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Ep. 235 The Impact of Nutrient Density and Why it Matters with Chris Kresser


I am delighted to connect with Chris Kresser today! Chris is the co-founder of the California Center for Functional Medicine, the founder of Kresser Institute, the host of the top-ranked health podcast Revolution Health Radio, and the New York Times best-selling author of The Paleo Cure and Unconventional Medicine. 


Chris is as gracious in person as he is online! I have been following him for years and feel honored to have him joining me on the show today! He shares his background, and we dive into bio-individuality and functional medicine. We talk about changes to the nutrient density of food, why the RDA is inadequate, why synthetic nutrients are not beneficial, genetics, how mindset affects our health and measurable ways to improve neuroplasticity. We also discuss his new supplement line, Adapt Naturals.


I hope you will enjoy listening to today’s information-packed conversation with Chris Kresser as much as I did recording it!

Stay tuned for more!


IN THIS EPISODE YOU WILL LEARN:

  • How Chris’s journey to health led him to where he is today.

  • How has his approach to bio-individuality and personalized medicine changed over the last ten years?

  • Chris explains why it is hard to do research studies on functional medicine treatment.

  • Chris dives into his current focus on the nutrition spectrum.

  • Solving people’s nutritional problems is usually pretty straightforward and could have a massive impact on the burden of chronic disease.

  • How modern-day changes have decreased the nutrient density of our food.

  • How chronic disease and environmental toxins impact our ability to absorb nutrients.

  • Why has the US government failed to update the RDA to meet the current research on our daily nutritional requirements?

  • Chris talks about nutrient synergy and shares his thoughts on synthetic vitamins.

  • What is neuroplasticity, and how can it be measurably improved by a shift in mindset?

  • What makes Adapt Naturals unique in the supplement space?


Bio:

Chris Kresser M.S., L.Ac. is the co-founder of the California Center for Functional Medicine, the founder of Kresser Institute, the host of the top-ranked health podcast Revolution Health Radio, the creator of ChrisKresser.com, and the New York Times best-selling author of The Paleo Cure and Unconventional Medicine. 

He is one of the most respected clinicians and educators in the fields of Functional Medicine and ancestral health and has trained over 2,000 clinicians and health coaches from >50 countries in his unique approach. Chris was named one of the 100 most influential people in health and fitness by Greatist.com and has appeared as a featured guest on Dr. Oz, Time, The Atlantic, NPR, Fox & Friends, and other national media outlets. He has recently launched Adapt Naturals, a supplement line designed to add back in what the modern world has squeezed out and help people perform and feel their best.

 

"You can't supplement a bad diet or lifestyle"

-Chris Kresser

 

Connect with Cynthia Thurlow


Connect with Chris Kresser


Transcript:

Cynthia Thurlow: Welcome to Everyday Wellness Podcast. I'm your host, Nurse Practitioner, Cynthia Thurlow. This podcast is designed to educate, empower and inspire you to achieve your health and wellness goals. My goal and intent is to provide you with the best content and conversations from leaders in the health and wellness industry each week and impact over a million lives.

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Today, I had the honor to connect with Chris Kresser, who is the co-founder of the California Center for Functional Medicine. Founder of the Kresser Institute, the host of the top-ranked health podcast, Revolution Health Radio, the creator of The New York Times best-selling book, The Paleo Cure and Unconventional Medicine. Today, we dove deep into his background, as well as the role of bio-individuality, functional medicine, the impact of Bruce Ames work, changes to our food nutrient density, why the RDA is inadequate, why synthetic nutrients are not beneficial, the impact of genetics, the role of mindset as it pertains to health as well as measurable ways to improve neuroplasticity and we talked at great length about his new supplement line, Adapt Naturals. I hope you will enjoy this conversation as much as I did recording it. It really was an honor connecting with Chris. I've been a follower of his for years and he really is as gracious in person, as he is online.

[music]


Cynthia Thurlow: Chris, it's so nice to connect with you today. I've really been looking forward to the conversation. 


Chris Kresser: Me too, Cynthia. It's pleasure to be on your show. 


Cynthia Thurlow: Absolutely. I'd love for you to start the conversation sharing a bit about your background in your own health journey because I think it plays a large part in your open-mindedness and your willingness to look at each patient as a bio-individual. 


Chris Kresser: Yeah. Well, going into the health profession was not my original plan. In my early 20s in film industry, believe it or not, and I burned out of that very quickly and decided to take off all by myself for a couple of years. About a year into that trip, I was in Indonesia on a little island called Sumbawa surfing, one of the things that I was doing on that trip, and I got extremely ill with a tropical. At that time unknown tropical illness and at death's door for several days. The only other westerner in the village was an Australian guy who had some antibiotics in his medical kit that brought me back from the brink. But that evolved into a very long story, which I won't go into but the short version is 10 years of complex chronic illness that brought me to my knees. 

I have long periods of time where I couldn't work or really function much at all. I saw probably 30 to 40 different doctors in at least four countries, tropical disease specialists, infectious disease specialists. Then when I wasn't getting answers, I expanded my search bronchoscopist, naturopathic doctors, energy healers, shamans, pretty much leaving no stone unturned just to find some answers. Through the course of that search, there was no one particular thing that, as is often the case in recovery that made the difference, but certainly a nutrient-dense, paleo type of diet was instrumental, didn't really [audio break] your diet then or at least was not as well-known as it is now. Then functional medicine, which again, was not very well known at the time, but just this idea of getting to the root cause of what's happening instead of suppressing symptoms with drugs, which is what most of the very well-meaning doctors that I saw were trying to do.

I discovered some clinicians along the way that we're in the functional medicine space or functional medicine adjacent if you will, and that's what really inspired me to pursue this as a career myself. People around me saw what was happening and were curious and started asking questions. I realized that I could turn lemons into lemonade perhaps by taking some of my own experience and translating that into a way that could help other people. So, I went back to school, got licensed open functional medicine practice, and here I am, more or less, there's quite a bit there that I left out, but that's the short version. 


Cynthia Thurlow: Oh, [unintelligible [00:04:43] purpose stories, I think are so inspiring, and I didn't even realize that whole other aspect when I do all my podcast prep, I spent hours and hours listening on other podcasts and doing as much reading as possible. When you go through a significant health illness and you're searching for answers that makes you profoundly empathetic towards the suffering that so many people go through. Let's really start there, the concept of bio-individuality, the concept of really personalizing medicine for your patients. How does that process look for you now versus 10 years ago? 


Chris Kresser: It's a great question. When I wrote my first book, The Paleo Cure that was published almost 10 years ago. So, 2013. One of my mantras in that book was, "There's no one size fits all approach." So, this has been a key part of my way of looking at things for many, many years, but I would say that that's only increase over the last 10 years, my appreciation for the importance of an individual approach has only grown as my clinical experience progressed. As I started training practitioners and I left that part out of the story. But in 2016, we launched the ADAPT Practitioner Training Program, we've trained 600 plus doctors and other health professionals in functional medicine in my particular approach. As the feedback from all the people that we trained, I just developed a greater and greater for this. We all do share a lot in common, of course, as human beings, and there are some things that are just going to be true for everybody. So, for example, eating cheese doodles and drinking Big Gulps all day long, there's no human being that is going to benefit from that. [laughs]

We might be harmed [audio cut] by that approach, but there is nobody that is to benefit from that, so that's just one simple example of what we share in common. On the other hand, when you start talking about things like macronutrients, calories should come from carbohydrates, and protein and fat, when you start talking about supplementation, when you start talking about physical activity and approaches to exercise and movement, when you start talking about what stress management or stress reduction techniques are going to be best. Those are all highly individual questions and they will depend on people's health status, their genes, their gene expression, their goals, their geography and climate that they're living in, their preference, so many factors. So, this is both, I think the challenge and the opportunity when it comes to medicine is that the way that our medical establishment is designed is, we do randomized controlled trials on single interventions and control every other factor and assumed we're kind of just robots where like, you just put in one input, and everyone will respond in the same way, which is totally ridiculous and totally flies in the face of everything we know about human biology. And yet, that we have this sort of mechanistic view of medicine and how medicine should work. 

It's very difficult the design studies that take this bio-individuality into account because the complexity just gets overwhelming. When people ask, like, "Where are the studies supporting functional medicine?" That's one of the responses is like, there are thousands support the foundation of functional medicine, the mechanisms and the principles, but it's very difficult actually to do studies on functional medicine treatment because, by its very nature, it's highly individualistic. That's what makes it so much more effective but that's also what makes it harder to study with our current framework. 


Cynthia Thurlow: I think that's a really important distinction. Obviously, a lot of my work is focused on women, and people are always asking, "Well, where are the studies? Where's the data, the research that's supporting? Some of the things you're talking about, and I have to point out that women's bodies are very complex and so just taking into account the menstrual cycle, a lot of women were completely taken out of research because it was just deemed to be too complicated. Now, when you add in, you layer in a functional integrative medicine approach where we're looking at multiple variables, I completely agree with you that it makes it probably a little bit more challenging for researchers and it may not come to fruition because there's so many different moving parts that are contributing to whether or not an intervention is beneficial or not for that particular individual. 


Chris Kresser: I think there are some ways around that. Some of the best studies I've seen, for example, have just compared functional medicine care to standard care. So, at the end of the day, that's what the patient cares about. It's like, I have two options, I can go to my conventional doctor and do what they recommend or I can go to a functional medicine clinician and do what they recommend. Some studies have just looked at that like, "Okay, let's take two groups of people and put them in these different camps and see what happens." And, not surprisingly, the functional medicine patients who are treated with functional medicine often do much better than pay patients that are treated with a conventional therapies. But that does require just even a whole different paradigm of understanding how we might set up research studies and do them because it's shifting the focus away from a single drug intervention, which is, again, what most randomized control trials are looking at to something that's much more inclusive and comprehensive. 


Cynthia Thurlow: Do you find that most practitioners that you're interacting with either in your programs or outside your programs, are they open to the possibility that a lot of what we trained with is not fully embracing the beauty of what makes each of us unique? Or do you feel there's still some degree of significant cognitive dissonance?


Chris Kresser: With the practitioners I've trained?


Cynthia Thurlow: Yes.


Chris Kresser: Most of the people I trained come into the program with openness to this perspective, or they probably wouldn't be there in the first place. Of course, that can vary from by degrees, we've had people come in from very conventional background as ER docs for example and they're pretty new to functional medicine. But being an ER doc is something that really opens your eyes to the failures of the conventional model, you cannot be an ER doc and not see what is wrong with the conventional model because you have people using ER as primary care because they're not able to get the care that they need. You have people showing up with late-stage complications from type 2 diabetes and most of these ER docs are thinking to themselves, "Well, jeez, maybe we should intervene a little bit earlier so that they don't end up in my yard that with needing to have their foot amputated." 

I think almost everyone is aware of the shortcomings of conventional medicine and the strengths that I get hit by a car, [laughs] and taken to the hospital and take advantage of all the incredible trauma and emergency medicine treatments that are available. And there's some just incredible diagnostic procedures that have been developed and allopathic medicine that we use all the time and functional medicine. I'm not saying there's a conventional medicine is bad across the board, wrong tool for the job when it comes to addressing chronic disease. I'm encouraged actually by what I've seen over the past five years, especially, there are a lot of new startups like Noom and SteadyMD and Salvo Health and Clearing. These companies that are embracing a functional medicine approach. They're not actually using the term functional medicine per se in their marketing because not enough people still really know what it is. But they've set up their entire business model with a functional approach. 

Clearing, for example, is a company that is dedicated to offering nonpharmaceutical approaches to chronic pain management. They use CBD and a bunch of other therapies but their whole mission is to get off of these opiates that can be so addictive and so harmful. 

Salvo Health, which I'm a board member of is creating a series of clinics that are taking a functional approach to specialty. Their first one is gastroenterology but then they have a plan for women's health clinic and a cardiovascular clinic. And it's combining health coaching with an app and education and training for patients and a doctor. There's these cells [audio cut] that are now venture-funded and they're raising a lot of money and they're making ways and they are based on this new approach that we're talking about, so it's not all bad news. I think there's some really exciting stuff happening. 


Cynthia Thurlow: Absolutely. I just want to echo what you just said that I applaud my traditional allopathic train peers that are doing emergency medicine, urgent medicine, trauma because the United States is just about better than anywhere else in the world. One area of medicine that I personally was able to see that were really not doing a fantastic job, and in a more traditional sense is prevention and then chronic disease management. So, I echo a lot of what you're saying. It's exciting to see all the ideas that are coming to fruition for different ways to manage chronic disease, to manage preventative disease and to do it in a way where we're integrating kind of, I don't want to use nontraditional but whether it's acupuncture, whether it's meditation, I mean, so many different ways to address chronic pain and other issues that people are experiencing. 

Now it goes without saying that the impact of nutrition is profound and I know you've had your own journey going from a macrobiotic vegan diet into a more ancestral health perspective. I know when you're working with clients, everything is tailored, but where are you right now on the nutrition spectrum? Are you still leaning into more ancestral health diet. What are some of the things that you're integrating into your day-to-day? 


Chris Kresser: Yeah. Probably now more than ever because over the last five years the big aha for me has been recognizing the role that nutrient deficiency plays in chronic disease and poor [audio cut] shortened lifespan. I really did a deep dive into Dr. Bruce Ames work, he's a professor of biochemistry, I think, at UC Berkeley, and has done some pioneering studies in this area. One of his series called Triage Theory, which is the idea that all proteins in the body can be separated into two groups. One is survival proteins that are needed for short-term survival, and the second are longevity proteins that are needed for all the processes that help us to live a long and healthy life. His research shows that when we don't get enough of the roughly 40 micronutrients that we need to function optimally, then whatever nutrients we are getting are diverted into survival functions first, that makes sense. The body always prioritizes immediate survival over everything else. And so, the processes in our body essentially compete for the same proteins, if we're getting less than the optimal amount, then those are going to go towards survival functions and not towards longevity functions. 

Longevity functions are not just about extending our life, those are things like conception, having a baby. If the body's survival needs are not being met, then there's not going to be anything left over for conception and raising a baby to full term. A healthy pregnancy. That can be blood sugar regulation, it can be sleep, it can be healthy hormone balance, it can be cardiovascular function, it can be all the things that don't contribute to staying alive, literally, like now and in the next few days or weeks. 

So, over the course of my nearly 15-year career now, I've treated thousands of tested literally every single person that comes through my door for nutrient status, and I do a bunch of different kinds of tests. So, we do blood testing, we do hair analysis, we do urinalysis, we do saliva testing, we do buccal cheek swabs, do depends on the nutrient that we're testing and that's very important. And then we have clinicians use an app called Cronometer, assess their diet for three days, it cannot be measured in any body tissue, or fluid, like [audio cut] example of that. 

I would say in that 15-year period, probably count the number of people that did not have nutrient deficiency [audio cut], which is just remarkable when you think about it because my patient population is very motivated. [chuckles] These are people who listen to all the podcasts, they read the books, they read blog articles, they're doing a lot of the right things, and most of them are already on a nutrient-dense diet. And still, even with all that awareness, I was just seeing nutrient deficiencies pretty much every day in the clinic. Then, I started-- me being me, research geek, nerd, I started to dive into the scientific literature on this subject and just found over and over, most people are not getting enough of the nutrients they need. 

I just want to [audio cut] talking about over true clinical deficiencies that lead to diseases like or beriberi or rickets or pellagra. Thankfully, rare in the developed world, it still happens in the developing world. But we're talking-- Bruce Ames calls Nutrient Inadequacy. A frank deficiency that's going to send you to the hospital today, permanently alter your function necessarily. It's enough, but it's not getting the optimal amount and it's enough to divert those nutrients to the survival proteins rather than the longevity proteins that we want to nourish so that we can achieve all of our health goals and live a long, healthy life. 

Once this sort of light bulb went off for me, prize, frankly, that more people weren't talking about it. I was sort of looking around going like, "What's going on here? Why isn't this a bigger topic of discussion, because it's so prevalent?" If you look at the statistics from Linus Pauling, and many of your listeners probably know Linus Pauling is two-time Nobel laureate, brilliant minds in science, in nutritional science in particular. The Linus Pauling Institute has published summarized data showing that 100% of Americans don't get enough potassium, probably over 95% don't get enough magnesium, 94% don’t get enough vitamin D, 92% don't get enough choline, 89% don't get enough vitamin E. I could go on but you get the idea. We're not talking about a problem that affects a handful of people, we're talking about most Americans and probably most people in the industrialized world not getting enough of most nutrients. So that's where my focus is now, I'm happy to talk more about that but it just strikes me is like one of the most critical things that we can discuss, not just in this interview, but I mean just in the larger health conversation, because unlike some other problems that we're facing this one has pretty simple solution. 

I'm not talking about reversing environmental air pollution and water pollution and addressing the problem of glyphosate and the food supply or dealing with sleep deprivation, which is a result of a whole bunch of [audio cut] involving screens and people being busier and two income families. Those are really hard complex problems to solve. What we're talking about here solvable problem and it's pretty straightforward. I think it could end up having massive impact on the burden of chronic disease. So again, I'm sort of looking around going like, "What am I missing here? Why isn't this a

bigger topic of discussion?"


Cynthia Thurlow: I think for listeners, what is it that's changed about our food to impact nutrient density? I think that's to me something I knew a little bit about. But in preparation for interview, I now know a whole lot more about that you're a fantastic resource on this.


Chris Kresser: Yeah. That's a great question. So, there are a lot of challenges that we face in the modern world that make it really difficult to meet all of our nutrient needs from food. Our ancestors were able to. I mean, obviously, our ancestors were not taking nutritional supplements. That's absurd and they weren't even thinking that much about what they were eating. They were just eating what was available in their environment. But there're five or six reasons that I think are really important to understand in terms of how things have changed today. 

The first is changes in soil quality. The easiest way to think about this is, it's not so much that the amount of nutrients in soil has declined over the past 100 years. It's that the plant's ability to extract those nutrients from the soil has changed. And that, again, if you use another analogy here, it's because we've disrupted the microbiome of the soil, in the same way that antibiotics disrupt our gut microbiome and cause changes that make it harder for us to digest and absorb nutrients, which by the way, is one of those causes that I referred to. We've disrupted [audio cut] the soil with pesticides and fertilizers and other chemicals, that have had that same impact on plant's ability to extract nutrients. That has multiple downstream effects. 

So, first of all, when we eat those same plants, those plants don't have as many nutrients as they did even 25 years ago. When the animals that we eat, eat those plants, the same thing is true. They're not extracting the same amount of nutrition from those plants. So, we're eating an omnivorous diet, we're consuming both plant and animal foods, we're getting hit on both sides there. 

One of the studies I read, this is something I'll never forget, it was just such a shocking piece of data was that we would have to eat eight oranges today to get the same level of nutrition that our grandparents ate, they got from just one single orange. That's two generations, that's an enormous change in two generations. And then we have data from the US, shows that there's been a decrease in magnesium levels of 25% just between 1940 and 1991. In the UK, that decline was closer to 35%, over the same time period, so the exact decline will differ from region to region based on the soil there. And 1991 is 30 years ago now, so if I'm virtually certain that if we were to get updated data, that decline would be even greater. I think that's number one cause is changes in soil quality. 

Let me just take a step back and say to that, I'm assuming we're having this conversation with the assumption that people are eating a healthy diet. But of course, that's not as safe as in the US, like 60% of calories now come from ultra-processed foods, which are virtually devoid of nutrients. I would be remiss if I didn't point out that that is by far the number one reason that people are nutrient deficiency is, garbage in, garbage out. But I know your listeners, Cynthia, are not in that boat for the most part, so we're having this conversation assuming that people are eating a relatively healthy diet. 

The second cause, I think is really significant is the shift from local organic culture to an industrial global food system. As you know, Cynthia, as soon as you take a vegetable out of the ground, it immediately starts to lose nutrients. The problem with that is that the average carrot that somebody buys at the grocery store and eats has been shipped for almost 2000 miles before it gets to the grocery store. During that time, it's in a dark turck, then it's stored in a dark warehouse, it ends up in the back of the grocery store in the dark, and it's losing nutrients throughout that entire process. And that's true of vegetables, it's true fruits, it's true that of all we eat. 

Even in our grandparents' time, that was unusual. Most food that people ate came from the local place that they were living. And they lived in a place where there wasn't any produce over the winter, often canned their own produce, from their own gardens or from farms that were local. So that's another profound shift in just a relatively short period of time. 

The third reason is the rise of chronic disease. We know that six in 10 people now have a chronic, and four in10 have multiple chronic diseases. Chronic diseases affects nutrient status in two ways. The first is it increases the demand for nutrients. Chronic disease is a stressor on the body and when the body is under stress, it actually has a greater need for nutrition. The second reason is that many chronic diseases decrease nutrient absorption or production so. 

For example, people who struggle with obesity, they produce less vitamin D in response to exposure to sunlight than people who are lean and then they also absorb less vitamin D from any food that they eat than people who are lean. I mentioned earlier that disrupted gut microbiota leads to decreased nutrient absorption and that's an [audio cut] thanks to antibiotics and NSAIDs and hormonal contraception and poor diet and tons of other factors that have disrupted our gut microbiome. So, we get hit with that double whammy of chronic diseases. I'm going to stop there because I've been talking for a long time but I guess the last I'll say one more, environmental toxins. 

We have heavy metals like mercury, lead, arsenic, cadmium that are ubiquitous. Now, unfortunately, in food supply, we have glyphosate, BPA, and other organic and inorganic toxins that are very commonly found in our foods now. The problem with these toxins is that they bind to minerals, typically, and that new complex of mineral and toxin can't be absorbed and utilized by the body. If calcium is binding to one of these toxins, we're not going to absorb it and utilize it as calcium. So that's another problem that our ancestors didn't face to the extent that we're facing today. I think those are probably the

four biggest ones. 


Cynthia Thurlow: I think it's really interesting because if you look at the RDA, so the recommended daily allowance for these minerals, it's woefully low. It's not even in a therapeutic range, and so why is it that the US government hasn't caught up with all the research and the compelling information that we're discussing? I would imagine that Big Ag has a lot of pressure that it puts on regulatory agencies and it's probably a larger discussion than we could have in the context of an hour on a podcast. But letting listeners understand that the recommended daily allowance is woefully inadequate on top of all of these other factors.


Chris Kresser: Yeah. That's a great and there's a lot to say about that. I'll start when the RDA was developed, which was during World War II, as a way of just making sure that the rations that we were giving our soldiers were enough to meet their basic nutritional. Again, this was wartime, this was not like trying to answer the [audio cut] optimal amount of nutrients for optimal health. It's like, "How do we give our soldiers this [audio cut] war?" Those are two very different questions. I think that's pretty obvious. The second critical thing to understand about the RDA is that they're based on several different factors, including age, and sex and health status and life stage. So, for example, the RDA for calcium is different for a pregnant woman, an elderly person than it is for a younger person who's not pregnant. And that's true of virtually all of the nutrients, and we can use magnesium as a good example because the RDA for magnesium was last updated in 1997. So that is almost 25 years ago, and so that RDA says that for 31- to 50-year-old adult male he should get 420 milligrams of magnesium a day, and then a female that same age group should get 320 milligrams. But those RDAs were based on a formula that included average body weight, and the average body weight in 1997 for a male was 166 pounds and for female was 133 pounds. 

Now, just last year, researchers published a study suggesting that, "Hey, wait a second, average body weights have gone up dramatically in that period of time. So shouldn’t we be like reevaluating some of these RDAs based on that increase in body weight?" And they focused on magnesium. So, they redid the RDA and the new average body weights were for a woman 169 pounds, so that's an increase from 133 pounds in just 25 years. And for men, it was 196 pounds up from 166 pounds, so a 30-pound increase in 25 years. 

When they recalculated the RDA for both of those groups, they found that instead of 320 milligrams per day for women, it should be between 170 and 535. And instead of 400 for men, it should be between 575 and 660. So those are massive increases in what the optimal amount of magnesium should be. That's not the worst part. The worst part is that the average intake of magnesium today for US adults is 340 milligrams for men and 260 milligrams for women. They are falling short. Most people are falling short of the old, outdated RDA. They're falling 200 to 300 milligrams short per day of this new more accurate RDA that reflects the optimal amount that we need. That's just one example with magnesium. I could go on down the line with B12 and folate and all of these other nutrients that are critical for our health and well-being. And the RDA is just like you said woefully inadequate as a measure of how much of each nutrient we should be getting. 


Cynthia Thurlow: It's really interesting. I can certainly state that 16 years in cardiology as an NP, almost everyone was low in magnesium, and it provoked palpitations and arrhythmias and cramping. So, one of the things that we did almost with every single patient was they were taking magnesium. I would say that's probably the one electrolyte that I'm most knowledgeable about. What are your thoughts about synthetic vitamins? This is another side of this issue is that the processed food industry has created a lot of synthetic vitamins that they've embedded in our processed foods. I would imagine these are also woefully inadequate and oftentimes, probably not even readily available for the body to be able to use.


Chris Kresser: Definitely. Yeah, I'd love to answer that question. I thought of one more thing that I want to add regarding the RDA that's really problematic. It's not even on the rate, like, what I just described to you in terms of updating the RDA based on changes in body weight and other factors, that's discussed in the scientific literature, like I just mentioned a study that purposely reevaluated the RDA based on that factor. But one really important factor that is less commonly discussed is nutrient synergy. We know and you know very well, Cynthia, that nutrients don't exist in the body in [audio cut] most nutrients require the presence of other nutrients, which are called cofactors, and that situation to be adequately absorbed and utilized. Going back to magnesium, we know that magnesium requires vitamin D to be absorbed in the intestine. 

So, imagine a scenario where someone is miraculously getting enough magnesium, even with this new RDA. Well, I just mentioned earlier that 94% of people are deficient in vitamin D. So, somebody could be getting enough magnesium on paper, but if there are low on vitamin D, they're not going to absorb that magnesium in the intestine, and they'll still be biologically deficient in magnesium. Iron is a great example. Copper is required for iron deficiency. I've met over the years who've had iron deficiency anemia, their doctor just kept giving them more and more iron, nothing was happening. We test them for copper, find out they're copper deficient and then just give them a little bit of copper, and all of a sudden, their iron deficiency anemia goes away and improves. It even works the opposite way for vitamin D.

Vitamin D requires magnesium to be activated. So, someone could be taking vitamin D supplement getting enough vitamin D, but then if they're magnesium deficient, they're physically deficient in vitamin D. And so, I think that's actually a good segue into the question of synthetic nutrients is a lot of times the synthetic approach doesn't take this nutrient synergy into account. Whole food naturally, this is the amazing magic of nutrients in food is that foods often contain the very cofactors that are needed to absorb those nutrients and well-designed supplements do too. But a lot of the synthetic products that people are taking do not. And so they might have high levels of an isolated nutrient, but then none of the cofactors that are required to absorb those nutrients. That's one problem. 

Another problem with synthetic nutrients, in some cases is that they're a foreign form of that nutrient for the body. The body doesn't recognize that nutrient as well or doesn't convert it well into the form that we want and problems can arise from that. So folic acid is a good example there. This is a nutrient that has been prescribed particularly to women who are trying to conceive or who have already conceived because folate can prevent neural tube defects so something that happens way more than we would like to admit, in the US, the richest, industrialized country in the world. For some women, they won't have any problem converting folic acid, the more active forms of folate that we need, but there's a substantial subset of the population that doesn't do that conversion very well. They have genetic polymorphisms that impair their folate metabolism. Some people have heard, of course, of MTHFR, and some of these polymorphisms, and they end up with a lot of unmetabolized folic acid. 

There are some studies that suggest that unmetabolized folic acid can increase the risk of cancer. So, these are [audio cut] talking about, they're really important to understand, and especially in the supplement industry oftentimes, it's like the cheapest [chuckles] "Let's load this thing up with the cheapest ingredients available so we can make the most money." And you walk into GNC or Costco or someplace like that, that's often what you're going to get. And that's problematic because supplements can be incredibly useful and helpful, but they can also be harmful if they're not taken properly. 


Cynthia Thurlow: I think that's a really important point because we have a methodology and a mindset as a culture that a supplement going to fix a lifestyle issue before we even think to change the nutrition, before we think to lean into sleep and exercise, etc. I'm the first person to say that supplements can be incredibly therapeutic, incredibly valuable. But we also have a diet, weight loss culture that has convinced us that the hot new pill, potion, powder is going to be the one thing that's going to yield weight loss. So, we've got a mindset of pills and supplements fix everything. And yet, I think we need to be very attuned to being quite astute or really making good choices based on our own unique needs, and that bio-individuality piece, especially MTHFR. I'm actually homozygous, so I have two copies of A677T. And so for me, it's been interesting navigating the supplement world and then having to be very attuned to those synthetic vitamins, and recognizing that they may not be the best choice for me personally. 


Chris Kresser: Absolutely. Yeah, I mean the way I put it is, you can't supplement a bad diet or lifestyle. I don't care what supplements you take, how many supplements you take, it's like building a house in quicksand, there's no foundation there and it's going to have that same result. On the other hand, if you have the foundation of a nutrient-dense whole foods diet, and you're taking good care of yourself, you're getting enough sleep or you're at least you're making efforts in the area because nobody's perfect. Life is full and busy, hard, and most of us have a lot going on [audio cut and is really solid foundation, smart supplementation on top of that is going to amplify your effects and your benefit. The way that I think about it, and I just tell my patients flat out like, "If you're not doing these basics, I want you to put all of your energy and attention in that area first, and then we can kind of layer it," because I think then supplements can be helpful and getting people to feel better, have more energy, and then they can turn that energy into a little bit more physical, maybe starting meditation practice, and there's this upward spiral there but you have that foundation to begin with. 


Cynthia Thurlow: No, I couldn't agree more. I know a lot of the focus of your work is on the role of mindset as it pertains to health, and so neuroplasticity is one example for those listeners that are maybe not familiar with that term is that you can actually change your mindset which will actually rewire aspects of your brain. But let's pivot and talk about that. I do want to come back to the supplements because I know you have this amazing new line that I do want to focus in on. But if we're talking about all these lifestyle changes that we're encouraging people to do, it really requires shifting our mindset and our focus. 


Chris Kresser: Absolutely. Yeah. I mean, this is I think, probably the most exciting development in medicine and our understanding of health in the past 50 years. I mean, that's a bold claim, but in retrospect, especially later on, we will look back on neuroplasticity and understanding that we're getting from of how the brain and nervous system work as a major turning point in our understanding of health and well-being in the body and how it functions. So, for people who are not familiar, neuroplasticity basically refers to the fact that our experiences, so that could be our thoughts, our emotions, our behavior, and our life experiences actually change the structure and function of the brain. So, in a way that can be measured by a brain scan. 

This is actually a concept that I think most people are familiar with, even if they don't know they're familiar with. A good example would be learning anything new. When you first learned to drive, you had to pay really close attention to what you were doing, your both hands on the wheel, you're really thinking about every choice that you're making and it's awkward, and it's unusual. That's because the connections between the neurons in your brain that are related to driving have not been formed, and they've not been strengthened. Over time, the more you drive, the more those connections get strengthened. 

There's a saying in neuroscience, "Neurons that fire together are wire together." The more t