If listeners can take one thing away from this podcast and if they take nothing else away, take this away.

There are no shortcuts.

99.9% of the products and gimmicks and supplements that you are sold in health and wellness do not work.

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There is little to no regulation.

People can and will sell anything.

The only way to truly land on health and wellness is to put in the time and effort and the planning.

Hello and welcome to the November 14, 2025 edition of the Tridock Podcast.

I'm your host, Jeff Sankoff, emergency physician, a triathlete, a triathlon coach and a multiple Ironman finisher.

Coming to you as always from beautiful sunny Denver, Colorado.

The voice you heard at the top of the program was that of my guest today.

He is an exercise physiologist, he is a science communic and his name is Nick Teller.

Nick joined me from Scandinavia where he is in residence and working on a new book and he shares a similar interest to a guest I had pretty recently on my program, Dr. Jonathan Jarry.

In helping athletes sort out a lot of the misinformation and disinformation, yes, there is a difference between those two things that so permeates social media and is continuously influencing athletes and making decisions as to what kinds of things should be putting in their body and on their body to try and help them achieve the kind of results that they wish to in their training and racing.

The kinds of things that we try to help dispel on this podcast.

Well, Nick works very hard to try and help athletes understand how to sort through all of the chaff and really make the best decisions when it comes to understanding what they're reading, what they're hearing, what they're seeing, and make good decisions for their health and wellness.

He is going to join me a little bit later on the program and I think you will enjoy that conversation very much.

Before we get to that, the medical mailbag has a somewhat light hearted, almost, I don't know, whimsical kind of conversation about a subject that was sent in by a listener.

We are going to be talking about earthing or grounding.

It's a little bit out there.

It doesn't completely tie into multi sport, but you will hear that it does have some connections we had.

I don't know, I want to say a little bit of fun trying to answer this question, but I think you will at least appreciate that we are here at the Tridoc podcast, putting in the work, getting to the bottom of these questions so that you have a better understanding of what's coming across the airwaves.

This was a question that was submitted after one of our listeners saw something on Amazon prime of all places, a very well funded and slick documentary about this subject, Earthing or grounding.

And we are going to look into the science around that sub and that's going to be coming up in a short bit.

Now, as you know, I have just recently returned from Marbella, Spain where I got to participate in the Ironman 70.3 World Championships.

It was quite a spectacular event, specifically when it comes to the professionals who had just an amazing day of racing.

We have really been treated to quite a series of races of championship races for the professionals going back to Nice in September and then of course the epic day in October of women racing for the Ironman World Championships.

And then we had both the women and the men in Marbella, both of whom provided us with just tremendous days of racing.

To see Lucy Charles Barkley and Taylor Knibb come back from their epic collapses in Kona and be able to perform at the highest level and in fact finish 12 on the podium was in my mind quite surprising.

I didn't think both of them or either either of them really would be able to perform at that level in such a short time after the kind of physiologic stre that they endured in Hawaii.

But there they were doing exactly what they did, leading from pretty much the get go and holding off the rest of the field the whole way.

And Lucy Charles establishing herself as the two time 70.3 World Championship, separated by what, a couple of years, I guess in between her two championships, but still showing that she remains a dominant force at that distance.

And really it was quite a performance on the men's side, an epic sprint finish that nobody saw apparently because the broadcast once again Ironman distinguishing itself in not exactly the right way.

They had a phenomenal location for a race, scenic, really beautiful.

And then the whole thing went apart in the last, what hundred meters as Yellow Gaines and Christian Blummenfeld were sprinting to the finish.

The broadcast apparently did not hold up and people didn't actually see what happened.

And I understand not having watched it myself because I was participating that the commentary was its usual, shall we say, subpar performance, led by the usual tag team of Rinny and Mike Lovato who did not distinguish themselves yet again.

So as we look ahead we have to wonder whether or not Ironman is going to listen to the people who actually watch these programs and update their broadcast.

Are they going to try and professionalize the broadcasts and make it something that we all want to watch and listen to?

I don't know.

I don't have an answer to this.

I certainly hope that they will because I for one, really enjoy watching the professional races.

I don't turn the audio on because I find it just not worth listening to.

And I would really prefer that it was something that I could think of as much see, much must, must see viewing.

And the only way that that's going to happen is if they invest a little bit of money, a little bit of time into improving.

Will they do that?

I'm not terribly optimistic.

I know that my partner at our sister podcast, the Tempo Talks podcast, Matt Sharpe, he thinks that a tipping point has been reached and that Ironman is going to have to do something to improve the quality of broadcast.

We'll see.

We can only hope.

As to the event in Marbella itself, I came away with kind of a plus minus sort of feeling about the whole thing.

The course itself was spectacular.

It was very, very difficult.

The swim in the ocean was fine.

A lot of turns kind of made it slow for everybody.

Certainly the best swimmers had their usual time, but for people who were kind of average swimmers like myself, our times were really impacted by the constant turns on the course.

That is not a knock on the course itself.

It's more knock on the swimmers like me who just aren't able to manage a course like that.

I actually enjoyed the swim course though.

The number of turns actually made it a little bit easier to manage mentally.

It slowed my time down coming out of the water and onto what was the most difficult bike course I've ever had to contend with.

It was still one that I had trained for and actually felt like I managed quite well.

The descents were insanely fast.

I hit the fastest speed I've ever hit on a bike, which was 49 miles an hour and it was just amazing.

The roads were great, there was still drafting.

Amazingly, I was quite surprised to see packs of 29 year olds going by me the way they did.

There was.

There was very little presence of officials on the road.

Penalty tents were empty the whole time.

I was quite surprised by that.

But here's what it is.

It didn't affect me, didn't bother my race because I wasn't competing against those guys.

The climbs were long, they were difficult and they definitely made the run that much more difficult as well.

The run profile looked a lot flatter than the run actually was.

The run was actually quite difficult and the setting for the run was great.

It was very well supported, tons of crowd support, and it just made for a really fun day, a fundraise to do.

Now, there were a lot of negatives about Marbella.

The organizational logistics were really terrible.

Honestly, the worst of any 70.3 worlds that I've ever done.

And that's going to be something that's going to be discussed in much more detail on the Tempo Talks podcast, which is also coming out today.

It's delayed.

Matt and I have had some scheduling issues, so it will be out, but it will probably won't be out until much later today or even tomorrow.

So I encourage you to look that up if you're not already a listener and you can hear my thoughts as well as Matt's and our discussion about the logistics and the just the overall kind of experience of Marbella.

That will be a subject that we will get into in much more detail on Tempo Talks here on the Tridark podcast, though, we are going to move straight into the conversation around grounding or earthing.

And that's on the Medical Mailbag segment.

And then after that, my interview with Nick Deller.

And that's all coming up right after this break.

All right, everybody, it is time once again for the Medical Mailbag.

Now, it's a weird kind of timing thing for Juliet and I because we're recording this just a couple days after we recorded our last episode, but this one won't come out until after I get back from Marbella, so we can't really talk about how things went, even though we should, because when you hear this, it will be after Marbella.

And my monologue, my opening monologue to this program, will have discussed how things went in Marbella, but we are not going to be able to.

I guess we could make it up.

No.

Yes.

Amazing Race.

Oh, it was so good.

I had so much fun.

I don't want to jinx it, though.

I don't want to jinx it.

So, yeah, let's.

No, we'll do it.

We'll do it in the next episode, which will then be 10 days after, and everyone's going to be sick of hearing that.

We're still going to talk about it.

That's o.

Okay.

Yeah, we will have fun doing that.

But I just wanted to explain to everybody the reason we're doing this is because I get back kind of midweek.

I get back Tuesday, the week that the next episode is out, and I didn't want to have to scramble to try and record and then edit and then get the episode out.

So Juliet very kindly agreed to do two episodes this week.

I am at the same time recording two episodes with Matt.

So it's been a very busy week.

Yes.

And you did the webinar on 70.3 worlds.

You've been a big, busy man week.

It's been a hectic week.

I haven't even started packing.

So that's.

That's my next.

That's my next thing to do.

Fortunately, I'm off work tomorrow, so I'll have some time to do that.

We.

With all that said, we do have a medical mailbag.

And I'm happy to say it's a listener question, though maybe.

I don't know.

We are excited to talk about this topic.

Okay, I'm just gonna take the mic away.

All right.

I am driving across Massachusetts when I was back there last week, and.

And my partner in crime here said, this is what we're talking about for the next medical mailbag.

And he then sends me a link for a movie, which is like an hour and a half long.

And I'm thinking, oh, my gosh, I'm gonna have to watch this one movie before I talk about the medical.

And so don't do this at home, friends.

I started to listen to it while I was driving.

Cause it's a good thing to do, like listening to a podcast.

And I put it on 1.2 speed, and then I put it on 1.5 speed, and then I put it On 2.0 speed, and.

Because it was crazy.

And so this question comes to us from a listener named Jesse from Sebastopol, and he is really.

Honestly, he's really writing us more for marital advice than he is for this particular medical topic.

Because apparently his partner, his wife, was watching this documentary in the adjoining room, and Jesse was dragged into it and just could not believe what he was seeing on the screen.

And as Dr. Jeff Sankoff, if he could kindly weigh in with a little bit more data and a little bit more research than this documentary, which is obviously very pro this topic.

So what we are talking about is called earthing, which apparently is the process of returning to the earth.

And what we mean by that is having quite literally more contact through our bare feet with the Mother Earth, on the grass, on the sand, on the whatever.

But other words, you can't just walk around your house barefoot.

You actually have to be outside walking around on the field or a park or whatever it is.

And there were a number of advocates for this, they interviewed a number of different people in the documentary.

It all started with a young couple who was trying to heal their daughter, and they had tried everything.

And then it went on to the story of this very successful cable executive who had everything, had all the money, had all the time, and was still not fulfilled and satisfied and was ill and everything else.

And so he decided he wanted to.

Instead of watching electrons go through cables, he wanted to figure out how to electrons through his body and on it goes.

But the idea is that through Renewed, through returning to our roots and returning to contact with Mother Earth, by letting the Earth's natural forces flow up through our bare feet, we can heal many ills.

So, yeah.

Do you have anything else to add in terms of background there, Jeff?

That's pretty good.

I think we should probably just.

Okay, so the science of the electrical science.

Everybody knows lightning strikes only go one direction.

They come from the sky, and they always go to the Earth, to the Earth.

And the reason for that is because the Earth is this huge electron sink.

It basically has a enormous potential to absorb electrons.

And when you have.

In a lightning storm, you have a gigantic amount of static electricity that builds up in clouds where you have friction of dust and raindrops and all of this stuff happening in a cloud.

It creates this gigantic negative charge and it's attracted to the ground where it can.

The electrons can just be absorbed.

And so that's why you get this lightning strike.

Similarly, you have to ground all of your house.

Your house is grounded because you actually.

There actually is.

If you go to your basement and find wherever your fuse box or wherever your circuit breaker box is, there is actually this big copper wire that essentially just goes into the ground because that is how your home is grounded.

You basically, any kind of short circuit or any kind of surge of power will eventually flow its way through that copper wire into the Earth.

Because the Earth can absorb this enormous amount.

It's just an almost infinite amount of capacity to absorb electrons.

So I'm not.

We couldn't really figure out exactly where this kind of idea came from as far as we could tell.

Gwyneth Paltrow has something to do with it in terms of its rebirth.

Right.

Which.

Which is never a good sign, but it's been around for a long time.

The idea is that our physiologic processes, our diet inflammatory things, tends to build up these negative charges.

And.

Oh, no, if we have all these negative charges, all these free electrons running around, that can't be good.

And so if we could just ground Ourselves.

And it does.

If you remember Pretty Woman, you remember Richard Gere.

She tells Richard Gere, you really just need to walk in the grass barefoot, and that's going to solve all your ills.

And off he goes and he walks in the grass.

And, yeah, he becomes a better man for it.

And my favorite Christmas movie, we're soon going to start talking about that again.

Oh, boy, here he is, right?

Takes his socks off, fists with his toes to relax, and suddenly he feels better.

Clearly, Hollywood has unknowingly embraced this concept of grounding.

So the idea is that by getting in touch with the earth and allowing your electrical discharge to flow through your feet down into Mother Earth, you can somehow decompress.

De Just.

I don't even know what to call it, but.

Right.

Jess's question to me was, in essence, like reading between the lines.

Is this a bunch of malarkey?

And I would say it's probably malarkey.

The problem is nobody's really done great studies on this.

No.

I was left with a lot of questions, but let's just talk about what we did find.

Cosette Rhodes was the Internet, who begrudgingly took this on.

I told her also she had to watch the movie, and, oh, my gosh, she was game.

She was game.

But she came back and she was pretty much giggling and rolling her eyes about the whole thing, because it does it.

It is not particularly scientific.

We found a single study that had anything to do with athletes, and it looked at whether or not this kind of concept of grounding could actually help with delayed onset muscle soreness, which, hey, that's good.

It does not, unsurprisingly, again, it might feel good to walk around barefoot in the grass as long as there's no creepy crawlies in there.

But it didn't do anything to change any objective measures.

It did change, apparently, creatine kinase, which is a marker of muscle breakdown, and we've talked about this in the past.

You could find changes in these kinds of biochemical markers, but if you can't see a change in actual measures, then does it really matter?

So that's what we're left with there.

We did find some other studies that basically said, look there.

There's a bunch of very preliminary, kind of suggestive supporting.

If you squint funny and you look in the right light there, there is some evidence that this kind of idea of grounding, otherwise known as earthing, may have some impact on physiology and could improve some certain health incomes.

And all of the keywords here are may and could because there's really no obvious, there's no good evidence here.

Nothing has been done to really investigate this in any really good clear way.

Most of the stuff that's been done has been a lot of theoretical.

We think this is good because.

But nothing has been done to really show that it would be.

And I know you and I were both left with questions like why do you need to do this outside your house?

Is scrounge, Grounded, Grounded part of your house?

Unless you live in an apartment building where you, I mean your apartment is grounded as well.

But when you live in a concrete sort of floors apartment building, you are somewhat detached.

It's not.

You are not totally insulated.

You still have a connection.

But when you know you're in your house, certainly if you live in a single level house, you're pretty grounded, pretty close.

So why not walk around there?

Last year or last episode we talked about this concept of confounding principles.

If you go outside and walk around outside, that's going to be good for you no matter what.

And if you walk around outside in a really nice place where you can take your shoes off and actually go barefoot, even better because that means it's clean and you can.

Mindfulness slowing down.

We know all of this is good for you.

I know.

See, we're all rolling our eyes, right?

I know this.

But yeah, people get outside, go walk across the.

Go walk across the field.

You'll feel better.

The other thing is they talked a lot about how oh disease really came to.

It was the invention of shoes that led to all of our problems.

All of our problems come from the developers.

But no, not just any shoes.

Rubber soled shoes.

Rubber soled shoes, not moccasins.

Right.

And so I was like, but rubber soled shoes are a fairly more recent thing and we don't wear rubber soled shoes all the time.

Many of us do wear leather soled shoes or alternative soles.

So I found myself wondering.

This seems like a bit of a stretch.

I love when they were connecting their beds through a wire out the window to touch the ground so that the bed could be grounded.

That was good.

Anyway, Jess.

Yeah, we feel confident in letting you tell your wife that.

Looks, look once again, not going to hurt you unless you're out there during a lightning storm.

But we think this is very much overblown in this documentary.

Very much overhyped in terms of its ability to really do much of anything.

And like Juliet said, I think the psychological well being is not to be scoffed at.

But at the same time I think that's probably the most you're going to get out of this.

The miracle anecdotes that are presented in the documentary are laughable in that.

Come on, Seriously.

All I could think of when I was watching the video is cursing Jeff and thinking, God, this is an hour I'm never gonna get back.

These are the sacrifices that we make.

For our medical mailbag.

Yeah, this is.

They don't understand how much duress we put ourselves through.

All right, we're not gonna belabor this because honestly, it's.

It's not.

There's not that much to it.

I did want to bring it up, though, because, hey, it was a listener submitted question and I so appreciate those.

And, guys, I gotta tell you, we're coming towards the end of the year and the medical mailbag is running dry, so if you've got questions, please send them on in.

Yeah, I mean, there's all kinds of stuff I know going on out there, and I'm sure you've got questions, so don't be shy.

Listen, we'll take on earthing.

We are here.

We are here.

We're here for you.

We're obviously scraping the bottom of the barrel if we're talking about earthing.

But actually, before we leave, you wanted to bring up some of the results you found or some of your thoughts about this brand new study.

Very preliminary, but interesting.

Let's swing it back around one more time to creatine.

Yeah.

And I wanted to bring this back because when Griffin McMath was here and joined me for.

When you were away in Switzerland and we talked about creatine again, we spent a bit of time talking about the benefits of creatine on mental health and on post concussion syndrome and even cognitive decline, its ability to prevent cognitive decline.

So I think for me, my takeaway from that episode was, look, as an endurance athlete, I'm not going to use creatine, but as an aging individual, creatine does seem interesting, and I'm going to pay more attention to that kind of literature.

So just this week, a paper came out and I sent it to you and a couple I sent to my wife and some other friends who are in the same kind of demographic.

And basically, this paper looked at creatine and its ability to impact cognitive.

A cognitive decline in menopause.

Right.

And we know that, Juliette, you've talked about it before.

We've heard other guests talk about it.

That as you get into that perimenopause and then into menopause, you go through this period where Your mind just seems to be mush.

Describe that for us again.

Let the younger listeners know what they can look forward to.

I'll preface by saying what we've all heard a thousand times is that menopause is very different experience for everybody.

There is no one single menopause journey.

And so I can only speak about one of the symptoms that I can speak about many of the symptoms, but the one that we're talking about.

And it doesn't affect everybody.

But.

And that is just one of brain fog.

Like, you go from.

From what feels like an incredibly capable, highly functioning woman who can handle many things at once and crank through a day to just feeling like your brain is underwater.

And when it's not underwater, it's wildly fluctuating between incredibly optimistic about all things on earth and oh my gosh, my life is going to hell in a handbasket.

So there's all kinds of stuff that's happening just to the brain alone.

Forget about the physical sort of manifestations of menopause cause.

But the thought is that creatine could help a little bit with the mental piece.

Sandra came across this thing on social media that she thought was hilarious.

It cougar puberty.

Have you heard about this?

Is the new way of referring to menopause.

Oh, I wish.

It made us feel like a cougar.

She.

She sends me some of these reels where it's.

It's like teenage boys or teenage girl saying, my mom is going through cougar puberty.

And then they'll show mom, like eating a gallon of ice cream or something.

It's just a typical sort of stereotypical menopause anyways.

So the.

What you're describing is very well known and very well described.

And basically the genesis of it is just estrogen is a vital hormone for brain health.

And when estrogen just disappears, as it does in menopause, it causes alterations in brain activity and brain physiology.

And one of the main things that happens is the brain just becomes the brain cells.

The neurons become much less able to handle the demands that are needed when you have to do things that require a lot of energy.

So it doesn't make use of glucose as well.

It doesn't produce and store ATP as well.

And so those neurons, when you suddenly, when you have a cognitive test for those neurons, they just.

They aren't as snappy as they were when you were before menopause giving creatine.

What that does is creatine gets into the brain.

And this study actually showed.

So it looked at, it gave women 750 milligrams of creatine a day versus 1.5 grams of sort or 1500 milligrams of creatine a day.

And those were both of creatine hydrochloride.

And then they gave another.

A third group, I believe it was 1500 milligrams of creatine monohydrate.

And then they gave.

And then they had a fourth group that was placebo.

So good, well designed study.

The only negative, it was very small.

It was only nine people in each group.

So that was one of the first negatives.

But still, it's.

It was still enough to see a difference.

And they saw a big difference in that the 1500 milligrams a day clearly stood out in terms of cognitive capacity.

Over the four weeks, they were much quicker to be able to react and do the tests that they were being given.

And it was quite striking.

And the reason is because the creatine, they were able to show with these specialized scans that the creatine was getting into the neurons and was actually gather.

It was.

There was large amounts of creatine in those cells.

And creatine works as like an energy buffer and actually improves the energy transfer system by virtue of its creatine creatine phosphate.

And it's a buffer for phosphate.

And so it helps with ATP formation.

And so these neurons were basically getting like a boost.

It was like a Red Bull or a monster for your neurons.

Right.

And I thought it was fascinating.

Now, there were definitely huge limitations to the study.

It is not a definitive study.

It should not be taken as the final word because it needs to be repeated on a larger scale.

But it's still really interesting and intriguing and just one more kind of piece of information that for women and I, I'd be fascinated to know if this was similar for men, because we've seen some of the other studies have shown that it helps with men's cognitive function as well.

But for women who are menopausal and having these kind of cognitive difficulties, this may be a way to.

To get around it.

And it's not huge amounts.

1500 milligrams is a much smaller amount than what we see for putting on muscle.

Yeah.

So I thought it was fascinating.

I think it's a really interesting study.

The limitations.

I just want to get back to the limitations.

I think the major limitation, besides the small sample size, sample size was the fact that they did not stratify the dosages by weight.

So you had women who were very small taking 1500mg and then you had women who were very large.

So the milligrams per kilogram was not nearly the same in those women.

So it'd be interesting.

You would hope to see a dose response that was based on milligrams per kilogram.

So that would be.

Those would be the two major limitations.

But I still think, very promising, very interesting, and I hope more to come.

And as our listeners know from time to time, when we see something that is tickling around the edges of being effective, we go ahead and try it ourselves.

Right.

Like you are trying better a lumos mask right now before you head off.

It's not Lumos.

Yes, it is.

Yes.

Yeah.

Before you head off to worlds to see if it helps with your jet lag, we both experimented with tart cherry juice, spirulina, which we found through the research to be effective.

So I just, I went and bought a jar of creatine.

I'm not a big supplement user, but I started it this morning.

750 in the morning, 750 at night.

That's like 1500 a day.

That, that one test group that had the best results.

And I have to tell you, after only one dose, I got the wordle in three.

I got the medium pips in under a minute.

So clearly it's already having a huge effect.

And I can't wait to report back.

If I get the hard pips in under two minutes, I'm sold.

It's only $30 for 90 servings.

Okay, so first of all, $30 for 90 servings is great.

Yes, 90 servings.

What?

Sorry, that's 45 days.

That's 45 days.

That's 1500 a day.

30 bucks.

$30 less days.

No, not bad.

I got it off Amazon.

I bought the hydrochloride.

Yeah.

And it came in capsule form, so you don't have to deal with the problem.

No, no capsules for sure.

If you're a wordle player, listen up.

This might be the ticket in three.

People pips is even harder.

Medium pips are under a minute.

Yes.

Anyway, let's let you know.

Okay.

If you have a question about creatine, we've answered creatine a few times.

But if you have other questions about creatine, if you have questions about something esoteric like grounding or something really tri related, we want to know.

So please go ahead, reach out.

You can reach us in the Facebook group.

If you're not a member, just answer the easy questions.

We'll gain you admittance.

If that doesn't suit your fancy, then send me an email tri docloud.com I'd love to hear from you.

We'd love to take on your questions in a future medical mailbag.

For now, though, we are going to say goodbye, Juliet.

We will pick up this conversation and talk about what went down in Marbella in our next episode.

Wait.

Good luck.

The Tridoc community will be cheering you on.

It's funny we're saying good luck, but I've already.

I know it's going to be.

I know.

Whatever.

All right, take care, everybody.

We'll talk to you soon.

And thanks, Juliet.

Okay, bye.

Bye.

If you heard my show a couple of episodes ago where I interviewed Jonathan Jarry, then you know that I am starting a series of interviews where I'm going to be talking to people about science disinformation, a subject that basically is the whole raison d' etre for this program in the first place.

As you know from the medical mailbag, we every single episode tackle some kind of subject related to multisport and endurance athletes, and we look at the actual science behind the claims being made by the manufacturers and promoters of whatever it is that we are discussing.

And invariably, you know that there's a big disconnect.

Unfortunately, in the current environment, we're seeing disinformation really run amok, and it is taking its form across governments, it's taking its form very much in social media.

And it has impacts on public health, and it definitely has impacts on us and endurance athletes in terms of what we choose to put in ourselves, how we choose to train, how we choose to recover.

And as I am a big advocate for, choosing the big things that will actually make us better humans, better performers as athletes, and staying away from these little trivial things.

So with all of that said, my guest today is Dr. Nick Tiller.

He is a physiologist, he's a researcher and a science communicator.

Similar to Jonathan Jerry, who was at my alma mater, McGill, Nick specializes in exercise science and the myths of the modern wellness industry.

He is a research associate at the Lundquist Institute for Biomedical Innovation at Harbor UCLA Medical center and the author of the Skeptics Guide to Sports Science, named one of the best sports science books of all time.

He is a regular contributor to Skeptical Inquirer, Ultrarunning Magazine and other outlets, where he examines the intersection of health, wellness and consumer culture.

In 2023, he was elected Fellow of the Committee for Skeptical Inquiry for his efforts to promote science literacy.

And when he's not in the lab or writing Nick is also an accomplished ultramarathon runner, bringing both professional expertise and lived experience to conversations about health, performance and the wellness marketplace.

I am thrilled to have some of his time.

He's joining me from Norway, just outside of Oslo, where he lives with his wife.

Nick, thank you so much for joining me today on the Tridoc podcast.

It's a pleasure to be here.

Thanks for the invitation, Nick.

We are, as I mentioned, inundated with disinformation.

It's coming fast and furious.

Social media has been, as much as it can be, a positive.

I think I know several people who find it to be a great outlet.

It's been an avenue for them.

It's really a big negative, I think, for our teenage children who are influenced by it and are overtaken by it, but it's also a big negative for our society as a whole.

What are some of your main concerns that you've written about that you, you've continued to look at in terms of how the wellness industry has really co opted pseudoscience and promotes kind of snake oil to us as athletes and consumers?

Yeah, and actually in your introduction you touched on a bunch of really important topics.

The first one being that we're absolutely inundated with information and misinformation and disinformation.

And the difference between the two, of course, is misinformation is something that is spread inadvertently by people sharing a link that they haven't vetted or telling somebody some kind of conventional wisdom that turns out to be false.

So this is information that is wrong, that is shared inadvertently by people who are just careless, really.

Disinformation is something that is incorrect information that is deliberately spread by people who want to influence the way that you think, your behaviors, your buying habits and so forth.

And we're absolutely inundated with both misinformation and disinformation.

The other thing that you touched upon is how, I don't know, the average age of your listeners, probably you and I can remember a time before smartphones and social media ruled our lives.

So at least we have that frame of reference for how things have changed.

My biggest concern, or one of my main concerns, is how the the young generation, Gen Z's, they've never known a time without social media and smartphones.

So this is ingrained in their lives in a way that we can't possibly even comprehend.

And I'm working on my new book, which will be out next year, called the Health and Wellness Lie.

And in it I recount this very brief anecdote about my niece who is now 12 years old, but when she was 18 months, I remember her crawling along the floor picking up a photo frame.

And this is before she could talk, pretty much.

And she starts swiping her finger across the glass, expecting the image to change and because she thought it was an iPad.

And so these technologies are integrated in, in our lives now in a way that there's no going back, basically.

And the other thing just to mention is that I absolutely think that social media has had a net negative effect on the way that we communicate, on the way that we share information.

Yes, it's brought so many positives, but when you look at the main avenues for how misinformation and disinformation are spread now, it's almost exclusively through social media, or you could say more broadly digital media.

But it's digital and social media, and these have become some of the main outlets for marketing and marketing misinformation that there is little to no regulation in health and wellness.

There is little.

There is no regulation on social media.

There probably should be, but these are largely private platforms, so they have no legal obligation to control the content that they share.

And why would they, when we know that incorrect information, falsehoods, fake news, if you like, are spread further, farther and deeper on social media than correct information in any category.

And that's because the stuff that gets, that's the stuff that gets the most engagement, that's the stuff that makes people feel, that makes people react, that makes people engage with the content is the more sensational stuff.

So when you think about how health and wellness interacts with social media and smartphone addiction, which basically afflicts everyone, it's the perfect storm.

And health and wellness has been evolving for many decades, but it was waiting for something like social media to come along because it's got marketing devices in the pockets of every man, woman and child on the planet.

You said so many things there that I know.

Sorry, follow up on.

No, it's great.

One of the things I recognize in myself and compare to, say, my kids or I try to instill this in my kids, is that we have as a society lost the ability to be skeptical.

And so whatever we see, we immediately, we just assume it's truthful.

And especially with AI coming out now, the AI stuff is really scary.

And so we have lost the ability to discern in terms of how to process the information we're receiving before we just accept it as truth and then forward it on.

And to me, that's been a major shortcoming of all of us.

And it's been something that these wellness influencers are very quick to just grab onto.

How can we regain that control without just putting down our devices?

Because let's face it, I agree with you.

I don't think that's going to happen.

So how can we regain a modicum of skepticism to not just react when we see something and instead pause?

Because I try to teach my listeners all the time the golden rule is if it sounds too good to be true, it is.

And if something's coming across promising you easy answers, the likelihood is those easy answers are not real.

Because if they were, we would have known about this before whoever it is telling you them.

So how do we regain this healthy skepticism?

Yeah, two things have happened.

You're absolutely right in that our critical faculties have been slowly eroded over time.

But I think the main thing that's happened is that the health and wellness industry has evolved to be better at exploiting our cognitive frailties, our biases to begin with.

I think those biases are always there.

But whereas a few decades ago, 50 years ago, we basically got most of our news information from either the TV or newspapers were still widely circulated or magazines, if you go back a hundred years, there were just a few magazines and newspapers that were in charge that were responsible for the vast majority of news stories.

There was less competition and they were able to put more time into producing quality content as a opposed to quantity.

Now we are bombarded with so much information, we have information overload.

So it's difficult to discern the good from the bad information.

But also marketing and social media and health and wellness intertwined within that have evolved very specifically to target our cognitive frailties.

So it's not just that our cognitive, cognitive faculties have degraded over time because we're reading less, because we're, we have more fractured attention and so forth forth.

But the marketing landscape has evolved to make us much easier targets.

To answer your question, then it means that we've got to upgrade our, our critical thinking machinery.

We can't just rely on the fact that we, we're pretty good at telling when somebody's lying.

It's not just good.

It's not good enough to be able to think.

I'm a intelligent individual.

I can read an article and know that whether it's telling me the truth or not, we've actually got to do some work to reclaim some of the power.

And just like you wouldn't expect to wake up tomorrow morning learning being able to speak a new language or being able to shred on the guitar or you wouldn't turn up to an ironman.

Two days of training.

It takes time to develop these skills, to develop these.

These faculties.

So it means.

Yes, it means reading, it means listening to podcasts like this.

It means watching lectures, it means maybe even going to evening classes on critical thinking and scientific skepticism, whatever it is.

It means putting in the time to sharpen your critical faculties.

Because the information landscape is evolving, as I've said, it's evolving specifically to target our cognitive biases, to get us to buy things that we don't need, to get us to believe ideologies that are harmful.

And so we've got to put in the work to make the requisite changes, otherwise we're just going to be prey.

Could you expand a little bit on what you mean by the cognitive frailties and the cognitive biases?

Because I think for myself, one of the easy ones for me is we are inherently lazy.

We don't want to put in the work.

If somebody's going to promise us an easy fix to a problem, I can give you Product X and it's going to make you faster than your competitor.

Without doing any extra work, you're automatically going to default to, oh, I want Product X.

So I think of that as a cognitive bias or frailty.

What other ones or what inherent ones do you think of when you.

When I'm asking specifically, because I want people to be aware of how they're being targeted by these very savvy marketers and wellness influencers.

Yeah, absolutely.

So the best thing to do is just to give your listeners some examples.

There are hundreds of what we call logical fallacies.

These are informal fallacies of logic, and they're basically, I guess you could call them mistakes or errors in reasoning that basically oftentimes leads us to making bad decisions.

So in health and wellness, probably about a dozen come up time and time again.

One of them would be the appeal to nature, which people are probably very familiar with.

And that is the idea that something that is natural is inherently good and something that is unnatural is inherently bad.

And the example I always give, I used to, when I was teaching, I used to ask my students, used to take them through this thought experiment, and it went like this.

If you had in one hand a teaspoon of sugar that was cultivated in a lab, synthetic sugar, synthetic sucrose, table sugar.

And in the other hand, you had the exact same stuff, but it was natural.

It was grown in a field and harvested from a plant and turned into sugar.

Sugar.

And they're absolutely identical in every way.

But one of them's natural, one of them's synthetic.

Which one would you rather put in your tea or coffee?

And almost every single hand shoots up and they'd say, oh, I'd rather have the natural one.

And I would always ask why?

And the answer is, inevitably, I'd rather put something natural in my body than unnatural.

But the reality is, if these two sugars are identical, if you look at them under a very high powered microscope, they have the exact same chemical structure, they'll have the exact same effect on the body when you consume them.

They'll spike your blood glucose, they'll cause a short rise in your insulin levels.

There's absolutely no reason to favor the natural one over the synthetic one.

This is a bias, a cognitive bias that is very easy to exploit.

For some reason, we've evolved this idea that natural is better.

And so now you see products that are advertised ad nauseam with natural ingredients, all natural ingredients derived from nature.

You'll see the best example.

The best example is cane sugar versus corn syrup.

Exactly.

Yeah.

A high fructose corn syrup is.

It has, is basically just sucrose that has the chemical bond broken and it has a slightly higher concentration of fructose, but it's just sugar.

It's just liquid sugar.

Same calories, same everything.

As soon as you put table sugar in your mouth and your saliva starts to break it down into liquid, it basically becomes high fructose corn syrup, but just with slightly less fructose.

So it's has basically an identical effect on the body.

Yeah, but everybody has demonized high fructose corn syrup because it's unnatural.

And a lot of organic food is sold on the basis that it's natural GMO food, or, sorry, the anti GMO movement is derived a lot because of this appeal to nature bias.

But actually, when you break it down, there is no logical reason to favor something that is natural.

It's just something very easy to exploit in marketing.

And another similar one, when we're talking about these biases, is like the hearkening back to the ancient world, so.

Oh, that's a good one.

Old.

Yeah.

So can you give us a good example of that?

I know there's a lot.

Yeah, this is called the appeal to tradition or the appeal to antiquity.

And this, again is the idea that everything that was developed in the, in the olden days, in ancient times, when athletes were pure and there was no disease and people lived off the land, that these things again, are somehow better.

But of course, in the olden days, if you go Back to ancient times, the average age of survival was 30 to 35 years.

People did die of chronic diseases, people die from tooth infections.

It isn't just because something is old, it doesn't make it good or effective.

The common ones that we see in marketing would be the Paleo diet.

Eat like your Paleolithic ancestors.

There's nothing inherently wrong with the Paleo diet necessarily.

Actually, I think it advocates for some fairly, has some fairly good, some fairly good advice when it comes to not getting normally, it's like avoiding refined sugars, avoiding refined carbohydrates, getting fruits and vegetables and roots and getting high protein.

I don't think you should necessarily get too much red meat.

But that, that's as an aside, nuts and seeds, all good stuff.

But the idea that it is inherently good because it's old or because it's something that our ancestors did is a fallacy.

The other one is barefoot running.

That one comes up a lot is run like your ancestors did.

Running barefoot keeps you in contact with the ground, connected with nature.

And again, just because something is old, it doesn't make it effective.

Things like ancient Chinese medicines, acupuncture, cupping, Reiki, these have been around for thousands of years and they have survived at least in part because they've been around for a long time.

And it's this idea that something is old is inherently good.

But I'd rather use something because it works, not because it's old.

And as a scientist, we have pretty robust ways of determining if something works and if it doesn't.

And something like acupuncture, for example, if you look at the high quality studies, they generally show that acupuncture is pretty ineffective.

And actually, when you compare it to things like sham acupuncture, where the needles are put in the body but put in slightly different locations, not on official acupuncture points, so people can't tell the difference.

That people have the exact same response to acupuncture as they do sham acupuncture.

So, yeah, so that's another, another very common one.

The appeal to tradition, the appeal to popularity is again, comes up a lot.

Buy this because it's popular, because your friends and colleagues are buying it.

As seen on tv, over a million units sold worldwide.

We like to invest in ideas because other people are doing it.

But again, I'd rather invest in something because it works, not because it's popular.

So those are just three examples of a dozen that come up very often in wellness marketing.

So, yeah, please go on, go online and look up logical fallacies and learn about the various ways that marketing will leverage those biases to get you to buy things you don't need and believe things that you probably shouldn't.

Yep, so many wellness influencers are.

I mean, many of them are just people who are just dunderheads.

That's just the Maha moms and all that jazz.

But then there are a group of them out there who should know better.

The Andrew Hubermans of the world, the Joseph Mercola who is trained as a physician.

Besides just striving continuously to feed their egos and their checkbooks, they have struck on an enormously successful formula.

They have untold orders of magnitude more listeners than I do.

And is it just because they're promising quick fixes?

Is it like, what is the magic that people are so attracted to with these dis and misinformation enthusiasts?

Because they clearly have always been out there.

They clearly have done significantly better in gaining traction than have the people who are out there promoting the Cold hard truth, which is that everything they're saying is unfortunately tempered by reality.

And the results they're promising are often a mirage.

There are a few different dynamics that contribute to the success of these kinds of characters.

One of them is the obvious appeal to their credentials and their authority.

Huberman is a great example because he's a Stanford neuroscientist, right?

So he trades off of his credibility as a respected scientist.

And he was a respected scientist, ironically, before he became very successful and very popular.

I was looking back at some of the articles and an old article in Time magazine credited him with reviving America's his interest in science.

And then more recent articles refer to him, much less generously as Gwyneth Paltrow for men or Joe Rogan in a lab coat, which is.

Which is much less.

Which much more derogatory and much less complimentary.

And that just speaks to how his brand has evolved.

So, yes, he leans into his academic credentials and his authority.

He's also.

He comes across as a man's man.

He markets himself predominantly to young men.

He's got probably 2/3 male listenership, so it's not exclusively young men, but he definitely taps into that audience.

And people love the idea that this respected credentialed scientist is telling them how they can biohack their way to better health.

And that's what it comes down to.

As you said earlier, we love the idea that there are shortcuts we've evolved for economy.

If people love to hear that we can get fit and healthy and build our muscles and burn fat without actually having to put in the time and effort required to plan our diet and to exercise regularly and be physically active.

If there is a pill that we can take, if there is a garment that we can wear, if there are a pair of electrodes that we can strap to our abs and zap ourselves for five minutes a day, then that's what people are going to believe, because that's what people want to believe.

So these science influencers have absolutely struck on the right kind of formula, telling people what they want to hear and leveraging their credentials to sell those ideas.

But again, as you said, if people, if listeners can take one thing away from this podcast, if they take nothing else away, take this away.

There are no shortcuts.

99.9% of the products and gimmicks and supplements that you are sold in health and wellness do not work.

Or at the very least, they don't work in the way that's claimed.

There is little to no regulation.

People can and will sell anything.

The.

The only way to truly land on health and wellness is to put in the time and effort and the planning.

Burn that into your brain.

And if you can just accept that one simple fact, you'll be much less likely to fall for all the bullshit.

Because all of the wellness influencers and the wellness gurus and the science influencers, they're trying to sell you the shortcuts and the quick fixes, and you just have to trust and you have to believe deep down that you know that it isn't true.

Well, Nick, I think we're done.

I'm just gonna put that little clip on repeat and I'll just put that out every two weeks because I feel like I've been preaching that now for almost 200 episodes.

Yes, I hear you loud and clear.

I think that was very special.

And make no mistake, look, I've been an exercise scientist now for more than two decade.

Decades.

I've run, I don't know, I've lost count of how many marathons and ultramarathons.

I've run a Dun Ironman.

I've been around the block.

I've worked in Olympic sport.

I've been an associate professor and a researcher, and I've worked in mainstream health and wellness.

I know this industry well.

And I've also.

I've been in the place where I've tried acupuncture because I had a calf injury that wouldn't disappear, and I've taken supplements that I didn't need.

And I've wanted to believe that There were shortcuts and quick fixes, but having come through the other side of the rabbit hole, if you like, and I have a new perspective on it.

And really, once you understand the mechanics of how this industry works, you'll wonder how you fell for any of this stuff to begin with, because it's really quite transparent.

Yeah, okay.

I do wanted to.

I do want to get to the supplements you've used though, because.

And the reason I bring this up is because since we've been doing the program, we have reviewed a few things that actually do have some benefits.

None of them are earth shattering, of course, but some of the things in a hundred, and we're up to over 180 episodes now, I could count on two hands.

There have been a few things that have actually stuck out as you know what the science actually supports some of the claims being made.

Sure, very rarely to the degree that the claims are being made, but still I have been equivocal in my support for some of the things that we have seen.

Spirulina, for example, tart, cherry juice.

Those are the two that kind of stick out in my head.

Beet juice has been something that has shown some promise for certain athletes in certain situations.

I am curious that if in your own research have you come across anything that you feel like, you know what, there actually is something here.

Either you take it yourself or you think, think something maybe we on this podcast should look into, if we haven't already.

Yeah, sure.

And you're talking specifically about supplement.

Supplementation, that kind of thing.

Yeah.

Or potentially a device.

We look at devices as well.

Yeah.

It's much easier to tell you the things that do have some scientific benefit than the things that don't because.

Oh, absolutely, yeah.

I probably count on one hand the things that actually have a benefit.

And just for transparency, I have no sponsorships, no affiliate links.

I'm not a brand ambassador for anything.

And so I'll just give you my honest take on it, my objective take, or as objective as anybody can be on anything.

Yeah.

So something like creatine, for example, we know that has been studied for decades.

It's been studied since the early 90s.

And creatine is extremely beneficial for explosive type activities, for recovery from high intensity activities in the few minutes that you have recovering from efforts.

It's very beneficial for things like weight training, martial arts, that kind of thing.

It's not perfect for everyone.

And I don't necessarily think it's beneficial for endurance sports.

I think it can be in some contests, but the Additional weight gain that you get might offset any of the benefits that you will initially have.

I was worried, I was worried you were going to go against what we said when we reviewed it just a couple episodes ago.

But you said exactly what we said, so.

Good.

Yeah.

Look, I know endurance athletes that have used creative routine.

For me personally, I tend to respond quite potently to it.

I put on at least I would say six to eight pounds.

I probably retain more in fluid.

It doesn't really work for me for endurance sports.

But anyway, it's pretty robustly studied.

Lots of crappy research as well.

But if you look at the net effect, it seems to be positive and especially beneficial for women as well.

So if you're training for any kind of strength or power based sports, I think it's a good one to start with.

With I think for endurance sports.

Beta alanine has been shown to be pretty beneficial as an acid buffer.

I know lots of endurance athletes that take it seems to be better tolerated than something like sodium bicarbonate, which would work via a slightly different mechanism, but essentially it's targeting the same population of middle to long distance athletes.

But beta alanine, creatine have both been rigorously reviewed by for example the International Journal of Sports Nutrition.

They came out with their latest update.

I think the last update they did on supplement research was 2019, I think, and that sort of considered to be the expert consensus on supplementation.

And both of those were recommended as relatively science based.

Beyond that, I'm pretty conservative when it comes to supplementation because number one, I don't just look at the research, but I look at the quality of the research as well.

And I know that a lot of research in sports science, especially sports nutrition, is quite crappy, unfortunately.

So even when there are studies showing beneficial effects, I set my bar a little bit higher.

I need there to be good studies showing beneficial effects.

Then you have to throw into the mix the idea of or the fact that something like 1 in 7 over the counter dietary supplements are contaminated.

So you have to use supplements that are third party tested and not many of them are.

Then you have to throw into the mix the idea that a lot of supplements are very expensive.

Supplements are sometimes not just contaminated with anabolic steroids or stimulants, but sometimes heavy metals get into supplements as well.

So once you add all of these different things up, like I say, I'm much more conservative.

I tend to go for things that are absolutely rigorously shown in scientific research to be beneficial.

A third party tested, maybe bare the informed sport Logo or some other kind of third party lab that has tested them.

I take a protein supplement as well because protein is really important, as we know for muscle recovery.

And there's nothing magic to a protein supplement.

It's not going to help you build muscles without exercising.

It's not going to turn your fat into muscle.

But if you are exercising regularly and if you're training hard, particularly if you have a high training load, there's a good chance you're not meeting your protein requirements.

And rather than just eating chicken breast three times a day, which is not healthy and it's not environmentally sustainable, I don't think there's anything wrong with taking a protein supplement.

The fact that it's a powder is irrelevant.

And I happen to use a soy protein powder because I'm, I'm lactose intolerant.

And I add leucine to the powder as well just to bump up the leucine content.

Because the research has shown that leucine has the most important, probably has the most important role in triggering the anabolic response to training.

So those are pretty much the only things that I would take myself.

And the only other thing to, to mention is that I take a vitamin D tablet in the winter because of blood tests last winter showed that I was vitamin D deficient.

And that can have an effect.

Yeah, exactly, yeah.

Where we don't get a lot of sunshine.

And with the sunshine that we do get, I'm covering myself in fact to 50, so I don't get a lot of sun, I don't get a lot of vitamin D. So I supplement in the winter with fairly low dose.

And again that's off the back of a blood test that showed that I was deficient.

Those are all really good points.

The crappy research is one I bring up a lot.

So frequently we see either non controlled trials or trials on very small numbers of people or on just animals.

Or they're studying in very controlled experiments or they're not measuring things that really matter to us, they're measuring biomarkers as opposed to actual performance results.

So these are all.

You gotta look at the effect size.

Even if a supplement does work and it shows a statistically significant effect in the study, how does that translate to a practical benefit?

Is it worth the time and effort and expense and the risk of contamination?

And it's it.

The, and the other thing is that, that even if you do take a supplement that works, it should be considered the cherry on the cake or the icing on the cake.

The cake itself comes from your Nutrition comes from your training.

90, 95 to 98 to 99% of the adaptations you'll get will come from training and eating and sleeping.

If you want to use a supplement once you've got all of those things in place, then knock yourself out.

But until you've optimized and perfected all of those things, then I wouldn't even waste your time on supplements.

All very well said.

I'm going to have to look back at Beta Alanine.

Beta Alanine was something I reviewed very early in the course of this podcast.

And at the time I believe that I found evidence that suggested that it was beneficial, but not to the extent that you're, you're saying.

And I know there's been new research since I looked at it.

I will go back and take a look at that.

For an upcoming medical mailbo bag, Dr. Nick Tiller.

He is a physiologist, researcher and science communicator.

He has written a very popular book, one of the best sports science books of all time.

It's called the Skeptics Guide to Sports Science.

I will put a link to it in the show notes.

And you said you have a new book coming out next year and what was that one?

Yeah, it's called the Health and Wellness Lie, which is in line with what we've sort of been talking about today.

And as you'd expect, it's an expose of the health and wellness industry, everything that it is, everything that it claims to be, and how to navigate the industry with your with your integrity and your wallet intact.

It's going to be published in the US And Canada by John Hopkins University Press, in Europe by Bloomsbury Publishing.

And I hope that it will be out by the spring, but it's probably more likely going to be the summer.

Excellent.

So watch this space.

We will look forward to it.

Nick, thank you so much for joining me for this fascinating conversation.

I really enjoyed it.

You're welcome.

Thanks so much.

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