Ep. 312 Optimizing Health and Metabolism with Dr. Molly Maloof

I am honored to have Dr. Molly Maloof joining me on the podcast today. She provides health optimization and personalized medicine for high-achieving entrepreneurs, investors, and technology executives. She used to teach at Stanford University and has served as an advisor or consultant to over fifty companies within the digital health, consumer health, and biotech sectors. 

In our conversation today, we dive into metabolic health and explain how mitochondrial health impacts our immune system, particularly in COVID, Long Haul COVID, and chronic fatigue syndrome. Our discussion also encompasses the significance of hormesis, gender-based variations, the influence of physical exercise, measuring VO2 Max, and why sedentary lifestyles can be more dangerous than being overweight. Additionally, we explore the latest trends in modern medicine and nutrition, the benefits of continuous glucose monitors, and how healing from trauma happens through spiritual growth.

Dr. Molly is adept at helping people talk about things that make them feel uncomfortable. I am sure you will enjoy learning from her invaluable insights!

“Inflammation is this alarm signal that is going off inside you.”

– Dr. Molly Maloof

IN THIS EPISODE YOU WILL LEARN:

• Metabolic health, intermittent fasting, and the importance of measuring and improving mitochondrial function
• Mitochondrial dysfunction in long-haul COVID patients, and the importance of understanding the root cause of persistent symptoms
• Alternative therapies for treating COVID
• How hormesis (a mild stress response) can be beneficial for females
• Dr. Molly discusses her approach to becoming metabolically flexible
• How being obsessed with health tracking could result in orthorexia and body disapproval 
• Why we should focus more on human connection instead of sacrificing it in pursuit of a perfect lifestyle
• Why is being sedentary more dangerous than being overweight?
• The significance of VO2 max in understanding metabolic health and longevity
• The potential of MDMA-assisted therapy for healing from sexual trauma
• Dr. Molly talks about her book, The Spark Factor, and Adamo, her new program for optimizing sexual health

Connect with Cynthia Thurlow

• Twitter
• Instagram
• LinkedIn
• Check out Cynthia’s website
• Submit your questions to support@cynthiathurlow.com

Connect with Dr. Molly Maloof

• On her website
• On Instagram
• Find out more about Adamo sex therapy by emailing molly@adamobioscience.com 
• Your Healthspan Journey video course

Transcript

Cynthia Thurlow: [00:00:02] 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.

[00:00:29] Today, I had the honor to connect with Dr. Molly Maloof. She provides health optimization and personalized medicine to high achieving entrepreneurs, investors, and tech executives. She previously taught at Stanford University and has been the advisor or consultant to more than 50 companies in the digital health, consumer health, and biotech industries. Today, we spoke at great length about metabolic health, the impact of mitochondrial health on our immune system, and specifically COVID, long haul COVID and chronic fatigue syndrome, the role of hormesis and how there are gender differences, the impact of exercise, VO2 max, why being sedentary is more dangerous than being overweight, trends in current medicine, nutrition, and continuous glucose monitors and lastly, the impact of trauma as a shared experience and the way out of trauma is through spiritual growth. I hope you will enjoy this conversation as much as I did recording it. 

[00:01:33] Thanks for jumping on, Dr. Maloof. I’ve been really looking forward to this conversation. I kind of stumbled upon your work earlier this year and thought to myself, we need to have more female biohackers on the podcast talking about ways that women in particular, are able to harness metabolic health in proactive ways. 

Dr. Molly Maloof: [00:01:53] Well, I’m here to help. [laughter] I mean, I definitely enjoyed writing this book. It’s been a life of just figuring out what is health about and how do you measure it and how do you improve it. And when I discovered the mitochondria and their role in health, I felt like I hit the holy grail. And I just finally understood why we got so sick in this country and why the world is getting sicker and sicker. And we have this energy crisis we’re all going through on a macro scale and a micro scale. And the micro scale is within all of our bodies with these dysfunctional mitochondria that are a result of our modern lifestyles that are out of sync with our genetic design. And on a larger level, we’re having a crisis of energy as well, so we’re on this oil dominance path and we’re trying to become energy independent. 

[00:02:41] And when I really saw this relationship between energy metabolism on a micro scale and energy metabolism on a macro scale, I felt like I could really understand what’s wrong with this world right now. And so, what we have is this beautiful ability to take in fuel from our environment in order to survive. And that’s programmed within each of us. And we’re very fortunate that we have this machinery for digesting carbohydrates when we can find them and being able to tap into our own fat supplies when we don’t have carbs available, when we don’t have food available, we can literally get into ketosis. And that’s on purpose, because that would keep you alive in a famine, that would keep you alive if you were on a hunt or maybe we’re gathering food and there wasn’t a lot of food available without being able to tap into your body’s own innate capacity to create energy, you’d be dead. 

[00:03:32] And at the same time, we have gotten into this place collectively where everybody is on this carb-dominant lifestyle, where everyone is eating way too many carbs and way too much sugar, way too much refined carbohydrates. And we’ve had this obsession with fat for, like, literally 50 years, telling everybody that you got to eat a high-carb diet, high-grain diet to be healthy, which is just patently false, [laughs] which is just the bold-faced lie. And so we were lied to by these authorities. And as a result, we have massive amounts of toxic foods in our diet, high fructose corn syrup, refined carbohydrates, refined breads, lots and lots of processed foods, which are damaging the metabolisms of our bodies. And that in combination with never fasting, always being stressed because of this highly stressful environment we’re living in, because of the news cycles that feed on our natural inclination to pay attention to negativity and we drive cars all day long, we don’t bike around like we should. 

[00:04:35] And so our cells are not getting the messages they need to function properly. They’re getting all the messages that they should be dysfunctional. And so, inflammation, I was telling one of my friends today, is this alarm signal that’s going off inside your cell. There’s a fire. You got to put out a fire, so we got to send an alarm out. And then oxidative stress is basically the exhaust fumes, the smoke coming out of that fiery building, and somewhere between 88% of the country is basically metabolically unhealthy, which means that they’re on fire, which means they have insulin resistance, inflammation, and their bodies are not well. And this is skinny and fat. And so, we’ve obsessed with obesity for a long time, thinking that obesity is the answer to all our problems. If we just solve obesity, we’ll solve our health problems. But it doesn’t solve the health problems. What solves health problems is developing metabolic flexibility, developing the ability to tap into your own fat supplies, developing the ability to turn on your glucagon, turn down your insulin and gear shift. And when I figured this gear shifting thing out, I was like, “Oh, my God. I feel like I understand what my body’s meant to do.” 

[00:05:44] And if you eat all day long, 24/7 you’re never going to gear shift into fat metabolism. And there’s a really great book on top of my book, there’s a great book called Brain Energy. And what I love about this book is that this doctor at Harvard basically took the exact same principles in my book and applied it to mental health. So now, we’re basically seeing that the biggest causes of disease in our modern lifestyles, heart disease, cancer, diabetes, dementia, and mental illnesses and diseases of despair, there’s a root cause of mitochondrial and metabolic dysfunction that begins in the gut, it begins in your muscles and your gut, and its basically metabolic disease. 

Cynthia Thurlow: [00:06:23] Well, and it’s interesting, I had Dr. Chris Palmer on at the tail end of 2022 and I recall meeting him last summer when he started telling me about the impetus for the book, I said, “You realize you’re going to change the narrative about how we, as clinicians, view mental health and metabolic disease. And he, of course, being this incredibly humble person, was like, “Oh, yeah, maybe.” And it’s so wonderful to see that it has really opened up these opportunities to understand this complex interrelationship. And so, one of the things that I think is unique over the past three and a half years, it has all been the social experiment of pre COVID, post COVID, understanding if but nothing else, the understanding when we’re looking at people that have developed long-haul COVID have significant mitochondrial dysfunction.

[00:07:14] And so can we kind of start the conversation speaking to what’s happening? Because ironically enough, over the last several days, I kind of put out into my community that were connecting, and there were several women who were mentioning they have long-haul COVID, they’ve got a lot of brain fog, they’re otherwise young and healthy, and saying to them, really at the basis, the root cause of that is mitochondrial dysfunction. And you speak in the book about when our mitochondria is depleted significantly, like under 50% that’s when we start seeing this sequelae. So what exactly is happening when we’re looking at this social experiment? I’m going to put that in of the last three and a half years. “What’s happening to these individuals that have contracted COVID, gotten through the virus, and now they are dealing with the sequelae of symptoms that are really unmanageable for them.”

Dr. Molly Maloof: [00:08:00] So what’s going on is that there’re a lot of people walking around with metabolic disease that don’t even know they have it. And there’re a lot of people walking around with gut problems and they don’t even know that they have it. And they just think it’s normal to have gas and bloating. They think it’s normal to have constipation or diarrhea. And I was one of those people 10 years ago, I literally had so many gut issues and I just thought it was normal to have diarrhea on a regular basis. And it was clearly related to gluten intolerance, which I believe was celiac. But I didn’t get a biopsy because I didn’t really feel like getting a procedure done to confirm that I was ill. [chuckles] So, I’m not like anti-gluten or anti-bread. I think there’s a lot of parts of the world where you can eat those things. 

[00:08:39] We just have a completely damaged food system in this country and our food system has been designed to create the conditions where food is highly preserved. And as a result, people are just eating food that is not easily metabolized and causes immune system dysregulation through the gut. So, if you have that baseline immune system dysregulation from gut health issues, which legions of men and women have, you are setting yourself up for infection. You’re setting yourself up. Like, I literally have two friends who both got an infection. One of them took antibiotics, they got another infection, got a viral infection. And why do you think that was? Because her gut got compromised, because she was taking antibiotics after antibiotics for her sinus infections and that compromised her immune system. 

[00:09:25] So legions of people are walking around with damaged immune function because they’re stressed. Their gut’s dysfunctional. And this is naturopathic medicine 101, but yet they don’t know how to fix these things. And if you have gut issues, you should see a naturopath or you should see a functional medicine doctor, because it’s literally their bread and butter. And yet so many people just exist feeling like garbage every day. And I used to be one of those people. I would eat wheat or pie or something and I would be passed out. Literally, I couldn’t even keep my eyes open. I was so tired. And it felt like there was this mass amount of inflammation and this huge energy drain, and I was just like, “What is going on in my body? Why am I so fatigued after eating wheat and after eating sugar?” And it was this glycemic roller coaster I was going on and it was this mass amount of inflammation coming from the antibodies to gluten.

[00:10:12] So, if you do have problems with long COVID, the first thing you got to ask yourself is, “How healthy were you to begin with?” You may not have been in as good of a state of health as you thought. Typically, what I see when people get sick with chronic fatigue or chronic COVID, by the way, I studied viruses in the summer of 2019, and I was like, “Oh, who knew that viruses caused chronic fatigue syndrome?” And I was like, “This is not like this big mystical pathology anymore.” We know the answer. When infections get inside the cell, they hijack the metabolic machinery and they use your metabolic machinery to make themselves. And then sometimes they break open the cell and cause damage to the body. So, it’s no fun getting a virus.

[00:10:59] And when a lot of people use antibiotics to treat viruses, they damage their immune function and their gut and they get hit with more infections. So, when you have chronic COVID or you have a bad case of COVID you got to tune the mitochondria back to normal. And it’s not an easy process. It’s expensive, time consuming, and there’s no easy fix. But the big tools in the toolbox, the sort of power tools that I would turn to, would be in acute COVID, I would do ozone and then as you’re getting better from COVID I would do HBOT. Ozone is basically when you feed ozone into blood. And basically, it’s called 10-pass or I did 4 passes, I didn’t have time to do 10-pass. 

[00:11:35] But you basically take the blood out of the body, you mix it with ozone, put it back in, and it gets super bright red. And you feel so much more energy because you’re getting all this oxygen in your body, and you’re also getting that ozone into the insides of the cells. And when you get ozone inside the cell, that’s where it can affect the viruses. And then HBOT, what it does is it flips this switch of pressure. And so high pressure to low pressure is a switch that activates hypoxic inducible factor, which is basically a survival mechanism in the cell to amplify your body’s capacity to thrive amidst a challenge, which if you were to be, like, living in an altitude, you would want hypoxia inducible factor to turn on so that your body could actually better adapt to that high pressure state.

[00:12:20] So, what we’re doing is we’re trying to teach the body to do these switches to actually toggle back and forth between high pressure, low pressure, between high oxygen, low oxygen, like carbs, between fasting and feasting, between exercise and recovery. You got to be really careful with exercise after you get sick, because a lot of people have exercise intolerance because they’ve literally damaged their mitochondria, and they just can’t do the same kind of exercise. So, I couldn’t do as intensive exercise after I got COVID last year, and I slowly ramped it up, but I needed to fix those mitochondria that were broken. So, I did five days of NAD therapy using what’s called the Koniver protocol and it involves a large amount of niacin flush after you get an hour of NAD therapy. So, you get this massive vitamin push and you just get flushed with niacin. And whether the niacin or the NAD did it, I felt like 20 again, which was amazing. So, I do that with my friend in Sedona and then there’re a bunch of supplements that you can take during sickness.

[00:13:16] So one of my friends has COVID right now and I’m like, “Let’s mega dose you on pharmaceutical grade omegas.” And why would I mega dose pharmaceutical grade omegas? Well, they have pro-resolving mediators. They’re one of the most potent anti- inflammatories you can find. Now, whether your doctor will prescribe you a prescription grade, pharmaceutical grade omega is another question. But in my case, I get mine from Norway. There’s a brand that’s not available in America that I get from Norway and it’s just like, you’ve got to throw whatever you can at this inflammation. N-acetylcysteine is a particularly good supplement. Hard to get sometimes because the FDA is kind of starting to regulate it. But it’s great for clearing mucus and increasing glutathione, which we know is a problem in the lungs when someone’s sick with COVID And so you got to do everything you can to dampen down that inflammation. If you can get walks in, try not to get deconditioned, because deconditioning will really wreak havoc on your body. And just being in bed for a few days, you’ll lose a lot of VO2 max.

[00:14:10] So I still exercised within a few days of getting COVID, and I just forced myself to. And I don’t know if everybody would be as ballsy as me, I just understand that if I don’t move my body, then my mitochondria are going to suffer. And so, I kept exercising even when I was really stressed out last year. And you have to be really compassionate to yourself when you’re sick. You got to take the time off to heal. And in my case, I didn’t have a lot of time to heal, but I definitely started doing all these things except for I didn’t do HBOT because I didn’t have access to it. I did have some blood sugar dysregulation as a result of COVID and I did do a little bit of MOTS-c peptide and Ozempic, and it really did fix the glucose intolerance, but it also dropped my blood sugar so low that I got panic attacks. So, I had to stop that because I was really imbalanced. It was really crazy how imbalanced I was because of that Ozempic. So, I’m just like, “It may be a useful tool in the toolbox, but be careful with peptides, they can be really powerful. 

Cynthia Thurlow: [00:15:08] Absolutely. And it’s interesting, I think it was Dom D’Agostino, when he got COVID, he was actually trending the degree of insulin resistance he was experiencing. And here’s this incredibly metabolically healthy man and he was showing over like a three-month period of time, and he was sharing this publicly. So, there’s nothing I’m sharing that’s disclosing information that he wasn’t already doing. And it just goes to show you, post COVID, many, many people are experiencing a degree of insulin resistance. For the benefit of listeners who may not be familiar with hyperbaric oxygen, could you kind of touch on or explain what it is? I think for many people that probably seems really intangible, but I think it’s also really interesting, the science behind how it is helpful for mitochondrial dysfunction. 

Dr. Molly Maloof: [00:15:50] So hyperbaric oxygen puts oxygen under high pressure and under that high pressure, you hyper oxygenate the cells. And then when you relieve the pressure slowly, that sends the signal that there’s a big difference in pressure and oxygen, that sends the signal to the mitochondria to start inducing repair and to start inducing repair pathways through things like hypoxia inducible factor. And so, when I was studying HBOT and mitochondria, I was like, “What exactly is this all about?” But basically, it creates stress on the mitochondria, which will make them stronger. It’s what’s called hormesis. So, a little bit of stress on the body is going to make you stronger. And what it does is that it actually increases antioxidant defense systems, which are in the mitochondria. And that’s generally the gist of it, but it’s short-term stress on the body to induce the body’s capacity to heal itself. 

Cynthia Thurlow: [00:16:48] That’s super helpful because I think most of my listeners are very familiar with the term hormesis and hormetic stress in the right amount at the right time. 

Dr. Molly Maloof: [00:16:56] Yeah.

Cynthia Thurlow: [00:16:56] So because we’re talking around hormesis, and this is so important for understanding why things like intermittent fasting or exercise or certain types of foods are so beneficial, let’s talk about hormesis and in particular females, because I have a lot of females that I interact with online. And the mindset is if a little bit of hormesis is good, more is better. And what I’m hearing from you and from reading in your book is really helping women understand, especially women that are still at peak fertile years, women who have not yet gone through menopause, really being mindful about the degree of stress they’re putting their bodies under in order to evoke a response. 

Dr. Molly Maloof: [00:17:39] Yeah. So, the thing is like, I wrote this book because I made a bunch of mistakes myself and I wanted women to know that you’re not a man and you shouldn’t try to be one. And so, what I’ve learned is that a gentler approach to hormesis for women works much better than an incredibly ambitious approach. And I’ve seen more than one of my girlfriends who are naturally lean start doing ketosis, fasting, and training, and sauna, and weight training all at once. And don’t get me wrong, you can layer those things. I definitely have done that in short spurts, but if you do that every day, it’s a totally different story. So, you have a stress cup and you don’t want to overflow your stress cup. You want to have a enough stress that it makes you stronger. But if you fill this thing all the way, then you will overflow. 

[00:18:30] And that’s what happens to women when they undereat, overexercise, overstress, and end up having hormone dysfunction. So, I’ve seen this in the sort of lean young women, seen this in bodybuilding women, where they’re just pushing their body like a man’s and not honoring their cycles and kind of not really giving themselves the capacity to recover from all these stresses. And women really need recovery from stress and we don’t really give ourselves enough of that. And so, anyone who’s met someone who basically was really struggling with weight loss in particular. A lot of women really struggle with weight loss. If you’ve met anyone who’s a woman who’s really struggled with weight loss, usually if you ask them like, “Well, what are you doing?” And they’re like, “I’m doing everything. I’m weight training, I’m HIIT training, I’m doing all these things and I’m just not getting better.” And it’s like, “Well, the reason why you’re not losing weight is because your body is under so much stress it needs to hold on to that weight because it’s afraid, it’s scared. It needs to feel safe.” 

[00:19:33] Long story short, if you want to be super fit and strong, you’ve got to give your body enough stress, but not so much that it causes you to break down. And relative energy deficiency of sport is super common in women who are very fit and very strong and they’re not eating enough. And so, you just got to make sure to fuel your body. And I’ve been doing a bit of reverse dieting where some weeks I do a lot of things that basically send, I do kind of like what I call metabolic cross training. So, I’ll go through phases where I’ll do high carb and then I’ll do low carb, and then I’ll go through phases where I do higher calories or lower calories. But I’m not sending the same signals to my body every single week. Because by changing up these amounts of food and by changing up the actual types of food that I consume, my cells learn to adapt to different demands that, alongside exercise builds a lot of metabolic flexibility. 

[00:20:29] So, like, last week, I was visiting a friend in Jackson Hole and eating way higher carb and doing more low intensity cardio. And I came back like two pounds lighter in a week and it was like, “Oh, cool.” And then this week, I got back into my weight training regimen and I’m getting back into my higher protein on those days where I weight train. And I found that some weeks I’m going to push myself really hard in the gym, and then some weeks I’m going to give myself a little bit less intensity and maybe more low intensity cardio, maybe just more relaxed stuff. And by sending different signals to my body and getting a lot of rest in between these periods of intensity versus relaxation, my body is just in the best shape of its life. I literally could not be happier with my body right now. And it’s just so cool to know that there’re solutions to this stuff now. We actually have answers. And if you’re looking for a program to follow, I mean, my book is really about first principles of health. It’s about understanding the base of how does your body work? How does metabolic health work?

Cynthia Thurlow: [00:21:30] Well, and I think it’s really important for women. And it sounds like part of what you’re doing with cycling your carbohydrates, differentiating the types of exercise that you’re doing, that you’re doing some support around your menstrual cycle. So probably during your luteal phase versus your follicular phase–

Dr. Molly Maloof: [00:21:50] Yeah. I’m in my follicular phase right now, so I’m feeling like full force. Let’s go into the gym and let’s work out. But last week I was in my menstrual phase and I was like, “I’m going to be lower energy, I’m going to be more chill, I’m going to be more relaxed.” And I let myself take some naps last week and it was really nice for my nervous system. 

Cynthia Thurlow: [00:22:09] Yeah. I think it’s really important to honor that. And where do you think the tipping point is when we’re talking about women that are overdoing it and looking at the impact of overtraining, over tracking, orthorexia, orthosomnia, like, now that we have all these amazing activity trackers, metrics with Oura Rings, etc., I think people can sometimes get to a point. I think it starts off well meaning, but women in particular can get to a point where they are over obsessing over every single detail, like, to the point where they can’t leave their house, they don’t want to eat out, they don’t want to eat with friends. 

Dr. Molly Maloof: [00:22:42] Orthorexia really sucks. Honestly, it’s a real shame that a lot of people get stuck in this idea of believing that there’s some sort of perfect health that they’re trying to achieve. When I gave up perfection during the pandemic, it was really the first step on the path of true body acceptance for me. And it was like this realization, like I was like 10 pounds heavier. It was actually 15 pounds heavier than I am now, maybe like 12 pounds heavier than I am now, which a lot of people are like, 12 pounds, big deal. But for me, I mean, I’m 5’5”, that’s a big amount of weight. And I was so hard on myself. And then I was like, I woke up one day and I was like, “Why am I being so hard on myself? My body’s trying to protect me. My body’s here to protect me.” And this is my body’s way of saying, “Here to take care of you.” And so, there’s this magical adaptive capacity within each of us to survive danger. And holding on to weight is one of those ways we do that. 

[00:23:39] And adjusting our thermostats through our thyroid is another way that we do that. And I just think it’s now so magical that our bodies have this capacity to take care of us. And I don’t look at my body fluctuating with weight as much as a problem and as much as it’s like, “Oh, I’m noticing my body is trying to protect me right now. How amazing that my body can do this for me.” And instead of trying to force myself into a size, I’m kind of letting my body do what it needs to do to get strong and fit and not be stressed about it. And that has taken me 39 years. [laughs] I really, really, really, really wish that when I was 19 years old, I could have had this attitude or 29 years old or even nine years old. And if there’s women out there listening to this, know that there is a path where you can be free of this orthorexic attitude. But you do need to take off some of the trackers for a period of time if you’re finding that you’re so obsessed with your metrics that you’re not able to actually live a normal life.

[00:24:41] I eat things that I want to eat when I’m out with friends, I’m going to enjoy and savor things that are delicious, things I don’t normally consume. I ate a lot more carbs last week than I normally eat and I came back leaner and I was like, “Cool. Maybe this is something I should pay attention to.” And so just keep in mind that you have to be a human and you have to live your life, and you really don’t want to ever sacrifice human connection for food and for a perfect lifestyle, because human connection is the path to health. And when you have lots and lots of positive human connection, your nervous system starts to feel more safe. And that’s a big part of the book, is teaching people that connection is part of health, and you can’t ignore it. It’s a really important part of health. And so, you really should spend as much time with your friends as you can. And, yeah, you might have some– I don’t eat wheat and I’m not going to eat wheat if I’m with people. But that doesn’t stop me from seeing people. Doesn’t stop me from hanging out with people. Yeah, I’m not going to eat pancakes at a pancake breakfast, but I am going to say hi to my friends and order some eggs.

Cynthia Thurlow: [00:25:38] Well, and it sounds like you are in a position and a point of happiness with where you are in your life and with your body and how healthy you are. And I agree with you. I have women that I’ve told you have to take your CGM off. You need to stop wearing your Oura Ring for a period of time because the amount of anxiety it was provoking, like they would live and die by whatever the number was on their Oura Ring. Like, “Oh, I didn’t get an hour and a half of deep sleep. My sleep is wrecked.” I was like, “No. [chuckles] How do you feel?” Let’s check in with yourself first and not worry as much about the metrics. 

[00:26:10] Now, let’s pivot a little bit, because you say something in the book that really stood out to me. You said, “Being sedentary is more dangerous than being overweight.” Let’s unpack that, because I think that’s really important. I fervently believe, certainly my patients, I would tell them, if you do nothing else, just be cognizant of how much movement you have in your day because there’s this thought process that if you go to the gym and you do CrossFit or Orangetheory fitness or intense HIIT, and then you sit on your bum for the rest of the day, that’s okay. And I think a lot of what we as a culture don’t understand is that we’re becoming increasingly less physically active-

Dr. Molly Maloof: [00:26:47] Yeah.

Cynthia Thurlow: [00:26:48] -and that has a huge net impact on metabolic health. 

Dr. Molly Maloof: [00:26:51] Yeah. I mean, I have a treadmill desk underneath here that I’m intending to use more often than I am. But it is one of those things where you basically have to recognize that your cells are kind of like engines on idle when you’re sitting all day long, which means that you’re in a garage and you’re letting all that exhaust fume build up in your body, which is not great for your blood vessels. And it’s blood vessel health that is really tied to longevity. And so, it’s so, so, so important that you don’t ignore the fact that sitting is not your natural design. You’re just really supposed to be moving your body. And that’s something that I think a lot of people just don’t pay attention to. They’re just so used to sitting and sitting, and sitting and it’s like, “No, you really actually need to move your body.”

Cynthia Thurlow: [00:27:39] Well, and it’s interesting because many people don’t realize that actually being physically inactive actually exacerbates this low mitochondrial output, exacerbates a lot of these chronic things that we’re talking about. So more often than not, when people are not physically active, it’ll lead to more fatigue, less energy. And exercise in and of itself, helps increase mitochondrial output, upregulates autophagy, helps with BDNF or brain-derived neurotrophic factor. And so, I think that exercise for so many of us– and also understanding that our muscles are actually where insulin resistance actually starts. 

Dr. Molly Maloof: [00:28:15] Yeah.

Cynthia Thurlow: [00:28:16] So, most of my kind of, I would say my community are women in perimenopause and menopause. And I know you kind of touch on this in the book, but helping them understand, like, we don’t want to be losing muscle, we want to do everything we can to help preserve it. And that’s why exercise, movement, and strength training are so helpful. 

Dr. Molly Maloof: [00:28:33] Yeah, exactly. You know, I think that there’s another thing that people need to understand about movement and that your cells need the signal to make more energy or they make less. And so sedentary behavior, in particular, especially with people who don’t exercise, is super damaging because you’re basically sending the signal to your cell that you don’t need to make more energy. You’re like, “All right, I’m going to stop producing so many mitochondria, because why should I have so many mitochondria?” And what happens is that your muscles are supposed to be eating glucose. And if you’re not eating the glucose because you’re not using your muscles, then which, by the way, when you’re exercising and you use glucose, you don’t need insulin. So, it’s a very conducive to good metabolic health to exercise, because you don’t actually need insulin to bring in fuel. 

[00:29:17] And what’s really neat about exercise is that you’re sending these signals to your cells to make more energy and you’re building your muscle sinks. Your muscles are basically power packs of mitochondria and they’re power plants. And if you have nice, strong muscles, you don’t have as much fatty infiltration of those muscles, which contributes to metabolic disease and metabolic dysfunction. And it’s better for your liver health because you’re draining that glycogen. And the more you drain your glycogen and the more space you have to put glucose in and the less fat builds up, because when you have excess fuel in your body, it’s got to do something with it. Where does it go? Well, if you have excess fuel in your body that you’re not using, it leaks into your viscera, and it starts surrounding your organs, and it gets stuck in your muscles, and it literally makes your muscles really marbly, which is not what you want. You don’t want a bunch of marbled muscles. You want to have really strong, red muscles on cross section. And when people get older, they just get fattier muscles and fattier livers. And fatty liver is now contributing to more liver transplants than an alcoholism.

Cynthia Thurlow: [00:30:23] That’s unbelievable. I’m in the midst of reading Peter Attia’s new book, and I’m in the section talking about fructose, a nonalcoholic fatty liver disease, and understanding that how fructose is so damaging to not only our health, but helping people understand that not everyone who develops nonalcoholic fatty liver disease will go on to develop cirrhosis, which is a bad outcome for your liver.

Dr. Molly Maloof: [00:30:47] Yeah.

Cynthia Thurlow: [00:30:47] But helping people understand that much of what we’re seeing in terms of liver-related metabolic disease is a byproduct of what we’re doing not only with physical activity, but also dietary choices. Kind of what you were talking about at the beginning, a lot of processed carbohydrates, not enough protein, wrong types of fats, etc. Now, before we kind of wrap up around exercise, you do talk about VO2 max, and this is a topic I probably have not spoken about on the podcast. What is the significance of VO2 max? Why should people have a sense of what that number or that metric is to give them a sense of how well they are? We’re all aging, but in terms of our longevity, metabolic health.

Dr. Molly Maloof: [00:31:31] Well, VO2 max is the oxygen carrying capacity of the cell. And so how well your cells can carry oxygen and deliver that to the mitochondria is kind of like how good your engines are tuned and you need oxygen to burn fuel to make energy. So, we breathe air, we eat food, and then we take the food, and we turn it into substrates through our digestion. So, we break it all apart, we absorb it, and then it goes into the cells as acetyl-CoA. And when it gets into the cell, we need oxygen to burn that fuel. And if you don’t have good amount of oxygen in your body and you don’t have good oxygen carrying capacity, you’re just not going to have efficient metabolism. It’s so funny because it literally has taken me so long to understand this, but it’s so simple. It’s like you literally need oxygen to burn fire and your metabolisms are like, they’re cauldrons of burning energy. You need to create body heat and to create actual energy and charge. So, without enough oxygen, you’re just not going to have a great metabolism. This is another reason why people feel so good when they really get into exercise, because you’re literally oxygenating your body because you’re getting that blood flow. And blood flow is amazing. It makes you feel incredible when you have great blood flow. 

Cynthia Thurlow: [00:32:46] Well, and I think for those of us that at one point worked in clinical medicine, have left clinical medicine, are now entrepreneurs. I tell my husband all the time, if I don’t get my exercise in when I get up in the morning, because that’s my kind of opportunity to do it, it doesn’t set the tone right for the rest of the day. So, it is a huge priority. And I think for many many people, they just realize they feel so much better, not just physically, emotionally, spiritually, whatever it is that they’re doing, our bodies are conditioned to move. They’re not conditioned to be sedentary.

[00:33:16] So when we’re talking about nutrition, and I know you’ve kind of alluded to the fact that you have kind of a cyclical, as you said, reverse dieting, kind of carb cycling philosophy, do you feel like there’s one kind of prevailing methodology or approach to nutrition? Or I probably should phrase it differently. Are there things we should avoid in our diets for health’s sake? Because I know a lot of people assume that I’m all about ketogenic diets or low-carb diets, and I always say, “No, I’m more about enough protein, the right types of carbs, the right types of healthy fats.” But through your work in writing this book, do you have kind of a prevailing theme for yourself that you recommend to your clients and your patients?

Dr. Molly Maloof: [00:3:01] Yeah. I mean, I’m just generally speaking, more of a low-carb eater, because if I eat super high carb, like, the bigger thing for me is grains and legumes in like America, I seem to do okay with some legumes. I’ll do okay with some beans, some lentils, but they have to be cooked properly, and they need to be pressure cooked so the lectins are destroyed or soaked properly beforehand. I do like protein, but like I said, it’s a paleo diet really. So, it’s meats, vegetables, fish, poultry, nuts and seeds, fruits and vegetables, a lot of roots and berries in particular, and leafy greens, cruciferous vegetables. The big problem I see for a lot of people is because there’s so much gut dysfunction. By the way, I do do some dairy and eggs.

[00:34:49] I reintroduced dairy because my body said it wanted some, but I didn’t do dairy for a long time because I just didn’t feel it, didn’t feel I needed it. But I do a little bit of dairy now, mostly sheep’s and goat’s milk, cheeses in particular. But I have a pretty diverse diet and I really started emphasizing more vegetables in the spring of this year because my body was like, “Yeah, you need to eat more vegetables. You need to increase your alkalinity a little bit.” I was getting a little too acidic on my labs and so I just started eating a plate of vegetables with a ton of really high-quality olive oil from Italy and just making a plate of that every day. And so, I was adding like four servings of vegetables to my diet, I’d already been eating vegetables, but I hadn’t been eating enough. So, I just started adding more vegetables to my diet and that’s really the foundation is protein and vegetables. And then I do like fruit and I have some really tasty mamey sapote in my fridge right now. 

[00:35:45] So, before we started this podcast, this is my naughty thing that I do is I eat like mamey sapote with pecan butter on top of it. It’s definitely not the healthiest. I mean, it’s like high fat, high carb, but it’s like eating a dessert, basically. It’s like I’m having like a natural dessert. It tastes like a vegan dessert. It’s like so tasty. But if you’re going to have dessert, you might as well eat something that’s like whole food. I make bliss balls out of different nuts and fruits, like figs or dates, and I’ll make like bliss balls and just have those in the fridge to pop out for some extra energy when I need some. And sometimes I’ll put like adaptogens in them. I do a lot of matcha, but in my matcha I add– the Tahini Goddess brand has really good inulin. So, I added inulin, I add collagen, I add this weird product called Cellfood that they sent me, which is supposed to make things more hydrating. I add a little bit of stevia and I think that’s mostly what I add to the matcha mix. And then I use like the almond milk and I make this into my own matcha blend. 

[00:36:43] And I was going to the coffee shop spending $7 on a matcha, and I was like, “I could just buy the matcha that they have and make my own barista blend,” and I’ve made it for friends, and they’re like, “Why does this make my stomach feel so good?” And I’m like, “Because I put a lot of nourishing things for your stomach in it.” [laughs] So, to me, my kitchen is a medicine cabinet and I’m always making potions and making things in my kitchen to nourish my body. So, if you look at my fridge, there’s like a whole drawer of random medicines, and I’ve got, like, NAD patches, I’ve got BPC 157, I’ve got some leftover peptides, and then it’s mostly fruits and vegetables. And then my freezer is packed with really healthy meat from [unintelligible 00:37:21] Rancher.

[00:37:22] So to me, paleo diets just work really great. And I put almost everybody on that kind of diet, unless I see that they would better adapt to eating a more vegetarian vegan diet. I had a friend who was vegetarian vegan during a pregnancy and she got so anemic and really wasn’t gaining the weight she needed to gain. And I asked her, “Do you think that your pregnancy was affected by your diet?” And she’s like, “Absolutely.” Until I started eating meat, I really wasn’t putting weight on. And I think that my baby was underweight because I just was eating a vegetarian vegan diet. So, so important to people realize you got to get the building blocks of the body, you just got to do it. And at the same time, I’m really not a believer in the carnivore diet. I just think that the people who are subscribing to the carnivore concept are people that have clearly got damaged microbiomes. And all of the evidence suggests that you need a diverse diet for a healthy microbiome.

[00:38:20] So, the more I try to get, like, 30 different types of plant matter in my body a week, and that’s including spices, herbs. I have, like, four different types of herbs in my fridge that I bought at the store. I bought sage, thyme, rosemary, dill. Just adding herbs to your recipes, adding spices to your recipes, you can easily get, like, 10 different types of plants, and then you can just buy fruits and vegetables. And so, I’ve got carrots, peppers, eggplants, squash, zucchini, sapote, celery, watermelon, radish, lemons, limes, all sorts of– I’ve got broccoli rabe. I’m trying to think of what else is in my fridge, all these different vegetables in my fridge. And I do feel like when I’m cooking for myself it’s just way more affordable and I feel way healthier when I’m making my own food. So, I really should write a diet book, but it needs to teach people how to adjust based on their individuality. So that’s the thing I want to do. I think I would love to write a book on personalized nutrition. Like, “How do you personalize your diet?” I put a lot of it in my book, but I need, like, a how-to version as the next book. 

Cynthia Thurlow: [00:39:28] Well, and I think for a lot of people that are listening, they’re hearing common themes. We had Dr. Robynne Chutkan on a few weeks ago, and she talked about the 30 plant varieties and people were like, “Oh, my God.” And she was like, “Before you freak out,” that includes herbs and spices and all these other things that many of us don’t realize. It sounds like you have a really great variety. Curious for you– 

Dr. Molly Maloof: [00:39:47] [crosstalk] really good. And my labs look better than they’ve ever looked.

Cynthia Thurlow: [00:39:50] Yeah. And I think kind of leaning into what your body is intuitively telling you. I go through periods of time where I’m obsessed with one. Like, right now, it’s shishito peppers, for whatever reason. Shishito peppers, maybe I need some vitamin C, but I mean I’m grilling them and I love them, and they remind me of– they’re much larger here in the United States than they are in Spain, but they’re delicious. Like, I could go through bags and bags of shishito peppers. They’re delicious. And every once in a while, you get a really spicy one. But when we’re talking about kind of different philosophies about nutrition, I agree with you. I think carnivore for people like, I know for myself I was hospitalized in 2019 for 13 days and after a lot of antibiotics and a ruptured appendix and a bunch of side effects, I was on, that was the only thing my body could handle but I missed vegetables and when I started reincorporating them back into my diet, it made me realize that for me personally, I do a whole lot better with protein centric, lots of non-starchy vegetables. That’s where my body is really feeling really good. 

[00:40:48] Now, let’s talk a little bit about metabolism. And I know something that you and I both embrace, continuous glucose monitors or glucometers, how valuable they can be for determining how stress impacts our blood sugar, how sleep impacts it, nutritional choices, where we are in our menstrual cycle. Let’s talk a little bit about some of your hacks for helping to lower blood sugar. What are some of your favorites? I know we’ve talked about, like, walking after meals, but do you have other– I know you talk about some of this in the book, but what are some of your favorite ways to help lower blood sugar response?

Dr. Molly Maloof: [00:41:25] I would say that the big one is start– I mean, this is the simple stuff, like stuff that the glucose guidance talks about, but I’ve been talking about for years, which is first and foremost, put a blood sugar monitor on, see what spikes you. Find out where you have a problem before you go out and change behavior. Start experimenting with different food order, like eating your vegetables first, protein second, and your carbs last. Really cutting back on refined carbohydrates and sugar. Apple cider vinegar before meals, berberine with every meal if you really struggle with blood sugar issues, I like it more than like, metformin. What it’s doing is fixing metabolic issues through the microbiome. So, a lot of people have insulin resistance, but it’s just because their microbiome isn’t healthy, so they need to fix their microbiome. And I mean, I have a whole bunch of things on my list in my book. I’d have to go look up. But the big ones are weight training. Getting enough weight training in is really such a key, key, key solution. I started doing glute training and it has made my body so much more metabolically healthy just by getting my glutes big. Like, your glutes are your biggest muscle in your body, so you really do need to pay attention to your glutes. 

Cynthia Thurlow: [00:42:34] Well, and I love that you brought that up because I think many women are always, and I say many women, I’m going to just say, I’m going to paraphrase that. People are fearful they’re suddenly going to look like they have too much muscle. And it’s just physiologically, unless you’re taking anabolic steroids, that’s not going to happen. But I do think it’s important for people to do those large muscle groups. It’s a lot of bang for your buck. That’s why I do legs twice a week. That’s how important I think it is. And so, as we kind of wind down our conversation today, I would love to kind of touch on metabolism and emotional health. You’ve kind of talked around it, but I do know you do a particularly good job of this in the book, talking about the role of ACEs versus PCEs, so protective child experiences, gut. 

Dr. Molly Maloof: [00:43:13] Yeah.

Cynthia Thurlow: [00:43:14] I think some of these terms my listeners are definitely familiarized with, but the net impact of these on our metabolic health. It’s very much tied together and I think there’s more and more, obviously, Gabor Mate, talking about trauma, trauma response, but helping people understand that things that you’ve experienced in your lifetime can have a net impact on your emotional health as well as your metabolic health.

Dr. Molly Maloof: [00:43:36] Yeah. So, I’ve been talking a lot about this lately because one of the things that I think is really unfortunate is that there’s so much sexual trauma in this world that’s not talked about. And when you can learn to lift shame around trauma, it’s the first step to your healing. So, I just really think it’s so important for women and men with trauma to get help for it. And I’m so excited about MDMA-assisted therapy coming to the world because the greatest cause of PTSD is sexual trauma. And it’s so pervasive in our society that it really is a huge issue. And a lot of people just don’t know where to begin their healing journey. And there’s also just trauma from relationships, like just being in challenging relationships that were harmful, that can really create the conditions for people to be really hurt and fearful of getting involved with new relationships. And so, it’s really important that people heal from those problems. But then there’s also social injury from childhood and a lot of kids were abused or neglected or unloved and weren’t taken care of.

[00:44:38] There’s a lot of human trafficking in the world that is just horrific. And there’s a new documentary I just heard about that just came out. It’s getting a lot of attention. But I’m a firm believer that the path to healing trauma is not just a psychological healing. Even though EMDR and CBT and somatic experiencing and some of these psychedelic therapies are useful. To me, the real treatment for trauma is spiritual growth and it’s really committing to a higher purpose and higher God whether you believe in God or not, like to me, that’s how you heal from real deep pain. And so, a lot of people just don’t want to go there because they’re just not– There’s a lot of atheism out in the world. But I think that there’s an incredible amount of healing capacity if you tap into something much greater than yourself. And that’s something that I never would have said 10 years ago, but because of my own healing journey and my own ability to overcome challenges, I’m just so convinced that humans are so much more capable of healing than we ever realized.

[00:45:43] Attachment work is something that a lot of people should be doing and they’re not doing, especially if they did have challenging upbringings. So important to do attachment work with yourself and maybe even your parents, if they’re still alive and your partners, if they’re around. And I just think that when you have any social injuries that can create the conditions for attachment issues, and so it’s so important to turn towards people when you want to turn away from them. And, yeah, that’s definitely part of the journey. 

Cynthia Thurlow: [00:46:08] Well, thank you so much. I think it’s such a great way to kind of end the conversation today. Please let my listeners know how to connect with you, how to purchase your book, how to find you on social media. 

Dr. Molly Maloof: [00:46:17] Yeah. Well, first off, I’m on social media @drmolly.co. That’s my Instagram and my website. D-R-M-O-L-L-Y dot C-O. I am launching a program for sexual health optimization called Adamo. And Adamo means to fall in love in Latin. So, my company has created a new sex therapy that is designed to increase sexual function, decrease sexual dysfunction, increase feelings of love within and between individuals, and help enhance secure attachment. So, we’re in this process of developing a beta. If you’re curious about it, you can drop me an email molly@adamobioscience.com. M-O-L-L-Y at A-D-A-M-O-B-I-O-S-C-I-E-N-C-E. I need to change that website, adamobioscience.com. And I’d love to tell more people about it because it’s going to launch this year. 

Cynthia Thurlow: [00:47:10] That sounds very exciting, and thank you for making individuals talk about things that at times make us uncomfortable, but that’s the way that we heal, is when we open the opportunity to have those discussions.

Dr. Molly Maloof: [00:47:23] I would also add that if people are interested in really digging deep into the science of this book that I’ve written, The Spark Factor. I have an online course that is like a college level course on health optimization. And it’s really from this first principles approach to mitochondrial function. So, it’s a really comprehensive course I taught at Stanford, and I turned it into an online course. And so, you can get that at yourhealthspanjourney.com. 

Cynthia Thurlow: [00:47:47] Awesome. Thank you so much. 

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