How To Be WellnStrong

66: The Top Causes of Inflammation and How to Reduce It | Dr. Ryan Greene, DO, MS

• Jacqueline Genova • Episode 66

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Inflammation can manifest itself in the form of heart disease, cancer, diabetes, depression, and more. Typically, inflammation has been wreaking havoc inside one's body well before it leads to noticeable symptoms. In this episode, I'm joined by Dr. Ryan Greene, an osteopathic physician with many years of experience in human performance, sports medicine, nutrition, and the most cutting-edge recovery methods. Dr. Greene is also the co-founder and medical director of Monarch Athletic Club, a medically centered health club. In today's conversation, Dr. Greene and I discuss the biggest drivers of inflammation, the difference between acute vs chronic inflammation, early warning signs of excess inflammation, how to measure your inflammation levels by analyzing certain metabolic markers, the best dietary approach to reduce inflammation, and much more.

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*Unedited Transcript*
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Jacqueline: [00:00:00] I was browsing your Instagram. There's, there's so much content right in this week. And I was like, what do I really want to hone in on that? I haven't yet discussed with my audience and I went back to, and I think you, you spoke about this with Max on his show, which is where I first heard of you, but the whole concept of inflammation, right?

It's, it's a term that's thrown around so much. Oftentimes, I mean, um, You know, not very accurately. So I wanted to create an episode just on this topic, bust some myths, um, get the low down and, you know, just kind of share what is actual truth, uh, versus again, what we hear a lot of people throw out in the wellness space nowadays. Awesome. Yeah, so with that, let's just start with the basics. Can you explain what inflammation is

Dr. Ryan: Yeah, that's a great question. Um, and it's most simplest form information is. It's basically your body signaling to the [00:01:00] immune system, you know, other components of the body. Hey, like something is happening here, whether it's, you know, damage or the encounter of, you know, a foreign pathogen and invader bacteria, virus, you know, something else, you know, you get a splinter, right?

Like wood shouldn't be in the skin. So your body sends an inflammation signal that allows your immune system to respond. So at the very minimum. Inflammation is signaling. And I tell this to every patient we have with Monarch, like the goal is not eliminating inflammation. Having zero inflammation is not the goal.

The goal is to minimize the amount of inflammation that we're exposed to over the course of our life. Because with every benefit of the inflammatory process. There are also potential, uh, maladies in negative impacts that can occur from sustained [00:02:00] high levels of inflammation for a long period of time.

The most common are, you know, it can impact your arteries and veins. It can cause hardening or calcification of those structures where we need them to be flexible. They can become fixed and solid if they're exposed to too much inflammation for too long of a period of time. And then the other part is, you know, primarily.

Impact on nerve structures, so high levels of information can impact nerve conductivity and function, which you see commonly in people that are diabetic pre diabetic. They start to get numbness in their fingers and toes. They start to lose sensation. It can impact their ocular function, their, their, uh, their vision.

So. Um, you know, big picture inflammation is signaling. We need it. We just don't want too much for too long. It should absolutely be intermittent and purely in a response to something that our body needs to, you know, protect itself from or repair [00:03:00] it.

Jacqueline: right? Absolutely. And again, alluding back to this term, chronic inflammation, right? Some folks say chronic inflammation is the root of all disease. Would you agree with that?

Dr. Ryan: Uh, yes. So I think it's more nuanced and I think what they're trying to say with that is chronic high levels of inflammation, because again, we always have some sort of inflammation in our system. So technically if you said chronic inflammation, like if you're generally You still have a little bit of inflammation.

So I think when you say chronic inflammation, what people need to understand is chronic high levels of inflammation sustained over a long period of time.

Jacqueline: Right? And here's a question for you. So, Unless someone really goes to a functional or integrative practitioner, oftentimes a regular conventional doctor is not going to throw in a CRP blood test, uh, in a regular panel. So what are some of like the warning signs of excess inflammation that people should [00:04:00] be aware of?

Dr. Ryan: Yeah. I mean, I think one of the simple ones that pretty much everyone is going to get, as long as they go get a, you know, a physical done every year is hemoglobin a one C. So your hemoglobin a one C is your diabetes risk metric, you know, crudely. So basically what's your average blood sugar over the last three months.

It's measuring the percentage of red blood cells bound by a sugar molecule. So if you have higher blood sugar, less sensitivity to insulin, decreased insulin function, your A1c, your blood sugar percentage is going to go up. And that can be a metric of, you know, pre diabetes, diabetes, metabolic disease. If your A1c is high, you know, meaning greater than 5.

7, you probably have high levels of inflammation because. You know, whether that's causing your blood sugar to go up or your elevated blood sugar is, you know, sugar and access is toxic to the body. Like that's another great metric to look [00:05:00] and try to understand, like how much inflammation is probably present in my body because I've.

Very rarely seen people with borderline or above, you know, pre diabetic range that don't have other high markers of inflammation such as CRP or, or, or sed rate. And so even if you're not going to a functional medicine practitioner or integrated medical practitioner, pretty much every primary care specialist will do, will do.

A hemoglobin A1c, and like if you're 5'7 or above, if you're considered pre diabetic or worse, like you probably have higher levels of inflammation in your system purely based on blood sugar control and insulin sensitivity.

Jacqueline: Interesting. I, uh, I had some blood work done not too long ago. My hemoglobin A1C was like 5. 6, I think. So relatively good. But my CRP was slightly elevated. So, and I know, and I know CRP, I mean, it can increase if you have sunburn, right? Or if you exercise a lot the previous day. So with that, I mean, does one necessarily like correlate to the [00:06:00] other or not, not

Dr. Ryan: Uh, kind of, but like CRP is a lot more, uh, acute in terms of what it's measuring. Yeah, so like, it's difficult to say, but if you consistently get your blood work done and you have a CRP that's, Kind of depends on who you're talking to. But if it's higher than three, it's definitely too high. Some people say higher than one is too high.

I try to keep our people less than 1. 0, but if it's consistently elevated and your a one C is consistently elevated. They are probably synergistically not helping you in terms of, you know, potential health outcomes. Um, but again, like it's very day to day dependent. If you didn't get good sleep the night before your CRP may be elevated.

If you just got off an illness, you're coming off the back end, or maybe it's starting CRP be hard to work out and CRP is going to be hot. Yeah. There's all sorts of different things. Um, and and back to your previous questions, I realized that I didn't fully answer it. Other [00:07:00] signs and symptoms, swelling, you know, chronic pain, rain fog, low energy, low libido, potentially depression.

Those are all things, body weight retention, like difficulty losing body fat, like those are all things that could potentially be associated with higher levels of inflammation. Um, you know, if you think as, as a woman, like the menstrual period is an inflammatory period as, as those things are changing in your body, what happens during those periods of time, you're bloated, you're swollen, you're irritable, your mood changes, like.

A lot of that is hormones, but there's also a contributing factor from, from the inflammation as well. So those are some simple things to think about. I find one of the most common ones to be honest, is people with like, when you're, when your inflammation levels are high, your pain threshold is lower, your nerves are more sensitive.

So when people are super stressed, they have a lot of inflammation, they're sick, like everything hurts, everything bothers you. [00:08:00] And then once you get over it, like you're not as, you know, Sensitive to those things. So I, I, I tend to find people who for whatever reason have like higher levels of daily pain, achiness, soreness, whatever, and they don't necessarily like know what caused it specifically.

It's pretty generalized. Those people tend to have higher levels of baseline inflammation as well.

Jacqueline: Right. And for those people, I mean, what do you identify as some of the main causes? of inflammation. There is, I mean, that's a loaded question, right? There's so many things, but from what you, from what you've seen, like, what are the most common?

Dr. Ryan: Yeah. Um, so, um, I would say lack of sleep, alcohol intake or diet or nutrition. Um, dehydration, not drinking enough water. Those are probably the most common. So it's basically like, [00:09:00] yeah, sleep, hydration, nutrition movements, not moving enough, you know, one of the best things that you can do to control blood sugar is lift weights, resistance, train.

Um, so I think, um, You know, people that are exercising tend to have higher levels of inflammation, but from the, from, for the most part, the simple ones are people that don't sleep well, they drink too much alcohol, they have a poor diet, they're not drinking water, those are the, those are the big ones. I do see a lot of people that exercise too much, which can also actually cause.

inflammation because if you're overdoing it, you know, you're constantly damaging muscle. You're not allowing your body to appropriately recover. I tend to see higher levels of, you know, inflammation or inflammation related issues in those people as well. So you can do too much of a good thing.

Jacqueline: Interesting. Yeah. I was going to ask you that. Uh, you're going to think I'm crazy, but here in Greenville, South Carolina, we have some incredible trails and I am [00:10:00] always walking. Walking is like my stress outlet such that I I think I average around like 25, 000 steps a day and yeah, and, and my, my body's used to it because I'm, I do it every day.

Right. But I mean, could that lend to an increase CRP level or like at some point does your body adjust?

Dr. Ryan: The human body is super resilient and super adaptable. So like walking 25, 000 steps a day. It probably was the norm for us hundreds of years ago, thousands of years ago when we were hunters and gatherers, right? So, as long as like, you know, you're not noticing chronic fatigue, you're not noticing your ankles, knees, hips are, you know, chronically sore or, you know, painful, swollen, things like that. And your energy levels are pretty good. Like we have the ability to adapt and we should be moving, you know, all throughout the day. So I don't think there's a threshold. There's a number of steps. I think, you know, allow [00:11:00] your body to be the guy. Like if you notice like, Hey, I'm sore, I'm tired, I'm achy. You know, I'm not sleeping well, I'm generally irritable.

Like then, yeah, you may be pushing it too hard. And there may be days where you're just like, I need a rest say today, like today, I'm not going to hit that number or I'm not going to be as active. Those things are totally fine. Like allow your body to kind of guide you in terms of, of what you're doing.

But, um, I don't, I mean, there's even been studies looking 000 steps a day. Like, is that actually accurate? Like people hit 10, 000 steps, so they have more significant beneficial health outcomes. You know, those, those pieces of data are, are, are somewhat mixed. So I don't know if there's a number, but like moving your body is never a bad thing.

That being said, if you're going to be super active, you need to make sure you're getting good sleep and you're drinking enough water to replenish fluid loss, you need to make sure you're getting enough calories and protein to help feel your body. So you don't contribute. You know, and don't slide into a state of, you know, muscle breakdown versus muscle repair.

So, [00:12:00] um, I will never stop someone from moving as long as it's not, you know, specific causing them immediate harm. Um, or also like, you know, we get people here that are, you know, in the club for three to four hours a day. And like at a certain point. You know, me telling them, I think you're exercising too much probably is not going to work, but me showing them their biologic data, which is like, Hey, man, you've had or male or female, like you, your information levels are high.

Your hormone levels are starting to decline, you know, your mood states shifting. Like, there's a lot of other things that can, that can be associated, um, with that, you know, higher stress, prolonged exposure experience. So usually I let the numbers and the data. You know, support me and why I'm trying to explain something.

Otherwise they just feel like you're, you're, you're forcing your opinion on them and there's a, well, I've been doing this forever and like, I'm still doing, okay. And like, I know, but look at your blood work, [00:13:00] but look at your body form or whatever. So, um, yeah, being, being, being armed with data, you know, typically helps.

And if you can show someone, and which is why we do what we do here at Monarch and have the medical and the physical therapy and the nutrition, and we're collecting objective data, like. If they still refuse to change their behavior, like we've done everything that we can do, and potentially there needs to be a intervention of a, of another source, whether it's a health issue or, or something else that, that really like shocks them back into, uh, better alignment.

Jacqueline: Yeah. No, that makes sense. Again, I'm super excited for you to open up that one in Miami because I really, I love the approach. I love everything you're doing. Um, but I'll, I'll be sharing more about that later, but I'm going back to diet. I am curious, what are some of the most like common dietary triggers of inflammation?

So you mentioned alcohol. I mean, yeah, this, this could be a whole episode in itself, but I mean, [00:14:00] you know, refined carbs, like seed oils, like again, all these terms thrown out. What are, what are the worst ones? What should we avoid?

Dr. Ryan: man. Well, anything that's not natural. So if you're looking at preservatives, artificial flavors, colors, The seed oils is an interesting one because like, you know, I think that's relatively recent in terms of the introduction into our diet. So we're still trying to figure out like what's doing what there, but for the most part, seed oils tend to be problematic for people.

Um, you know, high sugar diet, high glycemic diet. So refined grains, processed foods, ultra processed foods, which typically have some of those other things we talked about preservatives, colorings, flavorings, things that are not natural. Um, alcohol in itself is like, it's kind of a nuanced response because yes, it's a simple sugar. It causes us, you know, to be inebriated if we [00:15:00] consume and in too great a volume. I think the bigger thing from an inflammation standpoint is it impacts our sleep. It causes us to be dehydrated. So it's like the subsequent effect secondary to the alcohol consumption. Perhaps they're going to start eating things late at night that we wouldn't typically eat because of, you know, whatever poor decision making that we, you know, we follow.

So it's not like the alcohol in itself. It's typically the other things that are associated with that behavior, which are disrupted sleep, poor diet choices. You know, dehydration, which is inevitable with alcohol, because alcohol is a diuretic. So, I mean, I'm, I am not a strong supporter of alcohol intake. I think the overwhelming data is like, if you can avoid it, avoid it.

Um, but if you're going to do it, like you need to ensure you're making other appropriate lifestyle decisions to like, to allow your ability to tolerate that gluten and dairy, like

Jacqueline: Yeah. What are your thoughts on these?

Dr. Ryan: I mean, If we were in [00:16:00] Europe and our agricultural and nutritional practices were regulated, um, more consistently like the European model, probably wouldn't have a huge issue with it.

I have a lot of patients that are gluten sensitive, you know, lactose sensitive. They go to Europe for a couple of weeks. It's very common in LA. People disappear for a month in the summer and the winter. They have no problems. They eat all the pasta. They have all the cheese, you know, whatever, no issue. So there's something not only about Gluten and dairy, but there's also something about how we have cultivated them agriculturally here.

And there's, you know, if you've been paying attention and you shop at places like all foods, excuse me, and others, like there's this rise of popularity and it's called a two milk. I don't know if

Jacqueline: Mm hmm.

Dr. Ryan: but like casein, which is the milk protein, there's two primary subtypes. They want an eight to a one tends to be more inflammatory.

That's, that's seemingly. The subtype that's more common in, in the cows, uh, that we have in the United States, a [00:17:00] two is more common in Europe. So something's happened chemically, uh, from a confirmation standpoint of, of the case in the milk protein. Um, so in the U S it's like the high concentration of gluten in our foods, dairy tends to be a little bit problematic.

Um, beans and legumes, an interesting one, like there's a book called the plant paradox, which.

Jacqueline: Mm hmm.

Dr. Ryan: who wrote it, but, um, you know, their premise is we weren't meant to eat beans and legumes. They have natural defense mechanisms that tend to cause us to have, you know, GI issues and GI response and immune system response.

You know, I found that I do pretty well with beans. I love hummus. Um, but other people don't. And so like, those are like, those are probably the, the big areas that I, I try first. For people, if they're struggling, GIs, you know, situations, inflammation situations is like, all right, let's look at our diet. Can we cut out [00:18:00] ultra processed foods?

Can we minimize gluten and dairy or ideally eliminate it? Can we decrease our alcohol intake because of the multitude of things that it impacts, including our, you know, gut microbiome and, and, and, uh, decreasing the, the, um, diversity because alcohol can basically kill a lot of gut bacteria. Those are the big ones, um, as well as anything that's non natural, preserved, artificial.

Seed oils, I'm still playing around with, but the other ones are pretty common. And the other ones are massive staples of most people's diets, so like, one of the phrases I say quite often is, common things are common. So if we can eliminate the common things, let's see how we do there before we start, you know, seeking out the needle in the haystack,

Jacqueline: right. Yeah. No, that makes sense going back to gluten So again, I mean so many different opinions on this Some people are like just avoid gluten completely Some people are like if you don't have a gluten intolerance or celiac like you can have it I've heard that gluten in the u. [00:19:00] s. As you said earlier, it's it's binary It's not pure gluten and that's why when folks go to Europe, they don't have any issues.

Has there been any actual research on that? Because then I've also heard some people say, well, when people go to Europe, they're on vacation and what are they doing? They're not being stressed all the time. They're in a different mindset. So does that play a role in the perhaps subsequent, you know, feelings that they might have upon eating gluten if they're in a different mental state?

Like, has there been any research on that?

Dr. Ryan: No, not, not that I'm familiar with. So, um, I do think we have a, a, you know, the, the amount of gluten and the type of gluten that works. Those two is probably different here than in Europe. I would agree with that. And I think, you know, I'm, I have to practice what I preach. So, like, I am very gluten light.

If I can choose gluten free, I typically do. Um, that being said, if I can't, I'm not, I'm not stressed [00:20:00] about it. I, I don't have significant bloating issues or GI issues. Um, but some people do. So, you know, if you, if you've noticed that, then obviously avoiding it is reasonable, um, but you are 100 percent correct.

Like the mind body effect is, is very significant as well. So perhaps there is an association with lack of stress, greater enjoyment, You know, uh, work related responsibility, how that impacts our mood state and then how our gut functions like the mind body connections. Absolutely real. Um, and so, you know, perhaps there's something there.

I don't, I'm not familiar with any study that's looked at, like, just general stress levels and quality of life associated with food intake. Um, I think it'd be a difficult one to study. And ultimately, like,

Jacqueline: Yeah.

Dr. Ryan: You know, if you follow the money and especially in research, like most studies tend to have some sort of proprietary, uh, funding source.

So I don't [00:21:00] know if that will get done anytime soon. Um, but ultimately, uh, there's, there's absolutely a consideration associated with your mental state, stress state, and how your body responds, you know, from an information standpoint. So,

Jacqueline: Yeah. Absolutely. And I love that the feeds that you mentioned also promote Strong gut health, right? So I'm assuming there's a connection between people who suffer from what we can call increased intestinal permeability, right? Or leaky gut and then an increase in inflammatory markers. Have you seen that?

Dr. Ryan: uh, yeah, I, I, I think so. I, I, I think the, the CRP metrics and some of the other sedentary Typically people with those GI situations tend to have higher inflammatory profiles. Um, so it's, it's difficult to say. Um, but typically if they're having an acute inflammatory response or an acute episode, we typically see those [00:22:00] inflammatory markers going up as well.

Jacqueline: Yeah, that makes sense. So you touched on foods to avoid what food should we be consuming? If we want to decrease our inflammation and is there a general diet, right? Like again, we hear all these different, you know, there's diet wars out there, carnivore, plant based, Mediterranean, recognizing that everyone is different, right?

We have to have an individual personalized approach. What is like the one that you think most people or would lend like the most beneficial to a majority of the population?

Dr. Ryan: Yeah, that's a, that's a great question. Um, for all those listening to this podcast, if you're looking for another podcast, that would be. Be very beneficial from a nutrition standpoint, Huberman and Dr. Lane Norton, uh, recently recorded one and lay norms, a guru and all things nutrition. So, uh, like absolutely listen to it.

It's four hours. So carve out some time or listen on a 1. 2 speed. [00:23:00] Um, of his points, which, which is consistent with how I feel like the best plan is, is the one that you can stick with. Um, so. You know, the way I approach it is if I, if I was to classify like how people should eat, I would say it's like more Mediterranean.

So a lot of vegetables, you know, whole fruits, healthy oils, high quality protein, healthy fats, um, you know, that's, you know, I don't eat a ton of animal protein for, you know, some personal reasons and some, because I just, I don't think we produced super high quality animal protein in this country. So that's just my preference.

Um, but again, that's like totally me, totally personal. I recently started introducing, uh, I have no tie to them, like Maui, Newey, venison, um, just because it's a hundred percent grass fed wild caught. Like, uh, I had a good friend, Dr. Andy Galpin sent me like 30 pounds of venison. So I just started like, we got to start eating it.

So I was [00:24:00] going to take up too much space. So, um, not a great reason why I started other than I just had it. And, and, um, yeah, it seems to work for me in terms of a good protein source. I think the biggest thing that we can improve from an, from an overall diet standpoint, regardless of what you would classify as your diet fiber.

We do not get enough fiber in our diet. Most of our food is stripped of fiber because it prolongs the shelf life. Part of what fiber does is it causes, you know, moisture to be retained in, in, in the substance of whatever your, whatever food source it is. And, you know, the more moisture. You know, the higher likelihood it's going to spoil faster.

So we've taken fiber out to prolong shelf life from an overall metabolic health standpoint, gut health standpoint, microbiome standpoint, cholesterol standpoint, like fiber is increasingly important. Uh, and the current recommendation is like 35 to 40 grams per day. Last I checked. If you actually look at how much fiber [00:25:00] is in most of the foods we eat, it is not a lot.

And I have found that most people from an inflammation standpoint, gut health standpoint, and just general metabolic health standpoint, blood sugar control, cholesterol. If you can get enough fiber in your diet, many of the things that bother many people tend to be attenuated. They tend to be reduced. So, um, if I was to have to pick a diet, I'd say more Mediterranean, Tends to work because it's pretty diverse, emphasizing more whole foods, plants, high quality fats, high quality protein.

You know, the grains aren't, aren't a massive part of that other than. Key on and things like that, but fiber, fiber, fiber, fiber, I cannot tell you how many people we work with that just once they increase their fiber intake, whether that's through natural foods or, you know, potentially adding like a psyllium supplement tend to have better G.

I. Function, less inflammation, less G. I. Um, irritability, their cholesterol levels [00:26:00] tend to improve.

Jacqueline: Yeah,

Dr. Ryan: So fiber is fiber is a big one. Yeah.

Jacqueline: Have you ever done one of those DNA report tests like from Max Gen on if you're familiar with that company? I mean, there's a ton out there, but basically they get back to you with this report. I think it's like a saliva test or maybe it's a blood prick test, but they basically come back to you and they say, based on your genetics, this is what your body is.

Like tolerates well and doesn't tolerate well and for me it came back that my body doesn't process saturated fats all that well and the recommendation was to really try to avoid foods rich in saturated fats, which was really interesting because then I looked at my blood work recently and I noticed that my Apo B was higher than it should be for a 29 year old.

Female who again, exercises a lot and eats relatively clean. So I'm doing a little bit of an experiment now where I'm really reducing my meat intake, uh, over the next two or three months to have my APOB [00:27:00] retested. But yeah, I mean, I, I think it's really interesting now. I don't know if you're familiar with Dr.

Matt, uh, Dawson, he co founded a company called Wild Health. I spoke with him last week, but we were talking about precision medicine, right. And how like all of these insights really do. Determine, right? Like what diet you should pursue or, you know, different lifestyle interventions. So what are your thoughts on like the future of precision medicine when it comes to, you know, interventions to help mitigate inflammation?

Dr. Ryan: I mean, I think it's, it's very interesting. So, um, like the way we talk about it here with, with Monarch is this idea of like precision elegance. So like precision, meaning using the new technologies that we have, but also not, um, deviating from like the foundational components that we know are associated with high quality health.

So, you know, epigenetic testing, DNA testing, You know, specific targeted supplements for [00:28:00] individuals, like all very exciting food sensitivity testing is, you know, been around for a while. I still think there's a ways to go in terms of the applicability and usability. Um, so I'm not opposed to any new technology.

I'm always willing to learn and see what we can do in terms of, uh, medical community and the advancement of how we can help people. Um, so yeah, I'm, I'm not opposed to new things coming out and we'll use things that, you know, we think will provide a significant impact, sustainable impact on our, on our patients and members.

I think for me, what I have found has been, um, most consistent is people tend to get caught up in like, The new stuff, the shiny stuff that, you know, potentially can provide a hat, so to speak, so that they don't have to, you know, be adherent to the simple things that we know are going to help people live a long life, right?

Like,

Jacqueline: Yeah.

Dr. Ryan: are you getting enough sleep? Do you have a good sleep [00:29:00] routine? Are you moving your body enough? Are you resistance training? Are you drinking enough water? Are you eating a high quality diet? Are you getting enough calories? Are you getting enough protein? Um, Are you, you know, minimizing sources of inflammation that we, you know, we know that we can reduce whether it's physical, mental, emotional, like, you know, I, I, again, like we're starting, um, Monarch mind, which is our, our mental health component.

So we're doing neurofeedback with patients. They get a brain scan. We have a neuroscience Institute that comes in and, you know, looks at just, you know, basic cognitive performance, like your brain shifting You know, the wavelength state that's required to do certain things, does it get stuck there? Is it able to have mobility and flexibility so that when we need to be resting, our brain can also be resting?

So I think there's, there's other things that, you know, from a day to day standpoint, I, you know, we have 500 something numbers that come in two to three times a week. And, you know, even with all this new technology. I have still [00:30:00] found that most people have poor sleep, poor sleep routine, have a hard time sticking with a diet.

They're not exercising or moving their body enough. I'm not drinking enough water. So, um, to kind of like summarize my point and, and, um, Peter Tia actually said this on his most recent podcast, which is like, when you're thinking about health and you use the analogy of like the Titanic, the problem with the Titanic, he was headed straight for an iceberg.

And that heading and direction of the boat was people's sleep, hydration, movements, and just basic metabolic health. All the other stuff, the supplements, the interventions, the new testings, the potential longevity drugs, those are equivalent to like, you know, what was the last meal on the Titanic? Like, did that really impact where the boat was going?

No. So, until we get those foundational elements really dialed in, I think a lot of these new things are interesting and could potentially be beneficial, but I do not know if they will [00:31:00] overcome those daily decisions. Yeah. It's like daily decisions that people are going to make or not make. And, and I just, I, from what I've seen from thousands and thousands of, you know, data points here over five years, it's like most people have a very hard time sticking with a very basic foundational, you know, health program.

I mean, if you, you know, use blue zone populations as. As a model, like they're not, to my knowledge, using a lot of these newer interventions, they're just like, you know, they get good sleep, they get outside, they get sunlight, they have strong communities, they eat primarily, you know, whole foods, plant based, they exercise regularly.

So like, that's, that's where I'm. In a world where we're continuing and rapidly advancing in terms of our technological development, which is great and I think needs to happen. Um, I still feel strongly. We have for most people, um, we're yet to have found ways that we can get people to do those simple things [00:32:00] consistently.

Jacqueline: Yeah, no, I couldn't agree more. Dr. Dawson, too, I mean, I was like, you know, of all the patients that you've seen in your lifetime, what is one intervention that everyone could use more of? And he said, human interaction. Right. And I mean, there was, I forget. I mean, I, I'm always listening to podcasts and one this morning they basically said there was a, a recent study done, um, that basically said community is like two to three times more important than nutrition and dietary interventions when it comes to longevity, which at first I was like, wow, that's crazy.

But then you actually look at it and it's like, it's really not that crazy. Right.

Dr. Ryan: no, I, they may have been referring to the Harvard happiness study, which looked at people about over about 80 years of time and their takeaway.

Jacqueline: a good one.

Dr. Ryan: Was essentially the quality of our connections with other humans is probably the most important factor in terms of our, you know, longevity and quality of life.

So, um, yeah, again, like the reason we created monarch the way that we did and made it, you know, a smaller club [00:33:00] environment. Because I'll be honest, like, part of the reason why I think we're successful is. Our members just love coming in and working with. The training team and the physio team and the medical team.

And we develop relationships with people because we see them on a regular basis and we get to know them as human beings. Like What are they interested in? What's happening in their life? What's happening with their kids? What's happening with their family? And there's, there's studies, um, in the cancer space where, like, when people are going through cancer treatment, like, if you have a strong emotional support network, people tend to do better.

And if you don't, the outcomes tend to be worse. Like, treatment's the same, surgery, radiation, chemo, but the outcomes are different. And, and, you know, I, I think we have to pay closer attention to the, the quality of care. Of community and connection that we have, because we are, you know, we are communal beings, we're meant to be impacts

Jacqueline: Yeah, no, a hundred percent. And I feel like too, I mean, we're still coming out of COVID, but now recently, I think over the past like six months or so you see all these running clubs popping up. [00:34:00] I actually just joined one in Greenville. It started back in February, but it's insane. There's about 300 people all twenties and thirties that just show up to run like three miles.

So I started going to me. I mean, it was beautiful just to see like people show up wanting connection and doing it in a healthy way. Right. Instead of going to a bar, like Let's go for a three mile run. So we're seeing more of that. Um, and it's, it's really, really great.

Dr. Ryan: totally. It's, um, I see memes on Instagram all the time that like the next, the next hinge and the next Raya was just like, a running club.

Jacqueline: yep. People are sick of the apps. Yeah, that's so funny. Um, what else did I want to touch on? Oh, so going back, you mentioned supplements. So, I mean, I'm of the opinion that ideally most of like your nutrients and the things we need should be derived from food, right? But I think there certainly are some situations where supplements might be necessary.

Um, first of all, Aside from inflammation, are there any, like, supplements that you [00:35:00] think everyone, or, I won't say everyone, but a majority of folks should be including in their diet, like magnesium or a probiotic?

Dr. Ryan: Yeah. I mean, the ones that we talk about that are, you know, most, I think most important and most reasonable for, you know, the majority of people, I kind of break it down to like my top three, which is vitamin D. Because most people tend to be low in vitamin D, um, protein and creatine. I just don't think people get enough protein and we're learning more and more about creatine, especially in aging populations and its impact on maintaining lean muscle mass and also its improvement in cognitive function.

So, yeah, so I think, you know, In a world where there's more studies coming out about the, uh, poor quality control in terms of like, are you actually getting the dose in your supplement that's, that's on the label? Are we absorbing it well? Is it making it through our liver via the first pass effect? [00:36:00] You know, especially with orally administered, you know, capsules, tablets.

You know, the, the absorption and the actual bioavailability. Like most people aren't going to do studies on like, if I take 500 milligrams of vitamin C, like how much actually gets into my system, like they would with an FDA approved medication. I think, um, I think, you know, protein, creatine, vitamin D are probably the most common three that I think longterm we know have beneficial impact, especially on, on longevity.

Um, because most people don't get enough protein. Uh, most people are low in vitamin D. We know creatine is beneficial for the things that previously mentioned, you could probably argue fiber, especially if people have a hard time getting enough fiber in their diet, adding some sort of like, you know, silly and compound, especially if it's a powder can be absorbed in water, you know, is usually a good way to get that.

So that's typically where I'm like, these are the supplements that we routinely recommend beyond that. You know, there's some other things that we use on occasion, and the best way to know is it [00:37:00] working or not is like, are you taking it? And then what's our, what's our KPI? What's our performance indicator that we're trying to follow?

Is it decreasing A1C? Is it improving cholesterol? You know, whatever that looks like, and then just get your blood tested. And if you're taking things consistently and they're not, You know, achieving the outcome that's desired. We either need to change up our approach, change the supplement, get it from a different provider, or, you know, potentially it's, it's just not going to work for us and we have to rethink our approach.

So that's typically how we, we do it.

Jacqueline: yeah, no, that makes sense. I just started supplementing with creatine. I want to say a month or two ago, um, post conversation with JJ virgin, who speaks so highly of it. And I've noticed such a change in my energy levels, like just working out. Um, and then I read up recently about the, the cognitive benefits of that.

And I thought it was really, really interesting.

Dr. Ryan: Very interesting.

Jacqueline: yeah. What are, what about, um, tumeric and like omega three? Fatty

Dr. Ryan: Yeah. So, I mean, I think from a, from a heart health standpoint, from an inflammation [00:38:00] standpoint, there's plenty of data when I was a fellow, there's a, like a small study at Mayo Clinic that was being done, looking at arthritis and like a proprietary ingredient. You know, tumor actually outperformed the proprietary anti inflammatory ingredient is just super interesting.

And, you know, the response was like, well, you know, tumor it's difficult to, to, to regulate. And so, you know, we're not really thinking much about it. Um, I think the omega three is the fish oils, the impact on heart health, brain health, incredibly important. Again, quality is a huge issue. And. You know, sadly the, the nutraceutical industry is highly unregulated.

So, you know, the quality of the fish oil you get, um, it's hard, you know, it's harder to find high quality supplements. Um, but again, like if you're going to try a supplement for anything. You need to monitor to see if it's working. There's like, why spend the money or potentially expose yourself with something that, you know, could theoretically be harmful, um, for a long period of time, if it's not actually leading to the outcome that you're opening for.

Um, so, you [00:39:00] know, again, like if you're going to try something, God bless, as long as it's reasonable and there's data to support it, but ultimately you want to follow up and make sure, like, is it actually working?

Jacqueline: right. And also to, I mean, to know about like, sometimes things have to be paired in order to be better absorbed, right? Like D3 and K2 or tumeric and black pepper. I like recently is that, would you agree with that? Like there are certain things.

Dr. Ryan: Yeah, I think there's, yeah, I think so. And, and again, like. I think there's other factors that have to be considered in terms of like, you know, when are you taking it? What are you taking it with? Is it supposed to be with food? Is it supposed to be fasted? You know, the absorbability, what actually gets through your liver, you know, depending on other factors.

If you're, you know, you know, your cytochrome P system is elevated because you had a cocktail the night before. Like, is that going to impact the bioavailability? So I think there's a lot of other factors, which is where like, We come back and we say all the time with Monarch, like supplements are meant to supplement [00:40:00] your lifestyle.

So, you know, again, like if you're hoping that supplements are going to overcome sleep deprivation, dehydration out to, you know, poor diet or alcohol intake, excessive alcohol intake, lack of exercise, you know, inability to tolerate. Life stresses, work stresses, family stressing, but I'm not aware of many supplements that are going to overcome all those things, especially if you, you, you're hitting all of them.

Uh, so I place less emphasis on supplements and more on the, the daily lifestyle choices that we make or don't make.

Jacqueline: Yeah. That makes sense. And speaking of lifestyle choices, and you mentioned fasted state before, what are your thoughts on fasting? So again, this, this is an area where there's a lot of controversy, and I'm just curious to hear your thoughts. And let's, let's assume like, This is fasting for an otherwise healthy young individual who doesn't have any other health issues.

Dr. Ryan: Yeah. So I think there's a lot of data, um, [00:41:00] on, on the, the fasting world in terms of calorie control. Like if people are struggling with, You know, weight, weight management, you know, intermittent fasting may be helpful to, to literally just decrease the amount of calories they consume and health control body fat potentially improve insulin sensitivity, you know, reduce risk for metabolic disease.

Um, from a longevity standpoint, you know, in mouse studies, there's some evidence that it may be, you know, longevity promoting there's others where it doesn't seem to have an impact. Um, I find that most people when they fast, like biologically. You know, it's better for us to eat more of our calories earlier in the day versus stacking them late, because if we're not digesting them, it can impact our sleep quality just based on like thermogenesis and core body temperature.

Um, so I think from a fasting standpoint, if it helps people be consistent, you know, make sure [00:42:00] they're not overeating or over consuming and pay a little bit closer attention to what they put in their body. I'm absolutely not opposed. But, you know, again, like if it's going to impact getting enough protein, getting enough fiber, getting enough calories in, in general, um, yeah, I mean, I, I think you have to consider that as well, because if you're losing lean muscle mass, if you're losing strength, you know, because you're not getting enough calories and protein, I think that's a problem as well.

And I think being intermittent fasting alone is probably not going to make a huge, a huge deal.

Jacqueline: Yeah. What about longer fasts like water, like 24 to 48 hour water fasts? And again, I mean, people talk about all the benefits of autophagy, which we know you can also derive from, from things like exercise. But yeah, what are your thoughts on, on longer fasts? And even like the fasting mimicking diet. I've tried Prolon in the past before.

I mean They say there's a lot of clinical trials and research behind that, but I don't know. What's your take?

Dr. Ryan: I [00:43:00] don't know enough about them cause I haven't studied them enough in depth. So it's hard for me to provide like a. A true answer, um, you know, again, for some people subjectively, it seems to help in terms of, of the goals they're trying to achieve, reducing inflammation or improving cognitive performance, reducing brain fog.

Yeah, potentially from a weight standpoint, like, jump starting their metabolism. But again, like, what I'm thinking about based on what we see is like, what are what are things that people can do consistently for the rest of their life? Um, that will help promote longevity and, and, and those things may be beneficial intermittently, but ultimately it's like not something that you're going to do the rest of your life.

And I am finding in the general population, like people have a very hard time sticking with, like the very simple thing. So I tend not to complicate things because then. Uh, people tend to either, you know, fail or get discouraged or get confused. So we try to keep it a little bit more, more simple.

Jacqueline: Yeah, [00:44:00] no, that makes sense. And when I was checking out the Monarch website earlier, I saw that you offer Different interventions or hormetic stressors. You can call them like sauna therapy and and cold plunges What lifestyle interventions and I mean, I'm assuming those are two of them are great for reducing inflammation

Dr. Ryan: Yeah. Again, I think sauna and cold are probably the oldest and most well studied contrast therapy. Um, the infrared sauna has plenty of data supporting it's, it's, uh, benefit reducing inflammation, detox, cold exposure, same thing, also growth hormone production, you know, cold exposure is great for your mood state.

There's a really good book called the dose. Um, uh, dopamine nation all about just like our obsession and with like quick hits of dopamine. And one of the things they talk about is just literal cold exposure and its impact on our mental health and mental state, its impact on our adrenal function and resilience.

So those are the ones that we've included because I [00:45:00] think they have the most evidence to support them and also like the easiest to use and build into your daily practice. Um, you know, we use a lot of modalities like the TheraBody, uh, pneumatic sequential compression boots just to like, you know, help people after they're done moving, like flush their lymphatic system, you know, move any damage or debris secondary to, you know, movement or lifting.

You know, back to their, you know, lymphatic system to their courts, you know, which can eventually be filtered out. So versus just like exercising and going sitting rest of the day at the desk, like, what can we do to help with fluid movement for, you know, elimination, I think are important. But again, like, changing temperature also does that because it's, it's impacting vasodilation, vasoconstriction, you know, fluid movement.

Um, so those are the ones that we use most commonly, because again, like. There's data to support their utilization. Um, and they're also relatively easy to implement into your daily routine.[00:46:00] 

Jacqueline: Yeah. What are your thoughts on PEMF therapy?

Dr. Ryan: I just don't know. I'm I'm familiar with its with its efficacy. I just I haven't done enough of a deep dive into, um, how how it functions, especially in terms of the minimizing inflammation aspect. So I'm I'm still kind of a novice in there. Um, we're thinking about integrating it as we move forward. Um, hyperbaric oxygen therapy.

Um, just because there's, yeah, there's, there's a lot of evidence supporting, supporting that treatment, especially for people with, you know, concussion, mild traumatic brain injury, uh, tissue healing, you know, postoperatively. So, my, considering what I know, and us trying to implement things that people can use on a regular basis that also have evidence to support them, um, you know, PEMF is on our radar.

I just don't know a ton of, as much about it and how [00:47:00] it can be integrated. Um, in an effective way.

Jacqueline: Yeah. I love that you're considering hyperbaric I actually experienced my first two legitimate like medical grade hyperbaric sessions three or so months ago and it It was a really interesting experience, and I wish it was available a decade or so ago when I had some pretty severe concussions because I knew about it at the time, and obviously now more research is coming out about the benefits of using it following concussions to help mitigate, you know, post concussion symptoms, but, um, But at the time, I mean, I, like, after my concussion, I was calling all these locations and I'm like, is there any way I could come sit and use your hyperbaric chamber and they were like, no, it's just for burn patients.

Um, and, you know, there's a lot of research to now, so I don't know if, you know, my, my mom has been dealing with, um, stage 4 breast cancer for the past 6 years and she's the reason I started. I started well and strong, but I'm a huge, um. Enthusiast when it comes to trying different integrative modalities and hyperbaric oxygen.

Again, there's a lot of [00:48:00] literature on that even for cancer So to be able to access that right for someone other than a burn patient Um would be really really incredible. So that's really exciting.

Dr. Ryan: yeah. And that's, that's my opinion as well. So, um, again, like, what we are trying to do is, is offer a space and a system and a program that allows people to have access to these things and be able to make it part of their, you know, almost daily routine. Because again, like, if you can do the simple things consistently over a long period of time, it's just the principles of compounding, like those continuous positive inputs, Well, exponentially improve your outcomes or potentially the opposite way if you're not doing them.

And I think, unfortunately, most people experience, you know, the downward curve versus the upward mobility.

Jacqueline: Yeah. And absolutely. And last thing too, Dr. Green, I want you to touch on is, I mean, with these hormetic stressors, like the whole concept is that it's a short term stressor that improves our resilience thereby helping us long term. How does that [00:49:00] work? Like what is that process?

Dr. Ryan: So, interestingly, like, I learned a while back that homeopathy was one of the primary forms of medicine that was used in the United States until we pivoted more to like alopecia.

Jacqueline: I love homeopathy. If you look in my cabinet right now, 80 percent of it is just homeopathic remedies.

Dr. Ryan: Yeah, and to be very generic, um, cause I'm not an expert, but I learned about it in my integrative fellowship briefly, is like, it's like treats like, so the long and short is if you can give yourself, you know, a little bit of a, you know, a highly diluted stressor, whatever you're trying to treat, you know, the, the human body is meant to adapt.

It's meant to experience stress and then it's designed to figure out like, okay, like, what That caused this outcome. How can we fortify our, our response to allow us to be stronger in the future? That's how our immune system adapts. As we're kids, we're meant to get sick. We're meant to get exposed to things.

So our immune system can learn how to tolerate those stresses. The whole point of [00:50:00] exercise is a stress. You stress yourself, you know, you create a little bit of damage, you recover and you come back stronger. So I'm absolutely in alignment that if you can, you know, subject yourself to an appropriate dose of these hormetic stressors.

You know, some people even with alcohol, they think like a little bit of alcohol is like a hermetic stress, like that's a, that's a different conversation that I think, you know, what we consider a little bit is like way more, uh, exposure in terms of like volume and frequency. But, um, yeah, I mean, that's, that's how the beating body's meant to function.

We, we are exposed, may cause a little damage. Hopefully if we treat ourselves well, we can adapt, recover. And then the next time we experienced that, we were able to tolerate it. Like that's, that's how we function as human beings. So, um, yeah, however you can do that. I think again, like, as I mentioned early on in the podcast, like we can absolutely overdo it in terms of anything, like how much we exercise, [00:51:00] how much time we spend in sauna and cold, like how much we stress ourselves in terms of, you know, fasting and changing our, our, our metabolic, um, Inputs like you can do too much of a, of anything and it can end up being, you know, negatively impactful based on, you know, dose response.

So, um, yeah, I, I, I'm all about stressing ourselves. How do you want to do that? Ultimately remembering like there's, there's a balance that we need. There's a harmony that we need to seek and achieve. Hopefully.

Jacqueline: Yeah. Yeah. That makes sense. Awesome. I can't believe we're almost coming up on the hour. There's still so much I want to talk to you about. So I'll have to have you back on. But I do want to touch on Monarch. So I understand that right now your two locations are in California, but for listeners there, how does that work?

How does the process work to, to sign up? I know you're building another one right now or looking 

Dr. Ryan: Yeah. 

Jacqueline: in Miami.

Dr. Ryan: Yeah. So we've got West Hollywood. We've got Brentwood. We're opening Playa [00:52:00] Vista end of this year, um, which is just south of where we're at in, uh, in L. A. I think it's still technically considered L. A. Then we're opening Miami and we have a couple more after that. Um, what we've created is a one stop shop.

So it's unlimited medical, personal training, physical therapy, nutrition. Plus we have all the other recovery modalities, mental health and neurofeedback, as I mentioned. And then it's community. Each club has a set number of members that we will bring in because we want people to be. You know, part of a community and get to know other staff members, everything like that.

Um, every member gets quarterly assessment, you know, blood work, body composition. We do strength testing so that we can, you know, monitor those metrics associated with maintaining not only lean muscle mass, but also power. We do VO two max, the sub max testing, cause we don't have like a proper metabolic heart, but we're, we're collecting data every quarter to [00:53:00] help people understand.

What's working to help them achieve whatever their goals are, and it could be anything. Sometimes it's aesthetic. Sometimes it's body composition. Sometimes it's, you know, you know, overcoming an injury, but we felt as long as you had unlimited access to movement, medicine, physical therapy, nutrition, as well as a community around you that you, you know, you enjoyed.

You know, immersing yourself in, we would probably appreciate the outcomes that we were trying to achieve to like help humans be human, to help them live a high quality life, pursue their passion, maintain their joy. We just happened to have created these facilities that are also high end. They have world class amenities.

My business partners come from the restaurant and hospitality world, so they're all about environment and ambiance and, you know, people like nice things, you know. And so we've kind of created this model that we can continue to grow and expand, open up more clubs. You know, your, your program is shared amongst our entire network.

So you're not tied to a trainer or a physical therapist, [00:54:00] like you can go to any club anywhere and, you know, continue to progress along your program, which is one of those areas of opportunity. I was just like, all right, like I travel a decent amount. And when I travel, I need to figure out where can I go to a gym?

Where do they have a whole foods? Like, where can I get my smoothie? I'm like, I'll do that because it's part of my lifestyle. Most people don't. And so we wanted to eliminate the barriers that allowed that, you know, Allowed or prevented people from achieving that, that high quality health. And at the end of the day, like right now, full disclosure, we are offering you an opportunity to achieve the best quality version of yourself, whatever that looks like. But it's still tough because it requires an investment in both money and time, and we're still not quite at the point where I've got a couple of things up my sleeve where I think we'll be able to solve this. But, you know, right now in healthcare, the more money you send, the healthier you get. You get no discount on your insurance.

It still gets more and more expensive. You know, one of the areas that we're working on solving is like, how can we go, whether it's [00:55:00] insurance providers, companies, corporations, or whatever, that by being a Monarch member will improve someone's quality of life, reduce their risk, reduce their chronic disease risk, decrease their costs to themselves and, you know, whoever's providing their benefits long term.

And I think if we can nail that, we will become the preeminent health and wellness model in the United States and potentially the world. It's very simple what we're doing. But it's not, it's not free. Like we have to invest time, we have to invest money and we wanted to make it something where, you know, it's not, you know, we're not inexpensive, but all things considered, our value is enormous for what people get versus what they're spending often in aggregate, but in multiple different places that are now communicating.

So we just wanted to make it super simple and say, Hey, as long as you show up. And you listen, um, you'll do pretty well.

Jacqueline: that's awesome. Yeah, I couldn't agree more and I'm sure once you mean you have that research and you know those findings to share with those providers. I mean, [00:56:00] the data will speak for itself right in terms of incentivizing them. But, um, yeah, that's super awesome. Again, I'm really excited for your Florida location.

I will drive to it. Um, but you definitely have to get one in Greenville. And when you do, I'll be one of your first members. Um, awesome. Dr. Green. Well, where can listeners find you?

Dr. Ryan: Yeah. So, uh, easiest for me is Instagram. It's dr underscore green with an E at the end, underscore D O dr underscore green underscore D O. Um, or, you know, uh, uh, if you want to share my email in your show notes, so I can share that with you. And if people want to reach out, I can't guarantee that I can help.

Um, but potentially I can provide, provide. You know, uh, uh, a push in the right direction. If, if I can't help her, I don't know someone who can.

Jacqueline: That would be great. No, I'll definitely be including the links to those. And my last question for you is what does being well and strong mean to you?

Dr. Ryan: It's a great question. And I [00:57:00] think it's something that is a driving force behind what we do with Monarch, which is, you know, being well and strong means you get to do what we do, what you get to do, what you want, when you want to do it. Um, and ultimately I think that's freedom. Like one of the things we talk about is health equals freedom.

If you're well, if you're strong, you know, you're not inhibited by anything and you get to live the life that you choose to live. And sadly, many people as they get older, start to lose the ability and lose freedoms to continue to enjoy things that, that bring them purpose, bring them, you know, uh, allow them to, to maintain a life of, of passion and purpose.

And, um, that, that to me is one of the saddest things that can happen to anyone is. You know, it's continuing to be alive and not being able to participate. So if you can maintain your wellness and if you can maintain your strength, both both physically, mentally, and then also emotionally, you know, [00:58:00] there's there's really no reason you will not be able to live the best quality of life you could possibly live.

Jacqueline: Yeah. Nailed it. Couldn't agree more. Well, Dr. Green, this was such an awesome conversation. I'm really excited to share it with listeners. And yeah, I mean, we still have so much to talk about, so I definitely will be having you back on again at some point.

Dr. Ryan: Awesome. I look forward to it. Thank you for having me.


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Jacqueline Genova

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