May 14, 2024

Dear Melissa and Friends: Fueling Good Energy and Metabolic Health with Dr. Casey Means

Dear Melissa—Melissa Urban wearing a light blue jean top and darker blue jeans, cooking on a wooden table top, and smiling at the camera.

In this special Dear Melissa & Friends, Whole30 CEO Melissa Urban chats with Casey Means MD, co-founder of Levels Health and author of the new book, Good Energy: The Surprising Connection Between Metabolism and Limitless Health. Read on as Dr. Means breaks down buzzwords like “metabolism” and “inflammation” in truly accessible ways, and offers practical, actionable tips to improve your energy, sleep, and hormonal balance; and reduce your risk for chronic disease.

MU: Your book focuses on metabolic health as the foundation of health, vitality, energy, and longevity. What do you mean by metabolic health?

Dr. Means: Metabolic health refers to the set of cellular mechanisms that transform food into energy and that power every single cell in the body. The food we eat is the potential energy that our bodies then transform into usable energy to power the trillions of chemical reactions happening in our bodies every second. This conversion process of potential energy to usable energy is metabolism, and it is the most foundational aspect of health, because without power, nothing else works. I refer to metabolic health as being able to make “Good Energy” in the body, and most of this happens in the mitochondria, the “powerhouse” of the cells. 

When we have great metabolic health (or Good Energy), we are more likely to feel energized, calm, and free of chronic symptoms. When we don’t, it can contribute to (or directly cause) so many of the common symptoms and diseases we face in the U.S., ranging from depression, anxiety, infertility, gout, migraine, chronic pain, erectile dysfunction, arthritis, brain fog, belly fat, fatigue, acne, eczema, and ADHD—all the way to cancer, heart disease, stroke, type 2 diabetes, dementia, autoimmune disease, chronic liver disease, retinopathy, and more. All of these conditions are linked to metabolic dysfunctions; a fundamental underpowering of our cells. 

MU: We talk about inflammation a lot at Whole30. How is your metabolic health (or “Good Energy”) connected to inflammation?

Dr. Means: You can think of each of the forty trillion cells in the body as a little specialized machine that needs to do work all day, every day. Health is the result of all these cells doing their work well. To do all this work, cells need constant energy, and we get that energy through our metabolic processes. When the mitochondria become damaged, the cells don’t make enough power to do the work. This leaves them in a state of distress and dysfunction. A distressed cell will send out signals to the body asking for help (like a broken-down car calling for AAA). This causes the immune system to rev up a big fighting response. This is how metabolic dysfunction—a state of chronic underpowering of the cells—can lead to chronic inflammation. 

The things that hurt the mitochondria and cause metabolic dysfunction are mostly environmental and behavioral, like ultra-processed foods, chronic stress, lack of good sleep, environmental toxins, excess blue light at night. Because the instigators of the distress are outside the body, the immune system can’t help the distressed cell. (This is in contrast to something like an infection, where the immune system is capable of addressing and eliminating the problem, thus resolving the inflammation.) Unless the environmental triggers of metabolic dysfunction are resolved, the vicious cycle of metabolic dysfunction ➡ underpowered cells ➡ chronic inflammation continues. This is the root cause of most chronic diseases in the United States today, in all age groups 

It’s important to minimize inflammation, to support optimal metabolism and energy production in our cells. To do this, we should be supporting all the aspects of our diet, lifestyle, and environment that we know can hurt the mitochondria. Unprocessed, nutrient-dense foods; good sleep; stress management; non-toxic living; adequate sunlight during the day and avoidance of artificial light at night; and regular movement through the day all support our mitochondria and can help quell chronic inflammation. 

MU: What are some signs that your energy is “good”? And what are some signs that your energy is less than optimal?

Dr. Means: To understand if you’ve got Good Energy, there are two things you can focus on:

First, before going to labs or wearables, the best thing we can do is tune into our own body awareness! Our bodies are constantly speaking to us through our symptoms and intuition; our job is to slow down and listen. Symptoms are a signal from the body that the cells are not getting their needs met. Think of your cells as ­forty trillion infants in your care. Like infants, the cells can’t communicate with words, so symptoms are their way of wailing to get your attention and have their needs met. Every time a symptom crops up, I ask, What is my body trying to tell me? If my neck pain starts acting up, I look at my sleep and stress levels. If I have anxiety, I think about whether I’ve been exercising and how much alcohol I’ve had that week. If a pimple pops up out of the blue, I look at my sugar intake. If I have a headache, I think back on my hydration over the day. If I have PMS symptoms, I think about all the factors that may have affected my hormones differently that month, like fiber intake, alcohol, stress, and sleep.

Second, you can use your own personal biomarkers and lab tests. Now is the most exciting time in history, because we have the tools and technology today to “hear” our own bodies, and access to basic science to understand what our cells and bodies need to function. For example, wearables can help you understand how much activity and quality sleep you are actually getting, which are two critical inputs for metabolic health. (Research has shown that people significantly overestimate the amount they sleep, compared to their wearable sleep data. Similarly, studies show that some people overestimate their physical activity by six times compared to what wearables show.) There are also some simple lab tests your doctor can perform to know if your cells are making Good Energy. These include fasting glucose, triglycerides, HDL cholesterol, hemoglobin A1C, and blood pressure—many of which are free at your annual physical. Download my free guide How to Know if Your Cells are Making Good Energy.

MU: You have multiple chapters on creating a diet that promotes good metabolic health. How does the Whole30 play a role in promoting or restoring good energy?

Dr. Means: The mission of Whole30 and Good Energy are so synergistic: empowering people to eat more whole, real foods, and examine their relationship with ultra-processed foods, added sugar and alcohol.

Many people report after completing Whole30 that they have fewer cravings, and they feel more energetic, and happier. The reason for this is one of the principles from Good Energy—food cravings are feedback from your cells that you’re giving them mixed messages.

If your body is pushing you to acquire specific foods (cravings), that can be a signal that your human cells’ or your microbiome cells’ biological needs are not being­ met, and they are employing their tools—like hunger hormone ­secretion—to get you to aggressively seek food with the chance that you’ll eat something that scratches their fundamental itch. 

The best advice I can give anyone in transforming their health is to find a ­way—​­like the Whole 30—​­to stick with unprocessed, whole, nutrient-dense foods for just a month or two. By the end of this self-experiment, I can nearly guarantee that your preferences and cravings will have changed! 

Similar to Whole30, my approach involves totally transcending dietary dogma and food wars and focusing on what actually matters: the molecules and building blocks our cells need for optimal biologic function. Through this first principles lens, I boil down five elements of food we’d ideally get in every meal: antioxidants/micronutrients, fiber, healthy protein, omega-3 fats, and a probiotic source. Learning your favorite foods in each of these categories and stocking your kitchen with them is a great step towards creating an infinite variety of mix-and-match meals to support metabolic health. (This works whether you’re vegan, paleo, keto, or anything in between!) 

MU: If you were to offer ONE action item that can help cascade other health efforts to come, what would that be?

Dr. Means: The number one Good Energy habit that everyone could do, starting today, is eliminating refined added sugars from your diet. This is challenging, because compared to one hundred years ago, we are consuming astronomically more sugar (e.g., up to three thousand percent more liquid fructose), and it seems to be in everything from salad dressings to ketchup to prepared foods.

If you conscientiously reduce your added-sugar consumption, it will help you reduce your cravings and maintain stable blood-sugar levels, which reduces your chances of developing a chronic disease in the future. So where can you start? Start by reading all labels for any “added sugars,” and start making swaps for items in your home or pantry that might have added sugars.

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