JESSE: I was reading on your Twitter feed you had posted the 2012 study that you were part of that keeps still getting quoted. So, lack of exercise, major cause of chronic diseases. Is that what you did for your thesis or was that separate?
MATT: That was a separate project. So, when I was at the University of Missouri, I worked with this guy, Frank Booth. And Frank is really a pioneer of what I would say the physical inactivity science, and physical inactivity physiology. And basically, that is, sort of it is the opposite of being active, but not exactly. And it’s just saying that what we’re really interested in is, we know all of these different diseases are associated with physical inactivity, but we don’t really know what the trigger is. We don’t have a smoking gun for those.
So, a sort of analogy to that is, once smoking was determined to have like caused direct mutations in genes and have a direct cause to cancer, we had sort of a smoking gun, and all sorts of public policy changed around the idea of smoking, right. You can’t smoke in bars anymore, smoking in public places is sort of looked down upon. And it really changed the whole conversation around smoking. We don’t have the same thing for inactivity. Like smoking, we know it’s bad for you, but we don’t really have the sort of smoking gun, unintended, I guess, that can then allow, like massive policy changes to get people to be more active.
And part of that paper, which we wrote, which I wrote with Frank was to basically just take all of the evidence that we have, try to find all of the evidence we have, and all the different ways that inactivity is bad for us, and just put it all in one spot. And that’s why it’s become a pretty highly cited paper, and it’s a really good resource for students and researchers who are interested in what are the effects of inactivity to have. I mean, I think we have over 450 references on that paper. It took a year to write that thing. So, it wasn’t directly related to my thesis because it’s not in the original research, it’s more of a [??? 2:27] paper. But it’s related to sort of the topic and what I was studying while I was at the University of Missouri. Yeah.
JESSE: So, I mean, how do you classify inactivity? Is it obviously so many people now in the work office jobs and sitting down all day; do you classify it in terms of– I know, steps is really popular right now as a measure of activity. Do you classify in terms of steps do you like how do you actually quantify? So, that’s, quote-unquote, inactive.
MATT: Yeah. So, that is a difficult question. And one of the reasons why I think that researchers sort of struggle is because we use all these indirect measures of inactivity, we steps frequently, we use sitting time, or TV watching time, in epidemiology studies for inactivity. But an activity is essentially the the lack of any sort of muscle contraction. So, even walking would be something that would counter inactivity. It doesn’t necessarily have to be exercise, that’s countering inactivity, it can be just your sort of daily life and movement.
So, things that counter the sitting that we do and I guess it’s mostly defined by by how much sitting that we do is how inactive we actually are going to be. So, taking ways to sort of encourage standing, walking, being more accurate, are all things that can counter inactivity. But we don’t have like a definition saying, X amount of sitting is bad, or X length of time is bad. But you do see that even an hour of sitting, can sort of really reduce some metabolic effects, some metabolic benefits you get from just moving around slightly. Yeah.
JESSE: So, in an ideal world do we do we structure our society or in our, I guess let’s say, or cities, more like European cities, where there are less cars and more walkability? Or do you have an idea of how– I mean, we’ve got walking desks and all these things, but have you thought about– If you were to I guess, play God, but like, if you’re in charge of the Sims, and where the Sims and you’re redesigning our team, like what do you do that changes our everyday life?
MATT: Yeah, you just have to, I think a built-in environment is so important. So, having, I mean, I’m not a psychologist, but I think a lot of the changes will have to sort of make the active choice, the easy choice, right? Right now, the active choice is not the easy choice, it’s much easier to just get in the car and go rather than say, take public transportation or ride a bike to public transportation or things like that. And changing the environment of the cities itself is going to be critical to that. And so maybe that is changing a work environment in which you only have standing desks, and people just get used to it. Or there is just a culture of people taking walk breaks every hour. So, building that into sort of the environment, I think it’s going to be the key thing. If you’re going to redesign a city, it’s really changing the built-in environment that makes the easy choice to be active, and the hard choice is to get in the car and sit or things like that.
JESSE: Right. I know it’s not as easy as just saying fix it. There’s so much like red tape and funding and you already have infrastructure that set up. I have a friend who actually went to Davis and she does, what was it urban transport playing. She basically works on making, I think she still lives in Davis. Anyway, she’s, she works on making the city more bikeable, increasing accessible safe bike lanes and that kind of stuff. I know here in Kansas City, our public transport is horrendous. I, fortunately, moved to a neighborhood that’s much more walkable like I’m staring at the grocery store right now. It’s that that’s my house. So, I live in a very fortunate part of town, but much of our urban sprawl is you have to get in the car. And I kind of think about that in terms of, yeah, how do we make all these suburbs more like the one that I live in? It’s more walkable, just from a cultural standpoint.
MATT: You may want to have Eric on your podcast then because you know, he used to be the head of the bike K City. So, that’s his jam is sort of figuring out how to make the city more, your city more rideable and more public transport.
JESSE: Yeah, I’ll definitely have to reach out to him. I know they’ve got, ride K City Casey has all kinds of stuff going on right now. We’re trying to extend the streetcar line. And there’s new electric bikes, and they just came out with better scooters. There’s all the private companies doing the scooters, but they’re on the radio doing ads for their new scooters. And they’re really trying to work on like better public transport. So, yeah, I’ll have to talk to Eric about that or reach out to him and see if he’s willing to talk to me.
MATT: There is no one size fits all solution. And there’s no one sort of switch that you can flip and then everybody’s going to be–
JESSE: Everyone’s out walking and happy and active. Yeah, I know it’s not perfect. It’s a transition thing. I’ve seen a lot of things happening here, which I’ve been happy about. So, I was just curious of your opinion there.
MATT: One thing that I mean, maybe this feeds into more of the research and I can talk about, like the projects that I’m interested in right now, something that should be accepted fairly soon as the study that we did, looking at sort of the timing of exercise, versus meals. And so one of the key things is trying to keep your blood glucose levels low even after you eat, so that the postprandial hypoglycemia normally comes from when you eat something with a bunch of carbs, or even not with a ton of carbs, protein, you have a rise in blood glucose levels. And how much that rises is actually a predictor of health, cardiovascular mortality, overall mortality. And that’s not just in diabetics, but in healthy people as well.
And so we’re interested in, we know that exercise can lower blood glucose. And we know that even exercise, like a moderate amount of exercise an hour say, of aerobic intensity can definitely lower and limit the rise in blood glucose. But we want to see how little exercise or could you do and when would you want to do that? Would you want to do that right before a meal, right after a meal, say 30 minutes after a meal? When’s the ideal time to sort of get those muscles contracting and sort of get them ready to soak up the glucose? And so we looked at 30 minutes either before, right after or 30 minutes after about a 500 calorie meal. And the exercises that they did were really easy.
In fact, not even exercise. One arm of the study was just standing. Another arm was walking at like 2.3 miles per hour. So, super slow. And the other arm was doing some bodyweight exercises. So, just doing like 10 air squats, 5 lunges, 10, push-ups and some sit-ups. And we looked at then the blood glucose levels after the meal. And what we found is doing those exercises or those movements, that physical activity right after the meal, regardless of what type of activity it was, was the best way to lower blood glucose. So, one of the recommendations that if you’re going to be physically active, or to try to minimize physical inactivity is to do it at a specific time and minimize that physical interaction right after you eat. So, getting up and moving right after you haven’t meal seems to be important to sort of minimize that postprandial glucose spike that happens.
JESSE: Yeah. I’ve seen suggestions that like, say, you go for a walk after a meal, it aids in digestion, but I don’t know that I’d seen anything in particular about it affecting your blood glucose levels.
MATT: Yeah. And we’re really interested in making these very practical types of studies, things that people can actually do in a very free living sort of environment. So, this was like a breakfast meal. And so you know, there’s all sorts of caveats with research. And this research has the caveat of it was a liquid breakfast meal. So, apply to lunch and dinner, we can’t really say right now, just some sort of epidemiology evidence that it might. And then we don’t really know, does this apply equally well to diabetics. Do they need the same minimum amount of exercise, maybe they need a little bit more, maybe they have to walk a little bit faster. But it is a nice step forward and we’re going to continue to sort of explore this path.
That’s one of the things that, that I’m going to try to keep doing in the lab at College of Idaho to explore the sort of really practical free living, experimental stuff, especially because we have access now to these continuous glucose monitors that are amazing pieces of technology. They measure your glucose every five minutes, fairly non-invasively. You do not have to prick somebody’s finger 400 times. So, we have some tools that really allow us to gain some insight into like what people do in a non-laboratory, super well controlled environment. And that makes it a little bit trickier to do some of the study, but also makes it a little bit more applicable to the general public, at large. Yeah, so that’s one area that we’re focused on and moving towards.
JESSE: So, how did you decide on doing a liquid breakfast? I guess, when I think about and this is, I apologize if this is a dumb question. But I think about, I think about like recoveries products and stuff like that, it’s always like, general liquid, supposedly, because it absorbed faster. Is the liquid going to have, say having like a shake or whatever that liquid thing is for breakfast versus I’ll say, like a full English breakfast, assuming caloric intake is the same and like macro profile is the same. I mean, do you think that would affect that change of blood glucose level?
MATT: Definitely. I mean, you’re going to have a slower absorption of blood glucose with a more solid meal and depending on the glycemic index of that meal. So, is it processed carbohydrates or is it veggies and whole fruits and things like that? That in itself is going to change what that postprandial glucose looks like. So, there’s the potential that if you eat that, so-called healthier, less processed meal, that maybe you don’t need to actually stand up and move and the level of blood glucose is just going to remain fairly low after that meal. But you have to make decisions with studies is the what you’re going to do. And this is a great idea for the next study, right? Does the same thing hold true, we do a 500 calorie whole food breakfast rather than the fluid? So, that then requires bringing kids in, giving them a breakfast, making them some eggs in the lab, yeah.
JESSE: [??? 14:58] get away out of the portions, some of that will still be hungry, deal with all that. And then I would think, ideally– Would it make sense to…could, but wouldn’t it makes sense to try to use the exact same people that you used previously? Or would you want a new group so you could– I basically thinking about trying to control for, in variations in sensitivities to different foods?
MATT: Yeah. Well, people just different general, right. So, they’re gonna have different levels of digestion and absorption. So, it’s going to be faster or slower in some people so yeah, the best is always having the same people do the same studies over and over again. But this had 16 people in each of those different exercise or activity interventions. So, it was actually three different studies kind of, not with the 16 people in all three. But yeah, you start to run up against roadblocks in terms of how much time you can expect from subjects, especially when you’re not necessarily compensating them financially or anything, which I don’t have the resources to do. And it’s not like they’re getting a benefit of say, like a training benefit, like I’m not training them or anything. So, they might be learning something interesting about themselves, but that’s essentially the compensation that I’m giving them. So, they have to be volunteers, which makes it difficult to get people to come in and say, you’re doing four or five trials, and each one lasts two hours, that’s 8-10 hours of sort of time somebody.
JESSE: Just for their dedication to science and curiosity.
MATT: Yeah, I mean, maybe I can trick them with the credits. In some of my classes have tried to do that a little bit. Psychology Department requires students to volunteer and some other classes.
JESSE: Yes. We did that as well.
MATT: Yeah. But I haven’t gotten quite to that point.
JESSE: Okay. That kind of leads me into I think I saw that you are– kind of your interest and some of your focus is, studying the microbiome, gut microbiome. So, I think I saw you’ve done some stuff with ultra runners. Have you actually put together a study with them? Or are you just like trying to do independent measures like pulling that glucose level at various stages in the race? Or what do you do in working with them?
MATT: Yeah, so we got funding from Ultra Science Foundation, which is a foundation started by Marty Hoffman, who is the medical director at the Western States 100 for a long time. Western States is kind of the World Series of ultra running in the US, right. It’s the biggest ultra running race in the US. And that project was funded to collect biome samples, which essentially means fecal or poop samples from athletes. And the idea is that ultra runners have, like one of the main symptoms they have during races is GI issues, gastrointestinal issues like stomach problems, nausea, vomiting, etc. And the microbiome is known to be protective against a lot of these things. And one of the reasons they may have this GI issues from heat and just the physical exertion of an ultra.
So, as we get hotter, the gut becomes a sort of ischemic, and there become gaps in the sort of intestinal wall that allow bacteria to sort of move from the gut into the circulation. And those bacteria can then induce a sort of pro-inflammatory, what we call endotoxemia response, that induces cytokines, and that can do some of the Najah. And so we were wondering if different ultra runners had different microbiome that might be protective or not against the symptoms. So, we measured their gi symptoms during the, during the race itself, and then collected samples beforehand. And right now, that project is in the stage of– we’re trying to isolate the DNA still. And I’m working with the group at the University of Kentucky, who are sort of becoming pros in this area. And it’s just one of those things that given my lack of resources, lack of facility space that I can’t really do on campus.
So, I needed to find a collaborator to work on that with. And so it’s a little bit slower process than I would have liked and I would have liked to have the data by now. And I would have liked to have something written up by now. But it’s just one of the things about working on a small school, is making these projects come to fruition takes more time, and you have to be a little bit more creative. But I was really fascinated with how interested the runners were in the project, and how I was able to actually get a fairly high end. So, I had 50 people volunteer, and I only limit it at 50, because that’s all the sort of kits that I made up beforehand. And the race is capped at 400 people.
JESSE: Yeah, I mean that’s a pretty big–
MATT: Pretty big percentage of the athletes and they ranged from top 10 finishers all the way to just under the just at the deadline type finishers. So, I have a whole spectrum, whole age spectrum. And so I’m hoping that I can figure some sort of interesting, something interesting will come out of that data once we get it done. Yeah.