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Josh Dech - CHN (01:14.198)
I'm excited to talk about what we're talking about today because it's something we actually haven't covered yet to date. We're going to be diving into insulin resistance and inflammation and healthy aging and all the things in between. But I did you a great justice, of course, in our introductory, a quick, you know, minute or two intro that I do before the show here. But I'd love to hear it from you, Dr. Nolte. Who are you and why is it that what you do is so bloody important?

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Morgan Nolte, PT, DPT (01:40.59)
Yeah, well, thank you for having me first off. I'm excited to share the message of insulin resistance with your audience. I'm a geriatric physical therapist by trade, and I saw firsthand the negative effects of insulin resistance, which is the root cause of conditions like type two diabetes, obesity, Alzheimer's and vascular dementias and cardiovascular disease.

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And I saw all of these conditions affect people, rob them of their quality of life, rob them of their retirement and funds. You know, it's expensive emotionally, financially, physically expensive to be sick. And I thought, this is heartbreaking. And I saw their adult children following in their footsteps. And I wanted to be a little bit more on the proactive side of it because I saw too many people with dementia forgetting their family members' names.

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and too many people who had oxygen cords strapped to them around their house, and too many people who suffered a stroke and could no longer walk independently for the rest of their life. And so many of things, like these are preventable things. And I think that that's what so many people need to hear is that you can take control and responsibility for your nutrition and your lifestyle as early as possible and actually prevent a lot of this stuff.

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that I was seeing in geriatrics and impact your family in bigger and better ways than you can if you're sick. And I knew that because I had healthy grandparents, relatively speaking. So I saw my 80 year old grandparents acting like 60 year olds and my 60 year old patients acting like 80 year olds. And I thought, well, I definitely don't want that. And I don't want that for you, but my hands were so tied in geriatric physical therapy. You can only do things that are re reimbursable by insurance and health coaching is not one of them. So.

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Josh Dech - CHN (03:17.618)
Hmm.

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Josh Dech - CHN (03:30.386)
Mm -hmm.

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Morgan Nolte, PT, DPT (03:30.99)
I had to kind of go out on my own and learn about insulin resistance. And I'm so passionate about it because a lot of people are unaware of it. Like you said, you haven't talked about it on your show. Most physicians completely overlook it. And I think it's important to talk about what are some of the signs of insulin resistance. And like, if you are pre -diabetic, if you have diabetes, you have insulin resistance. If you have high blood pressure,

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you likely have insulin resistance and physicians are not even checking fasting insulin levels. So insulin is that hormone that kind of regulates your blood sugar and it can rise for 10 to 20 years. Insulin can be going up and up and up in the background under the radar for 10 to 20 years before you see a rise in your blood sugar or your hemoglobin A1C, which is that three month estimator of blood sugar. And I was thinking the other day, I'm like, what if we treated cancer?

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Josh Dech - CHN (04:24.911)
Hmm.

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Morgan Nolte, PT, DPT (04:30.414)
like we treat prediabetes, i .e. insulin resistance, there would be outrage. Like if you went to your doctor's office and they're like, well, you had your mammogram and you do have some cancer, but we're just gonna watch it for now. Like you don't really need to do anything different. Maybe cut back on your sugar a little bit and maybe try to walk a little bit more, but we'll just retest in six months. That would not fly. And we're not even doing that.

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Josh Dech - CHN (04:48.911)
Hmm.

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Morgan Nolte, PT, DPT (04:57.902)
for pre -diabetes. Josh, I was reading some labs the other day for a Zipflee member and on the lab report, quote unquote, normal blood sugar, I was like, I don't know, 60 or 70, maybe 70, up to 126. And I'm like, so they completely ignored the pre -diabetic range for blood sugars. And so many physicians completely glaze over blood sugars between 100, so fasting 100 to 125. That's that pre -diabetic range. That's the red flag.

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Josh Dech - CHN (05:06.67)
Mm.

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Morgan Nolte, PT, DPT (05:27.438)
that we really need to start paying attention to, not saying, you're fine. Just watch it for soon. We'll retest in six months. Like, no, we need to be treating metabolic health like we treat cancer just because cancer's consequences can be a little bit more acute and fast acting. So we're more aggressive with our treatments. You know, insulin resistance can take decades to develop and decades to manifest into real health problems.

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But just because the effects take a long time doesn't mean that we should ignore it. It doesn't mean that we should be casual about it. We need to be recommending lifestyle changes far before someone's ever prescribed metformin or genuvia for type two diabetes.

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Josh Dech - CHN (06:09.844)
You know, it's really interesting we get to the blood sugar conversation. I've often quoted stats like looking at the CDC's own website. 14 out of 15 of the leading causes of death they have listed come directly back to the gut. The chronic inflammatory conditions which are tied back to insulin and there's some new research coming out. I'm sure you're very familiar but as a quick note for our listeners, I mean, they're now saying we have five types of diabetes. We know type one.

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where you need insulin, type two insulin resistant, type three is Alzheimer's, type four PCOS, type five is cancer. And so now we have all these things coming back to insulin levels and inflammation and chronic inflammatory conditions directly connecting your gut state of health.

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Morgan Nolte, PT, DPT (06:42.158)
now.

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Josh Dech - CHN (06:51.306)
and your microbiome and the toxins and inflammatory processes inside versus your insulin, insulin resistance and how it's affecting your metabolic health and systemic inflammation and how these create disease. But yet the Western world refers to disease almost as if they are innate to the human body, which is insane to me. So, yes.

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Morgan Nolte, PT, DPT (07:08.59)
Right. It's total malpractice. I think it's such a rigid mindset and it's like, well, diabetes runs in my family, so I'm destined to get it. Or, you're never going to get off this medication or there's nothing we can do about it. It's just, it's sad. Yeah. So I completely agree with everything you just said.

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Josh Dech - CHN (07:28.393)
Well, I'm glad we're on the same page. I'd love to find something you can disagree with me on too, though. I doubt we will, because it sounds like we're both of the same mind. But can you walk us through, can you define insulin resistance, how that process works? And I'd love to start getting into how this creates disease.

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Morgan Nolte, PT, DPT (07:33.966)
I don't know. Yeah.

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Morgan Nolte, PT, DPT (07:44.462)
Yeah. So insulin resistance is exactly what it sounds like. It's when your cells, every single cell in your body can become insulin resistant, resistant to the effects of insulin. And the primary effect of insulin is to keep your blood sugars in a healthy range. So after you eat, for example, a high carbohydrate meal, your blood sugars are going to go up. And just assuming that you're sedentary after the meal, insulin will be released from your pancreas.

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And that will bind to a receptor on the cell and it will allow glucose then to move from the bloodstream into the cell to be used for energy or to be stored. And so when we're insulin resistant, the cells kind of tune out the effects of insulin. So more and more is needed. It's kind of like when, when I'm talking to my child and I'm saying like, go brush your teeth, please. You know, and I asked nicely on the first time.

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Dawson, go brush your teeth. Dawson, you need to brush your teeth. They get louder and louder and louder because they're tuning me out. So insulin has to increase more and more and more because our cells are tuning it out if we have high levels of insulin over an extended period of time. And so that's how insulin really, insulin resistance develops. Same as like antibiotic resistance or resistance to alcohol.

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Josh Dech - CHN (08:47.689)
Mm -hmm.

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Morgan Nolte, PT, DPT (09:08.974)
So I like to give the example of somebody who used to get a buzz after like one shot or two shots. Now they need like five drinks before they even feel the effect. That's because their cells have tuned out alcohol become resistant resistant to alcohol. And the thing with insulin resistance, like I said, it goes under the radar for 10, 20 years because your insulin levels can keep rising. Your pancreas can keep producing more and more insulin.

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Josh Dech - CHN (09:14.121)
Mm.

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Morgan Nolte, PT, DPT (09:36.654)
to keep the blood sugars in a normal, healthy range. And the test that I recommend is called the Kraft test K R A F T. If you just YouTube it, you'll find videos about it because that's going to show you if you have rising levels of insulin, but normal levels of blood glucose. So that would be like pre pre -diabetes essentially. And when insulin resistance happens, it happens gradually, but

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sometimes the effects are not reversible. So peripheral neuropathy with diabetes, for example, like if your nerve dies and you're an older person, it's probably not going to come back. So it can improve, like your nerve health can improve, but people who have lost brain cells or cells in their retina, so they have that splotty vision with like diabetic retinopathy, or they've lost cells to their nerves and they can't feel their feet.

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Like that stuff isn't reversible, but you can reverse insulin resistance at any stage, but you might still have some permanent deficits from the damage done. Yeah.

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Josh Dech - CHN (10:46.997)
So it's the damage done from the insulin or from the high levels of blood sugar and the neuropathy that's caused the damage that damage at a certain age is irreversible or is it reversible if you're young enough?

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Morgan Nolte, PT, DPT (10:59.63)
Reversible if you're not young enough. So I wouldn't necessarily say age. I would say stage. it just depends on how advanced it is. But, I had one gentleman once in geriatric physical therapy and he was wheelchair bound and, multiple amputations from diabetes. And I walked into his house and I was like, doing his medication reconciliation. I was doing home health. I said, where are your diabetes medications? They're not on here. And he's like, I don't need them anymore. I was like, what?

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Josh Dech - CHN (11:04.961)
Hmm, more interesting.

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Morgan Nolte, PT, DPT (11:28.27)
you're telling me you've had multiple amputations, you're bound to a wheelchair and you don't need any diabetes medications. And he was like, yeah, because they were gonna take my foot. And so I finally turned my diet around so that I would not lose my ability to at least stand and transfer myself. And so he had had those advanced complications of diabetes and was still able to reverse his insulin resistance to the point where he didn't need medications.

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Josh Dech - CHN (11:52.255)
Yeah, I wasn't able to regrow the limbs they cut off, but I getcha. Yeah, I mean, there's some, yeah, there's some serious damage done. Yeah, yeah. And I mean, even like you mentioned, like, neuropathies and retinal damage. Have these damages that we start to get, is it because the inflammation has attacked the nerves or is it the blood sugar being so high and the blood being so viscous, we're not getting oxygen to the area? Like, what is it with high, high blood sugar that's really damaging these tissues?

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Morgan Nolte, PT, DPT (11:54.574)
Exactly. No, that's kind of what I mean. Yeah. There is a point of no return for certain things.

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Morgan Nolte, PT, DPT (12:19.95)
That's a really good question. I'm thinking about a recent interview that I had with Dr. Georgia Ede. You'd probably really like to interview her. She's the author of Change Your Diet, Change Your Mind. And I asked her like, what is it about, you know, sugar in the brain and insulin resistance in the brain? And she said it's really a trifecta of high blood sugar levels, high inflammation and oxidative stress. So when it comes to the cellular damage, it really comes down to like that starvation of oxygen.

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And that, I mean, to me, it comes down to inflammation, kind of wrecking your cellular health one cell at a time until ultimately that cell is no longer oxygenated or innervated, and then it dies off.

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Josh Dech - CHN (13:05.444)
So it's sort of a starvation of oxygenation and proper nutrient just like a whole human body on a cellular level things start to die little by little until that whole limb or that was those fingers turned green from lack of oxygen they got turned black they cut them off.

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Morgan Nolte, PT, DPT (13:20.91)
and like blood flow, right? So if you think about, well, how does it not get oxygen? Well, it's not getting blood flow. And so sugar makes your blood sticky. It doesn't flow as well. It's almost like it turns water into maple with maple syrup, you could say. So it has a harder time moving through those small capillaries, which become inflamed. And so the diameter through which the blood can flow is smaller. So to me, that's kind of how I think of it on a microscopic level.

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Josh Dech - CHN (13:49.306)
Very interesting. Yeah, you know, we start diving into the human body. It's such a well oiled machine, but so often we find we put sand in the engine and wonder why things fall apart. And it's just remarkable. We start looking at it's like the human body is always, always trying to heal us on a nonstop basis. It's amazing what we can actually withstand. You know, I did a just recently released a podcast episode, whatever this one comes out on the pesticides.

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that we use, like over a billion pounds a year. One in particular called Delta Methrin at 25 micrograms, so 0 .00025 milligrams per liter is enough to kill a fish like a trout. Yet we put over a billion pounds, I mean it's apples to oranges, different chemicals and concentrations, but we put over a billion pounds on our food every year, which is 181 quadrillion times more pesticide than what it takes to kill a fish per liter. And like we're all still alive.

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We're not dead. And so we have to seriously commit to screwing up our insulin and our blood sugar for it to accumulate over many years to actually lead to limb amputation, which still is a better way than dying. Like our human body is amazing. So there's so much breakdown. Are you seeing this young like as food gets worse and as diets get worse, are you seeing these types of neuropathies and blood sugar insulin issues in younger kids more than just geriatrics where you specialize?

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Morgan Nolte, PT, DPT (15:02.766)
right.

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Morgan Nolte, PT, DPT (15:08.174)
and

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Morgan Nolte, PT, DPT (15:16.398)
I don't know. We don't work with anybody younger than 18 in our company. Definitely in the 60s, you know, so sometimes people like I say geriatrics and they're like, what do you mean? But most of the people that I would work with would be in their 50s and their 60s that I've seen. But yeah, you're right. Health habits are deteriorating faster and faster. There was a stat I saw the other day. I don't know. Don't quote me on this.

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but it was like kids eat on average 80 grams plus of added sugar a day. my goodness. That like is true, I believe. And it's hard as a parent, you know, it's hard to control that sugar intake, but I am that mom, you know, we were just at the lake for Memorial Day weekend and an ice cream truck came down the beach and my cousins got ice cream, their kids got ice cream, we did not get ice cream. And my kids are at the point now where they just...

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it's okay with them. You know, they're six and four and they know what is healthy. They know what is unhealthy and they know why it's important to make healthy choices for their body because it makes them feel better and they can just thrive. Like they're just thriving. And I think that I am kind of heartbroken to see where the health of the youth is going. I knew that this would be the case. I've been in geriatrics so long, but I knew once I had kids in school and I stopped more upfront.

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It's going to be sad. Like there's so many, there's so much sugar in the school, birthday treats, PTO events. It's just, it's really sad. And I'm like, do people not know? Do they not know that eating added sugar directly causes insulin resistance when, especially when they do it in excess, like so many people do, or do they not care? What do you think? Do they not know, or do they not care?

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Josh Dech - CHN (16:48.34)
Hmm.

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Josh Dech - CHN (17:04.532)
Yeah.

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I think it's a bit of both. I think there's a level of ignorance where our lack of knowledge leads to a certain amount of apathy, right? Where it's even more interesting. I mean, the FDA regulations just recently, if you follow like Callie Means and his sister Casey Means, they had this new book, Good Energy, and they'd recently talked about some pretty crazy stats. Like the FDA has approved 10 % of the average like childhood diet being added sugar. 10%.

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Morgan Nolte, PT, DPT (17:33.326)
That's disgusting.

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Josh Dech - CHN (17:35.474)
it's criminal enough to cause diabetes and this is where we're seeing it in younger ages. But I mean, you of course being the geriatric specialist.

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Morgan Nolte, PT, DPT (17:37.742)
Yeah.

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Josh Dech - CHN (17:42.834)
I think this is really interesting to start figuring out a couple different things. Yes, we can see where things are getting worse, younger and younger, but I think this is also a great opportunity not only for us to discuss on this episode right now, but how to help people who are currently aging or older, but how do we help those who are young who will be old soon? So what are some of the first things that you're seeing or I guess I should say, let me back this up. What are some of the things that you're seeing in your geriatric patients?

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where you could go back as an early warning sign and say 50 years ago, had we seen this, you wouldn't be dealing with X problem. What does that look like?

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Morgan Nolte, PT, DPT (18:16.558)
The first thing is get your fasting insulin checked because your doctor is probably only checking blood glucose and only checking hemoglobin A1C. Do not feel weird if your doctor gives you pushback on checking your fasting insulin. If they won't order it, you can order it yourself. We sell it on our website for an at -home finger prick test. You can go to testing .com and order one and take it into like a quest or a lab core lab in your area and get it drawn.

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So number one is know your insulin because again, that will start to rise 10 to 20 years before your blood sugar or A1C will start to rise. The second thing is look at your blood pressure. The second that blood pressure starts creeping up, you need to be paying attention because insulin resistance for several different reasons can contribute to high blood pressure. So even if your insulin is fine, your glucose and A1C is fine, if your blood pressure is...

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creeping up, that should be a kind of an alarm for you. And then weight gain, you know, undesired weight gain, especially fat mass. It's not healthy for you. And I know it's a pain in the rear end. And I know that it's difficult to control because eating habits can be difficult to control, but you need to lock it. I say lock it up, lock up the sugar intake. So really focusing on simple things, simple, not necessarily easy. Stop drinking pop.

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Pop is going to be the single biggest contributor to insulin resistance. We need to stop drinking regular pop, stop drinking diet pop, because as you know, all of those artificial sweeteners are terrible for our gut health. So stop drinking pop, stop eating like sugary stuff like candy, ice cream, keep them, I like to say rare and appropriate occasions in an appropriate serving size. The less added sugar you eat,

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the better. And then the third thing that I would really say early on to really focus on in your diet is reducing refined seed oils. Those consists, the toxins from those are really inflammatory. They stay in your body for a long time and contribute to insulin resistance in the longterm. So early on, the sooner you start to eat real food,

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Morgan Nolte, PT, DPT (20:41.998)
the better because you're not getting the added sugar and you're not getting those refined seed oils. So I think keep your diet simple, eat real food, eat meat, eat eggs, eat fibrous fruits and vegetables. There's differing opinions always, you know, there's always differing opinions, but I think everybody can agree that whole food is better for us than processed food.

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Josh Dech - CHN (21:09.098)
Love that. 100 % agree entirely. I'm non -partisan. I'd say between foods. I'm definitely very much advocate for animal based personally. I've done carnivore, which I think could be therapeutic. Are you carnivore, animal based, or what do you prefer?

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Morgan Nolte, PT, DPT (21:18.478)
Me too.

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Morgan Nolte, PT, DPT (21:24.078)
I like animal based. The number one thing that I eat is meat. So I eat a lot of eggs, chicken, steak. I do dairy. So I do not have a dairy sensitivity or anything like that. We were talking offline. I'm learning how to ferment my own yogurt. So I'm trying to do some homemade yogurt and it's really good. It tastes very delicious. I will do some higher sugar fruits with smaller portions, like maybe half a frozen banana and a protein smoothie.

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or some apple with some peanut butter, but most of my fruit intake is going to be strawberries, blackberries, raspberries. I do a lot of vegetables, a lot of broccoli, asparagus, some sweet potatoes, carrots. So it's not, I'm not a purist by any stretch of the imagination. My boundary, I think it's important to talk about boundaries around the foods that contribute to insulin resistance is one standard sized sweet a week.

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That's my limit. That's my boundary. And I try to do that on Saturday or Sunday. So I have found that for me, that boundary works well. I don't use it every week. I don't like if there's no occasion to eat something, I'm not going to go out of my way just to like have it on the weekend. But for me, that's a reasonable amount of sugar and it's condensed to a timeframe. So I think having those boundaries around.

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Those exception meals is what I call them. I don't like calling them cheat meals because I think we have to be very careful in collapsing morality in food. I don't like to say there's good foods and bad foods. There's, I don't mind saying healthy and unhealthy. That's pretty straight up, but good and bad is more moral, you know, ethical words. And so I try to stay away from that because no one needs any more guilt around the whole topic of what we eat, what we look like, all of that stuff.

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Josh Dech - CHN (23:04.773)
Mm -hmm.

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Morgan Nolte, PT, DPT (23:18.798)
but some healthy boundaries in place are great. But yes, definitely more animal -based.

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Josh Dech - CHN (23:22.316)
Well, I did find something we did we disagree on I definitely villainize shit food I Said we I did find something we do disagree on I'd like to villainize trash food Good right. I look at it. I'm like it's not food, you know, like I don't look at this tape measure and I'm like, well

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Morgan Nolte, PT, DPT (23:28.238)
You want to say that again?

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Morgan Nolte, PT, DPT (23:34.606)
good. Yeah. So, yeah. We're on the.

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Josh Dech - CHN (23:42.724)
if I just have one bite. Like it's just not food. And so there are, there are lines like that, but I'm definitely not a purist either. I'm guilty of going out and you know, once a year I might have A &W. I look at it, I'm like, you are going to mess up my gut for about 24 hours and I'm doing it anyway, but it's an informed decision. I think that's the most important. Yeah, we at least know.

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Morgan Nolte, PT, DPT (23:59.342)
Exactly. It's informative, proactive, and thoughtful. And I think that's the point that I want everyone to get to is proactively choosing your boundary, not being reactive with our food intake and just eating it because it's there. There's so many things that go into eating behaviors, scarcity mindset, I can't waste food. Maybe they had that messaging growing up or.

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this is the way that we've always done it, or I show my love through food. It's like, there's so many things that need to be unlearned. Another one too, is I think a lot of people get their only source of joy and relaxation and comfort from food. And a lot of that comes from like high sugary foods. And so that to me tells me that you need more joy, comfort and relaxation in your life so that you don't turn to food for that, because food can't fill that.

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Josh Dech - CHN (24:51.297)
Mm.

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Morgan Nolte, PT, DPT (24:52.558)
So there's a lot of mental aspects to this whole behavior change conversation too.

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Josh Dech - CHN (24:57.377)
Yeah, I've had some interesting conversations with many professionals in the functional space now who have also brought on purpose and meaning. And I think it goes deeper than just, you know, on the vibrational or frequency level and how your body's actually healing and reacting to the spaces and things around you, but also our behaviors and patterns and habits. If you have no love or connection or joy or purpose, you'll find your joy in food, which will lead to inflammation. I do want to back up to one thing. So I'm just kind of following the rabbit holes of where this conversation is going. Let's talk about

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quote cheat meals we'll say this permissive meal once a week if you will to be more PC about it but

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If you get somebody in, for example, I specialize in the worst of the worst gut disease. Like we're flipping around Crohn's colitis like no one's business. It's supposed to be impossible. It's really not that hard. And so, but the thing is we have to be very, very strict. If I get somebody coming in, for example, with true autoimmunity and they do have true autoimmune, like say hypothyroid or Hashimoto's with this and they eat gluten, well, through a process we call molecular mimicry where these molecules are actually look like things your body produces. One single bite of gluten, for example, can

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trigger a response of inflammation for up to three months. So if somebody even has this like, we'll have cake on this birthday, I'll have this on my anniversary and this for Christmas. If you're eating gluten four times a year spaced out, you're inflamed all year. So I do require perfection in some regard. When someone's dealing with insulin resistance, maybe it's...

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Morgan Nolte, PT, DPT (26:09.39)
on.

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Josh Dech - CHN (26:25.022)
you know, in relation to stages like you mentioned earlier, is there a certain level of strictness around diet you might require based on the severity of the case? Or do you say you don't once a week is fine to have that donut? What's your take on that as a professional here?

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Morgan Nolte, PT, DPT (26:38.382)
I think it really depends on the severity. And that's another reason to get healthy as soon as you can, because the healthier you are, the more your metabolism can take that hit without and bounce back quickly. You know, so like you said, somebody with that gluten intolerance, they could be inflamed for three months. But I think the healthier you are, the more you can tolerate carbohydrates or exception meals. I take a little bit gentler approach just because my target market needs that.

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My target market are, they tend to be perfectionist anyways. They tend to let that all or nothing mindset prevent them from taking any action. And so I find that a lot of people want that structured meal plan because they want to feel like they're doing everything perfectly. But in the long term, they're not going to follow that forever. and so I need to teach them a system and a strategy and educate them on.

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this is how this food affects your body and that food, but then empower them to have that structured flexibility. And so I think for your specific conditions that you treat, yes, like they've got to follow the protocol. And by the way, a lot of people with insulin resistance would also benefit from that strict protocol for gut health, but from a behavior change standpoint, what feels better to me to teach is a little bit more of a gentler.

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approach to like meet somebody where they're at and help them get one step better at a time versus like the lifestyle overhaul just simply because for the people that I work with, they would never do it. You know, that's just not something that they would consider or want to do. So yeah, I mean, the stricter you are with your diet, the faster you're going to see results for sure.

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Josh Dech - CHN (28:27.481)
What?

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Yeah, I'm glad you brought that up. So I think it's really interesting. One of the reasons early in my career, I did work in diabetes. And one of the reasons I stopped because I'm not a psychologist. It really is a lot of like behavioral change and pattern. I think that's really interesting. So so it's really less of a matter of seeing, okay, well, that one permission meal, say, once a week, it's not so much that it's going to screw up your progress and set off a cascade of events like it would in someone with, say, Crohn's disease, as much as it is just integrating the lifestyle in a way that's tolerable to gradually make

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Morgan Nolte, PT, DPT (28:53.102)
Right.

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Josh Dech - CHN (28:58.17)
the changes they can sustain is that right?

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Morgan Nolte, PT, DPT (29:00.174)
That's perfectly said. Yes. And you're so right. I was not a health coach for very long before I realized, my gosh, the strategy is not enough. It is not enough because it'll go in one mirror out the other. And I can talk to them till I'm blue in the face and they're not going to follow through. And so I had to really like figure out how do I, how do I teach people this mindset side of behavior change? Because understanding insulin resistance.

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Josh Dech - CHN (29:09.24)
Hmm.

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Morgan Nolte, PT, DPT (29:27.566)
understanding a low inflammation and insulin lifestyle through diet, through fasting, exercise, stress, sleep, it's all important and they all get it. But if they don't have a strong mindset, then when something happens, when a holiday happens, vacation happens, they're stressed out, their dog dies, their husband gets sick, their parent gets sick, they have to watch their grandkids, guess what happens? All of those pillars fall over. So the mindset, the strong mindset is like what the pillars stand on.

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So that when those storms of life come, they can maintain those healthy habits. And I think that another thing, it's interesting. I don't know if you've ever looked into this, but a lot of people like studying stuff. They like taking the courses. They like reading the books. They like listening to the podcasts. And I like to say, you need to be a student of yourself. You need to study yourself, study your thoughts, study your habits, study your behaviors, study your eating cues, study what sets like.

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Josh Dech - CHN (30:13.014)
Mm -hmm.

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Morgan Nolte, PT, DPT (30:26.062)
What sets you off and makes you want sugar? Who sets you off and makes you want sugar? Where are you? What time is it? All of those things are really wrapped into this mindset side of things because NutriSystem doesn't give you mindset. Optavia, I don't know what Weight Watchers is doing these days. I kind of feel like they're changing like every week. Taking a weight loss medication like some glutide or govee or ozumbec, that does not address.

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Josh Dech - CHN (30:46.547)
Hehehehehe

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Morgan Nolte, PT, DPT (30:55.214)
The mindset skills required for long -term behavior change. And that is what I'm about. You know, I don't care if you lose weight. I don't care if you lose weight for one year or four years. Like I want you to lose weight and keep it off. I want you to actually change your health habits. So I think that that takes a much different mindset. This long -term sustainable behavior change. Yes, it requires a lot of psychology. but it's possible. It's so possible. And I think.

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that we don't talk about that enough. People are just like giving strategy, learning strategy, learning strategy. They might try it for a little bit, like, and then wonder why they're not seeing results and then give up. And it's like, we got to start with the mindset. And that's, that's really what we teach is we have a 12 week course, teaches the strategy, teaches the mindset, teaches a system to kind of be accountable. But when we get to the implementation part, we always start with mindset. Like a daily mindset routine is the first habit that we want people to implement because it's free.

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It's easy, requires no physical activity and like 15 minutes. So if you can build your self -esteem and your self -confidence by following a daily mindset routine, you're going to be more likely to follow your meal plan or your exercise plan or whatever else it is. So I'm a huge, huge advocate that we have to talk about mindset when we talk about insulin resistance.

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Josh Dech - CHN (32:15.889)
Very good. Hope you don't mind Bruce comes to pay us a visit too.

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Morgan Nolte, PT, DPT (32:18.574)
I love it. Yes, hi Ruth.

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Josh Dech - CHN (32:21.201)
So mindset is something that's really interesting. We've talked about it a fair bit from time to time on different episodes and it's it's so nuanced and unique to each individual because you know I'd like to think my audience is really here is here to learn but at the same time I consider myself a constant learner but the biggest thing that I need is not more education it's to be reminded of the things I already know but cease or should I say cease to do I just don't do right here I am looking for big fancy words and I sound stupid so we look for the

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these things. It's always like the new thing, the new shiny object, the new shiny whatever. But the reality is if your dog is overweight, what do you do? You cut back the food and make them exercise. Right? What do we do for ourselves? We eat the same things. We pout about it. We go and buy pills and bottles and things. We never fix the brain. Like we know better. We just need to be reminded of what to do. And it's part of this bright shiny object syndrome. So when people are trying to change, so obviously mindset, big, big pillar.

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We're trying to change the insulin resistance. And that's something that, like we talked about in other episodes, so I'd love to explore some of the other hiccups people might be experiencing. For example, like my wife's dealt with insulin resistance issues, say from stress, for example, right? And so what are some of the other factors besides just eating junk and eating sugar? Can we talk about some of the other factors that might be driving people to insulin resistance and what we can do to help manage some of those issues?

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Morgan Nolte, PT, DPT (33:33.582)
Okay.

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Morgan Nolte, PT, DPT (33:45.966)
Well, you mentioned it, stress and a mindset routine is the first thing I recommend for anybody dealing with stress, especially one that incorporates like three specific gratitudes over the last 48 hours. We really want to feel it. And in order to really affect our habits, we have to get into the subconscious mind. We get into the subconscious mind with feelings, with emotions. So if you're going through this like mindset stuff, just to check it off a list, it's not going to work.

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We have to do it in a way that it ignites our emotions and speaks the language of our subconscious mind so that it follows through. So stress is really a big one. I was just on another podcast earlier talking about this. And I think that we get in our rhythms of life and we get used to certain levels of stress, certain levels of anxiety, certain levels of depression, and it's our norm. And I think if we can take a step back and be a little bit more self -aware and see,

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Well, how does the future version of myself think? How does the future version of myself who has already reached my goals, how do they feel? They feel happy, they feel relaxed, they feel organized, they feel calm, they feel successful. So how can I start to create opportunities within my schedule to feel happy, calm, relaxed, successful?

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because I think a lot of people are going through the motions of their life and not taking time to live from their values. So if you're stressed out, what I would encourage you to do is first off, write a list of your stressors. Second of all, take some time, at least an hour, give yourself a block and have like a piece of paper that's like Sunday, Monday, Tuesday, Wednesday, Thursday, Friday, Saturday, and write out your ideal week. Like in your dream, not like,

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Not like 30 years down the road, like your retirement, but like right now from how could you optimize your schedule? What time are you getting up? What does your work blocks look like? Are you taking time off on a certain day? Like, are you taking a lunch break every day? So many people work through that and that causes stress. Are you exercising? If so, when? What time are you going to bed? What time are you eating dinner? Are you going to church on the weekends? Are you doing a fun activity on the weekends? Are you doing like...

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Josh Dech - CHN (36:05.544)
Hmm.

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Morgan Nolte, PT, DPT (36:10.19)
family stuff on the weekends. And so what we want to see, and if people need to even backtrack it a little bit more is maybe they identify their values first. two of my big core values are family and relaxation. my husband and I share those. And so I, we need to incorporate periods of relaxation into our, our weekly rhythm and to our daily rhythm. And we need to incorporate a lot of family time. And so if I wasn't sure and health,

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You know, health is a huge value of mine. So if we can look at health, relaxation, and family as my values, and you're looking at my weekly calendar, you bet that there are, there is exercise daily, there's relaxation daily, there's family time every week. And that allows me to say yes or no to different opportunities that are either in line with those values and in line with the schedule that I design or not. So I think that some people experience stress because they're living.

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out the expectations and values of other people instead of living from their own values and intentional life design. So that's the first thing. And then the second thing that I highly suggest is an evening routine for stress management. I think a lot of things that stress people out are things that are reactive, like, I missed that meeting or, man, I forgot to call them. It's their birthday or dang it. We're going to have for this for dinner and we don't have it.

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And so if you can like map out your day, the night before on so minor, it's always like morning routine, exercise, evening routine. Those are like my three that I do every day. And then whatever podcasts or meetings that I have, whatever my meals are going to be for the next day, I try to plan those out so that I can have a clear instruction manual. Cause your brain will do what you tell it to do. But the problem is we're not giving our brain clear enough instructions and we're not making decisions from our goal.

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from our vision. So we have to start making those choices as if we were the person that already reached our goal. And if that's your litmus test, then every decision becomes so much clearer. So if your goal is to lose 50 pounds and you're presented with a dessert at a party, would the person who is already 50 pounds less say yes or no to that dessert at the party? That's your answer. Would the person who is 50 pounds lighter,

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Morgan Nolte, PT, DPT (38:34.83)
Go to bed on time or would they stay up for an extra hour and a half watching Netflix? Nope. They go to bed. So you go to bed. So you really learn how to accept and reject ideas from the goal, but we have to be clear about what that goal is. And then I know I'm going on, but this is a passion of mine because I think stress is so overlooked, but man, are we in a consumer culture? People are overspending spending beyond their means and financial stress is a huge deal.

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Josh Dech - CHN (38:50.594)
I love it. Don't stop.

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Morgan Nolte, PT, DPT (39:04.238)
So I think learning to manage personal finances, creating budget, sticking to the budget, figuring out how you can reduce your expenses, that's important. And part of that is watching your spending habits. And so I know a lot of people who are like borderline hoarders and they buy so much stuff that they don't need. And then they're stressed out because their environment is cluttered. And then they don't want to cook at home because their home is dirty and they don't want to make it even dirtier.

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Josh Dech - CHN (39:24.866)
Mm -hmm.

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Morgan Nolte, PT, DPT (39:32.654)
So when we become more of a minimalist, I think that that helps so much with stress management. And I'm talking like in every area of your life, a minimalist in your possessions. And that's like my geriatric PT background. I saw so many people have to clear their house out, pare down to one room, and that's what you get. And then you die and no one really wants your stuff. And so it's like, why are we accumulating this?

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So I think like buy things that give you joy. Yes. But be very intentional about what you're buying, how much you're buying, why you're buying it. Don't make it on impulse. clean your stuff out, like look in your closet. If there's clothes everywhere that you don't wear, get it out of there. Like get the stuff out of your house, out of your environment. That is going to help reduce your internal stress so much. We want to be a minimalist in our relationships. I believe I think going deep instead of wide.

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is healthy, a minimalist in our consumption of social media, a minimalist in how many activities we choose to engage in. I don't let my children do like more than one activity at a time usually, because that's too much for me. It's too much for them. A minimalist in our dietary approach. We do not need to have like 20 ingredient meals here, you know, keep it simple. So I think when we adopt more of a minimalistic mindset, it takes time. It takes practice.

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but it will absolutely reduce your stress. So morning routine, evening routine, create your dream week and really thoughtfully do that from a value -based perspective and then become a minimalist in every aspect of your life. My last piece of stress management tips is make no your automatic answer. If someone asks you to do something, the answer is no until you can talk yourself into it.

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And I say that because a lot of people that I work with are people pleasers and they're chronically saying yes to things that don't light them up. Of course I'll be on that committee. Of course I'll be president of this group, or of course I'll be the church secretary or yes, I'll help babysit your kids on that day, even though I'm already watching them a week this month. so there's a lot of just that yes, yes, yes, yes. And what they're saying no to is themselves. They're saying no to what brings them joy. They're saying no to.

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Josh Dech - CHN (41:27.263)
Hmm.

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Morgan Nolte, PT, DPT (41:56.878)
their own values because they're afraid of disappointing somebody else. They're afraid of missing out. And so when we're talking about the mindset, you got to get over those fears. You know, you can't live from the fear of disappointing someone else. You can't make your actions dependent upon the actual or perceived judgments of other people. You know, so what you say no to the dessert. What's happened this week? And grandma offered me sweet bread. I'm like, grandma, I don't eat that. My kids don't eat that. I'm sorry you bought that. We're not going to eat it.

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And you can see the disappointment on her face. And I'm like, I don't care grandma. Like, I'm sorry. It's just not, you know, we have to get over the fear of missing out, the fear of judgment, the fear of failure. And cause all negativity is totally stressing people out. So the last thing from a stress management standpoint are negative thoughts. Any thought that you have is negative. I'd really encourage keep like, I call it a growth list. So keep a list of those recurring negative thoughts. I'm fat, I'm ugly. No one loves me.

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I'm so lonely. All of these things are creating negativity and creating stress. We create a lot of stress just from the thoughts that we think. So stress management, scheduling management, activity management. I always say you can't manage your time. You have to manage your activities. We all have the same amount of time, but live from your values, create intentional margin in your schedule for things that give you joy that are in line with your values. Make no, your automatic response. I always say.

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If it's not a hell yes, it's a hell no. That is like my mantra. So like a good example is someone wanted me to do like a speaking engagement on the weekend. I was like, I'm sorry. That's not in line with my priority of spending time with my family on the weekend. If this becomes a daytime activity, let me know. I'm all for it. But because I had proactively identified that family time on the weekend is my priority.

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and family is of value, I can weigh that against the opportunity cost of saying no, because so many people say yes to something they don't wanna do, and then how much do they fret about going to do that thing that they didn't wanna do in the first place? They're like, why did I say yes to this? So I think making no your automatic response to an external request is helpful. And that's just stress. We didn't even get into the sleep aspect of it, but that's important too.

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Josh Dech - CHN (43:59.447)
Hmm.

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Josh Dech - CHN (44:18.581)
No, not at all. I think it was episode 33 we did have a chance to chat with Molly Eastman about sleep. So we'll leave that one on there. Super important. But it's so interesting you bring all these things up and somebody might be listening going, yeah, yeah, okay, tell me the science. But the reality is all these things are very

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Morgan Nolte, PT, DPT (44:23.47)
and we'll see you next time.

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Josh Dech - CHN (44:34.229)
insidious stressors like you mentioned living up to other people's expectations of you societal expectations you should be this you should go to school for that here's how you should dress here's how you should look right down to the things we buy you mentioned people over buying over indulging there end up being hoarders but really we're all seeking this aspirational identity that's what marketing really is it's we want you to think like coca -cola you know be happy with friends have a coke like now they're trying to associate happiness and friendship with drinking high fructose

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corn syrup, which causes fatty liver and blood sugar issues and insulin resistance and diabetes and death. So the whole thing is just like we live in a world that is not biocompatible with our own biology, which I think is such a fascinating point of topic. But

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Morgan Nolte, PT, DPT (45:09.518)
I'm sorry.

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Morgan Nolte, PT, DPT (45:17.358)
Isn't it? Like we have not evolutionary caught up to our society. Like our bodies have not caught up to current culture.

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Josh Dech - CHN (45:26.292)
No, and if you've not read the evolution gap by Dr. or by Eric Edmeads, it actually talks about exactly that. The evolutionary gap between how technology has advanced so fast beyond where human beings actually are that our food and our technology, we haven't adapted to live this way, which is why we've seen this huge disease epidemic since the spike of technology in the 50s and 60s, along with junk food and other foods, epidemics of disease have gone up. I mean, the charts should climb if you're going to climb anything slowly. These are

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45 degrees or 90 degree angles, they jump. And so there is a lot to it. But then to loop it back to aspirational identity, that's what marketing does. Look like this, be like this. But you brought it back and said, hey, what is that person who's 50 pounds lighter? What do they do? That's your new aspirational identity. What do they say no to? And I love that you circle all this back just to the little insidious stressors that we don't realize are stressing us out, leading to elevated stress, which leads to sugar dumping into your blood, which leads to more use of insulin to get it.

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Morgan Nolte, PT, DPT (45:56.878)
Right. Yes.

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Josh Dech - CHN (46:26.115)
it from your blood to your cells leading to insulin resistance and weight gain. Wham bam. Here we are. Now you guys have the answers to eternal youth, which is great.

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Morgan Nolte, PT, DPT (46:31.502)
Yeah.

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No, and it's just, it is very important. And I think so overlooked because so many people are like, just tell me what to eat. And I'm like, what's causing you to overeat in the first place? How's your stress? And I'm like, well, I'm working like 8 a to 9 p And I'm like, this is, this is not going to work. You have to, you know, insulin resistance is a lifestyle disease. It is caused by certain aspects of your lifestyle. What you eat, when you eat, how you move, your stress, your sleep.

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but the cure must match the cause. You can cut your carbs all day long, but if the cause of your elevated blood sugar is high cortisol from chronic stress or from sleep deprivation, that is not going to work. So we must make the cure match the cause of insulin resistance. And I think that's why it's important to have a little bit more holistic and broad conversation than just food or fasting or exercise.

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Josh Dech - CHN (47:28.944)
So good. Well, Morgan, I know we're wrapping up to the end of our time here. So I want to wrap up with this. Is there anything we haven't covered? I want to get to where people can reach you and all that. But before we do, is there anything that we haven't covered that you think is an absolute must know before we wrap this interview up?

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Morgan Nolte, PT, DPT (47:49.966)
I think the only thing that I would emphasize again is to check your insulin because 88 % of adults in America have some degree of insulin resistance. Assume you do. Assume you do until you check. If you have optimal fasting glucose, optimal triglycerides, waist circumference, blood pressure, HDL, and insulin, great, you're not insulin resistant. But the majority of people listening to this are.

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And if you are, I highly suggest you start with our insulin resistance for beginners playlist on YouTube, because I go in more depth there than what I'm able to do in a one hour episode about, okay, what are the, what are the causes? how do we test for this? How do we eat for this? How do I move for this? What are some simple ways to lower blood sugar? So I just, I want this interview to bring awareness and recognize that this is not a one -time conversation.

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This I hope is the start of you learning about insulin resistance and use the free resources that we have on YouTube, that we have on our website. Use the free resources. They're out there for you. And then if you want to work with us on a deeper level, you can check those out as well on our website.

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Josh Dech - CHN (48:58.38)
Amazing and what's that website?

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Morgan Nolte, PT, DPT (49:00.238)
Yeah, it's zivli .com. So z -i -v -l -i dot com. And that means, so ziv means live in Croatian. All the English words were taken. And then the L -I stands for low insulin and low inflammation lifestyle. So it's to live a low insulin and low inflammation lifestyle. That's what it means.

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Josh Dech - CHN (49:08.588)
Hehehehe

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Josh Dech - CHN (49:18.892)
Love that. Beautiful. Well, Morgan, let me make sure all that's in the show notes. And I just want to encourage the listeners, if you think that you might be insulin resistant, and I think you are because 80 % of people are, then you're in that range. Like Morgan said, assume you are. You know, everybody always assumes they're better than the average driver. Well, if everybody assumes that mathematically it's impossible and there's no average. So do the research. And really, it's up to us. How long is that course? The insulin resistance for beginners.

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Morgan Nolte, PT, DPT (49:34.99)
Right, right.

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Morgan Nolte, PT, DPT (49:41.614)
That's funny.

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Yeah. So the YouTube playlist, I'm not sure how many videos are on there, but we do have an online course that's 12 weeks long. We opened enrollment again in September and it's lifetime access. So even after those 12 weeks, they can come back to it as many times as they want. But yeah, start with the playlist. You'll learn a lot there.

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Josh Dech - CHN (50:04.552)
Amazing and I encourage you guys go back do it a lot of people will say well I don't have time for that. No, you just have crap priorities You can make the time you're choosing not to how much time you on your phone or on Netflix. It's a choice So that's fantastic in in the lifetime access. I like I'll tell you Morgan I listen to my own podcast because the experts I have on teach me something all the time and I always go back and listen to what they have to say because it's my favorite topic So I'll be back listening to this one again after it releases as well. And so you guys can do the same

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Morgan Nolte, PT, DPT (50:13.582)
I love it.

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Josh Dech - CHN (50:34.505)
Use the lifetime access. You'll always learn more the second third time around Morgan, thank you so much guys. Look up Docker Morgan Nolte. I'll put all the links in the show notes. I'll put the website I'll put the zivli. I'll put the YouTube playlist everything will be there for you guys to check out Morgan Thank you so much for being here. This has been a blast

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Morgan Nolte, PT, DPT (50:52.078)
Yeah, Josh, thank you so much. I appreciated the time.