Jim Hill:

Welcome to Weight Loss And, where we delve into the world of weight loss. I'm Jim Hill.

Holly Wyatt:

And I'm Holly Wyatt. We're both dedicated to helping you lose weight, keep it off, and live your best life while you're doing it.

Jim Hill:

Indeed, we now realize successful weight loss combines the science and art of medicine, knowing what to do and why you will do it.

Holly Wyatt:

Yes, the “And” allows us to talk about all the other stuff that makes your journey so much bigger, better, and exciting.

Jim Hill:

Ready for the “And” factor?

Holly Wyatt:

Let's dive in.

Jim Hill:

Here we go. Holly, today we're diving into a topic that could change the way you think about movement and metabolism.

Holly Wyatt:

I like that.

Jim Hill:

Have you ever thought about what happens inside your body the moment you stop moving? Most people think metabolism is just something that runs in the background, burning calories no matter what. But the truth is your metabolism is constantly adapting to what you do or what you don't do. And if you're not moving enough, your body starts making changes that can slow things down, can impact how you burn fat, and can even affect your hunger.

Holly Wyatt:

Jim, that's an important point. I think when people think of metabolism, they tend to think about food. That kind of goes into their head. They think about what they eat, when they eat. They may think about how many calories they burn. But what I think most people don't think about or maybe don't realize is that movement plays such a huge role in metabolism. And I'm not just talking about structured exercise, how many minutes you go out there and do something that's planned. But how much you don't move can also impact your metabolism. And I don't think people think about that at all when they think about their metabolism. How much I don't move. How much time I'm sedentary. What's even more fascinating is that these changes don't take a long time. That's what I think is really cool. If you stop moving, it has impacts pretty quickly. And if you start moving, you don't have to wait a long time to have some impact.

Jim Hill:

Yeah, that's why we're diving deep into this topic today. We often talk about the importance of movement, whether you call it exercise or physical activity, but today we're focusing on why it's so important for your metabolism and what happens when you stop moving. And to help us unpack all of this, we brought in really one of the top experts in the field. Dr. John Thyfault is a professor at the University of Kansas Medical Center. He's got lots of important titles. He's director of the KU Diabetes Institute. He's one of the PIs on the Kansas Center for Metabolism and Obesity Research. He really is one of the world's leading researchers in metabolism, obesity, and exercise physiology. His work is transforming how we think about the connection between physical activity, energy balance, and long-term weight management. He spent years studying movement, or lack of it, and how it affects insulin sensitivity, fat storage, and even how our bodies regulate energy.

Holly Wyatt:

So, John, welcome to Weight Loss And. You've spent so many years researching this relationship between movement and metabolism. I mean, start off by telling us how you got into this field, why you were interested, and what led you to the University of Kansas to do it.

John Thyfault:

Thanks for having me. I really appreciate being on the show. I was an athlete and always fascinated with sports. And I was always really interested in how you could train your body and create these big physiological adaptations that would make you run faster and jump higher. And then slowly over time, that merged into how does it make you healthier? How does it counter obesity and metabolic disease? My father passed away at a young age. He had diabetes that was undiagnosed and cardiovascular disease back in the 70s when they told him to go on disability and not work, which is completely different now, right?

Jim Hill:

Right.

John Thyfault:

And so I think that probably played a role in my interest in this area as well in terms of cardiometabolic disease. I won't go through my whole training background, but I've been lucky to work with a lot of different great researchers. My first faculty job was at University of Missouri in Columbia, Missouri. And there was at the time and still, it was a great place for exercise physiology that did really molecular and cellular work. And so I was able to work under mentors that really shaped my knowledge and gave me lots of cool ideas and made me realize that this research is really important. And then about 10 years ago, I moved here to KU Medical Center in Kansas. And a lot of that was due to being a Kansas kid and getting closer to my parents. And I really love the Kansas City area.

Jim Hill:

And you're a Chiefs fan. That doesn't hurt.

John Thyfault:

Yep. I'm a lifelong Chiefs fan and a lifelong Jayhawks fan. I have basketball season tickets. That's a lot of fun to be here right now with national championships and Super Bowls.

Jim Hill:

That's cool.

Holly Wyatt:

Yeah. So my father died very young of heart disease. And it's one of the reasons why I got into the field too. So it's interesting always to hear what shapes what you're interested in and all of that. So thanks for sharing that with us. There's a lot of discussion about how exercise increases energy and expenditure. And a lot of people say, well, if I exercise more, then I'll just eat more, that kind of compensation. We've talked about that before. We've talked about the work of John Blundell that shows that most people don't fully compensate. And of course, we talk a lot about on this show, the debate, does exercise, is it necessary for weight loss? And our perspective has been that while exercise is helpful for weight loss, it's critical for keeping it off. That's really where it plays its big role.

But today, I think we really want to focus on the debate. We want to go deeper into how exercise impacts metabolism. Exactly how it does that. And I know you do so much research in that area. I think that's really the most exciting work. And I really can't wait to hear what you're doing and what you've discovered.

Jim Hill:

Yeah. So John, let's start with the big picture view. Metabolism is one of those words that, oh my God, it can mean so many things. Set the stage for how you see metabolism so as we talk about the role of movement, tell our viewers sort of how you think about metabolism.

John Thyfault:

Early in my career, when I was in an obesity lab, I would think about energy expenditure as a big part of exercise. And it kind of affected you. Like I'd go for a run, I'd be like, oh, I only burned three or 400 calories, but I would also then be more cognizant of my energy intake because I was always thinking about energy balance. But the last, I don't know how long in my career, once I started studying insulin sensitivity, my viewpoints changed. And so I'd like to step back and just, I think a lot of what we need to realize about exercise and cardiometabolic disease is linked to what's called insulin sensitivity. And what that is, is that every time you consume a meal, blood glucose goes up. You digest the food and your glucose goes up. And you have an organ called the pancreas that produces this hormone called insulin. And insulin tells your body to get the glucose out of the bloodstream and get it into tissues. And it goes into different tissues, goes into the brain, goes into adipose, goes into liver, goes into muscle. But the muscle is really a critical disposal site.

And so if you are active, you are much more insulin sensitive, meaning insulin can drive that glucose into the muscle where it's safely either stored or metabolized and not go into places where it can be converted to fat or be stored as fat. The other thing that happens is if you are very inactive, then it takes a bigger insulin release. And so your body compensates by just making more and more and more insulin to compensate for that change in insulin sensitivity, which we call insulin resistance in the tissue. So if someone is very inactive, they produce this insulin, but it doesn't promote glucose going in the muscle. So then their bodies produce more and more insulin. And that's called compensation. And eventually what happens is the pancreas can't make enough insulin anymore to keep up. And that's when you slip into what's called diabetes, type 2 diabetes. So, if we step back about what you talked about in the context of exercise affecting, not being the greatest thing to lose weight, but being really effective preventing against weight gain, I like to also think of exercise and physical activity and just straight up movement as something that's really important in preventing the transition to type 2 diabetes at any weight, at any body weight.

Jim Hill:

Cool.

Holly Wyatt:

Yeah. So, prevention of developing that, not just treatment of it. Yeah. And that's, I think, something that people don't necessarily think about when they're moving is one of those things.

John Thyfault:

Right.

Holly Wyatt:

Yeah.

John Thyfault:

We also know, just to, I want to highlight this, that even if we know that the genetic risk for type 2 diabetes is in the pancreas. So some people will progress where they can't make enough insulin anymore and they'll progress to diabetes. Other people won't. They have genes where they can always compensate for high insulin levels, but they start to have a little bit higher hyperglycemia and those people are at a greater risk for cardiovascular disease too. So what I want to highlight is even if we don't talk about type 2 diabetes, this insulin resistance phenotype seems to be at the very base of all these cardiometabolic diseases. And so if we can fix or eliminate that insulin resistance phenotype by being just more active every day, and it does help if you maintain a healthier body weight too, but being active can really tone that down and lower our risk. That's why I really push movement.

Holly Wyatt:

So a lot of the people that come to see me, they are convinced that their metabolism is working against them. That's broken. It's sluggish. I mean, they use all kinds of words. And this has been for all my career. At the very beginning of my career, actually my very first publication, I compared resting metabolic rates of people who had lost weight versus people who hadn't lost weight, trying to look for that defect or that metabolism that was working against them. And I didn't find it. We studied them in the fasting, one point kind of position. And we didn't, we didn't find a broken metabolism. But what I really kind of realized is that we were studying it the wrong way. At first I said, there's nothing wrong with your metabolism. And I've kind of grown to say, well, wait a minute, there's multiple ways to study the metabolism. And this kind of concept of a flexible metabolism, I've changed my perspective. I now think there's something about that and that there is certain metabolisms that are more flexible and some that are inflexible. And that's really the key piece. What do you think about that?

John Thyfault:

Yeah, hundred percent agree with that. So we know that individuals with obesity, and I'll always add on probably a sedentary and active lifestyle, that when you try to get them to switch what energy, what substrates, and when I say substrates, I mean, lipids or fats versus glucose, right, or carbohydrates, that they're unable to switch those substrates appropriately. So when you're fasting, you should be mostly burning fats. And when you consume a meal, then your carbohydrate metabolism should go up. And they seem to just not have this ability to switch between those substrates. And we call that metabolic inflexibility. And that is a hundred percent related to insulin sensitivity that I was just talking about. And you can take someone and you can make them move for three, four, five, six days, and their metabolic flexibility will improve because their insulin sensitivity improves. We've done studies with the seven days of one hour of exercise a day in previously inactive individuals. We improved their glycemia. We improved their insulin sensitivity. And we're not the only ones who've done this. Lots of people have done this. And then even one bout, one 30-minute bout of muscle contraction will insulin-sensitize muscle like in your legs or your arms. And that occurs in healthy people and it occurs in people with diabetes. And then that affects your metabolic flexibility. So I hundred percent agree with you. It's not always best to study metabolism kind of in a basal effect. You kind of want to stress it. And the stress that we all encounter is eating meals every day. That's the stress our body has.

Jim Hill:

John, Holly, and I often tell people that your metabolism can work with you or against you. And I think you see that in weight loss maintenance. And we've been very big advocates of weight loss is a very different process than weight loss maintenance. In weight loss, you just need to eat fewer calories. And I don't think metabolic flexibility plays a big deal in that, but I think it plays a huge deal in keeping it off. And what we try to get people to say is if you have a flexible metabolism, it's like your body is working with you. It's extra stuff. And if it's inflexible, you lose weight, you're trying to keep it off, you're not moving, you have to be so careful. Any little slip up, your metabolism is so geared to store energy.

John Thyfault:

Yeah and it's related to partitioning and what I mean by that is where do those calories go where those substrates get stored. You can think of like Price is Right with Plinko. You drop that thing and it would go the down and shake down at the different areas. If you're more active, those calories and those nutrients or substrates are going to go to the right places and if you're less active, they're going to go to the wrong places. And that plays a role in too much lipids or fat being stored in your liver and your adipose getting bigger.

Holly Wyatt:

I love that visualization. I don't know if people watch The Price is Right, but I totally know what you're talking about. You put it in and you see where it ends up. It's complex, but the idea is movement gets it into those columns you want it in to get more money or to be more successful. Wow.

John Thyfault:

Right. And if I could just add one more thing, And this was the concept that Dr. Booth brought up in a few reviews. And Dr. Booth is a famous exercise physiologist at Missouri who really has been saying inactivity has been killing people for 25 years. He's not wrong. From an evolutionary standpoint, we had to be really, really active to secure food. Then we would consume that food, store it, and then we'd be really, really active again. And we would have a caloric deficit and we would use those nutrients, right? And so, while the body would have its nutrient reserves depleted, then we'd have to work really hard again to acquire food. Now, we're in this stalled cycle. We don't have to work to acquire food. And it's cheap. I mean, you cover this a lot, right? It's cheap to have hypercaloric meals. It's easy to get. But we're not burning the energy and we're not using the metabolic pathways that we were designed to burn through our evolution.

Jim Hill:

John, I think we've got it backwards in a way out there, of people thinking that sedentary is the natural part and let's go and intervene for exercise when in fact movement is the natural state and not moving is the unnatural state.

John Thyfault:

You're a hundred percent right and again Dr. Booth wrote a review article 20 some years ago that the sedentary group should be the experimental group and the exercise group should be the control group.

Jim Hill:

I love it. So many questions here, Holly, but I'll start out. One of the things that we try to do is, number one, we tell people, if you're not prepared to substantially increase your movement, your chances of keeping significant weight off are very low. That's work with the National Weight Control Registry, with people that we've worked with. And part of the issue is, if you don't exercise, you have to eat so few calories to maintain your weight, and our bodies just aren't set up for food restriction. But we talk about really three big buckets of physical activity, and this comes a lot from the National Weight Control Registry. These are people that are maintaining about a 70-pound weight loss, and they've done it for long periods of time. The average amount of activity is about an hour a day. That's the average. When we tell people that, it's really interesting. An hour a day, is that a lot? One hour out of 24 and keep off 70 pounds? So we tell people you've got to do three things. You've got to increase your planned activity, increase your lifestyle activity, which is moving around more. And then the third one is decrease your sedentary activity. How do you think about those three buckets?

John Thyfault:

I hundred percent agree. And I hadn't thought about them as three buckets. I usually describe it in different ways, but a hundred percent agree that you've got to increase your ambulatory movement throughout the day. That's kind of what I call your, what you call the lifestyle physical activity. I think about having programmed exercise and those two things are linked, right? So if you commit that you're always going to walk to the furthest coffee shop, then you're going to get 10, 15, 20 minutes of continuous movement that is almost equal to planned activity, right? A planned exercise where you're getting a known duration. And the chances if you do planned exercise every day of 30, 40 minutes, then that gets the step count up, which is what comes from ambulation. So I hundred percent agree with you. I think the newest part is the breaking up the sedentary time. And it's kind of thought about in two ways, how much volume of sitting do you do during the day? And then also how long is each duration of sitting. And there has been really great work coming out of different groups.

David Dunstan out of Australia is really a leader in this area. That really impacts your insulin sensitivity, just what I was talking about earlier. So they took office workers and they did a glucose challenge test. And on three different occasions, the office workers sat for six hours, or they stood up every 20 minutes and stood for a minute and then sat back down, or they stood up and they did like light kind of half squats and just kind of some movements. And either standing up or just doing those light movements dramatically lowered the glucose and insulin responses to that glucose tolerance test. And these were obese office workers who were previously sedentary so that is proof positive, and they've done other studies like that and there's other more trials coming out looking at more long-term chronic effects, but that's that's proof positive how changing your sedentary behavior can really impact your metabolism. And again, where are those nutrients and substrates go.

Holly Wyatt:

Yeah. We've had discussed this somewhat. Is it standing enough or do you think you need to be moving also? Is there more about muscle contraction instead of the sitting, the sedentary? Is there any data on that or where are we on that?

John Thyfault:

Yeah. So their data would suggest standing is enough, but I think there's enough other data from a muscle health perspective that just doing a little bit more like walking down the hall and back, because you're going to stimulate more blood flow, you're going to activate different muscle beds. One of the tenants of exercise physiology is that the best metabolic benefit that you get in muscle are in the muscles that you actually activate when you're exercising. So if you walk for exercise, the metabolic benefits are primarily going to be in those muscles that do the actual contractions while you're walking. So the lower body, maybe the core. So that's why I like resistance training. You can activate shoulder muscles, arm muscles, leg muscles, all the muscles in your body is a potent tool to improve your metabolism because you activate more muscles. So with the standing versus some kind of movement, I would say you're going to just get more benefit from the movement. Even if it's not captured in a trial or something just a little bit more it's always going to be a little bit better.

Jim Hill:

John, I was reading in the news yesterday about a study that you were quoted and commenting on the fitness versus fatness for longevity and this reminds me of my dear friend the late Steve Blair who was saying this two decades ago that it's not just how fat you are, it's how fit you are. And this was, I think it was sort of a meta-analysis or a review showing that in the long run, your cardiometabolic fitness is probably a better predictor of your longevity than your body fat or your weight.

John Thyfault:

Yep, hundred percent. And I really have a hard time getting that message across to people. I think for a variety of reasons, one being when we think of obesity, it's not black and white, right? So someone that's a BMI of 32, 33, 34, there's a high chance they could be very active and have good metabolism and they just carry extra weight. I'm not just saying, they could be 37, 38. We all carry our weight differently. And I think a lot of people think about extreme obesity like really, really high BMI. Can they be active? They can. It's a challenge. There's going to be musculoskeletal problems and orthopedic limitations. So I think when I say that movement can improve metabolic health and longevity at any body weight, it is. We have to be careful. But at most people's obesity status, it can. And I want to also highlight, I'm not going to put out names, but some people have spent a lot of time trying to prove to us that exercise is not great for weight loss. And it just drives me nuts.

Jim Hill:

It drives me nuts too, John. Thank you.

John Thyfault:

In my opinion, anybody that's struggling with obesity, I want them to lose weight. But a huge public health outcome that we could have is if we could just stop everybody from gaining even more weight. Because everyone in America gains weight over the years. If we could just stop that.

Jim Hill:

I love this. This is what you and I talk about all the time. The first step is not letting the problem get worse. And John, we just did a podcast about this effort out there that you've seen, Make America Healthy Again. And I love the concept, but it's so all about food that there is no way we're going to make America healthy unless we can increase physical activity in the population. And back to my friend, Steve Blair, when he did the fatness or fitness thing, he got attacked big time by the obesity community that just did not want to hear that it was exercise versus weight or nutrition. And I think one of the problems in our field is we're arguing over those kinds of things. The analogy I always make is, is your net worth due more to your income or your expenditure? And the answer is yes, it is. And I just think we waste so much time arguing, is it diet? Is it nutrition? Is it fitness? Is it fatness? It's all those.

Holly Wyatt:

Well, they're all connected. It doesn't make any sense. They all impact each other. We know that activity impacts how much you eat and fuel and all of that. It doesn't make sense to have to say there's just one.

John Thyfault:

Yeah. I try to think about why do we get into these camps? And I tend to think it's part of his discipline oriented science. We grew up in nutrition or we grew up in exercise. And so we need more interdisciplinary research. I was lucky at Missouri. I was in a department called the nutrition and exercise physiology department. And we'd have seminars every Thursday and we had to listen to each other's side. And it was so transformative for all of us in terms of how we viewed all these things. But I also think there's certain people who want to make a mark and they think it's black and white. We just need to eat less carbs and then everything will be fixed. That's ignoring the complexity of our physiology and of all the great work that's been done for decades by people who've been trying to attack this problem.

Holly Wyatt:

And it's holding back the field. It really is holding back the field. And I think we need to stop funding that type of research and we could really move forward.

Jim Hill:

Yeah, I agree too, but that's what sells, those simple messages. Don't eat carbs, don't eat sugar, and everything's going to be wonderful. And people are confused out there, and I think we need people like you, John, to try to get the message out. This is not simple. It doesn't mean we don't have some solutions, but the simple stuff isn't going to work.

John Thyfault:

Yeah.

Jim Hill:

John, the big deal right now in the obesity field are the new GLP-1 meds. These meds are fabulous at weight loss. People are meeting their goal weight. This is great and Holly and I welcome the tools. What we're not so sure about is the long-term and a couple of things. So number one, if you give everybody who's obese these meds and everybody's a lower weight, but they don't exercise and data, is that success? And number two is what we're seeing, there's not a lot of data, but it looks like not very many people are staying on these over the long term. So when they go off, they regain the weight. What's the role of movement there and where do you see maybe that area going?

John Thyfault:

It fits our early discussion, I think that if we want to do it right, we need to give these drugs with good lifestyle counseling on why people should move more, why it's going to be important for keeping the weight off especially when they go off the drugs. And is our medical system set up to do that very well? No, unfortunately. Right? So you get very limited access to registered dietitians paid for by insurance and you get almost nothing paid for for clinical exercise physiology. And on top of that, a lot of our medical students aren't trained in exercise. They don't really understand what it does or how it does or works. And then even then if they did, they're going to have five minutes to say, tell a patient, you really need to exercise more. So it's a real challenge. I think there is a huge opportunity for clinical exercise physiologists and physical therapists to work together with physicians and advanced practitioners to do lifestyle medicine, not just lifestyle medicine, but movement medicine, help people fix their orthopedic limitations, help them learn how to exercise, help them find activities they like. That's the thing. I think it's really important. You can derive benefit for so many different things, right? Like we're in this pickleball revolution, right? People love playing pickleball. That's great exercise and they don't even know they're exercising.

Jim Hill:

I love it.

John Thyfault:

Or have a dog.

Holly Wyatt:

There we go.

John Thyfault:

Right? A dog that stares at you until you walk her, like my dog. Or have a partner that you want to talk to three times a week and you're going to talk on the trail. If we could help people get through this. But oftentimes they have small injuries, knee issues, access to sidewalks. So it's not simple for everyone. I get that. And safe places to walk and all that. But I wish we could use these new tools, which I agree with are very powerful and add with them just these subtle other things. And we'd get so much more bang for our buck than just handing these out. And that's it.

Holly Wyatt:

Activity is medicine, really using activity like we use medicine. But let's just say, John, that we had plenty of this, the new medication, and everybody that needed it could be on it and stay on it. And they wanted to stay on it, which is not true. But let's just say that was a situation and that basically clamped their intake low through the medication and they did not increase their physical activity. What do you think their health would be like? Would that be success? They’re lower weight without movement.

John Thyfault:

Yeah, I mean, their cardiometabolic risk will go down. Their insulin sensitivity will improve, but those things will not improve as much as they would if they were to increase activity on top of it. Because as we discussed earlier, being active is the normal condition. And so it's not that you need to exercise to be more healthy. You need to exercise and move to maintain just normal function. And so the other thing I get thinking about is we live so much longer than we did, whatever, 50, 60 years ago, right? And we all see relatives who struggle with physical function as they get older. And obesity, chronic obesity, has played a role in a lot of those people who have problems with physical function. And we know that like as soon as you break a hip or you lose your mobility, cognition declines, right? Happiness, the quality of life goes down. And then all these other disease states just add up on top of it. And so many of those things could be avoided if we can just maintain our physical function. And what I mean by that is being able to do the activities we want on our feet, with our arms. And so, yes, I think they'll be healthier, but will they be as healthy as they can be? No. And will that be the number one driver that makes them have high quality of life from age 60 to 90? No. There's a lot of other components to that.

Holly Wyatt:

I would say even younger than that.

John Thyfault:

Yeah, you're right.

Jim Hill:

So as a very much a senior citizen, John, I see so many people my age that can't even walk a mile. And it's just incredible to me. And it's not just the number of years you live, but it's the life you put in your years. And I think I saw something recently where Americans live long, but they're the number one place where people live so long with chronic disease and non-functionality. So it's not just how long you live, it's the quality. And that's where I think movement can play a real role.

John Thyfault:

A hundred percent. And I wish we could, and maybe there's physical therapy groups or physical therapy departments across the nation who work on this, but I really would love to see more interactions between physical therapists who really can help with this physical mobility, orthopedic limitations, getting past all that, work with obesity specialists, because I think there's a real need there.

Holly Wyatt:

Yeah. I'm going to switch just a little bit because you talked about the timing at the beginning, and I think people are really interested in that. So how long does it take, let's say you put in moving more, how long does it take before you have the effect? Or let's go the opposite way. If you suddenly become sedentary, how long does it take to have the effect on your muscles?

John Thyfault:

It's within hours. I mean, I'm not going to go down to like minutes, but it's within hours. So we've published, for example, when CGMs, which are continuous glucose monitors for listeners who don't know, those are little probes that go into your skin and they measure your blood glucose minute to minute or every five minutes and they do it in your free living environment. When those first came out, we did a study where we took healthy, active people who were getting more than 10,000 steps a day, and they wore them for three days and recorded what they ate. And then we had them get less than 5,000 steps a day and wear them again and eat the exact same meals at the exact same times. And there was dramatic increases in their glycemia in their free living environment. Their glycemic excursion, which I mean is how much glucose goes up after the meals, went up dramatically. Yeah. And that was taking a healthy active and make them inactive. We did a similar study where we recruited people with type 2 diabetes who have glycemic issues. And we asked them to come in and exercise one hour a day for seven days. And we compared their sedentary condition versus their active with these CGMs again. Again, glucose went down, time and range of where their glucose is supposed to be went up. And even the times when their glucose goes too low got fixed, it got better. And there's lots of other data like this. So I'll say ours. Some of the great work comes from bed rest studies where they were studying what happens to astronauts.

Holly Wyatt:

So I guess the good news for the listeners out there is if you start moving, you can have an impact right away. It doesn't take a certain amount of time, three months or three weeks or whatever. You can actually do something right away. I guess the bad news is if you stop moving, you can also have a negative effect.

Jim Hill:

You got to keep up with it.

Holly Wyatt:

Yeah, yeah.

John Thyfault:

Think about it as physiological. Basically, what's happening is the muscle is saying, I'm not contracting, I'm not using energy, so I don't need glucose to come in. It's just protecting itself.

Jim Hill:

That's why a low-carbohydrate diet works well for people that aren't moving. You don't need any carbohydrate. But if you're moving, carbohydrate is the fuel that fuels your movement.

John Thyfault:

Exactly.

Jim Hill:

All right, John. I'm an optimist, but when I look at what it would take to really increase physical activity in the population, it's hard to think that we're going to do this. Technology, our jobs, all this are moving us in the wrong direction. Do you see any hope that we're actually going to be able to increase physical activity in the population?

John Thyfault:

I think education at a young age about what movement does to our bodies and why it's important outside of body weight, right? That's the problem is people start exercising, they look in the mirror, their body doesn't change noticeably. They're like, ah, stop. But if we could educate people at a young age, how important movement is for our brain, our mental health, our metabolic health, our physical function, I think that's one component. The secondary component would be changing our built environment, having buildings that people work in where they walk a little further, or they want to walk further, or the stairs look like something they want to go up, and it's not hidden in the corner. There's just all these architectural things and environmental things, safe streets, bike lanes. We underestimate people's intelligence, I think, all the time. If we don't explain to them why movement is so good, why would they do it? If you just are like at a soapbox, you need to move more, you need to move more without telling them why and making it relatable to a disease that they saw their mom or their dad or their cousin have, it's going to have less effect. So I think education is a key component.

Holly Wyatt:

I agree with that. I think education is absolutely necessary and telling them why. And I agree. I think they want to know why. We should be. We shouldn't be simplifying it that much. We need to get into there and show them and tell them and give them great visuals so they can understand it. But I also think that we're going to have to then help them get there. There's so many barriers with that. So I think it's coupled together.

Jim Hill:

People used to move because you had to. You couldn't get through your day without movement. Now you can get through your day with very little movement.

Holly Wyatt:

So I think we're going to have to re-engineer some stuff maybe and figure that out. That's what I always tell people. Let's re-engineer your environment and see if we can do it.

Jim Hill:

But I actually think that is the single best thing we could do for public health if we could increase activity. I know there are a lot of other needs, but without that one, I don't think we're going to be successful in making people healthy. All right, Holly, we've got time for a listener question or two?

Holly Wyatt:

Yes. This comes from a listener that says, how do you know if your metabolism is slow? Are there signs that I can look for? And so I think that's a great question. Is there something that they could look for? How do you know if your metabolism isn't working for you?

John Thyfault:

Boy, that's a tough question.

Holly Wyatt:

I know. That's why we gave it to you.

Jim Hill:

We're hoping you have an answer because we don't.

Holly Wyatt:

I'm on the edge of my seat on this one.

John Thyfault:

It's hard to say. If they're talking about slow, do they mean that they seem to think they gain weight really easily? And again, we do have a lot of heterogeneity or variability in how someone may overeat for three straight days and be relatively inactive and gain one pound and the other person gain seven. And it just, from a mechanistic standpoint, we don't really understand it. So I would say that that is one way. Do you really kind of seem to gain weight rapidly in short durations of time? That'd be the best way to think about it. In terms of what my message was today is I would be paying attention to your glucose levels. And looking at your fasting glucose, they'll always measure that. Or typically they'll measure that. Now, that is a concern of mine that when I go in for a physical, they don't always do a blood draw. And so I'll ask, can I get labs done so I can see my fasting glucose and my lipids? So ask for that. It's paid for with your yearly physicals.

Holly Wyatt:

Well, more and more people are getting the continuous glucose. You can get it yourself. More and more people are going out there and getting that data themselves.

John Thyfault:

Yep. And the software will give you a readout of glycemic variability. So you want less variability and you want more time and range, which means your glucose is in this range where it should be and not outside of the range. The software will give you that information. So those could be readouts that are critical.

Jim Hill:

If you're overweight and sedentary and have been that way for a while, your metabolism probably isn't working for you.

John Thyfault:

It's probably. Instead of just assessing it, you could look at where you're at and get information. That's true.

Holly Wyatt:

I like what you said because there's a range. Even with people who are active, I think there's still a range of metabolism. And some people are going to have a metabolism that's going to predispose them to gaining weight or having to work a little bit harder to stay at a healthy weight. So there's this physiological range. But what I kind of say to people when they say this is, “Okay, because your experience.” Yes, your physiology, you may have a metabolism that works against you, but you can make it better. No matter where you are, you can make it better. And I think this movement is the key to making it better, no matter where you are on that spectrum.

John Thyfault:

Yep.

Jim Hill:

All right. One more quick question. I hear people say that your metabolism slows down as you age. Is that true?

John Thyfault:

Boy, it sure seems like it. Jim, you would know the literature on this better than me.

Jim Hill:

I think so.

John Thyfault:

I think so. But I will say I'm 49 going on, you know, close to 50 and definitely in the last five years, my weight can go up way more. I used to be a hundred percent resilient to weight gain, seem like, and now I am not.

Jim Hill:

So it's particularly important to continue to move as you age.

John Thyfault:

Yeah. And be mindful about your food intake.

Holly Wyatt:

Don't you think that's because of muscle? I mean, I've always said my standard answer and things change, right? I always things I thought were true and then get new data and you come up with a different one. But as we tend to get older, we tend to maybe lose muscle mass or maybe the quality of our muscle changes. Any data on that? Is it related to muscle changes as we get older?

John Thyfault:

So there is data and it's not that. I mean, even at the mitochondria, which is the little powerhouses in the cell of the muscle that burn the energy, they're not dramatically different. So there's been great studies done at Mayo where they take really older individuals who are extremely sedentary or extremely active and they compare them to really young individuals who are extremely sedentary, extremely active. Number one, insulin sensitivity does not go down with age. So that really active older people have just the same insulin sensitivity as the active young people. Now, some of the mitochondrial changes go down a little bit, but the muscle quality itself, and it just doesn't seem to change. So there is a lot of this that we think occurs with aging is really just us getting less active.

Jim Hill:

There you go.

John Thyfault:

Probably putting ourself less in front, right? Like with my kids' schedule of sports, it's hard. It is very hard after work to find any time to do anything for myself including eating a healthy meal and being active.

Holly Wyatt:

So it's not necessarily the age, it's what's happening in your life.

Jim Hill:

Best thing you can do to slow down aging. You can't stop it, but movement is the best you can do.

John Thyfault:

Movement is the best you can do.

Jim Hill:

All right. We're going to do a couple of vulnerability questions, John. So I know you have young kids. What are you doing with yourself, your kids, and your family to make sure everybody has optimum metabolism?

John Thyfault:

Well, I will tell you that it used to stress the crap out of me. Every time I'd see them on a screen or every time we'd have a snow day and we'd be stuck inside, I would wish I wasn't an exercise metabolism researcher. They play sports and I love lifting weights. That's what got me. I started lifting weights at 13 or 14 and it's a very empowering thing for young people male or female I believe. And so I've gotten them both into lifting weights and we have a gym in our basement and we're lucky to have that resource, of course. I try to talk to them about why movement's important and I spend a lot of time talking about how I think it's important for mental health because I really am a believer that kids were meant to move a lot growing up and play hard. I just handle stress so much more and I can tell in them too. We've actually had no days the last three days and my 12 year old was just going nuts. And he went over to a friend's house and they built a tunnel under a snow drift and he came home so happy. And I think it was because he was out being active. So I just try to get them to be mindful about it, I guess.

Holly Wyatt:

Yeah. So I got one for you. I love these vulnerability questions. We talk about movement as a way to optimize metabolism, but I know even experts, you know, we talk about it, Jim and I, and you struggle sometimes. Has there been times when you've fallen out of your physical activity or activity movement routine and how did you get back on track?

John Thyfault:

Yeah, I mean, I had a hip and lower back issue for about the last eight months. And I'd say the last two months, I'm almost back to normal. And I honestly think it's from sitting in a chair too much writing grants about exercise. That's what the physical therapist said. We all get weak glutes and we start to get imbalances in the muscles in our abdomens and our lower back from sitting too much. And so I had to do a lot of PT to get back to normal. And now I have to really make sure I'm doing these stretches and these simple strength exercises. But yeah, it was a real struggle. I couldn't do my Peloton. I couldn't go to CrossFit. All I could do was walk. And so I basically just did, I went to doing very long walks for a while. And the mental health part is what I struggle with too. I was like, I got to go to do something or I'm going to go crazy. So yeah, I've had these same challenges.

Jim Hill:

This has been fascinating, John. Wow. We could go on and on, but let's do this. I want to leave our listeners with one challenge. For those people that aren't active but would like to be active, what's one small thing they could do to get started?

John Thyfault:

I really believe in keeping track of your steps.

Jim Hill:

I love it.

John Thyfault:

Don't give yourself, I have to get this many steps every day. There was a program at Missouri at the University of Missouri a long time ago. They call it the million steps program and it was led by psychologists. And the idea was when can you get a million steps? And it wasn't driven by how much you can do every day. Because if you do that, you're going to not get it for three or four days and you're going to get disappointed in yourself and maybe quit. But you just say, you know, I'm going to see when I can get to a million steps. But if you do want to try to keep track, there's really good evidence that if you can just get above 7,500 steps a day, your health risk for cardiometabolic diseases goes way down. So I'm a big believer in just simple step count. And then try to do something that breaks up your sitting time if you are an office worker. I try to print down the hall and I try to get coffee across the street. So things like that.

Jim Hill:

John, thank you so much for sharing your expertise and to our listeners, let us know what you're doing, how you're going to increase your movement. We would love to hear from you. So thanks everybody. And we'll see you next time on Weight Loss And.

Holly Wyatt:

Bye everybody.

Jim Hill:

And that's a wrap for today's episode of Weight Loss And. We hope you enjoy diving into the world of weight loss with us.

Holly Wyatt:

If you want to stay connected and continue exploring the “Ands” of weight loss, be sure to follow our podcast on your favorite platform.

Jim Hill:

We'd also love to hear from you. Share your thoughts, questions, or topic suggestions by reaching out at [weightlossand.com](http://weightlossand.com/). Your feedback helps us tailor future episodes to your needs.

Holly Wyatt:

And remember, the journey doesn't end here. Keep applying the knowledge and strategies you've learned and embrace the power of the “And” in your own weight loss journey.