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RHR Research Review: Medicinal Mushrooms, Gut Microbiota, Blood Sugar, Root-Causeism, and Nutrient Deficiency


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In this episode of Revolution Health Radio, Chris Kresser covers some of the most interesting recently published research studies, shares some insights from his clinical practice, and discusses subjects he’s been thinking about lately. Topics covered in this episode include types of medicinal mushrooms and their benefits, the effect of gut microbiota on food cravings, high blood sugar as an indicator of cardiovascular disease risk, causes of and solutions to the prevalence of nutrient deficiencies in the modern diet, and how to apply a pleiotropic lens to the root-cause approach of health transformation.

In this episode, we discuss:

  • The healing benefits of medicinal mushrooms
  • Types of medicinal mushrooms
  • How to get the benefits of medicinal mushrooms
  • How our gut microbiota can influence our food cravings
  • Combining root cause and pleiotropy approaches to resolving health challenges
  • Elevated blood sugar as a precursor to cardiovascular disease
  • The prevalence of nutrient deficiencies in the modern diet and how to address them

Show notes:

Hey, everybody, Chris Kresser here. Welcome to another episode of Revolution Health Radio. This week, I’m going to do another solo episode. I’m going to cover some research studies, share some insights from my clinical practice, and [discuss] things I’ve been thinking about recently.

We’ll start by talking about the healing benefits of medicinal mushrooms. Not the psychedelic type, although I’m very interested in those, as well, and will be covering them on a future episode. But here, I’m talking about mushrooms like reishi, lion’s mane, turkey tail, etc. These mushrooms have a long history of use in traditional cultures, and they’ve also become the subject of pretty intensive research in the modern world. I’m going to dive into why I’m excited about [these] mushrooms and how we can use them to improve our health. Then we’ll talk about a fascinating study showing how our gut microbiome influences our food cravings. I’ve suspected this for years, but we’ve never had evidence to support it outside of the clinic, and now we do. Then I’ll share an insight I’ve had [after] 15 years of clinical work with patients and my own experience dealing with chronic illness that I believe will help you make more progress toward your health goals, whether that means recovering from a chronic illness, improving your performance, or just feeling better and extending your lifespan. I think this perspective that I’ll share not only works with health-related issues and goals, but also with any challenges that we might be facing.

We’ll briefly cover a new study making the rounds showing that getting blood sugar under control early significantly reduces the risk of cardiovascular events like heart disease or heart attack in people with type 2 diabetes, and what this means for everybody else with high blood sugar. Finally, we’ll talk about the growing problem of nutrient deficiency and why I’ve come to believe that even most people on a relatively healthy diet may be falling short of the optimum levels of some nutrients and what to do about that. All right, let’s dive in.

The Healing Benefits of Medicinal Mushrooms

Let’s start with medicinal mushrooms. These have become a hot topic with claims they can do everything from boost our defense against viruses and other pathogens, [to] protect us against cancer, support healthy brain function, [and] even improve our response to stress. But do medicinal mushrooms live up to the hype? Let’s find out. Medicinal mushrooms have a long history of use in traditional medicine. When I was studying traditional Chinese medicine many, many years ago, they were certainly part of my education. In China, they’ve been used for at least 3,000 years and maybe up to 7,000 years or longer. There’s a medical text known as the Shen Nong Bencao Jing, which is the oldest list of medicinal substances that we have discovered yet. It dates back to the 29th century BCE, and it lists several mushrooms including what we know as reishi today. Then, several centuries later, in the sixth century AD, there was another medical text called the Bencao jing jizhu that lists even more medicinal mushrooms. But the use of these mushrooms wasn’t just limited to China. We have a lot of evidence of their use all around the world. [An] example [is] one of the oldest medical mummies that was ever discovered, Ötzi the Iceman. You might remember the big news stories about that. This mummy was discovered 4,000 years ago in an area between Austria and Italy, and Ötzi was found with Piptoporus betulinus in his medicine kit, which is a mushroom that’s still used today as a natural antibiotic and anti-parasitic.

We have hieroglyphs in Egypt describing mushrooms as plants of immortality and sons of gods that were sent to the earth on top of lightning bolts. In Egyptian culture, mushrooms were so revered that they were only eaten by pharaohs, nobles, [and] priests, and [were] used in holy rituals. Some sources even suggest that Vikings may have consumed hallucinogenic mushrooms before battle, which certainly casts a new light on their famed berserker method of fighting. And today in the modern world, interest in medicinal mushrooms is at an all-time high. They’ve become the focus of both popular interest and scientific research. There are now over 400 studies published on turkey tail, a specific species of mushrooms, alone, which is likely more than the combined research that existed on all medicinal mushrooms just 30 years ago. Why is this? What makes mushrooms so special?

Well, number one, they’re a rich source of vitamins and minerals. In fact, some mushrooms have as high as 12 percent total mineral content. They’re rich in zinc, copper, iron, phosphorus, [and] potassium, and some species of mushrooms even contain vitamin D, although in the [vitamin] D2 form rather than the [vitamin] D3 form. Mushrooms are one of the richest sources of beta-glucans, which [are] special soluble fiber[s] that [are] being studied for [their] immune, cardiovascular, endocrine, and neurological benefits. We’ll talk a little bit more about that shortly. Mushrooms have shown exciting potential for supporting our brain health as we age, and they may play a role in protecting against neurodegenerative disorders like Alzheimer’s [disease] and Parkinson’s [disease], which are increasing in prevalence each year and we don’t have great treatments for. So that’s a really exciting potential application of mushrooms. And medicinal mushrooms can increase our resistance to viral, bacterial, and fungal infections, which is highly relevant in the post-Covid era that we’re living in now.

I’m going to have an expert on medicinal mushrooms, Dr. Christopher Hobbs, on the show in a couple of weeks, and we’ll do a really deep dive on this topic. So I’m just going to give a brief overview of some of the benefits of medicinal mushrooms now, and we’ll talk in much more detail about them in a couple of weeks. I briefly mentioned beta-glucans, special soluble fiber[s], that mushrooms are very high in. Beta-glucans have a wide range of functions because of their unique chemical structure. They’re often referred to as “biological response modifiers” because they strongly activate and regulate the immune system. They can increase resistance to viral, bacterial, and fungal infections, inhibit tumor growth, reduce the replication of cancer cells, modulate and regulate the immune system, and even improve our sleep and our response to stress thanks to the connection between the immune system, endocrine system, and nervous system. This is the field known as psychoneuroimmunoendocrinology, probably one of the longest words in the English language. If you go into PubMed and search for beta-glucan, you’re going to find so many recent articles that are investigating their potential in all kinds of conditions, ranging from blood sugar-related disorders to cancer to viral infections to [hypothalamic-pituitary-adrenal] axis dysfunction and stress-related disorders. Beta-glucans are thought to be one of the most bioactive compounds in mushrooms that explains their benefits. But they’re not the only compounds in mushrooms that have a medicinal effect.

Mushrooms are also rich in terpenes and phenolic compounds. You might have heard of terpenes recently in all the media coverage on cannabis and the healing effects of cannabis. Terpenes are also in the essential oils [of] plants like lavender and mint. Terpenes are highly aromatic. When you smell lavender or mint, and you get that really strong odor, that comes down to terpenes. And the cannabis plant, as well, which is known for having a very strong odor. Different types of cannabis plants with different medicinal benefits have different odors and different names, [and] that all comes down to terpenes, as well. Different terpenes are thought to have different medicinal effects, and mushrooms have these terpenes and other phenolic compounds. The research on terpenes is still relatively new, but it’s already very exciting. They’ve been shown to have anti-cancer, antiviral, anti-inflammatory, antioxidant, and liver-protective effects. Researchers are really focused on this area because there are a lot of potential clinical applications.

Types of Medicinal Mushrooms

I want to talk briefly about some of the most medicinal mushrooms that we know of today. There are thousands and thousands of species of mushrooms. Not all of them have been identified and studied, but there are a few that definitely rise to the top in any discussion of medicinal mushrooms. One is reishi, which I already mentioned before. It’s the top-selling medicinal mushroom around the world and for really good reason. It has several immune-supportive and antimicrobial properties, it supports normal glucose metabolism and liver health, it reduces inflammation and protects against oxidative damage, it inhibits tumor growth, and it improves cognitive function. It even relieves symptoms of anxiety, depression, and insomnia, as well as benefiting the lungs and respiratory tract. That sounds almost like a panacea. And I’m always a little bit skeptical of claims like that. But in the case of medicinal mushrooms, these claims are backed by both thousands of years of traditional use, in systems like Chinese medicine and other systems around the world, and now modern clinical evidence, and that’s why I’m so excited about them.

The second mushroom is chaga. This one has a long history of use in folk medicine, especially by the Khanty people in Siberia. We now know that it has over 200 biologically active compounds, including betulinic acid. I mentioned [the] mushroom that Ötzi had when he was discovered, [which contains] betulinic acid. We know now that betulinic acid has anti-cancer, antiviral, antibacterial, and anti-parasitic effects. But what makes it unique and especially useful in cancer applications is that while betulinic acid is toxic to cancer cells, it doesn’t appear to harm normal, healthy cells. And this is, of course, the Shangri-La when it comes to cancer because [with] any treatment that we might take, we want it to impact the cancer cells but not harm our normal cells. It appears from early research that chaga can do that. We also know that chaga can help promote healthy metabolic function, it regulates blood sugar and insulin levels, and it also helps reduce oxidative stress.

The next mushroom is lion’s mane. This is not only one of the most therapeutic mushrooms, [but] it’s also quite beautiful with a coral-like or shaggy mane type of appearance, hence the name. I encourage you to go on Google and look up some pictures. It’s really a gorgeous mushroom, and it’s delicious to eat. It’s one of the best culinary mushrooms. It is best known for its support of the nervous system and the brain. It helps to repair nerves and might even regenerate nerve tissue, which very few things can do, and is what it’s being most intensively studied for. It reduces inflammation in the microglia or in the brain. It inhibits structural deterioration of the brain, which is why it’s being studied for Alzheimer’s [disease] and Parkinson’s [disease]. It improves memory and cognitive function. And now we have studies suggesting that it may support a healthy mood and reduce the symptoms of depression. Anecdotally, in my own practice, I’ve seen it have pretty miraculous effects in people with neurological disorders. For example, in one patient with essential tremor, we tried the whole Functional Medicine pantheon, and he definitely improved in a lot of ways, but still had the tremor, albeit at a lower level. Lion’s mane was the thing that virtually completely stopped the tremor for him. This was a shock even to me. I knew how potent it could be, but this was a pretty dramatic improvement. When I think of lion’s mane, I think of neurological issues, [and] although it has many other benefits, that’s perhaps its most exciting application.

The next mushroom is cordyceps. This is probably more technically a fungus, and it definitely wins the award for the creepiest medicinal mushroom. It’s a club-shaped fungus that grows out of the head of a ghost moth caterpillar, [which] has been completely digested by the fungal mycelium of wild cordyceps. Wild cordyceps has the scientific name of Ophiocordyceps sinensis, and, as you can imagine, it’s quite difficult to come by. You don’t just go down to the store to get it because it’s a fungus that grows out of the head of a caterpillar. The good news is that there is a cultivated form of cordyceps called Cordyceps militaris, which is used as a more affordable and sustainable alternative to that wild form of cordyceps. Cordyceps has been revered in traditional Chinese medicine for well over a thousand years, and also in many other Asian countries because it’s widely known as a tonic for sexual potency, energy, vitality, and athletic performance. And today, we have research that confirms those functions. Studies have shown that cordyceps indeed improves exercise performance and reduces fatigue. It also balances and regulates immune function, it supports sexual health and reproduction, and it may also, [according to] the most recent research [that] I’ve seen, protect the kidneys from toxins that we encounter in the environment or medications.

When I think of cordyceps, I think of energy, vitality, and immune function. I’ve long included it as one of the substances in my protocol for protecting against colds and flus and other types of infections. If you’ve seen my articles on this, then you’re already familiar with cordyceps.

Next is turkey tail. I mentioned turkey tail briefly earlier because it’s the most studied medicinal mushroom with over 400 published studies [and] more being added every day. Perhaps one reason for this is that it contains a very high concentration of beta-glucan, that special type of soluble fiber we talked about earlier. [It has] more than 50 percent by weight beta-glucan content, which I’m sure contributes to its beneficial properties. Turkey tail is best known for its immune-stimulating and anti-cancer properties. It’s been used in over 40 clinical trials [on] almost 20,000 patients with stomach, colorectal, esophageal, and breast cancer. And these trials suggest that turkey tail may help improve survival rates, reduce the symptoms of chemotherapy like nausea, fatigue, and low appetite, reduce the chances of cancer recurrence, which is really important, and protect healthy cells from the toxic effects of chemotherapy. Turkey tail, like many other mushrooms, also helps prevent viral infections and reduce inflammation and oxidative stress.

The next two mushrooms I want to talk about are ones that you’re probably already familiar with [and] you might even use in your kitchen. The first is shiitake, and it’s the second most widely cultivated mushroom in the world. You can buy it at most grocery stores. and it is, of course, delicious, at least if you enjoy eating mushrooms. But while it’s best known for its culinary uses, it has many health benefits, as well. It supports both cardiovascular and metabolic health by lowering cholesterol and regulating blood sugar, it helps prevent viral and bacterial infections, and it’s being used by some oncologists during cancer treatment to reduce the side effects of chemotherapy and possibly extend survival times.

Maitake is another delicious culinary mushroom that’s revered in Japan and other Asian countries for its health benefits. It is best known for its ability to regulate blood sugar and also for its immunomodulatory effects. It can reduce tumor growth and help balance and regulate the immune system. It’s a particularly rich source of some essential nutrients like protein, the D2 form [of vitamin D], and some B vitamins, as well as being a really good source of beta-glucan at 26 percent by weight.

Last but not least, is agaricus. This mushroom comes from the same genus as the mushrooms that we’re all probably most familiar with like white button mushrooms you buy at the grocery store, portobello, and cremini mushrooms. However, those mushrooms, while being delicious, aren’t as well known for their medicinal effects. Agaricus is. It has a blood sugar and metabolic effect, it improves insulin sensitivity, it reduces inflammation, and it’s now also being studied for its supportive effects in cancer treatment. There are many more medicinal mushrooms, that’s by no means a complete list, but [from] my research and my discussion with many different mushroom experts, those are definitely my top eight and the ones that I’ve used the most over the years.

How to Get the Benefits of Medicinal Mushrooms

Let’s talk about how to get the benefits of medicinal mushrooms. One of the most obvious ways is just to eat them. Some of the mushrooms that I mentioned like lion’s mane, shiitake, and maitake are delicious, and with a little bit of education and practice, you can start incorporating them into your diet on a regular basis. One important thing to note that I think many people aren’t aware of is that you have to cook mushrooms in order to get the full benefits of their medicinal value. The beta-glucans in the cell walls of the mushrooms are tightly bound to another compound called chitin, which is a tough protein and sugar polymer that comprises the outer shell of crustaceans like lobster. Just [to give] you an idea of how tough it is. Only about 20 percent of the beta-glucans are soluble, meaning we can digest and absorb them without significant heating. So if you want to get the medicinal benefits of mushrooms, don’t eat them raw [and] don’t throw them in a salad raw. You have to sauté them, add them to soups or stews, or bake them with other ingredients.

I recommend that everyone incorporate at least some mushrooms into their diet if you digest them and tolerate them well. They’re delicious, they can add a lot of variety to meals, and as we’ve discussed, they have tremendous medicinal value. However, it is true that some of the most potent medicinal mushrooms are either difficult to find in stores, or they are quite bitter, or they’re chewy and have a texture that a lot of people don’t like and they’re much more difficult to prepare. In those cases, you have two options for benefiting from them. One is to make your own mushroom medicine. For example, chaga and reishi are pretty bitter and chewy when they’re consumed fresh, and they’re more difficult to cook with. In those cases, you could convert the mushrooms into a decoction, which is a tea, [or] you can make a powdered extract, or you can make a tincture. If you’re adventurous, you can learn how to gather your own mushrooms and then dehydrate and store them for medicinal use. Gathering mushrooms, I just want to remind everyone, does carry risks. There are poisonous mushrooms out there that are toxic and can be lethal. So this is not something you should just do on a whim. You really need to educate yourself on how to identify toxic mushrooms and gather the right types of mushrooms. Please do not just go out and do this without properly educating yourself.

I mentioned Dr. Christopher Hobbs, who’s going to come on the show in a couple of weeks to talk with me about mushrooms. He has a book called Christopher Hobbs’ Medicinal Mushrooms, The Essential Guide. There’s a chapter in there about mushroom identification and how to learn more, and also on how to make mushroom medicine. But this is something that I don’t think you should even learn from a book. You should take a local class or a workshop, and go out with an expert and learn your local environment and ecosystem, what mushrooms are available, [and] which ones are toxic. This can be a really gratifying and fun activity to do if you are prepared and educated.

The next way to benefit from medicinal mushrooms if you’re not up to gathering them yourself and making your own medicine is to take a supplement. Mushrooms have become really popular lately. I’m sure you’ve seen a lot of articles online and [on] social media and even in mainstream media. And when that happens, there is often a proliferation of supplements and other products related to that particular compound or substance. Whenever that rush happens, there are some good products and there are plenty of bad ones that are made by people who are just trying to profit [off] the latest trend. We’ve seen this with [cannabidiol] (CBD). I’m sure that many of you can remember [when] there were just a few brands of CBD available, and now, you can’t throw a rock without hitting someone who’s selling CBD. There [are] literally thousands and thousands of CBD products on the market with huge [variations in] quality. So it’s always a concern, and it’s always something to pay close attention to. I want to give you a few tips about what to look for in a mushroom supplement, and then share some exciting news with you about a mushroom supplement that I’m working on.

First of all, it should contain a blend of the best researched and most potent medicinal mushrooms. We know, as I’ve just explained, that different mushrooms have different medicinal benefits. And rather than just taking one, it’s best to take a blend so you get that full spectrum of benefit[s]. Everything from support against infections like viruses to anti-cancer effects to blood sugar regulation to stress modulation. If we take that full spectrum blend of different types of mushrooms, we get all those benefits. The second thing is that it should contain a clinically relevant dose of each mushroom, at least 200 milligrams of each mushroom and at least 1600 milligrams as a total dose of the product. I’ve seen a lot of mushroom products out there that [only] have miniscule doses of the mushrooms [and] are not really likely to have a therapeutic benefit. Certainly, they won’t hurt, but they’re not going to confer the types of benefits that we’ve been talking about so far. [The] next one is really important and also pretty rare in the industry—it should be a full spectrum concentrate. We have a tendency in the West to discover an important compound and then extract and sell that compound individually. But that’s not generally how it works in plant medicine. Plants have a broad spectrum of compounds. Already today, we’ve talked about beta-glucans, we’ve talked about phenolic compounds and terpenes, and there [are] so many other things that are being studied in mushrooms. It doesn’t make sense to try to isolate one component like betulinic acid and put that into a product because then we’re missing out on all the varied compounds that are in mushrooms and the potential interactions of those compounds that we don’t even fully understand yet. As an herbalist myself, I’ve always been a big believer in full spectrum concentrates, which utilize the whole parts of the plant. In the case of mushrooms, that would be fruiting bodies, mycelium, [and] primordia, as well as the extracellular compounds that the mushrooms naturally produce, like enzymes, acids, betulinic acid being an example, and antimicrobials.

Last but definitely not least, because this is another big issue with mushroom products, is [that] the medicinal mushrooms should be grown on sorghum rather than a common material like sawdust or straw or even compost. Ninety-five percent of sorghum is digested when the mushrooms are grown, leaving only a small amount, about 5 percent, of non-medicinal starch, which is alpha-glucan. This means that the mushroom product will be much more potent because it’s 95 percent active compounds and only 5 percent non-medicinal starch, which is benign. Most people tolerate it, but it doesn’t have any medicinal value. Whereas a lot of mushroom products on the market contain as much as 50 percent non-medicinal starch or alpha-glucan. When you’re taking them, you’re getting only 50 percent of medicinal compounds, and then [the other] 50 percent is just [an] inert substance that doesn’t have any value. So that’s something else to watch out for.

As I mentioned, because I’ve become so passionate about and interested in medicinal mushrooms, and I’ve had such a phenomenal experience with them with my patients and myself, and because I’ve been largely disappointed in the quality of most mushroom products out on the market, and finally, because as I’m sure you may have heard by now [that] I’m launching my own supplement line in July called Adapt Naturals, I decided to include a mushroom product with the initial bundle, which is called the Core Plus bundle. There are five products, and I’ll be sharing more about [them] soon. But I have become such a big believer in medicinal mushrooms that one of those five products is a full spectrum mushroom blend with the top mushroom species that we talked about. It’s called Bioavail Myco, and it’s going to be ready in July along with the rest of the bundle. You won’t be surprised to learn that it meets all the criteria that I just mentioned for what a good medicinal mushroom product should be, and it’s had a game-changing impact on my health and on many of the people’s health that I’ve shared it with so far. I can’t wait to tell you more about that, [so] stay tuned for some more information over the coming weeks.

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How Our Gut Microbiota Influence Our Food Cravings

Now I want to move on to the next study. This one is [on] how our gut microbiota influence our food cravings. The study was called “The gut microbiome influences host diet selection behavior,” and it was published in the Proceedings of [the] National Academy of Science[s] or PNAS. As I mentioned in the intro, I’ve long suspected that our gut biome influences our food cravings, and I’ve seen evidence of it in my practice. For example, we do gut testing on all the patients we work with, and when people report really strong food cravings, we almost always will find [small intestinal bacterial overgrowth] (SIBO) or fungal overgrowth or parasites or some gut microbiome imbalance. So I knew this to be true from my own experience, but there wasn’t any published peer-reviewed evidence that backed it up, and it was maybe less clear what the exact mechanism would be. In this study, researchers gave 30 mice that lacked gut microbes a cocktail of microorganisms from three species of wild rodents that had really different natural diets since all those different diets lead to different gut microbiomes in those mice, and they put them in each of the three different groups of experimental mice. They found that the mice in each different group chose different foods, which indicated, of course, that their microbiome directly influenced their food cravings.

We’ve known for a long time about the gut–brain axis, which is a bi-directional link between the brain and the gut. Most of the output of our brain goes into something called the pontomedullary complex, which, in turn, empties into the vagus nerve. As you may know, the vagus nerve innervates our entire digestive tract. But the connection works the other way, too, where [the] compounds that are produced in the gut affect the brain. An example of this would be byproducts of the digestive process [signaling] to the brain that we’ve had enough food, and that’s how we know to stop eating. This study showed that gut microbes can produce similar compounds that hijack this gut–brain axis and change the communication being sent from the gut to the brain in a way that benefits the microbes. This is a great example of how we [hope to] live in a symbiotic relationship with microbes, but sometimes the microbes take over to create circumstances that are better for them. An example of this is tryptophan, an amino acid that is common in some foods like turkey. You’ve probably heard that tryptophan is thought to be responsible for the post-Thanksgiving dinner food coma that many of us go into. But tryptophan is not just in foods like turkey; it’s also in some gut microbes. It can then cross the gut barrier, enter the bloodstream, and travel to the brain where it’s converted into serotonin. And serotonin has multiple effects on our physiology. One is that it helps us to feel satiated after a meal. But another is [that] it gets converted into melatonin, which, of course, is the hormone that makes us feel sleepy. So that’s what explains the post-Thanksgiving dinner food coma.

In this study, the authors showed that mice with different microbes in their guts had different levels of tryptophan in their blood, and that may have led at least in part to their different food choices. But while tryptophan is certainly one piece of the puzzle, it’s not the only one. In an interview about the study in Science Daily, the lead author said, “There are likely dozens of signals that are influencing feeding behavior on a day-to-day basis. Tryptophan produced by microbes could be just one aspect of that.” The gut is an incredibly complex system. The microbes in the gut are producing all kinds of compounds all the time, and we’re just barely scratching the surface of understanding this. But I think the takeaway from this study and how to [apply] it practically is that, if you’re having really strong cravings for foods, and especially cravings for sugar or other processed and refined foods, [because] bacteria love sugar as you probably know, and so do parasites, and so do fungi, that could be a sign that you have some type of imbalance in the gut. Maybe [it’s] a preponderance of harmful bacteria versus beneficial bacteria, maybe you have fungal overgrowth, [or] maybe you’ve got a parasite, and that could signal you to go get some testing from a Functional Medicine provider. Or if you don’t have access to that kind of testing, it might just be a sign that you need to clean up your diet [and] you might need to pay more attention to your gut health with things like bone broth, fermented foods, fermentable fiber, probiotics, prebiotics, etc.

I don’t necessarily think food cravings are always a sign of a disrupted gut. There can be other reasons for that, of course, like low blood sugar, although that is often connected to a disrupted gut, as well. But it’s very often a sign of that. So we can use our cravings to guide what might be appropriate action for us, whether we have access to [a] Functional Medicine practitioner and testing or whether we’re just going to make some positive diet and lifestyle changes on our own.

Can too much of a focus on ‘root-cause’ backfire? Learn about this and more, in this episode of Revolution Health Radio. #chriskresser #educator #mushrooms #nutrientdensity

Applying Root Cause and Pleiotropic Approaches to the Process of Achieving a Healthy Life

Let’s dive into the next section. This is something I’ve been thinking a lot about over the last several years, [and] particularly over the last few months. One of the core principles of Functional Medicine is getting to the root cause of a health problem so we can address it at that level rather than just suppressing symptoms. I’m sure if you’ve been following my work for any length of time or any other Functional Medicine clinician, you’ve heard this a million times, and it’s probably in large part what drew you to Functional Medicine. An example would be if you’re having a lot of gut and skin symptoms and you [come] into my clinic, we would test you for a whole bunch of different things, including gut issues, but just a whole spectrum of tests that would help us to identify why you’re having those gut and skin issues. We might find, for example, that you have celiac disease, and then that information would be invaluable in helping us to figure out what to do, and what kind of diet changes you need to make and what other steps we need to take to address those gut and skin problems.

Another example would be autoimmune disease. Autoimmunity is an underlying process that is driven by many different factors, including diet, gut health, infections, environmental toxins, stress, etc. Testing can shed light on how much each of these factors is playing a role, and then what direction we should go in the treatment process. So trying to identify the root cause of a condition and address that cause or those causes should always be a goal, and it’s a key part of Functional Medicine. Having said that, the reality is [that] it’s not always possible to, first of all, identify all the root causes. Or second of all, in some cases, it’s not possible to address the root causes. Autoimmunity is a good example. Sometimes even after addressing diet and all the other behavior and lifestyle factors, the immune system is still dysregulated. Unfortunately, the immune system has a long memory. Once it starts attacking self tissue, it usually doesn’t ever fully stop, and there’s always the potential [that] even if you get it under control, it will come back. So if we only focus our attention on identifying and addressing the root cause, we can miss out on other possibilities that can lead to greater health and well-being. I call this myopic focus on root cause “root-causeism,” which is a term I borrowed from the cognitive psychologist and linguist Steven Pinker.

Pinker wasn’t thinking about health when he coined this term, root-causeism. He was referring to how we approach complex societal problems. I want to quote from this passage in his book, Enlightenment Now: “This version of historical pessimism may be called root-causeism: the pseudo-profound idea that every social ill is a symptom of some deep moral sickness, and can never be mitigated by simplistic treatments which failed to cure the gangrene at the core. The problem with root-causeism is not that real-world problems are simple, but the opposite: they are more complex than a typical root-cause theory allows. So complex, in fact, that treating the symptoms may be the best way of dealing with a problem, because it does not require omniscience about the intricate tissue of actual causes. Indeed, by seeing what really does reduce the symptoms, one can test hypotheses about the causes, rather than just assuming them to be true.” When I first read this passage in Pinker’s book, it stopped me in my tracks. I literally put the book down and took a long walk in the woods near my house at the time. As a Functional Medicine clinician, of course, the idea of addressing root cause was at the core of my belief system in my approach to treating patients. Could it be that [it] wasn’t always the best lens to see through? Although societal problems and chronic disease are not the same, they are both complex, multifactorial, and systemic phenomena. And while root causes always exist, they aren’t always identifiable or addressable, if we can [even] identify them, as I just mentioned. If that’s the case, what’s the alternative to an exclusive focus on root cause?

I’m still trying to find a word or phrase to express the answer here, but the one I’m using right now is pleiotropy. This is a term that I borrowed from the context of pharmaceutical medication research and genetics. It’s a little bit techie and unwieldy, so if you can think of a better term, let me know. But pleiotropy is usually defined as the production of diverse physiological or psychological effects by a single drug or a gene. An example would be something like the drug metformin, which is typically used to lower blood sugar. It’s used in the context of diabetes. But metformin has been shown to have a bunch of other effects, too. It has anti-cancer effects, and it may even help promote longevity. But here, I’m talking about pleiotropy in a more general sense as any intervention that has multiple and diverse effects on us. This can include things like diet, exercise, stress management, and adjunctive therapies that I’ve talked about before like sauna or pulsed electromagnetic field therapy (PEMF). It could include a shift to a growth mindset, cultivating more pleasure and joy, building resilience, embracing positive psychology, [or] improving your relationships. All these interventions share one thing in common: they have pleiotropic effects, which means multiple effects across multiple different domains in our health and even our lives.

For example, eating a healthy diet doesn’t just have one benefit; it has multiple benefits. The same is true for exercise, meditation, [and] shifting your mindset. To make this a little more real, imagine a scenario where someone is feeling significant fatigue. If we embraced a 100 percent focus on root cause, or if we fell into what Pinker calls root-causeism, we might do a full blood panel [and] run a bunch of other tests to find the source of that fatigue. Is it [a vitamin] B12 deficiency? Is it hormone imbalance? Is it mercury toxicity? On the other hand, if we embrace a 100 percent pleiotropic approach, at least how I’m using that term, we might say, “All right, I’m tired, so I’m going to clean up my diet, I’m going to get more sleep, I’m going to rest in the afternoon, or do a PEMF session or a sauna session. I’m going to cut down on coffee, and maybe I’ll take some supplements that are designed to generally improve my health and energy.” Here’s the crucial point. Both approaches might get to the same goal, which is improved energy, regardless of the underlying cause. If it’s [vitamin] B12 deficiency, cleaning up your diet could help with that. If it’s a hormone imbalance, [improved] diet, stress management, more sleep, etc., could help with that. Even with mercury toxicity, doing daily PEMF or sauna sessions, eating a diet that’s rich in detox-supportive nutrients, and getting more sleep and exercise will all support detoxification. Maybe those aren’t enough on their own, but they’ll definitely help.

I would argue that the best approach is generally a mix of root cause and pleiotropy. The reason that I’m talking about this is that I’ve seen some people just get really focused on root cause at the expense of other interventions that are going to make their life better in real time. This is what Steven Pinker might call root-causeism. For example, let’s say somebody is experiencing a whole range of symptoms, including fatigue, but also [gastrointestinal] (GI) issues, and maybe they’re having skin rashes and [their] hormones are out of whack, and they’re not sure what’s going on. And let’s say after dinner each night, they have some free time. There [are] so many different choices that someone like that can make about how to spend that free time. They could go online and spend the next two or three hours doing research, searching for what might be the cause of their condition. They might spend time on social media forums or groups. They might join other forums of groups of people who are dealing with similar situations. And they might really put all their energy into trying to find the cause or the answer, at the expense of doing other things that could actually lead to improvements of their health, even if [they] don’t know what the cause is. On the other end of the spectrum, after dinner, they might go for a walk in their neighborhood, they might play with their dog or their kids, they might take out their guitar and play some music, [or] they might watch a funny movie with their partner. There [are] so many opportunities for doing things that actually lead to better health right then in the moment. I think this comes down to the understanding of health as a process rather than a destination.

So often, we think of health as something that we get to after some period of time and a whole bunch of things that we do. After we’ve finally gotten rid of all the symptoms and causes of our condition, then we will finally arrive at this place called health. But over the years, I’ve come to understand health as a living, breathing process that happens from moment to moment. All the choices we make from moment to moment on how to spend our time and what interventions to do and where we put our energy and attention, [is] what contributes most to health. I want to be really clear here; I am not suggesting that we shouldn’t look for the underlying cause of disease. That would be anathema for someone like me as a Functional Medicine clinician. I still think that’s critical and so important for the vast majority of people who are dealing with health issues. But I am suggesting that’s not the only thing we should do, and we should never do [it] at the exclusion of other interventions we can engage in, [which] would have these pleiotropic effects and help us start feeling better right away. And even, I would argue, eventually make it easier to find the root causes.

I hope this is helpful for you. It’s been a really important realization for me in my own journey earlier in my life with chronic illness, and even now it informs how I approach all kinds of different issues and problems or challenges in my life. When they’re complex and thorny, I’m always looking for [the] root cause. That’s the lens that I look through. But I’m also always trying to find ways that I can use this pleiotropic lens, as well, and think about shifting and moving through these challenges in real time by taking steps that generally make them better.

Blood Sugar and the Risk of Cardiovascular Disease

Let’s talk very briefly about a study that’s making the rounds on blood sugar and the risk of cardiovascular disease. This one’s called “Early and ongoing stable glycaemic control is associated with a reduction in major adverse cardiovascular events in people with type 2 diabetes: A primary care cohort study.” The researchers looked at people [who] were newly diagnosed with type 2 diabetes and separated them into three groups: one group with hemoglobin A1C below 7.5 percent, [the] next group with A1C between 7.5 [percent] and 9 percent, and the last group with A1C above 9 percent. They followed them for a year and observed what happened. They found that the people who went from having A1C at diagnosis in the highest group [of] over 9 percent to being below 7.5 percent, so these are the folks [who] really took action and lowered their blood sugar, their risk of cardiovascular event was cut by 25 percent. On the other hand, those who had the highest variability in blood sugar or saw increases in blood sugar had [a] 51 percent greater risk of cardiovascular disease. This shouldn’t surprise us, right? There’s no big “a-ha” moment here. But it does support what we’ve been talking about for many years, which is, the earlier we attend to our health and well-being [and] the earlier we intervene when there’s an issue, the better the outcome will be. This doesn’t just apply to people with type 2 diabetes; it applies to people with any blood sugar abnormalities.

In the clinic, when we treat patients, if somebody has even high-normal blood sugar, we’re immediately starting to look at what we can do to bring that blood sugar down into the optimal range. We’re not going to wait until they develop pre-diabetes to take action. We’re certainly not going to wait until they develop full-fledged type 2 diabetes to take action. Unfortunately, that is typically what happens in the conventional model. But as Ben Franklin famously said, “An ounce of prevention is worth a pound of cure.” And that is absolutely the case when it comes to medicine, perhaps more than any other field that I can think of. So what does this mean for you? If your blood sugar is starting to creep up, let’s say it’s in the low 90s consistently, or maybe in the mid 90s, if you go to the doctor, they’ll say, “Hey, you’re fine. You’re in the normal range.” All of a sudden, once you hit 99, even if you were at 98 for years before that, now you’re pre-diabetic. Of course, it doesn’t work like that. These things exist on a spectrum. There’s no binary thing that happens magically when you go from 98 to 99, even though technically, you go from normal blood sugar to pre-diabetes. So we want to always be looking at these things on a spectrum. And if your blood sugar is starting to creep up, now is the time to take action because it’s so much easier to reverse high-normal blood sugar than it is to reverse pre-diabetes. And in turn, it’s so much easier to reverse pre-diabetes than it is to reverse type 2 diabetes. Once you get to a certain point in type 2 diabetes where you’re losing beta-cell function and the capacity to produce insulin, it might be impossible to fully reverse, and you might be dependent on something like metformin or even insulin at that point. So it’s always important to take action early. And of course, this doesn’t just apply to high blood sugar. It applies to lipid disorders and all kinds of other things in health and medicine.

Prevalence of Nutrient Deficiencies in the Modern Diet

[Lastly], I want to talk about how, over the years, my view on nutrient status has evolved and changed, and why I think that most people, even on a healthy diet, may be falling short when it comes to some important nutrients. As you know, I’ve always been an advocate of meeting as many nutrient needs as possible through food. That’s been a core foundation of my approach. And in an ideal world, it would be possible to do this for every single nutrient that we need. But in the world that we live in now, this is extremely challenging for many reasons. First, most people just don’t eat well, [and] in the industrialized world, in particular. In the [United States], 60 percent of calories come from ultra-processed foods. Not just processed foods, but ultra-processed foods. These [are] foods like pizza, crackers, cake, cookies, etc., all kinds of foods that come in [a] bag [or a] box, sugar sweetened beverages, sugar, flour, seed oil, all these foods [that] are nutrient poor, but calorie dense. They’re high in calories, but they’re very low in the essential micronutrients that we need. They also disrupt the gut microbiome, which has so many different effects, some of which we’ve discussed in this episode, and they interfere with nutrient absorption. Even if you’re eating nutrients in other foods, you’re not going to absorb as many of them because of these ultra-processed foods. This explains why the majority of Americans are deficient in several essential vitamins and minerals. Data from the NHANES survey in the [United States] from 2007 to 2010 suggest that 100 percent of Americans don’t get enough potassium, 94 percent don’t get enough vitamin D, 92 percent don’t get enough choline, 89 percent don’t get enough vitamin E, [and] 67 percent don’t get enough vitamin K. I could go on, but literally every single essential nutrient that you think of, most Americans are not getting enough [of].

As bad as this picture is, it only tells part of the story. These statistics on the prevalence of nutrient deficiencies are based on the Recommended Dietary Allowance (RDA). There are several problems with using the RDA as a benchmark for nutrient intake. The first is that the RDA is the amount that’s required to avoid disease, not the amount that we need for optimal health. An example is that you might have enough vitamin C to prevent scurvy, which is great, but not enough to ensure adequate immune defense against pathogens and prevent oxidative stress. I know if you’re listening to this podcast, you don’t just care about avoiding disease; you want to live your best life and have optimal health. This is where the RDA falls short, and that’s the most important shortcoming. Another is that [the] RDA doesn’t consider the presence of chronic health conditions that increase demand for nutrients or reduce absorption of nutrients. A classic example of this that I’ve talked about a lot is vitamin D. We know now that conditions like obesity, inflammation, [and] GI disorders like SIBO or inflammatory bowel disease either decrease the absorption of vitamin D or, in the case of inflammation and obesity, also decrease the conversion of sunlight to vitamin D. They also increase the demand for vitamin D. So it’s a double whammy effect. And this isn’t just true for vitamin D. It’s true for many other nutrients that we need on a daily basis. When the RDAs were established, these kinds of effects were not known, and so the RDA does not factor them in and is likely way too low for that reason, as well.

The third issue with the RDA is that it’s often out of date and has not been adjusted for important changes that have happened to the population. Most people don’t know that the RDAs were originally designed by using [the] average body weight of a typical adult male or female in the [United States]. Let me use magnesium as an example. The RDA for magnesium is currently 420 milligrams per day for an adult male and 360 milligrams per day for an adult female. This was based on an average body weight. Back in 1997, when it was last updated, they used an average body weight for men of 166 pounds and for women of 133 pounds. In 2021, just last year, a group of researchers recalculated the RDA for magnesium based on updated average body weights because obviously, body weight on average has increased in the [United States] pretty dramatically over the past 20 years. So they updated the average body weights to 168.5 pounds for women and 196 pounds for men. After doing that, they came up with a new RDA for adult men of 575 to 657 milligrams per day. That’s over 200 milligrams per day more for men [at the top of that range]. And they adjusted [the RDA] to 467 to 534 milligrams per day for [adult] women. That’s almost 200 milligrams per day more for women at the higher end of that range.

This is really alarming because the average intake of magnesium in the [United States] is just 340 to 344 milligrams per day for men, and just 256 to 273 milligrams per day for women. This is well below even the outdated RDA, [and] it’s 200 to 300 milligrams per day less than the more accurate RDA that the researchers proposed. Despite this, the RDA for magnesium has not been updated, and that means [the] statistics on magnesium deficiency are dramatically under estimating the prevalence in the population because of using this outdated RDA. If we use [the] new RDA, almost 100 percent of people would be deficient in magnesium. This is, as a side note, one of the reasons that I have always recommended supplementing with magnesium, even in people who are following a nutrient-dense diet, because I’ve seen, through this published research and also tests that we’ve run on patients who come into the clinic, that virtually everybody is falling short of the optimal magnesium intake.

So we might think, “All right, nutrient deficiency is a huge problem in people eating [a] Standard American Diet with ultra-processed food, but I eat a nutrient-dense diet. So it’s not an issue for me.” I wish that were true. I really wish that were true. That was my belief for many years, with the exception of some nutrients like magnesium and vitamin D. Of course, there’s no doubt that eating a nutrient-dense, whole foods diet makes a huge difference in nutrient status. There are lots of studies to back this up, and it’s just common sense. But unfortunately, there are several reasons why even people on nutrient-dense diets can fall short of the recommended intake of nutrients for optimal health, not just the RDA, but for optimal health. One is the decline in soil quality over the past several decades. An example of this is [that] we’d have to eat eight oranges today by some estimates to get the same amount of vitamin C and other nutrients that our grandparents would have gotten from eating a single orange. [U.S. Department of Agriculture] data from 1950 to 1999 show reliable declines in many different nutrients and minerals from 43 common crops. From just 1975 to 1999, the average [amount of] calcium in vegetables dropped by 27 percent, iron dropped by 37 percent, vitamin A by 21 percent, and vitamin C by 30 percent. Another study has shown that between 1940 and 1991, magnesium content in vegetables decreased by 24 percent, fruit by 17 percent, meat by 15 percent, and cheese by 36 percent. In the UK, it’s been in a decline of about 35 percent across all those different food categories for magnesium. The decline is probably even higher in 2022, but we don’t have up-to-date research to reflect that.

According to some of the soil scientists that I’ve corresponded with, the issue is not that the nutrients aren’t still present in the soil; it’s that the composition of microbes in the soil has changed due to [the] use of pesticides and other industrial farming practices. This change in the microbe composition in the soil makes the nutrients [that] it contains less available to the plants that are growing in that soil. This is analogous, of course, to what’s happened in our own guts. Antibiotics, other medication, poor diet, toxins, etc., disrupt our gut flora, and that leads to decreased absorption of nutrients from the food that we eat. One way to think about this is that our farming practices have disrupted the gut microbiome of the soil, so to speak. This, in turn, has decreased nutrient availability to the plants in that soil, which, in turn, has decreased the amount of nutrients that we get from eating whole foods. Another factor that [I think] has decreased the amount of nutrients that people get even on a healthy diet is the dramatic rise in food intolerances. Almost everybody I know, and certainly many of the patients that I work with, are dealing with some kind of food intolerance, [or] some category of food that they can’t eat. Often, even healthy categories of foods like nightshades, for example, or nuts and seeds, or dairy products, or [fermentable oligosaccharides, disaccharides, monosaccharides and polyols] (FODMAPs), or something like that. That has led to a restricted diet for many, many people, and often, they’re not able to fully overcome those restrictions. Their diet remains limited, and they eat a more restricted variety of foods. Of course, what that means is they’re not getting as broad of a spectrum of nutrients. This is particularly common in kids and young people, and it’s even more of a problem for them because they have a greater demand for nutrients.

Another issue is the cultural shift in food preferences, particularly in the industrialized world. You know by now if you’ve been listening to the show for a while that organ meats and shellfish are among the most nutrient-dense foods on the planet, ounce for ounce. Also, things like sea vegetables and various kinds of fermented foods are up there on the list, as well. Those foods have fallen out of favor. Most people I know do not eat liver or other organ meats and can’t stomach them, even if they know they should eat them. They’re not eating a lot of shellfish, or small dried fish, or these other foods that [have] always topped the nutrient density list. They’re not eating seaweeds or other sea vegetables. These are just not typical foods in the American or industrialized country diets. I recently had Ty Beal on my show to discuss his paper on nutrient density, and we talked about all these foods that are so rich in so many of the essential micronutrients. And unfortunately, they’re just not being consumed very often. I think that’s another major problem.

Then we have the rise of intermittent fasting and fasting. This is, of course, in more health-conscious people. [It’s] not an issue in the mainstream. Intermittent fasting is fantastic. It has a lot of different health benefits. I’m a big believer [in intermittent fasting] when it’s applied appropriately. But in some cases, there can be [a] potential downside. Let’s say you’re only eating two meals a day and you decrease your calorie intake, and you’re not eating the same amount of food or calories, which is often the case. It’s probably one of the reasons intermittent fasting can work for weight loss. Some people even go more radical, and they go down to one meal a day. If you’re eating that much less food, you’re by definition going to get that many fewer nutrients. There’s no way around that. And like I said, while I think there are many benefits of intermittent fasting, that is one potential downside.

Lastly, if you look at comparisons of nutrient intakes from the Paleolithic era, we have some anthropological studies that looked at extant hunter–gatherer groups and quantified their nutrient intakes, and compared those to nutrient intakes in the modern world, and especially in the industrialized world. You see that all the way down the line, from essential vitamins to essential minerals to phytonutrients to fiber, there’s a dramatic decline in average nutrient intake across the board from people who were following [a] Paleolithic lifestyle to people in the modern world. And I think that has to do with all the factors that we’ve talked about so far.

My clinical experience, in addition to the research that I’ve just been talking about, definitely backs this up. I’ve worked with some of the most motivated people around. The folks who come and see me are not typically people who are just following a Standard American Diet. I’ve probably had less than a handful of those over almost 15 years of clinical practice. But even the people I work with, who are highly motivated and following a great diet, are often not getting enough of certain nutrients. How do I know this? Well, we test people for nutrients in the clinic, and we do it a couple of different ways. We do blood testing, urine organic acids, and other types of testing that can be helpful for clarifying nutrient status. Sometimes [we do] hair testing; it depends on the nutrient. We also have everybody use Cronometer, which is an app where they can carefully track their food intake over a period of three days, and it spits out a full nutrient analysis. On the basis of both of these types of testing, almost every patient I’ve worked with over the years is short of some of the essential nutrients. The most common would be vitamin D, magnesium, folate, [vitamin] B12, preformed vitamin A, retinol, choline, [vitamin] K2, and calcium. But I will say that in more than a decade of clinical practice, it’s only a few patients I can remember that we’ve gone through this process with, that are at 100 percent or more of all the needed nutrients.

So what do we do with this information? Well, to be honest, I struggled with it for quite a while. Initially, in my career, I had a strong belief that we should be able to meet most nutrient needs from food. I still have [the] belief that we should be able to. I want to be able to. But that belief kept bumping up against the reality of what I was seeing in the published scientific literature and the reality of what I was seeing in my clinical practice with patients and the testing that we were doing, and the impact that those deficiencies of nutrients [were] having on people. I’ve known for a long time that it wasn’t really possible for most of us to meet our vitamin D or magnesium needs through diet, so I’ve always recommended supplementing with them even on a maintenance basis. But after all this clinical experience treating patients and all this research, I have had to face the music and recognize that many of us are not able to meet all our nutrient needs through food alone, and that supplementing with additional nutrients in a really smart way is probably a good idea for most of us if we’re interested in reaching that optimal nutrient status and maximizing our health.

I started doing this myself a few years ago and suggesting it to patients. The results have been, as you might imagine, very positive, both in terms of subjective health benefits and in terms of testing [in] both the lab testing and Cronometer output. But there was a big issue, which is that none of the multivitamin, multimineral products out there measured up for me. As you know, I have very high standards, and I know what’s important in a nutrient product. A lot of the [multivitamins] out there have too much of the wrong nutrients. For example, they have high doses of calcium, which we know that [taking] too much supplemental calcium can increase the risk of heart disease or kidney stones. They have high doses of iron, which for some people can be problematic if they have a tendency toward iron overload, which is not uncommon in the industrialized world. Or they have vitamin E tocopherols like alpha-tocopherol. If you listened to my podcast with Barrie Tan, you know that supplementing with alpha-tocopherol can actually increase the risk of cancer and heart disease instead of tocotrienols, which are the more beneficial isomers of vitamin E. Or maybe the [multivitamin] has not enough of the right nutrients that we actually want more of, like vitamin K2 would be a good example, vitamin D is a good example, [or] magnesium. Or the product doesn’t have the right forms of the nutrients.

For many years, I’ve talked about the importance of supplementing with folate rather than folic acid for vitamin B9 because some people don’t process [unmetabolized] folic acid well. It’s a synthetic form. Unmetabolized folic acid has been shown to lead to a bunch of problems in some people who are susceptible to that. And people who have methylation problems are definitely among the people who are susceptible. Then you have cyanocobalamin, which is a cheaper form of vitamin B12. It’s not as well absorbed as methylcobalamin or adenosylcobalamin. Those are just a couple [of] examples, but there are many, many more. And what we’re talking about here is pretty good quality multivitamins from reputable manufacturers. We’re not even yet talking about the cheap multivitamins you get from Walmart or Walgreens or places like that. Most of those have lots of fillers, binders, [and] artificial ingredients. They’re really cheap quality. They don’t have therapeutic doses or meaningful doses of the right nutrients. I was really unimpressed with the quality of products out there. With my own patients and with myself, I had to cobble together a bunch of different products, which is expensive. It led to taking tons and tons of pills, and it’s a pain.

So when I decided to create my own supplement line, Adapt Naturals, this is one of the major problems that I was trying to solve. The result is a product called Bioavail Multi. This is one of the five products in the Core Plus bundle that we’re launching in July. I mentioned Bioavail Myco, the mushroom product, earlier. That’s one of the others. This is a multivitamin, multimineral, phytonutrient blend. It mimics nutrient intakes that are found in an ancestral diet. That was a goal for me when we set out to [create] this product. We wanted to have something that reflected roughly the same ratios and amounts of nutrients that we would get in an actual ancestral diet before all the things happened in the modern lifestyle that I talked about before that are decreasing our nutrient intake, like declines in soil quality and changes in food preferences, etc. I wanted to create a product that corresponds to a whole foods, nutrient-dense diet.

Of course, I wanted all the ingredients and forms of the nutrients [to] be food based, or naturally occurring or bioidentical. So folate instead of folic acid, methylcobalamin instead of cyanocobalamin, MK4 and MK7 forms of [vitamin] K2, even MK9 and other menaquinones. All the most bioavailable, highly absorbable, and natural forms of ingredients that we would find. In addition to the essential vitamins and minerals, I wanted [it] to also contain clinically relevant doses of phytonutrients that have been shown to be beneficial for health. We know that [the body can’t manufacture] essential nutrients like vitamin A, vitamin D, vitamin K2, and minerals like iron, zinc, [and] magnesium, and we absolutely need those for health. We can die without them. This other class of nutrients like these phytonutrients may not be essential for health in the sense that we can literally [not] survive without them, but a huge growing body of research suggests that they are definitely essential for optimal health. These are compounds like lutein, lycopene, bioflavonoids, [and] some of the phenolic compounds that we talked about earlier. These were almost certainly consumed in much greater quantities in the past by our ancestors, and they’re still consumed in greater quantities by people who are living a lifestyle that’s closer to our ancestral lifestyle.

Most [multivitamins] on the market are designed to meet the RDA. We’ve talked about the problems with that. The RDAs are insufficient for optimal health for almost all the nutrients. This product was formulated using both the principles of evolutionary biology and modern clinical research to determine what the optimal amount of nutrients is, not just the RDA. Bioavail Multi will be available as part of the Core Plus bundle, which is launching in July. I’m really looking forward to telling you more about this product as well as the other products that will be in the bundle, so stay tuned for more information.

Okay, everybody. Thanks for listening today. I hope this was helpful, and keep sending your questions in to ChrisKresser.com/podcastquestion. We have some really interesting shows coming up, including an interview with Dr. Christopher Hobbs, a medicinal mushroom expert, where we’re going to do a very deep dive on that topic, which, as you can see, I’m really excited about, and I hope you are, too. I will talk to you next time. Take care, everybody

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