4 Ways to Build Resilience

Our modern world has become easy. We live in climate controlled houses, get in our climate controlled cars, and climate controlled offices and gyms. Over time, this makes us fragile. Ever notice that kids seem to be immune to swimming in cold water yet you get sick every time you travel? We have “endpoints” that our bodies get used to and if we don’t expose our bodies to difficult things, those endpoints narrow and then when we have to do something difficult, the body will let you know that it’s too much. Maybe you get sick, or maybe you develop pain. Whatever system in your body is most vulnerable, it shows up like a canary in a coal mine. 

Our bodies strive for homeostasis, or balance. We have 4 main homeostatic regulators; pH, CO2/O2, blood glucose, and temperature. The good news is that through systematic and progressive training, we can train our endpoints. This will make us antifragile, or resilient.

Here is an example: 

What is interesting is that if you improve the endpoints in one of these categories, it confers benefit in the other categories. Cold water immersion can improve your blood glucose control for example. Here are some tips to improve resiliency:

1. pH

This refers to your body's acidity/alkalinity in the bloodstream. It’s a 14 point scale, 0 is acidic and 14 is alkalinic. Our body rests at 7.4 and can typically swing between 7.35 and 7.45. You may have heard of the alkaline diet. Turns out it’s hard to have a large effect on pH through diet. The best way to affect pH is through breathwork. When you inhale, O2 goes up and it makes you more alkaline. As CO2 builds up in your bloodstream, it makes you more acidic. You can take advantage of this by doing things like breath holds while walking or Wim Hof breathing. 

Also, when you exercise, the muscles demand oxygen, that’s why you breathe heavier. The muscles also need fuel. Now, the body can use either fats or glucose for energy. Fats are more energy dense, but harder to break down whereas glucose is the opposite. So the harder you are working, the more glucose you are using. Glucose breaks down to lactate, which is the real fuel source, and hydrogen ions, which is acid. That is the burn you feel when you work out, literally acid. The more you can tolerate, the more you can exercise and the more resilient you become.

2. CO2/O2

Again, this comes down to breathwork. When CO2 builds up, there are sensors in our bodies that tell us to breathe to clear the CO2. CO2 has classically been described as a waste product, but that’s not accurate. The more it builds up, the more it scrubs oxygen off of the hemoglobin and delivers it to the muscle tissue. This is called the Bohr effect. So once again, the more CO2 we can tolerate, the harder we can work. 

3. Blood Glucose

This is tightly regulated in the body as high levels of glucose in the blood can be very damaging. In a healthy individual, there is on average about a teaspoon of glucose in the blood. When glucose is high in the blood, insulin is secreted to deliver the glucose to the muscles and the liver in the form of glycogen. As blood glucose decreases, glucagon is released to do just the opposite. 

With our traditional standard American diet, we eat way too much processed sugars and this leads to insulin resistance and type 2 diabetes. If you eat an excessively high carb diet (and we mean glucose, not just bread/pasta), your system gets adapted to burning glucose for exercise and burning fats become downregulated. If you get “hangry”, this is a sign that you have become metabolically inflexible and your ability to burn fats has decreased. You can improve this by running the “backup generator”. In other words, condition your body to burn fats from time to time. This can be done by exercising in a fasted state. Or you could consider a low carb/paleo diet. We don’t think there is one “right diet” for everyone. We advocate that you experiment and find the diet that works best, but it’s a good idea to sometimes focus on using fats for fuel to improve your metabolic flexibility as a strategy to become more resilient. 

4. Temperature

As stated earlier in the article, most of us live in a climate controlled environment. By intentionally seeking out cold and hot environments in a systematic way, we can improve the window of temperature swing that our body will tolerate before breaking down or getting sick. For starters, you can take a cold shower. Or exercise outside if you are in a warm or cold climate. You can use saunas and do cold water immersion. Cold plunges are all the rage now and for good reason. There are tons of benefits, but this is one of the big ones. We know that it upregulates the immune system, helps convert white fat into brown fat (which is more metabolically active), improves blood glucose, and reduces stress. Many people with hypothyroidism have poor cold tolerance. There is now emerging evidence that this is a 2 way street; if you improve cold tolerance, you may be able to improve thyroid function. Regardless, temperature is yet another homeostatic regulator that can be modified through graded exposure to make you more resilient. 

Building your resiliency is also called “physiologic flexibility”. This is a term coined by Dr. Mike T. Nelson and we are big believers in this approach. If you are interested in learning more and getting guidance on how to improve your physiologic flexibility in a systematic way, we’ve built a program for you. Click on the link below to learn more.

Become Dynamic: The Hormetic Effect

Is intense exercise good for you? How about red wine? It’s good for the heart, right? How about fasting? Are ice baths good? Deadlifting is bad for your back, especially those Jefferson curls. When you look into the hormetic effect, you’ll see why there is so much confusion around these conversations. 

Whenever I hear that a relationship between a dose and a response has a U or J shaped curve, I immediately think it is due to the hormetic effect. Recently, I wrote a blog on the equation for adaptation: Stress + Recovery = Adaptation. Hormesis, or the hormetic effect, focuses on the stress component. It is described as a dose-response to an environmental stressor. It is characterized by a low dose stimulation and a high dose inhibition. 

Some examples of hormesis include: 

-exercise

-intermittent fasting

-hypoxia

-radiation

-cold immersion

-phytochemicals (depending who you ask)

-Jefferson curl

Let’s take fasting as an example. We did not evolve to always be in a fed state. Fasting will trigger ketosis (burning fat for fuel), and reduces insulin levels. However, you can’t fast forever and you will reach a threshold where it’s damaging and eventually deadly. 

This scene where Westley outmatches Vizzini by simply having a tolerance to poison, is a perfect example of hormesis.

Exercise is the same; we all know the benefits of strength and conditioning, however too much exercise can lead to rhabdomyolysis; a breakdown of muscle tissue. This segues well into another topic; how to use hormesis to our advantage. Humans are inherently resilient, but with the right training, we can become even more resilient. The person who never has worked out a day in his life, and suddenly decides to train heavy 6 days a week may run the risk of injury or rhabdo. However, if you want to train with that intensity, you can build up your tolerance to it.

Hormesis is a disruption in homeostasis. Homeostasis is your body's ability to maintain a balance. If you just sit on the couch, homeostasis is not perturbed and all is well. However, if homeostasis is never challenged, its capacity to handle new stress is not improved in any way. That’s why the couch potato injures his back when he has to travel and lift luggage overhead in the plane. 

“A Ship in Harbor Is Safe, But that Is Not What Ships Are Built For”

We should seek to improve our resiliency. However we should do this in an intentional and intelligent way. That means not doing the weekend warrior thing. If you want to play a sport, you should train for it. If there is a specific movement such as the Jefferson curl that you want to perform, you have to train for it. It’s the person that hasn’t trained who suddenly decides to play basketball that tears their achilles. Or herniates a disc with a Jefferson curl. That means progressive loading with consistency.

Despite mounds of evidence, the concept of hormesis is somewhat controversial. The opposing model is the linear model. A linear model would suggest that something is either good or bad for you, and more of that stimulus would create more of a response. This is a philosophical discussion and an important one, because it changes the recommendations for health and even policy changes. 

Perhaps it’s human nature to place things in boxes (good/bad), or a lack of understanding of the hormetic effect. I contend that it’s this idea of a linear model that leads to advice to stop playing your sport, stop exercising, and basically stop enjoying life. We know that life is more nuanced than this. This is why research can be so confusing. You can find evidence that red wine is good for the heart, and also find evidence that it is bad for the heart. Is this not just more evidence of the hormetic effect? 

I personally like the idea of preconditioning. This is the intentional practice of graded exposure to a certain stressor so that when the time comes, you are physically and mentally prepared for said event. This is why on my recent trip to Brazil, I decided to swim through this frigid waterfall. Cold water immersion is not about decreasing inflammation (debunked), it’s about building resilience.

Now I don’t think a one time swim through a waterfall is going to make me more resilient, but if I’m always seeking challenge over the course of a lifetime, I believe that I’ll be harder to kill compared to the person that shies away from anything risky or uncomfortable. That’s what it means to become dynamic. 

IF YOU ENJOYED THIS CONTENT…

Check out our Cultivating Resilience Program. It’s all about becoming antifragile.

What you get when you enroll in the crash course:

1. A 2 week course with daily emails on mindset, nutrition, mobility, strength, breathwork, and physiologic flexibility.

2. Access to our private Cultivating Resiliency facebook group.

3. Voxer access to Dr. Chris through the duration of the course.

4. A hand-picked list of 6 book recommendations, 7 podcasts, 13 relevant articles/blogs, 10 relevant YouTube videos, 31 mobility drills, a free protocol on muscle strain, links to measurement tools we use, and some gear we recommend. 

5. A PDF outline on how to do exposure training (cold/heat) correctly.

“It’s All About Stretching”

No. Stretching rarely solves a problem. We hear this all the time as, “you gotta do your stretches”. Or I have someone ask: “I have back pain, what stretches should I be doing”? 

Let’s see if we can clear this up. First off, we are talking about passive stretching. The classic bend over, touch your toes kind. 

Stretching in this fashion in my mind has only one purpose; to fix a range of motion deficit. Even at that, there are better ways to do it. If you are having pain because of a range of motion deficit, then getting that range of motion back is the right move. For instance, if your hip flexors are so stiff that even in standing they are on stretch, it’ll pull your lumbar spine into extension which could potentially cause pain. Or if you are missing ankle dorsiflexion which changes your set up in a squat, then restoring dorsiflexion is appropriate. 

So if you are missing range of motion, and it’s causing a compensation leading to pain, then the next question is: what is causing the restriction? It could be muscular, capsular, or even neural, and oftentimes, all of the above. So you see, stretching really only addresses one component of restriction. This is why you see a lot of physios doing mobilizations with bands and kettlebells; we are trying to affect the capsular stiffness. 

The other issue is that passive stretching can actually cause issues. Muscles and tendons provide stability around a joint. If you have too much flexibility (yes that’s a thing), the joint becomes unstable. Or in physio speak, hypermobile. Couple that with the fact that humans just tend to do what they are good at and you get a scenario where joints are put at risk. Think of the flexible female that loves to do yoga, or the stiff male that power lifts. People tend to self-select what they perform well. 

So, if you are stiff and it’s causing compensation, what are you to do? You can stretch, however active movement at end range is the smarter choice. Let’s dig into what happens when you stretch to illustrate this point. You have receptors in the muscle called spindles. When they sense stretch, they respond by resisting the stretch as a protective mechanism. Long duration passive stretching inhibits this response temporarily. Now that area is able to move a bit more. The problem here is that this newly gained range of motion hasn’t been used yet, so it’s an unstable range of motion. So, if you can find a way to use this motion actively, you are going to have more control and have less chance of an injury. 

Hip internal rotation tends to be a range of motion that many people are missing. Here is an example of a passive stretch for internal rotation:

And here is a more active approach and would be my recommendation:

Feeling flat? We have built a program to restore the arch of your foot. Find out more here.

Overhydration

We are all familiar with how important it is to hydrate, and you’ve probably been told by a medical provider that you have to hydrate more. However, there is such a thing as too much. As with everything in the body, it’s all about balance.

The balance, in this case, is all about electrolytes and water. The body is a bioelectric machine and requires the right balance of fluids to conduct signals like nerve impulses that create muscle contraction. When you eat and drink, the body takes what it needs to keep this balance, and then excretes the rest out. You can easily see this after a salty meal when you urinate. That’s the body dumping out the excess salt. Conversely, if you haven’t had enough salt, the body will excrete more water and your urine will be clearer. 

Dehydration has its risks and you won’t live long without water. However, overhydration can be just as deadly. When you gulp down tons of water prior to a sporting event thinking that it’s a good thing, you can develop hyponatremia. That means that you’ve diluted the fluids and now you don’t have enough salt. Under normal circumstances, the body would just eliminate some water and restore balance. However, if you are a distance runner, you likely are not going to stop to pee. Then if you continue to hydrate, you could get yourself into some trouble. 

Water in the body resides both inside a cell (intracellular), and outside the cell (extracellular). The extracellular fluid is primarily in blood plasma, with a small amount residing in the lymph. About ⅔ of the water is in the intracellular fluid and ⅓ in the extracellular fluid. When you are overhydrated, in an attempt to restore electrolyte balance, water will move from the bloodstream into the cells. This will lead to puffy fingers and toes, and even worse, it can cause hydrocephalus. This means swelling in the brain, and it can be deadly. 

There have been many instances of runners collapsing and dying from overhydration, and many more hospitalizations. So how do we know how much water to drink? This is a complicated question and depends on many factors, such as the type of sport, conditioning levels, male vs. female, body weight, sweat rate, environmental heat, etc. There are some symptoms that will clue you into the early signs of hyponatremia. If your wedding ring is feeling tighter, that’s a sign you have too much fluid retention. Other signs include confusion, cramps, vomiting, and headache. If it goes on for too long, one could go into a coma, have seizures, and even die. 

Part of the issue is that we’ve been told how important it is to hydrate, however this may be an overcorrection and there is a history behind it. In the 1900’s, athletes were told not to drink during a sporting event. Then in the 1960’s, gatorade was invented by a physician at the University of Florida that improved performance for their football team. A whole industry was born around rehydration. As humans do, we overcorrected to the point where many athletes are now overhydrating (thanks to Precision Hydration for the history summary). There are lots of recommendations out there for strategies to optimally hydrate, but bearing in mind all the individual differences we have and all the factors that go into fluid balance, there is no one size fits all answer. Precision Hydration is an organization that has a free online test you can take to give you an idea of what you may need and will even give you a hydration plan. Check it out here. 

Stop With the Egg Whites Already

Ok, I’m guilty of this too. I was doing the egg white omelettes with wheat toast and no butter back in the day. I thought I was doing it right. It’s sad to think of all those yolks I wasted. 

The egg white, is about 90% water, and 10% protein. That’s it, there’s not much to the egg white. Egg yolks are so nutrient dense and they contain the macros and micros that you want. It’s about 60% fats, 35% protein, and the rest is carbs. Fats are good, particularly the saturated fats. Our nervous system is made primarily of fats and they are essential to survival. 

Additionally, egg yolks are a powerhouse of essential amino acids, vitamins, and minerals. For starters, they are a great source of: vitamins A, D, E, K, B1, B2, B5, folate, choline, and minerals calcium, iron, magnesium, phosphorus, potassium, selenium, and zinc. They raise HDL levels and lower triglycerides (which is what you want). 

So why have they been demonized? Cholesterol. Eggs are high in cholesterol. Let me start by saying cholesterol is good. Why would our bodies produce something that is bad for you. And oh yeah, all animals produce cholesterol. Is this an accident? I think not. In fact there is a condition called Smith-Lemli-Opitz syndrome that is a genetic mutation causing low levels of cholesterol and is deadly if not addressed. One way these patients do better is a prescription of egg yolks. So why are we told cholesterol is bad? 

It’s a long story, but the short of it is that cholesterol is transmitted by a molecule called LDL (what is typically called the ‘bad cholesterol’). It is more like a bus ushering the cholesterol into other cells. There is a ‘key card’ on the LDL’s surface; a protein called apo B. When the LDL arrives at a cell, the cell recognizes the key card, and lets the cholesterol in. Sometimes, the key card gets damaged, and the cells no longer allow the cholesterol in. This is part of what leads to plaques in arteries. So what leads to this damage? A diet high in sugar and industrial seed oils, aka the standard American diet. For more on this, check out this article. 

So as long as you avoid packaged goods and don’t have a cookie problem, egg yolks are one of the best foods you can have. 

Why People with Hypoglycemia Should Eat a Low Carb Diet

Whatever it is, the way you tell your story online can make all the difference.

As a child, I was diagnosed with hypoglycemia. I had the typical symptoms; I was tired, shaky, irritable, and would have brain fog. My parents were told to keep me away from sweets and for years, I didn’t have candy. I remember even having pancakes with syrup would cause severe nausea and I’d have to lay down. I never really understood that if I had low blood sugar (hypoglycemia), why would putting sugar in the system bother me? It would seem that would be the way to fix it.

As usual, the answer to this is much more nuanced as it is the human body. It’s not just a simple input/output machine. Part of the answer is due to homeostasis, and the other part has to do with the endocrine system. 

I’ll give an analogy for the way homeostasis works. Imagine driving on a highway on a cold night, and you hit a patch of black ice. You start to fishtail out of control and then overcorrect the steering wheel to now fishtail in the opposite direction, but to a lesser extent. You tug the wheel back and forth until you finally straighten back out. This is how our bodies react to rapid swings in blood chemistry. 

When you eat a meal high in carbs, the endocrine system reacts by overcorrecting, for individuals that are carb sensitive. Insulin is secreted by the pancreas and wipes out the sugar by ushering it into muscle cells and the liver. Now the body is in a hypoglycemic state. 

The traditional medical answer is usually to add more sugar back into the system, but that is addressing the symptom rather than the root cause. Why not just stop eating high carb meals? The carbs are causing the spike in insulin and subsequent drop in blood sugar. Carbs are non-essential to the human diet. We are able to produce glucose in our bodies via the liver in a process called gluconeogenesis. 

One of the issues that arises in type 2 diabetics is insulin resistance. All cells have receptors for insulin, and when someone has a diet of high carbs over long periods of time, the receptors for insulin become resistant, and the cells don’t allow glucose in. Insulin has many functions, one of which is to suppress gluconeogenesis. So when the liver becomes insulin resistant, gluconeogenesis is not suppressed (Hatting et al., 2017). So now the liver is producing glucose, and more glucose is flooding the body through the diet. Now we are in a hyperglycemic state, and this is where much of the damage of sugars occur, furthering the disease process of diabetes. 

Glucagon is another player in this situation. It has the opposite effect of insulin; it draws sugars out of cells back into the bloodstream. Why not increase glucagon in the diet when we are in a hypoglycemic state? Turns out that eating a moderate amount of protein can stimulate glucagon secretion (Schmid et al., 1989). 

In short, a diet low in carbs and high in proteins and fats will keep blood sugars at normoglycemic levels, and can prevent the development of metabolic dysfunction. 

References:

Hatting, M., Tavares, C. D., Sharabi, K., Rines, A. K., & Puigserver, P. (2017). Insulin regulation of gluconeogenesis. Annals of the New York Academy of Sciences, 1411(1), 21-35. doi:10.1111/nyas.13435

Schmid, R., Schusdziarra, V., Schulte-Frohlinde, E., Maier, V., & Classen, M. (1989). Role of amino acids in stimulation of POSTPRANDIAL INSULIN, Glucagon, and Pancreatic POLYPEPTIDE in humans. Pancreas, 4(3), 305-314. doi:10.1097/00006676-198906000-00006