the top of their field, haven’t really done things properly. They’re just extremely talented. But when you start to apply some of the optimization, like, you know, our sort of thinking is if we can get peak performance on the inside, that will translate to peak performance on the outside. So when we’re looking at markers there, there’s often a lot of things to improve behind the scenes and that will translate into sort of I had a champion fighter I was working with and had so much room for improvement in terms of sleep quality, energy throughout the day, recovery levels, and even seeing that on blood markers, like looking at C reactive protein levels and saying, look at your recovery should be better than this. And that’s how you can get sort of that extra little bit. But I think even that is so specific because I have that particular athlete I’m thinking of who needed some improvement on energy, sleep recovery. Then you have other athletes that need nutritional tuning to fine tune it for them and that gets them to the extra level. So I think what we’re really good at, and what we’ve become good at is breaking somebody down really quickly and saying like these are the areas of weakness. So for you it’s this, this, for you it’s this. And then we explore those areas and then we open up those areas and see, OK, how can we can improve these pieces and then how can we show that objectively? I’m sure. Yeah, how can we improve that? And how can we see it on markers and biomarkers, and then when we see it there, it also translates into the activity as well, which is nice.

(Mohit): One core realization here is that probably longevity and performance are not on the same spectrum. I mean, they are on the same spectrum, but sometimes they are probably on different sides of the same spectrum.

(Answer):  Yeah. And if you look at the information on longevity, which is tied to, like, mTOR, right? So mTOR is your ability to build muscle, basically on a simple terms. The more you’re activating mTOR, the quicker you’re aging your body. Yeah. But the more you activate mTOR, the more lean muscle you have. So the better performance you’ll have now, but long term, maybe not improve. So there’s a sort of a fine line there where how can you maximize performance but also improve longevity so that they can compete for a longer time, just as sort of in between. Yes, it’s a little bit in between there, right? And I do a lot of weight. I used to, not as much now, but I used to do work with a lot of MMA fighters and UFC fighters and do a lot of weight cuts. So the same thing goes for that. It’s a similar analogy. You need to bring the weight down, but if you disregard performance, you could bring the weight down and then lose the competition. Yeah. You have to have a fine balance there where it says, let’s bring the weight down, but let’s not sacrifice performance while doing it.

Question (Mohit): Wow. And since you worked closely with UFC performers and MMA fighters, I think the challenges would be very different in terms of the injuries and the inflammation and the type of challenges that you would have with health because combat sports are something that is more impacted, like, you can say more, you can say prone to injury, potentially be a very different recovery protocol. Have a very different recovery protocol compared to an endurance athlete.

Answer (Callum):  100%. Yeah. And also because the volume of training is higher, because most UFC fighters are training like five to six different disciplines, which is almost like five different sports. Wow, right? So they would train boxing, wrestling, kickboxing, jiu-jitsu, judo, some sort of other so really, you’re almost doing the workload of five athletes yourself. So oftentimes they’re training two to three sessions a day. So recovery has to be a big focus there. And also, how do you get someone to peak at the right time? Because they’ll often do an eight week training camp. So if you don’t support the body properly, by the time you get to your actual fight competition, you could be completely burnt out if you don’t do it properly, right? So then you wasted all that effort, and when it counts the most, you’re at your worst.

Question (Mohit): Wow, that’s really cool. And talking more about recovery, apart from all the personalization stuff, which is about biomarkers and how do you individualize the approach for every individual. What are some of these common underlying approaches that you can summarize? Like, for example, the top five things and maybe the top two or three things that are really exciting in terms of potential? Like, I’ve been hearing a lot of athletes using cryotherapy, hyperbaric oxygen. What is the potential of some of those technologies?

Answer (Callum):  I think there’s great potential there. I mean, the research is a little bit new in terms of red light therapy, and some of the light therapies is a little bit preclinical. But cryotherapy there’s definitely benefits. Ice baths, cold water submersion, that contrast therapy. There’s good evidence on hot, cold back-to-back sort of thing. But oftentimes people will go to those sort of fancy techniques and they will miss some of the big impact things like just glycogen reloading, right? Like reloading your body with glycogen post training or post competition to restore your body so you can fire those muscles again. They missed that aspect. They missed the sleep aspect, right? Deep quality rejuvenating sleep aspect gets missed. And then you can start looking at inflammatory food sorry, anti inflammatory curcumin, things like that, that have good research on them that you could add in magnesium, things like that. I would be thinking of those things first as sort of low hanging fruit, easy things you can do and sort of check those off the list and then see where your recovery is. And then you can start adding some of the cold water submersion and even saw that good evidence on recovery, right? And kind of put those things in. The red light therapy is quite interesting. I just think there’s not enough data there yet to say that it’s effective or not. And IV therapy is good too. Intravenous therapy, depending on the athlete intravenous is great because you get the 100% absorption. You can put amino acids and electrolytes, some sort of glycogen replenishment in there as well. Yes, but I think for most people, they need to start with the basic pieces. Everyone wants to do the new and fancy technique, right? 

(Mohit): New and fancy ones first. It’s funny how the longevity science and the performance science go hand in hand. What happens in performance, it’s replicated to longevity and people trying to unlock something faster, but via methods that are fancier. So, as you mentioned, maybe sleep has 10x more ROI compared to a session of cryotherapy, but one might go for cryotherapy and sleep less. Yes.

Answer (Callum): And we always say to the people we work with, what you’re doing in the gym is that hour you’re spending in the gym or the hour you’re competing is not where all your improvements come from. It’s the 23 hours away from that that you’ll get all your adaptations and improvements and add muscle mass and improve all these pieces. So I think there needs to be a little bit of a mindset shift with most athletes because they’ll put maximum effort into that 1 hour and 23 hours they miss all those opportunities. That’s where you actually will improve, like even on the nutrition side, right? Even nutritionally, you will improve if you are putting the right protein, amino acids, carbohydrates in 4 to 6 hours post training sessions. That’s where you actually get your performance improvement. 

Question (Mohit): That’s a super interesting perspective. Your day is an improvement spectrum. And it’s not just that when I’m in the gym. And that’s really cool because lifestyle probably has the most compounded effect on your health and your performance. Switching a little bit more into the data that you generate when you work with athletes and when you talk about evidence driven interventions, when you say evidence driven, generally it comes down to markers that you can study. So what would be some of those core markers that have recently caught your attention or something that you find really interesting? And I would love to also nudge you a little towards like, newer biomarkers that are gaining popularity, like blood glucose, lactate, ketones, et cetera. So what would be your perspective there?

(Callum):  Yeah, I mean, there’s so many things to look at. I’ll often look at so many markers with athletes, so I can just get a big picture of everything. In terms of performance or health or both?

(Mohit):  Maybe a top five between performance and health.

Answer (Callum):  Yeah. So one of them that I like a lot is SigA secretory IGA. So that’s your mucus lining production for your gut, which is also the same lining in your mouth. So that’s a very good indicator for immune function. And you can also tell if an athlete is maybe overtraining because you’ll see some fluctuations on SigA. I find that’s a good marker. It also gives you a little bit of clues into if they have any issues with certain foods or if they have problems digesting certain foods. It gives you a little bit of indication there because you’ll see a spike in the SigA or a drop if it’s chronic. I think that’s a good one. I think IgG antibodies are good blood antibodies because then you get an idea which foods are cooperating. And there’s some good IBS research now showing that these markers are quite helpful in figuring out which foods you should be avoiding. Like, should you be avoiding gluten, should you be avoiding dairy, should you be avoiding eggs. What are the foods that are causing a negative response for you? That would be probably the second one. I think CRP is always great. C- reactive protein inflammatory marker, right? Systemic inflammation marker. In terms of new things, I don’t know if you’ve seen some of the stuff on Apolipoprotein B. I don’t know if you’ve seen some of the cluster markers. That’s a good sort of relatively new one just to see what’s happening on the cholesterol side and liver side of things.

(Mohit):  Yeah. Apolipoprotein B One is both interesting and funny at the same time. I think almost every lab that does  blood test actually has the ability to do it, but most of them don’t do it.

(Callum): Yeah, it’s interesting, right? It’s even on a lot of the ranges. Like if you look at the breakdown on a lipid profile, it will have it on there, but a lot of people don’t run it. It’s interesting. It’s a very good marker. I think some of the genetic markers are interesting for performance. For example, how well you metabolize caffeine. Got it. I think that’s very relevant. So caffeine is one of the best ergonomic supplements to use, best performance supplements. But if you don’t respond well to caffeine, then you should be using that because that will impact your ability to sleep, where you’re going to get most of your recovery. 

Question (Mohit): Would that be more of a genetic marker, metabolite marker, like a microbiome marker, in your opinion?

Answer (Callum):  Just a pure genetic marker, right? Yeah. And then, for example, if someone doesn’t react well to caffeine, then it’s not worth then using the caffeine because then you can’t recover. And if you compete again the next day, oftentimes athletes will say to me, I feel like I can’t fall asleep, I’m jittery, I’m anxious, I’m irritable, can’t sleep that night because of that, then the next day performance is worse. Got it. So in most cases, then you have to work around. A lot of athletes will have coffee before a competition or games, so those people have to switch. And probably the fifth one, I think, right now might be looking at circadian rhythm function. So looking at what our Cortisol levels doing, what our melatonin levels doing, because circadian rhythm drives about 80% of how your body operates. So if you’re not in sync with sun up, sun Down, you’re already behind, you’re already lacking, right?

And I think there’s a lot of people with those problems, especially with the artificial light and blue light we’re exposed to these days, and then tie in with your glucose comment too. So the more that you manipulate Cortisol, the less glucose regulation you have, right? Cortisol is going to be like your sleep. That’s your wakefulness. I don’t know if you’ve seen some of the stuff on Cortisol awakening response, but the Cortisol awakening response as the sun comes up, your Cortisol level should rise and get you up out of bed and kickstart your circadian rhythm. So if you can get that elevated and then ride that sort of wave when the sun goes down at night, it’s when your sleep hormones would kick in as they drop below a threshold. So if you have problems with your Cortisol regulation, your blood sugar is going to be extremely hard to control. And you would probably see that on your continuous glucose monitoring because that would give you a tip off that something is wrong there. And then you could also use the I like the continuous glucose monitoring to see your response to carbohydrate too, right? And I don’t know what you think of that one study that came out showing that different types of carbohydrates respond to people differently. For example, gluten has had a bad rap for a while, but for some people in the study, it showed that people were able to use gluten as a carbohydrate for performance and it was able to maintain good blood sugar levels. And some people would use rice and it would get a big spike and a big drop. Some people would use oats. So the point of it was that it was very individualized, it was very customized to the person. So it wasn’t like across the board, no gluten should be eaten, or it wasn’t like no rice. It was sort of a varied fluctuation, right? 

(Mohit): No, that’s very accurate because across 12,000 people who manage glucose levels on a daily basis on the platform, this is what we keep seeing, that the same food, the same raw materials, two people eating the same food have a totally different response and with the same level of activity. So there is probably microbiome interference. But there’s also how they react to carbohydrates individually. There’s, of course, the insulin efficiency effect as well, like how insulin resistant you are and what it leads to. But to add to your cortisol hypothesis, I think one of the studies I read on Cortisol and insulin resistance was that Cortisol does lead to improper glucose response because it makes you temporarily insulin resistant. But there is evidence that it might also make you progressively more and more insulin resistant over time. There are something called stress diabetes, for example, that over time you might just develop stress diabetes and not really just because of the food. Yeah, and I believe that. And we see that clinically, people who are chronically stressed, you see them fasting insulin levels higher or you’ll see HBa1C levels that are higher, even though that they are active and competing and eating well and all those things. I do think that the hormone component because Cortisol’s job is to release glucose into the bloodstream, right? So if you’re chronically doing that, your regulation is going to be off. Yeah. Wow. So I do think that there’s a good tie in there. Have you seen where people have varied morning responses versus night responses? Yeah. Yeah. So typically you’d have the highest insulin sensitivity in the morning. Are you seeing that and then the opposite at night? 

(Mohit): Yes. So essentially the effect of slowing down glucose metabolism is what we generally see. And this is true for almost 75% to 80% of people, except for some scenarios where we have seen that a lot of people stay flat throughout and they in fact become more insulin sensitive just before they sleep. And their glucose levels actually drop if they don’t fuel themselves as well as they would have. So they need some more carbohydrates just before they sleep and get their glucose levels up. That’s super interesting. Yeah. That’s one of the things that we want to study more, because there’s very little evidence around why that would happen. And we’ve seen close correlation with the quality of REM, the quality of deep sleep, the glucose last glucose rise, timing, all those factors. That’s the most interesting part, because there are 12,000 people, we have close to 100 million points now of glucose. Some of these studies are not even done yet. So those are the opportunities.

Question (Callum):  Have you heard of something called nocturnal hypoglycaemia?

Answer (Mohit):  Yeah, we try to deduce that on the platform via your timing of glucose and essentially whether your hypoglycaemia is either reactive, whether it’s a semi effect, or whether it’s actually not hypoglycaemia because you didn’t fuel as much. The closest we have seen generally is because people sometimes work out very, very late, like seven, eight PM. And then they have their dinner. Sometimes they skip their dinner because they’re doing intermittent fasting and they work out very late and then return hypoglycaemic after the sleep and they wake up very, very groggy.

(Callum): And sometimes, too, you can get that two to 04:00 A.m. Waking because of nocturnal hypoglycaemia, right? Your blood sugar is low, your brain panics wakes you up. And we see that in some of the elite athletes. And my theory is, because they’re using all their glucose in the day. Yeah. When they go into night, they’re already depleted and now the low level triggers their brain, right? So that would be really interesting to see that information, because then you could identify which people need carbs before bed to improve deep sleep.

(Mohit):  Yeah, that’s really cool because it’s very easy to call out carbs as bad or good or painted up blanket. You don’t need carbs, then just go ketogenic, et cetera. But it’s farther away from truth as much as possible. I agree. And I think you really need carbohydrate for performance. You need carbohydrate, right? Yeah, absolutely. I think that’s a great perspective as well, for performance. There’s no way you can ignore sugars and carbohydrates in your life. The other interesting thing is we recently sort of like, started doing a lot of craft tests on our athletes. So start studying the insulin and glucose in combination, and 30 minutes, 60 minutes, 90 minutes, and 120 minutes insulin, and sort of like a longish two or three hour test. It’s a little painful, but it’s worth doing it. What you’ll start seeing is that in very young population, where a young athlete, extremely active, no glucose response issues, extremely well regulated glucose values, might still have a very poor insulin response. And probably that’s one of the early markers of insulin resistance. Way early, like maybe like ten years early into their journey in life.

(Callum): Wow, that’s very interesting. And I wonder if those are the athletes that, as they go through their career, end up having more body fat, regardless of doing the same sort of routines. Because most athletes at a professional level will start doing a certain routine and when they feel really good, they’ll sort of stay with that. But then they’ll say to me, seven years into their career, I’m doing the same thing I was doing, but now I’m gaining body fat like crazy. So maybe it’s those people who had an insulin problem at the beginning that slowly got worse.

(Mohit):  Yeah. So probably they were maintaining a lot of deficit earlier. Even with elevated levels of insulin, they wouldn’t see, you can say body composition being on the higher side, like basically fat percentage on the higher side. But then as the insulin levels are elevated and activity levels come down, the deficit goes away, but the insulin levels are still elevated. You’re not unlocking your fats, essentially fats. Yeah.

(Callum):  And it’s hard to get rid of that. Yeah, I think those things play a huge role. And then you think about stress, how much stress people have connected to insulin stress, glucose stress from sports. And then you see probably a lot of people have problems regulating glucose because of that. Yes, eventually.

(Mohit): That’s a really interesting perspective that you mentioned, Doctor, because as you would know, the average age of an athlete has moved from 38 years to 44 years now, globally. And people are performing longer. People are sticking around for longer and they keep performing for more number of years. The longevity aspect of an athlete is increasingly becoming more and more interesting. Like athletes should ideally age better and perform more at the same time around performance, around different spectrums. The age will catch up eventually as they perform. But this is an amazing rabbit hole and I’m really enjoying my chat with you and I’m getting so many goosebumps along the way as I speak. But this is really amazing. And I think a lot of what I love what you just said is the fact that how you’re actually combining these evidence based aspects and bringing this to the modern world, starting with athletes and then eventually to general health for everyone.

(Callum): Absolutely. Yeah. And you look at the health markers over time, right? Think of 70 years ago till now. The increase in obesity, increase in insulin resistance, increase in diabetes, increase in mental health. These things are all connected. And the body is not a separated system. It’s one connected system, right? So if you influence one area, it will help other areas too. So I think there’s something there with obviously with the nutrition, stress, gut health, these things are all tightly linked.

Question (Mohit): Wow, this is really cool. And on the ending note, would love to understand more about your work with PhenomDoc as well. Like what would be some of the core problems that you’re trying to solve. And for our listeners, we would love to really discover that.

Answer (Callum): Yeah, so we’re always trying to improve everything. So we have our methodology that we kind of work people through as a foundation. Like we sort of work through gut health work through finding nutrition that’s best for you, make sure hormones are optimized, making sure liver detox is optimized, because those things are sort of the core foundations. But yeah, I think we’re definitely looking to improve all of those practices all the time. So, yeah, looking at the continuous glucose monitor is very interesting. I know that I’ve worn one myself before, so it gives you a good insight into what you’re doing and what’s going on there. I would say overall we’re just trying to improve everything, improve recovery, improve energy. How do we get people sleeping better? How do we get more deep sleep, whether it’s nutritionally? Or do we use an intervention, do we use a float tank or a sauna or whatever it may be? But I think that all this stuff is improving. And then the microbiome stuff I think is just right now is very interesting. With the studies coming out on fibre and fermented food. I think right there where our team is sort of concentrating a little bit on that right now, because I think that will also be the new wave in terms of obviously immune health has been so much of a hot topic the last couple of years around the world. Right? Yeah. So how do you stabilize immune function? You need your microbiome intact. Okay. How do you get your microbiome intact? You need to feed it. What do you feed it? They’re only food sources. Fibre, right? And how do you bring in new bacteria, fermented foods? How do you incorporate those? So I think sort of working backwards from the problem out, but I think that’s probably where we’re looking at more so right now. Wow.

Question (Mohit): Fascinating. I would love to end this podcast with the note around maybe your top three favorite methods or advice for people who are getting started with their health optimization. And it could be an athlete, it could be somebody seeking better health. But the top three foundations, according to you, something that people should just focus on, I think.

Answer (Callum):  Yeah. So the easiest ones I think right away, so in line with the circadian rhythm. And if you think about 80% of the way your body works is based on circadian rhythm. I think first morning sunlight is a very easy one that anyone can do. They can start doing that today, tomorrow, whatever. If you get 20 to 30 minutes of first morning sunlight, that sets your internal clock. So your SCM and all of that is designed on the light queue, right? I think that’s a very important one that everybody can do. So it’s kind of like if you get the first morning sunlight, the timer starts going off in your brain that a certain number of hours after this it should be sleep. So if you get the first morning sunlight, improves that cortisol awakening response, improves the daily energy, gets your sleep deeper just by doing that. And there’s really good research on people who’ve had chronic sleep and energy issues going away camping or going away in nature for seven days and having no electronics or artificial lighting being in nature for seven days. And you can reset your circadian rhythm because now you’re on the timing of the sun up, sun down with no other influence, right? I think that’s a big one. I think, just in line with the microbiome research. If you get about 30 grams of fibre a day, it seems to be, for most people, enough to feed your good health, good gut bacteria, and that also will get you eating a lot more fruit and vegetables, which also has polyphenols and phytonutrients and so many other benefits as well. So that’s another easy one, I think. And I think probably a third one might be getting rid of the blue light at night. Just seems to be an obvious easy one. At least 2 hours before bed. We have all of our athletes doing that now. So just getting rid of the screens, I mean you could wear some blue blocking glasses or have some sort of attachment to your screen, but I think just getting rid of the electronics because as human beings we weren’t really designed to deal with the artificial light like that. And I think in the future that light is going to be a problem as the research emerges. So light is a huge one then. Like just the alignment of alignment with the light rhythm or the circadian rhythm, essentially. Yeah. And human body likes rhythm. Like it’s all based on rhythm, right? So if you have a similar bedtime within an hour and a similar wake time within an hour, you’ll automatically have more energy, have better sleep, better mood, better everything. But if you’re always changing that sleep time, wake time is always different. It’s very hard on the body because I’m sure you’d see that in some of your glucose regulation results. But body is very rhythmic and look at the shift worker research. If you go the opposite, you go against circadian rhythm, what happens? Disease, cancer, all these things, right? It’s very prevalent. So I think if you can be in line with circadian rhythm, you’ll have a very big impact on how you feel and perform.

(Mohit): Wow, this has been really fascinating and I really appreciate Dr. Cowan for your time and also for sharing all the knowledge and all the experience here. I think it’s been an amazing knowledge journey. I learned a lot myself and I’m sure our listeners will too, of course would love to reach out and figure out further collaboration because I think there is a lot of alignment in the mission that we are chasing ourselves and that would be probably be my ending note. And thanks a ton for being here and I would love to see you again soon.

(Calum): Yes, thanks for having me. It was a great talk and it’s always great speaking with people likeminded, right? Coming from a similar perspective and similar goal to have a positive impact on a lot of people, right? So that was great. Really cool. Thanks for having me

Outro (Mohit): With that, regardless of your belief systems, you will still have to put in the work to understand what nutritional strategy works for you and what strategy of health works for you. In this episode, Dr. Cowan shed light on the overall picture of functional medicine and how, by taking this route, you too can get started on your journey of peak performance. We’d love to know your thoughts on this subject. Please tag us on Twitter and Instagram @UltrahumanHQ and get the conversation started. As always, please share this episode with your loved ones. We’ll soon be back with another episode.

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