Chris Kresser: Functional Health

More options for living better & longer
Sunday, September 28, 2014, 4:42 PM

Consumer Reports states that, person for person, health care in the US costs twice as much as it does in the rest of the developed world. And the kicker of their analysis: We don’t get much for our money. In a 2013 Commonwealth Fund study of 11 developed countries’ health care systems, the U.S. ranked fifth in quality and worst for infant mortality. America also did the worst job of preventing deaths from treatable conditions, such as strokes, diabetes, high blood pressure, and certain treatable cancers.

Today we welcome Chris Kresser to the program. Chris writes one of the most popular natural medicine blogs on the Web and has been named by Greatist.com as one of the 50 most influential voices in health and fitness.

In today's discussion, we explore the world of "functional medicine" and other approaches to health and wellness that offer potential to complement, or in cases, replace conventional western medical treatment. Some of these practices have been used by eastern cultures for millennia, others are just coming to light now. But the common thread in each is to focus on the biological uniqueness of each patient and use an evidence-based approach to identify and resolve the underlying condition -- rather than merely treating the symptoms, which modern health care (sometimes referred to instead as "sick care") is often guilty of.
Through his website and books, Chris provides a wealth of guidance and resources for how each of us can -- and should, if we care about living better and longer -- take an active role in improving our health and well-being. He places special focus on what he calls the "big four" practices: diet, physical activity, stress management, and sleep. 

Click the play button below to listen to Chris' interview with Chris Kresser (46m:23s):


Chris Martenson: Welcome to this Peak Prosperity podcast. I am your host, Chris Martenson. Consumer Reports states that, person for person, healthcare in the United States costs twice as much as it does in the rest of the developed world; twice. And the kicker of their analysis is we do not get much for our money. A 2013 Commonwealth Fund study of eleven developed countries’ healthcare, the United States ranked fifth in quality and worst for infant mortality. We also did the worst job of preventing deaths from treatable conditions such as strokes and diabetes, high blood pressure, and certain treatable cancers.

Now, this all obviously speaks to something that can be addressed, should be addressed, and that we should look at. So today we are welcoming Chris Kresser to the program. Chris is somebody I remember from being a part of the site a long time ago, back when he was a student. Now he is a very successful entrepreneur and writes one of the most popular natural medicine blogs on the web. It has been named by Greatest.com as one of the fifty most influential voices in health and fitness. Now in today’s discussion we are going to explore the world of functional medicine and other approaches to health and wellness that offer the potential to complement or in some cases replace conventional western medical treatment. Now some of these practices have been used by eastern cultures for millennia, others are just coming to light now. But the common thread in each is to focus on the biological uniqueness of each patient and use an evidence-based approach to identify and resolve the underlying condition rather than merely treating the symptoms, which modern healthcare does all too often.

So through his website and books Chris provides a wealth of guidance and resources for how each of us can, and should—if we care about living better and longer—take an active role in improving our health and wellbeing. So Chris, in addition to your expertise I just summarized, as I said you are one of our longtime community members at Peak Prosperity. It is a real pleasure to finally have you on as a podcast guest.

Chris Kresser: Hey Chris, yes, as you mentioned, I have been a part of the Peak Prosperity community since back in the day that it was ChrisMartenson.com and it is really great to be on the show.

Chris Martenson: Thanks. This is a very topical podcast for myself as well because I have just come through a period of feeling increasingly crummy over the course of a year and a half or so and finally it got bad enough that I went and saw a naturopath for the first time and got a lot of data. I mentioned this on a prior podcast, but for people who are listening, here is the summary: I actually am feeling a lot better than I used to. I was eating well before but I had some very specific things that I had to fine tune. Things I could only find out by doing a food sensitivity analysis. I am highly sensitive to almonds. I had no idea. But not pecans. Clams and scallops: no good. Shrimp: fine. So there were a lot of specific things like that that I discovered, tuned my diet around that, and the results have been really very, very dramatic. Tell me how does my story fit into what you do?

Chris Kresser: It is pretty typical, Chris. I see patients in my practice who are dealing with pretty complex chronic illnesses and they have not been able to find help anywhere else. You mentioned in the intro the difference between conventional and functional medicine. And it is interesting to think about that in the same context as the difference between what we talk about with the three Es and all the concepts you explain in the Crash Course and the difference between that and how the conventional paradigm looks at the economy and environment and energy. So for example in functional medicine, as you mentioned, we tend to look at things from the inside out. So instead of focusing on the symptoms that people are experiencing, we look at genes, we look at how environmental triggers like diet, lifestyle, things like food allergies which you mentioned interact with genes and genetic predisposition to create mechanisms. And these are underlying causes like blood sugar dysregulation or chronic infections or intestinal permeability, which is known as leaky gut. And then those mechanisms go on to manifest as disease patterns like hypothyroidism or diabetes or heart disease, and then you finally get symptoms.

And in the conventional model all too often what you see is focus from the outside in. So if someone has high blood pressure they take a drug to lower the blood pressure. Someone has high cholesterol they take a drug to lower the cholesterol. There is often no investigation into why the cholesterol was high in the first place or why the blood pressure was high in the first place. And in the same way our economic system is often functioning in that capacity. So there is a lot of Band-Aids being applied to problems instead of a deeper investigation into why those problems exist in the first place. And thinking from more of a systems-based approach to try to resolve them. So I think there are a lot of parallels between functional medicine and the kind of approach that we are taking at Peak Prosperity.

Chris Martenson: So if I understood that correctly, Chris, then functional medicine is really a synthesis of trying to get—that seeks to get to the root cause, and is maybe going to use a variety of approaches, some western testing, some eastern methods, things like that. Whereas in your view and I would think I would share this view, maybe, if I could paraphrase it this way, but western allopathic medicine really does a great job of treating symptoms but the symptoms are—you only get relief from symptoms, you never get cures from symptoms. Is that about right?

Chris Kresser: Yes, that is about right. I mean, I want to be clear here that I think allopathic medicine is important. It has made some incredible contributions. I mean, some of the things we are able to do now with allopathic medicine are just completely remarkable. We are getting to the point where we can reattach limbs and potentially heal disease with nano robots. And I will tell you what, if I get in a car accident I definitely want to go to a hospital because trauma and emergency medicine is incredible in what it can accomplish. But I think there has been too much focus on disease management and symptom management within the allopathic model and not enough focus on healthcare. And Ben Franklin said an ounce of prevention is worth a pound of cure.

And again, that is true, I mean, that is particularly true in medicine but it is true in many other discipline as well. And that is where functional medicine is really focused. And I really believe, and I think the data and the research supports this, that if we did focus more on preventative medicine—things like optimizing our diet, stress management, getting enough sleep, addressing some of the issues that you have been addressing in your work with the naturopath—our healthcare system would be in far better shape, far more sustainable over the long term, and not in danger of completely falling apart as it is now.

Chris Martenson: All right, so I completely agree with that. And so if we are sort of separating what allopathic does really, really well—acute care, it does a phenomenal job at. But the chronic piece, there has been some missing pieces. And it has been amazing to me to watch this whole—as I went down this path and starting learning more to finally understand in particular what sugar does and just what an abrasive chemical it is, right? And to understand that back in the seventies there were in particular a handful of doctors who understood that—understood that well—but that somehow it has taken another forty years for that basic understanding, that observational set of data that we can now back up biochemically, it has taken forty years for that to sort of percolate through to the point that they are just talking about now maybe we should start limiting the amount of sugar in these vending machines at the elementary schools’ drink bars.

So it is just amazing to me how long it takes for we will call sort of the more subtle and chronic things to really penetrate that allopathic mindset. And around which I would call—maybe our food guidelines sort of fit into that same approach, that it just seems to have taken forever for solid observations to have come to the fore.

Chris Kresser: It is really true. And we see this problem in medical research. There is often a really big lag time between what is evident in the scientific literature and what is discussed in the mainstream, both in the general public and the medical establishment. So a good example would be cholesterol and dietary cholesterol and saturated fat. For years we have been told that eating cholesterol and saturated fat raises cholesterol levels in our blood and then higher cholesterol levels in the blood lead to heart attacks. And if you look in the current scientific literature you will see that almost nobody, no researchers really believe that dietary cholesterol has any impact on blood cholesterol for the majority of people. And in fact, in Europe and Japan and other industrialized countries they have completely abandoned any restrictions on dietary cholesterol because the research does not support it anymore. And yet in this country we still see lots of people eating egg white omelets and if you ask the average person on the street they will tell you they are avoiding cholesterol because they are concerned about their heart health.

When we start to have this discussion about why it takes so long for new research to percolate down, part of the discussion of course is conflicts of interest. The statin drug industry is based on lowering cholesterol, and that is a multibillion dollar industry. And big pharma and insurance companies are vested in maintaining the current paradigm. And when new research comes to light that contradicts that paradigm and might threaten the financial interests of some of those companies, it is less likely to be—they are less likely to share that information or make sure that it gets out in the same way.

I am not a conspiracy theorist. I do not think there are any conspiracies here. I think it is just basic economics and also just the difficulty of shifting a dominant paradigm, which you know very well from your own work Chris.

Chris Martenson: Well absolutely, but if advancing your own personal interest is a conspiracy I commit them every day. And I [laughter] so I understand why companies do it. I mean, if you have got a big investment in a way, you defend that whether that is right or wrong.

Chris Kresser: Absolutely.

Chris Martenson: It is just that happens all the time.

Chris Kresser: One of my favorite quotes is from Upton Sinclair that says, “It’s difficult to get a man to understand something when his salary is dependent on him not understanding it.”

Chris Martenson: [laughter] There is a lot of mysterious not-understanding going on in these places. [laughter] And I think that quote—I love that quote, too, it explains a lot. So Chris your particular approach to health and wellness, then, as I understand it, focuses on the uniqueness of the individual, which I echoed in my own personal story and it is working for me. So you are seeking to find and address the underlying conditions. Let us say that I walk in the door with a specific health complaint, describe your diagnosis and treatment process. What I really want to get at here is that even though the larger machine has an old paradigm that it is sticking to, people, if they choose to, can seek out a practitioner like yourself and get tailored specific medicine. Is that correct?

Chris Kresser: Sure. Yes, and there are a lot of people out there who are doing this kind of work and functional medicine. And the process looks really different. So typically when you go see a family care practitioner within the insurance model you might have an initial appointment that lasts ten or fifteen minutes which is about enough to collect some main complaints and prescribe a medication or two to deal with those complaints. It is not really enough to get a sense of what is happening in this patient’s life, what their diet is like, how they are managing their stress, if they are getting enough sleep, are they getting enough physical activity. So in functional medicine, and with me, the intake process looks very different.

In fact, before I even see a patient I send them several pages of forms where I ask them really detailed questions about their symptoms, their diet, we have a diet survey, three-day diet diary people fill out. I ask them some pretty subjective open ended questions about why they think that they are experiencing their current symptoms, how committed they are to recovering their health, what obstacles or beliefs might stand in the way of recovering their health. And in this way I gather a really complete picture of the whole person. Not just their symptoms and their complaints but everything that is going on in their life that might contribute to why they are feeling the way that they are feeling.

And then I also do a lot of lab testing. I do a comprehensive blood panel and based on some of the other complaints I might do stool testing, might do urinalysis, might do saliva testing for stress hormones. I might do twenty-four hour urine testing for sex hormones like estrogen, testosterone, progesterone, some of the stress hormones metabolites. There is a whole range of testing that we do. There is a saying in functional medicine, which is: "Test it, do not guess." I am big believer in collecting data and analyzing it and using it to guide the treatment process.

From there we will use a combination of dietary changes, botanical management, I am trained as an herbalist, nutrients and supplements which are sometimes called "nutriceuticals" to achieve certain goals. And then of course lifestyle change, so these are things like optimizing physical activity, again, stress management techniques like mindfulness, meditation practices, making sure that people are getting outside, that they are having enough fun in their life, that they are connecting with other people, with their relationships. They have—working on their relationships, high quality relationships. So it is really a holistic approach.

Chris Martenson: Now you mentioned a number of things there which I want to ask more about. And it gets to this: In your experience, then, you are putting a lot of things into this basket around becoming healthy, staying healthy, and living well. You have mentioned nutrition, fitness, mindfulness. You mentioned mediation. Talk to—how does that factor in?

Chris Kresser: Yes, well, meditation is one of many techniques that can be used not just to manage stress, I mean, that is one of the—that is what I would say is a side effect, a beneficial side effect of meditation. But meditation at its core is really an awareness practice. So it increases our awareness of how we relate to ourselves and how we relate to the world around us. And awareness is really the crucial element that is a precondition for any kind of change that we want to make in our life. Because if we are not aware of what we are doing and how we are thinking and acting and behaving, we will not be able to change. So a simple example of this is: Let us say you work in an office, stressful job, you are trying to make dietary change and eat less processed food. You had a really stressful day at work, you come home, you come into the kitchen, there is a bag of chips that someone left on the counter and before you know it your hand is in the bag and you are eating chips because you are so stressed out you are not even really paying attention to what is happening and you are engaged in a kind of unconscious behavior.

So where meditation or mindfulness practice can help in that situation is you become aware of what you are doing as you are doing it. And once you have that awareness you then have a choice of whether you are going to stop and not follow through with that behavior. Whereas if you are just operating on autopilot you do not really—it is not a choice. You do not have the freedom to make that choice. So mindfulness is crucial from that perspective just in terms of dietary and behavioral change. But it is also—there are many, many studies now in the literature that show the power of meditation in terms of resolving all kinds of different disease states. For example, there was a recent study a couple years back on middle-aged African American men who had already had a heart attack. So that is the highest risk group potentially for a future heart attack. And they found that doing daily meditation practice reduced the risk of future heart attack by a significantly greater margin than taking statin drugs.

And the only side effect of meditation—unlike the statin drugs—were people feeling better, greater sense of connection with themselves and people around them, and more relaxed and at peace. So I am a big believer in meditation practice. I have been—my father actually introduced me to it when I was seventeen. I am forty now. So I have been meditating for almost twenty-five years. And to me it is hard to imagine life without it. It is just—it is something that has become a part of who I am and my daily routine. And it has just been an incredible gift for me.

Chris Martenson: I share that. It is a growing practice for myself. And I separate it a little bit from the way I practice mindfulness, which is literally just in my case just having a witness show up inside of myself, like imagine I split into two parts that just observes my behavior at certain points. So it could be the behavior of reaching for the chips, but it could be a reaction I am having to a person, to an event, to a circumstance. Which for myself I used to think my reactions were me. That is just who I am.

Chris Kresser: Right.

Chris Martenson: But it turns out my reactions are just reactions, and who I am can be a completely separate thing. And having that little gap, that mindful separation between the reaction and some sort of an internal witness has been a really profound shift in my life and has led me to have what I feel is a lot more conscious control over all facets of my life, nutrition being an important one.

Chris Kresser: That is right and that dis-identification that happens also means that you do not take everything so personally. [laughter] You see things as they are and it is not that you do not take responsibility but it is that everything does not mean something about you. And that can really be a relief and it can really free us up to make positive changes, whereas before we have that awareness we can get stuck in the cycle of self-recrimination and judgment and blame. So yes, I mean, I think this is a crucial health practice. So I prescribe it to my patients. And I am not dogmatic about the form or type of meditation. I think from a research perspective there are plenty of different studies that show that whether you are doing transcendental meditation or Vipassana or zen-based practice or something like that it all is helpful.

And I also try to emphasize that it is not—meditation is a part of certain spiritual and religious practices but meditation itself is a technique. It does not have to be religious and it can be done by people of all different religious faiths. Executives at Google and Apple Computer and other major companies are doing it in a secular non-religious way and they are seeing all kinds of benefits in terms of productivity and their own health and their relationships with people, their coworkers, and their family members. So yes, it is a powerful tool in so many different ways and so that is why it is always part of the clinical discussion I have with patients.

Chris Martenson: And I think it goes further. In my world it becomes a resilience practice because I think that regardless of what future arrives—it really does not matter, whatever arrives—that that good health and good nutrition and mindfulness, that those three things together will serve you well in any circumstance whether the future is a lot rosy or less rosy or what does not matter. They serve today, they serve tomorrow. But this idea of emotional resilience is a hard thing for a lot of people to get their hands around. To me this is the critical first step is this mindful practice. And whether that is attained through—again, I am not dogmatic either. If you want to do it through dance therapy or you want to do it through tai chi or you want to do it through Vipassana sits, yoga meditation, I do not care. But whatever works for you because different things work for different people. I found what works for me—and by the way, it is not sitting cross-legged with my fingers held in a nice little ohm shape, right.

That does not work so well for me but I found what does. So I would invite anybody listening, yes, experiment because there are a lot of different ways to get to that point, many paths, many paths.

Chris Kresser: That is right. And I am so glad you mentioned resilience because I think that is a powerful theme that goes through everything we are talking about. And that is how I view my work with people is helping them to improve their physiological, emotional, psychological, and even spiritual resilience. And those are all connected. We were chatting before the show about how the western medical model and just western philosophy in general, which is based on Cartesian dualism, has really kind of separated mind and body and spirit in an artificial way. I mean, in reality when you think about it there is no separation between those things. It is impossible to have physical symptoms that do not impact our psychology and our emotions. It is impossible to have emotions that do not impact our physiology and our thought process. And we have created language that makes it seem like these things are separate. But in truth there is no separation. You cannot find any separation in scientific studies. It is just not there.

So I think the functional medicine model is so powerful because it integrates all these different aspects of who we are and it recognizes that if you really—if you are really seeking wellness in the true sense of the word, you cannot focus on one thing at the exclusion of the other things. The things that you neglect are going to hold you back from achieving your goal.

Chris Martenson: Well said, well said. I want to focus now on the nutrition side a bit. I know that you write a bit, pretty frequently, actually, about the paleo diet and lifestyle. It is very popular now for some good reasons. Although the movement does have its critics here and there, what is your perspective on the merits and weaknesses of paleo?

Chris Kresser: Yes, I am both a paleo advocate and a paleo critic. [laughter] Perhaps a unique position to be in. I think paleo is a fantastic starting place but it is not a destination. And what I mean by that is that as human beings we do all share some important similarities, certainly genetically. And all organisms—human beings are organisms, like it or not—all animals, when you look at animals in their environment, they are all adapted to survive and thrive in a particular environment. And diet is a big part of environment. And so there are certain foods we have been eating as human beings for a very long time. We are well adapted to them. Our biology is set up to benefit from them. And those foods should really form the basis of our diet. They are nutrient dense. They are anti-inflammatory. And as I said, our bodies are well-designed to take advantage of them. So these are things like meat and fish, fruits and vegetables, nuts and seeds, and some starchy plants like sweet potatoes or plantains, et cetera.

But although our genes have not changed much in the last ten thousand years, there actually have been some important changes. In fact, the pace of genetic change over the past ten thousand years—which is when agriculture was invented about ten or eleven thousand years ago, and our diet started to change a lot—it is a hundred times faster than it had been in the previous six million years of hominid evolution. So scientists now believe that as much as ten percent of our genome has changed over the past ten thousand years. And those genetic changes actually have influenced our tolerance of certain agricultural foods. So if you take dairy products, for example, it is true that about two-thirds of people worldwide cannot digest lactose, which is the sugar in milk products. But the other third of people can, because a genetic mutation occurred about ten thousand years ago that allowed humans to be able to digest dairy products, and that genetic mutation spread pretty rapidly among farming populations in the world.

So full fat dairy products, when you look at the research, are actually beneficial when they are well tolerated. And I do not think there is any reason to exclude things like that and also things like legumes when the research says they are beneficial just because our Paleolithic ancestors did not eat them. So that is where I am critical of some of the dogmatic paleo viewpoints, because we have to—we have continued to evolved so our diet has also continued to evolve.

In my book I talk about a process that you can use for starting with a paleo approach and then starting to add some foods back in to make your diet more flexible and sustainable over the long term. Because at the end of the day we want to be as healthy as possible. But I think being completely obsessed and rigid around our food choices is not healthy.

Chris Martenson: Well, sometimes you are stuck on a plane, so things happen. [laughter] And food happens. But how about in your own life? So for yourself, how strict do you feel like you are in your diet and how often do you have those lapses?

Chris Kresser: Yes, I recommend—I call it the eighty/twenty rule. And there are a lot of eighty/twenty rules out there in economics and behavioral change and diet. That means eighty percent of the time you stick with the foods you know you are supposed to eat and maybe twenty percent of the time you are free to loosen up. If you are in the airport and you do not have any choice, it may be better to eat something that is not on your diet or your approach to food than is. And I do not mean that literally like eighty percent/twenty percent. For some people it could be ninety percent/ten, it could be ninety-five/five for others. You really have to kind of work that out based on your own needs. For me I would say it is probably ninety/ten if not ninety-five/five. And that is because I find that I feel better, I think better, I enjoy eating the foods that are whole foods, nutrient-dense foods.

But I also believe—there is a saying in Chinese medicine, "it is better to eat the wrong food with the right attitude than the right food with the wrong attitude."

Chris Martenson: I like that.

Chris Kresser: And I think there is a powerful—food obviously has a powerful psychological and emotional influence on us. And there are certain times with, say, if you are with a group of friends and they invite you out to a restaurant, the restaurant does not have foods that are perfect for you, if you have a choice to say "no" and not go out and enjoy your time with your friends or to say "yes" and maybe eat foods that you may not thrive on, in that situation I am going to choose to go out with my friends because I know that the benefit I get psychologically, emotionally, from connecting with them and having a good time is going to outweigh whatever downside there might be in eating foods that are not optimal or ideal in that situation. So that is kind of how I look at it.

Chris Martenson: So if you—help me out here. So when somebody typically comes to you and you are working with a patient, maybe a new one, I know you are not really taking new patients at this point, congrats on that, I guess, full practice. But when some—what are the most common sources of, I will use this term loosely, "self-injury." I mean, people do not know they are doing it, but in our lifestyles what are the big things that really, you just start there, eighty/twenty rule. If we could just start on this one thing, Mrs. McGillicuddy, here it is, what do you see that is most common that is injurious like that?

Chris Kresser: Well, I would say in my population it is a little different than in the mainstream. In the mainstream it would have to be diet, absolutely. But most people that come to me are people who have already been reading my blog and my book and listening to my podcasts. They are already on some version of a paleo-based approach or they are already eating nutrient dense whole foods. And in those situations, Chris, it tends to be more like what happened with you. You were already on a pretty good diet. You were eating the right foods but there were certain particulars that were unique to you that needed to be adjusted. So for you it was almonds and some other foods that were triggering symptoms for you. For some of my patients it might be, for example, if they have autoimmune disease, sometimes nightshade plants like tomatoes and eggplant and potatoes can cause problems, eggs can cause problems with autoimmunity. If they have digestive issues there are certain types of carbohydrates called FODMAPs, which is an acronym, I will not go into the whole name. [laughter] But there are certain types of carbohydrates, primarily in fruit, vegetables, grains, and dairy products that can feed the bad critters in our gut and cause bacterial overgrowth which then leads to gas and bloating and changes in stool consistency, diarrhea, constipation, things like that. So in that case removing or limiting the foods that contain those FODMAPs can be really helpful. So it is a deeper level of investigation into the diet.

Beyond that, I would say that the triad of sleep, stress management, and physical activity are the three other biggest things that people are not paying attention to. And so we can—for each of those, with physical activity almost everybody knows that exercise is good for them. I do not think that is a newsflash anymore. But what a lot of people are not aware of is that sitting too much is arguably even more harmful, because studies have shown now that even if you get the recommended amount of exercise each week, let us say you go to the gym three or four times a week for a half hour each time, if you are sitting for the majority of the rest of your time, like you work in an office, you drive to your office, and then you watch a couple hours of TV at night, you still are going to be at higher risk for early death and disease.

So I really work with people to integrate more physical activity throughout their day. So things like working at a standing desk or I even—I have a treadmill desk so that I am walking a lot of the times when I work which is pretty fun. You can take frequent breaks, even just a two minute standing or stretching break every forty to fifty minutes has been shown to really mitigate some of the harmful impact from sitting. You can—if you commute to work you can try riding your bike or walking. If you work too far away from your home you can drive and park about a mile away from your office so you can at least get a two mile back and forth walk to your office. There are a lot of things you can do to integrate physical activity throughout your day. Sitting on a yoga ball instead of a chair where you are constantly doing these micro movements. And those changes arguably can have a bigger impact than just getting more exercise.

With stress management, we already talked about mindfulness practice, meditation, tai chi, yoga, et cetera. And then with sleep, I mean, that is really the elephant in many cases, Chris. It is—we know now from the research that most people need seven to eight hours of sleep to function optimally. And the circadian clock, the system that governs our sleep/wake cycles, also governs every single cell in our body. And it controls—it impacts every body system. So if you are not getting enough sleep, it affects everything from your metabolism—we see that even a single night of sleep deprivation can lead to poor choices around food and increased food intake the next day in addition to decreased insulin sensitivity and glucose tolerance. We see increase in blood pressure. We see changes in your ability to burn fat. We see anxiety and depression. We see changes in hormone balance. I mean, it is really—it is kind of like there is nothing that sleep deprivation does not adversely impact. And yet thirty-five percent of Americans are getting fewer than six hours of sleep a night.

And I actually think this is probably the most dangerous and least discussed modern epidemic that we are facing right now. Because life is full for a lot of people. It is busy. It seems like it is getting increasingly harder to carve out that time for rest and sleep. And yet it is really fundamental to who we are as human beings. We cannot sleep when we are dead, so to speak. But that phrase, well, we will just sleep when you are dead. If you follow that advice.

Chris Martenson: Well, it is interesting. I have not focused on sleep that much in my own life. I think I do pretty good at it. But for most people, is it a choice? Are you suggesting that people could get more sleep if they just scheduled it into their life? Or are there certain other things people would have to do in order to help improve their sleep cycle so it is actually longer?

Chris Kresser: Yes, that is a good question. It is both. So there are two problems of sleep. One is just people not giving themselves enough time in bed. So my recommendation for patients is to allow eight hours in bed. And that—you may not sleep for those entire eight hours, but if you allow yourself—or schedule in—eight hours in bed then you are pretty likely to get enough sleep. Now the second problem is insomnia. And that is inability to sleep deeply and then non-restorative sleep would be a part of that. And that is related to any number of problems, medical problems. Everything from blood sugar issues to anxiety, depression, stress, to chronic inflammation, to conditions like rheumatoid arthritis or autoimmune diseases can interfere with sleep. So of course you have to address the underlying causes if you have any of those chronic conditions. But from a kind of straight out behavioral or lifestyle perspective, one of the biggest things that is impacting our ability to sleep peacefully and deeply throughout the night is artificial light.

And this does not get discussed a lot either. Artificial light is only really a hundred and fifty years old. So the vast majority of our human evolution, we woke up when it was light and we went to sleep when it was dark or soon after. And we were not exposed to artificial light. The reason that is important is that light is what governs our sleep/wake cycles. We are genetically and biologically programmed to awaken when light hits our eyeballs. This light causes hormonal changes, particularly affects hormones like cortisol and melatonin, and they regulate our sleep/wake cycle. And so the scenario that we are in now is the light—we wake up with the light, then the sun goes down, we not only turn on artificial lights in our room, we also now have these tablets—iPads and other electronic devices like phones, et cetera, televisions—that emit a spectrum of blue light that is very similar to the sunlight. And this blue light suppresses melatonin production. And melatonin is a hormone that makes us fall asleep and stay asleep.

So if you are sitting in bed, for example, and you are looking at your iPad just before you fall asleep, that is basically telling your brain that it is time to wake up. And so even if—it is going to make it harder for you to fall asleep when you do that, and even if you do fall asleep you are likely to have more interrupted sleep throughout the night because of that. So I recommend my patients to, if possible, limit their uses of electronic devices to a couple hours before bed.

And there are these amber-tinted glasses that you can get on Amazon, they cost about eight bucks, just search for orange or amber glasses. And these amber glasses, what they do is they filter out this blue spectrum of light that suppresses melatonin. So if a patient of mine is having insomnia I will tell them to get these glasses, put them on at night after the sun goes down and they put the lights on. And whenever, certainly, they are using a computer or a tablet at night to wear these glasses. And that single change can make a huge difference. I have seen people with intractable insomnia who have been taking sleep medications for years, just from these eight dollar glasses, go from not being able to sleep at all to being able to sleep without any medications. They are powerful changes. They do not cost a lot of money. They do not really have any side effects or negative impacts.

The others would sleeping in a dark room, taking your phone out of your bedroom. Switching to an analog clock that does not glow, getting some blackout shades in your room so that it is really dark. Maintaining a relatively cool environment, not too hot. Just making sure you have as few distractions as possible in the bedroom. Those are things that seem like little changes but when you put them all together they add up and make a big difference.

Chris Martenson: I love them because it is giving some confirmation to what I thought was a strange set of quirks of mine. I am so light sensitive that one of my pet peeves is the little recharging diode in my phone. It is just small. It is this little green diode but it lights the whole room up. I swear I could—it casts shadows that I could read by. It is just it is that bright to me and it does not look like much. So it has to be flipped over. Because if I have that stray light it really interrupts me quite a bit, for me. And I always thought I was just light sensitive or something but I need pitch black [laughter]

Chris Kresser: It is a real phenomenon. It is amazing. When people get used to sleeping in a dark room and not having these distractions it is amazing to see how obvious it is that those things do affect your sleep if you are in a situation where you do not have as much control over your environment. So there are a lot of changes that we can make that do not cost anything and they are not even that intrusive in terms of how they affect our life, but they can really have a powerful impact on our health.

Chris Martenson: I cannot wait to try the amber glasses. I know a couple of people that I am going to order some for. That is fantastic, very specific advice and sounds cheap. So we are going to try that one, thank you so much for that particular tip. I had not heard that. That is great.

So I see we are—I have taken up enough of your time today. And I really, really appreciate your time. I know that your website is ChrisKresser.com, that is K-R-E-S-S-E-R, ChrisKresser.com. But what else have you got in terms of how people follow you? I mean, you have got a book, you have got a podcast; tell us how people can follow you.

Chris Kresser: Yes, on my website I now have over eleven free eBooks on various topics including weight loss and thyroid disorders, high cholesterol, gut health, et cetera. So those are completely free, people can download those and learn a lot. My book is Your Personal Paleo Code, but in late December it is going to be published in paperback under a different title which is The Paleo Cure. My podcast is called Revolution Health Radio and that is available on iTunes and on my website. And as you mentioned, Chris, I am not currently taking new patients but for people who are interested in functional medicine and would like to find a practitioner who is familiar with that approach you can always check the Institute for Functional Medicine website. I believe it is functionalmedicine.org, O-R-G, and they have a directory of practitioners on there. And then you can also look at the Paleo Physicians Network, which is a network of physicians around the country who have a paleo orientation who are going to be familiar with and supportive of the paleo approach. So hopefully if you need some help you can find it in one of those two resources.

Chris Martenson: I really encourage anybody listening, if you have got something that is just a health issue that has been with you for a very long time and maybe it is just part of your personal story now—mine was that I was just getting old, and my joints really hurt and I had just started to accept it, but I have discovered—and I cannot wait to see how this continues to improve—but I discovered that that was a completely treatable condition and it was due to things that I needed a functional approach to unearth. It was very specific. I have my own little quirks dietarily that were important. And I also have some things to address around bringing more mindfulness in and continue to work on my sleep and things like that. So I am a huge fan and it really does work. And by the way, it really is one of the most important things we can do for both our physical and our emotional resilience.

Chris Kesser, thank you so much for your time today and thank you for the work you are doing.

Chris Kresser: It is my pleasure. There is one more thing I realize I forgot to mention.

Chris Martenson: Sure, what have you got?

Chris Kresser: This really could help people. In mid-October I am going to be launching a new program called the Fourteen Four and it is fourteen days to make four big changes: diet, physical activity, stress management, and sleep. And so it is actually all the things that we have been talking about. I realized over the years that those are really the four most important modifiable factors that we can change in our life to improve our health. And I wanted to create a program that really holds people’s hand every step of the way through that process. Because for a lot of folks they are not going to be able—it is difficult sometimes to find a functional medicine practitioner. A lot of times you have to pay out of pocket because our insurance system unfortunately does not always support it. And so I wanted to provide a resource for folks that just want to get started and want to make some really positive changes in their life and want to have some support while they are doing that. So it is going to be—

Chris Martenson: So that is Fourteen Four?

Chris Kresser: Fourteen Four. You can learn about it on my website. It is going to be under fifty bucks, really affordable. And I just hope it can help get you started on this road to optimal health.

Chris Martenson: And when is the best time to start? Oh, today. [laughter]

Chris Kresser: Yes, exactly, yesterday, today. [laughter]

Chris Martenson: Yes, that was the best time. Today is the second best. Second best time is always today. [laughter]

Chris Kresser: Yes.

Chris Martenson: Well fantastic.

Chris Kresser: It has been a pleasure, Chris, I really appreciate it. And I am a huge fan and supporter of your work and such important work that you are doing. So I am glad that you are continuing to improve your own health and walk your talk and be a model for everybody, all your listeners and readers.

Chris Martenson: Well, thank you for that, Chris, I appreciate it. And really, the best of luck and I hope we can do this again. And we will certainly—we will see how many people we can get to take the Fourteen Four. Maybe I will do it myself; we will have our own little experience with it and see what comes up.

Chris Kresser: Yes. Sounds like fun. I am going to be there. I mean, I have been doing this now for years but I do other kind of fourteen day program myself just to kind of hit the reset button a few times a year. It is kind of like a spring cleanse. So sounds good, Chris.

Chris Martenson: Fantastic. Well, thank you so much for your time today.

Chris Kresser: Take care.

About the guest

Chris Kresser

Chris Kresser, LAc, is a licensed acupuncturist and functional medicine practitioner. His health and wellness blog, ChrisKresser.com, generates over 400,000 visits per month; was just named “best science-oriented blog” by Paleo magazine; and according to DrMercola.com, is ranked one of the top 25 natural health blogs in the world. Greatist.com has named Chris one of the 50 most influential people in health and fitness, along with Mehmet Oz, Andrew Weil, and Deepak Chopra; and the popular LivingLavidaLowCarb.com and best-selling Paleo-nutrition authors such as Robb Wolf have ranked Chris as one of the top 10 trusted authorities in the Paleo-nutrition world. Chris has been a featured health expert in leading international media, including The Atlantic (USA), Globe & Mail (Canada), and Healthy (UK); he has been a featured speaker at top Paleo conferences, including Ancestral Health Symposium, PaleoFX, and Wise Traditions, and his work has been endorsed by leading health practitioners and scientists at institutions including Harvard Medical School. Chris is the author of the forthcoming book, Personal Paleo Code: Your Individual Prescription for Feeling Better Fast, Living Better Longer, and Preventing and Reversing Disease Naturally.

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KugsCheese's picture
Status: Diamond Member (Offline)
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Posts: 1469
Blue Light Blocking

On computers I recommend you load F.lux.  On iOS you must jailbreak to use it.  You set your latitude and longitude then set light type and program will remove blue light as the night descends.  I use orange safety glasses too; very important to block the blue light from the side too.

Adam Taggart's picture
Adam Taggart
Status: Peak Prosperity Co-founder (Offline)
Joined: May 26 2009
Posts: 3213
Happy F.lux user

Kugs -

I downloaded F.lux on my laptop a month ago and am very glad I did. Really helps those of us who spend time on the computer after the sun goes down not jeopardize our sleep quality.

For those that don't have it or know what it is, you can learn more here.

Arthur Robey's picture
Arthur Robey
Status: Diamond Member (Offline)
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Posts: 3936
On Cartesian

On Cartesian Dualism.

According to his philosophy, which is specifically called Cartesian dualism, the mental does not have extension in space, and the material cannot think.


We have to catch up with Physics and what the empirical evidence is showing us. (Warning: Turbulence ahead, Please fasten your seatbelt).

However the mental roughing up is worth it as it puts everything in perspective. Once you have the Ah Ha, then when bad things happen to you or your loved ones you can remind yourself. It is all an illusion. The purpose of the illusion is to grow Me. I am a child in kindergarten, this is My lesson for today.What matters is not so much what happens to me but my reaction to it. It is all about Me.

For instance my mother is about to be taken from me- from a materialist point of view, this is a bald inescapable fact. But is it? Is this "fact" not just another social belief? 

For answers to this question I turn to nut-and-bolts Physics. Once you have the Quantum Erasure experiment under your skull (virtual skull, of cause) then you can see it all for what it is. Data. The Subjective is more important than the Objective as there is nothing "out there".

The erasure experiment is showing us that once all memory of anything is extinguished they exist as potentials on the timeline.

I don't know how Christ, the Buddha and other Teachers did it, but they had this thing pegged. We are the Great Prize. Here is a quote of Christ from Thomas.

Bring forth that which is within you. If you bring forth that which is within you, what you bring forth will save you. If you do not have that which is within you, what you do not have will destroy you.

No maybes or caveats.

On Paleo Diets

What is airbrushed out of the story is that our ancestors were not guaranteed three square meals a day. Frequent fasting was normal and we are adapted to it. Because Cancers require sugars and because we burn ketones when fasting, one of the reasons for the uptick of cancer is the lack of fasting. Dr Seyfreid says that we should all fast for 7 (edit: consecutive) days each year as a cancer preventative measure. (Fasting means nil by mouth, except water. And water has some secrets too.)

Amber glasses.

LesPhelps's picture
Status: Platinum Member (Offline)
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Posts: 811
Excellent Podcast

So many points hit home that it's hard to pick one.  I get more than enough exercise, but probably sit too much.  I have insomnia, but read books on an iPad right before I shut the light off.

My wife, however, has issues that may or may not get addressed.  She takes incredibly expensive drugs to control lifelong gird issues.  None of the generic alternatives work for her.  She also has to limit what she eats, but it's based on personal experience, without any meaningful outside input.  This podcast has me wondering if there isn't an alternative to the approach she is taking.  Unfortunately, she can be stubborn about non-traditional health providers.  

Sounds like paleo-nutrition deserves another look.  I started reading about it a while back, but gave up due to what seemed to be a lack of scientific method grounding.

Thanks for this podcast.

KugsCheese's picture
Status: Diamond Member (Offline)
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Posts: 1469
LesPhelps wrote: So many
LesPhelps wrote:

So many points hit home that it's hard to pick one.  I get more than enough exercise, but probably sit too much.  I have insomnia, but read books on an iPad right before I shut the light off.

My wife, however, has issues that may or may not get addressed.  She takes incredibly expensive drugs to control lifelong gird issues.  None of the generic alternatives work for her.  She also has to limit what she eats, but it's based on personal experience, without any meaningful outside input.  This podcast has me wondering if there isn't an alternative to the approach she is taking.  Unfortunately, she can be stubborn about non-traditional health providers.  

Sounds like paleo-nutrition deserves another look.  I started reading about it a while back, but gave up due to what seemed to be a lack of scientific method grounding.

Thanks for this podcast.

Has she tried Lifeway Kefir and high quality high potency probiotic like Theralac?  I know someone who was in the same boat but was helped tremendously by Kefir.

JAG's picture
Status: Diamond Member (Offline)
Joined: Oct 26 2008
Posts: 2492
Greetings Old Buddy

It's so great to hear from Chris again!

I have missed his thoughtful input and I'm very happy to see that his career choice was so successful. I just downloaded about 80 of his podcast episodes and can't wait to devour them.

Many thanks to Dr. M and Adam for the enjoyable podcast with an old friend.



sand_puppy's picture
Status: Diamond Member (Offline)
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Posts: 2037
Functional Medicine in Central Virginia

I want to give a very favorable recommendation to a husband and wife functional medicine team in Charlottesville, VA.  Virginia Integrative Medicine

Marty Albert is a family practice physician and his wife, Peggy Wright is a Ph.D. dietician. My family is very happy with their work.

switters's picture
Status: Platinum Member (Offline)
Joined: Jul 19 2008
Posts: 744
Blast from the past!

Hey Jeff,

Great to hear from you! Glad to see you're still around. Hope you enjoy the podcasts and thanks for the kind words. 

Warmest regards,


prestonpapa's picture
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Posts: 1
Recommended books

Regarding paradigm shifts in medicine, as a physician, I highly recommend two excellent books:

Good Calories, Bad Calories by Gary Taubes

The Creative Destruction of Medicine by Eric Topol

PdeB's picture
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Posts: 39
I second Jeff's comments

I second Jeff's comments, Chris. Good to have your voice back on the site. And congrats on your book too. My family has benefited greatly from your site and podcasts over the past couple of years.




LesPhelps's picture
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Posts: 811
Reply to KugsCheese

Yes, my wife uses a probiotic as well as incredibly expensive drugs to try to control her gerd.  She is also selective regarding her diet.  She can largely control it but the cost and restrictions are significant.  Without health insurance, her meds for gerd alone would be upwards of $6,000 per year.  

I can't help but wonder what the pills cost to manufacture?

LesPhelps's picture
Status: Platinum Member (Offline)
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Posts: 811
Follow up reading on the Podcast

I've had a chance to sample some of Kresser's eBooks.  

I guess I'm not educated enough on the Paleo diet topic to notice any major difference between Kresser's approach and the other books I've sampled on the topic.  Also, the whole Paleo paradigm incorporates many "good" eating habits that have been recommended for years prior to Paleo.

One of the issues I take with recommendations similar to Kresser's is that the diet can only be practiced by the "fortunate few."  It is not a formula that would be feasible for 7 billion people, or even 4 billion people.  

For example, diet's that call for eating lots of wild fish are questionable.  I'm a lifelong SCUBA diver.  As such, I've followed studies of the health of Earth's oceans for years.  Most studies indicate that we have caught and consumed 90 to 95 percent of the fish that were once wild in our oceans.  How is a diet that recommends eating lots of the few wild fish left any different than a recommendation for everyone to commute in an SUV?

Organic vegetables and "organic" meat is another example, though not destructive.  Most of the world population can't afford organic food right now.  Perhaps, if the industry evolved this could change.  Yes, many people could find a plot to garden some of their own organic food and choose to watch reruns of Giligan's Island instead.  But as it stands right now, organic food is for the fortunate few.

I'm actually not offended or alarmed by the recommendation regarding organic food.  The wild fish recommendation, on the other hand, rubs me the wrong way.  I'd dearly love to see us navigate the population decline without doing massive incremental damage to the Earth and it's Oceans.

I realize that is not going to happen.  However, people who choose to recommend things like "eat wild fish" need to recognize that the recommendation is neither sustainable or green.


Rob111's picture
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Posts: 23
Interesting interview with addtional comments.


 Thanks for the interesting interview with good information for a healthy lifestyle. I would like to add additional information that was not covered that I think is helpful.  I am referring to telomere length and activities that promote it.  I'm not sure if you will allow this link but the presentation is very informative and I believe will be helpful to the many members of peak prosperity.  







phildenn's picture
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Posts: 38
Food sensitivity and the ALCOT test

Does anyone know if the ALCOT test is the appropriate way to determine individual food sensitivity? This website (http://whatsmyfoodintolerance.com) promotes it and would be wonderful if in fact it does what they say it does. Chris, Adam, how did you determine your food sensitivities? I am new to this whole area (food sensitivities) but my wife (only 29 and otherwise healthy weight, lifestyle, etc) has been developing all kinds of weird intermitant symptoms -- joint pain, fatigue, bloating, diminished libido, dry lips/skin/eyes. 

She's been to a couple of doctors, without any good answers. We're thinking of having the ALCOT test done but I wanted to check the PP community to see if anyone recommends it or other approaches to learning about our own unique food intolerances and such. Thanks so much for any thoughts!


cmartenson's picture
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Posts: 5972
Food Sensitivity And The ALCOT Test

The test I had done was the blood antigen (IgG) test that the ALCAN test claims to be superior to...I cannot evaluate that claim.

The test was simple enough...prick a finger (at home, I performed the testing), soak five circles on blotter paper, dry the whole thing out, mail it with $129 and wait for the results.

I had my Naturopath go over the results with me, but honestly a reasonable person could just decide to eliminate the high-sensitivity foods and see how that feels.

The list of symptoms you described are classic 'leaky gut' symptoms that point to food related inflammation processes.  All very treatable in my personal experience.

Best of luck!

Arthur Robey's picture
Arthur Robey
Status: Diamond Member (Offline)
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Posts: 3936

Apparently we have been lied to.

Surprise, suprise.

Time2help's picture
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Posts: 2890
cmartenson wrote:

The test I had done was the blood antigen (IgG) test that the ALCAN test claims to be superior to...I cannot evaluate that claim.

The test was simple enough...prick a finger (at home, I performed the testing), soak five circles on blotter paper, dry the whole thing out, mail it with $129 and wait for the results.

I had my Naturopath go over the results with me, but honestly a reasonable person could just decide to eliminate the high-sensitivity foods and see how that feels.

The list of symptoms you described are classic 'leaky gut' symptoms that point to food related inflammation processes.  All very treatable in my personal experience.

Best of luck!

Did the same here (IgG) two weeks ago based on a comment I heard at Rowe.  Turned out to be pretty much all dairy and chicken eggs for me crying.

Going on week two here without. It's amazing how many things have eggs and dairy (whey) in them.

Looking for a good local source for goose eggs...

Arthur Robey's picture
Arthur Robey
Status: Diamond Member (Offline)
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Posts: 3936
"Schizophrenia" cured.

But not in the Materialist West. 

Alex was an 18-year-old American who had suffered a psychotic break when he was 14. He had hallucinations, was suicidal, and went through cycles of dangerously severe depression. He was in a mental hospital and had been given a lot of drugs, but nothing was helping. “The parents had done everything–unsuccessfully,” says Dr. Somé. “They didn’t know what else to do.”
With their permission, Dr. Somé took their son to Africa. “After eight months there, Alex had become quite normal, Dr. Somé reports. He was even able to participate with healers in the business of healing; sitting with them all day long and helping them, assisting them in what they were doing with their clients . . . . He spent about four years in my village.” Alex stayed by choice, not because he needed more healing. He felt, “much safer in the village than in America.”
Read more at http://expandedconsciousness.com/2014/06/26/what-a-shaman-sees-in-a-mental-hospital/#BqYGX3LWJV2GyWeQ.99
Note: Scientific Matrialism is a philosophical view.
Arthur Robey's picture
Arthur Robey
Status: Diamond Member (Offline)
Joined: Feb 4 2010
Posts: 3936
The Road to Recovery.

Begins with first Acknowledging the problem. 

Begin here.


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