Food as Medicine for Mental and Metabolic Health

These days, stress can feel inescapable. But did you know that what, when, and how you eat can help you deal with stress more effectively?

I sat down with Functional Medicine Dietitian Ali Miller to dive into the connection between stress, metabolism, and the food on your plate. In our discussion, we covered how to know if you’ve got a cortisol issue; using food as medicine to support your adrenals, thyroid, and hormonal balance; and whether intermittent fasting is helpful or harmful.

Plus, we talked about how you can use diets as tools to empower metabolic flexibility and restore your connection to your body’s feedback.

It’s a juicy episode! If you’ve been feeling a little (or a lot) stressed recently, this is information that could truly change your life.


00:02:12 – What we’re covering in this episode
00:04:52 – The connection between stress and metabolism
00:08:28 – Signs you’ve got a problem
00:15:12 – Issues with morning cortisol tests
00:17:14 – The adrenals’ role in menopause
00:19:33 – Are you doing this right?
00:22:42 – Fasting: Should you do it?
00:27:49 – Foods to support hormone and adrenal health
00:31:21 – Protein prescriptions
00:33:31 – Are there concerns with plant-based diets?
00:37:04 – Keto, low-carb, and developing metabolic flexibility
00:40:23 – Carb cycling as a tool
00:42:26 – The mindset you want to avoid
00:43:23 – Why Ali avoids non-caloric sweeteners

Freebies From Today’s Episode

Enjoy 1 week of Ali’s 12-week Food-as-Medicine Keto Meal Plan

Resources Mentioned in this episode

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Subscribe to my podcast

Learn more about Ali Miller

Read The Anti-Anxiety Diet

Read The Anti-Anxiety Diet Cookbook

Listen to the Naturally Nourished Podcast

Podcast: Change Your Diet to Help With Anxiety with Ali Miller

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Theia Health Continuous Glucose Monitor

Designs for Health DHEA

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Click Here To Read Transcript

ATHE_Transcript_Ep 589_Ali Miller
JJ Virgin: [00:00:00] I'm J. J. Virgin, Ph. D. dropout, sorry mom, turned four time New York Times best selling author. Yes, I'm a certified nutrition specialist, fitness hall of famer, and I speak at health conferences and trainings around the globe, but I'm driven by my insatiable curiosity and love of science to keep asking questions, digging for answers, and sharing the information I uncover with as many people as I can, and that's why I created the Well beyond 40 podcast to synthesize and simplify the science of health into actionable strategies to help you thrive.
In each episode, we'll talk about what's working in the world of wellness from personalized nutrition and healing your metabolism to healthy aging and prescriptive fitness. Join me on the journey to better health so you can love how you look and feel right now and have the energy to play full out at 100.
So as we [00:01:00] start to age, and that's why this is called Well Beyond 40, some things start to shift. And if you understand what's going on, you can nip them in the bud before they start to wreak havoc. And what really starts to ship as we age is cortisol. In fact, unfairly, this is like the hormone that goes up as we age.
And that's not really what you want to do. You want cortisol to really go by its natural rhythm. So what we're going to be addressing today is how to really get your cortisol rhythm dialed in, what you might be doing, trying to follow some of the diet techniques out there that could be creating problems for you.
And then also how to become more metabolically flexible because again, as we age, what happens? Cortisol starting to come up. We become more insulin resistant. That is a double trouble for any kind of metabolic flexibility. That's going to tell you to store more fat, especially around your belly and be hungrier and crave things.
And I'm not talking about salmon. So I sought out Ali Miller. [00:02:00] We've had her on the show before because I wanted her to dig into this. Cause this is her area that she literally wrote the book on, writing the anti anxiety diet and the anti anxiety cookbook. And she takes an awesome food is medicine approach.
So you're going to hear really how to use diets as tools. When should you do intermittent fasting? When shouldn't you? What about carb cycling? How do we use this? And what does it really mean to be metabolically flexible? And how do you do that? And how do you also know if cortisol is an issue? And what will it do you if it is?
Lots of juicy info in this podcast. I could have kept going for hours here. Anyway, you will love what you're about to learn from Ali Miller. Let me tell you a little bit about her. She's going to give you a meal plan and I'll link to her other episode that we did and her books and all of that and her social at spelled A L I M I L L E R. Ali Miller is a registered dietitian. She's got a great background in naturopathy and she's got a huge passion [00:03:00] for using nutrients and food as the foundation for her treatment protocols and programs. She is a big expert in Ketogenic diets and also leptin and then really how to use food as medicine to support your thyroid, your adrenals, and your hormonal balance.
So you can see why she was the one I wanted to really break this all down for us. So I will be right back with Ali Miller. Stay with me. Ali Miller, welcome to the show. I'm super excited to dig into metabolic flexibility with you.
Ali Miller: Yes, it is kind of all the rage and it gives us so much freedom when we understand the feedback from our body and it keeps things from getting rigid.
So I think it's a huge topic to discuss.
JJ Virgin: All important things. We were just talking offline and where I really hope we can get this concept out is that diets are tools. And I don't know if you've noticed this, and this is kind of my hypothesis. I look at all of these things and I go, you know, a diet's a tool.
We need another name for it, or we need another name for how [00:04:00] we eat every day because we get the two completely mixed up. And, you know, if we use a diet therapeutically, learn some things, go, this works really well for me, or this didn't, equally important information, maybe even more important to know it didn't work, you know, all my friends have written diet books, like that's the world we live in, right?
And we write the book for ourself and then we become religious about it. So I love the exploration we're going on today, especially when you look at what does it mean to be well beyond 40 and two of the things that really confront us. that go right into creating this inflexibility with your metabolism, but also this rigidity with your diet.
are the big hormone that goes up as we age, which is so unfair, cortisol. And then the big problem that happens as we age that really destroys our metabolism, insulin resistance. And you know, I can't be metabolically flexible with insulin resistance. So I want to dig into all of that. And I'd probably start over with the stress and cortisol, because I know that you've really spent a lot of time there.
And I'd love to know first, what got you [00:05:00] into that?
Ali Miller: So my main books out there are the Anti Anxiety Diet and the Anti Anxiety Diet Cookbook. And, like you said, we write books to solve our own problems, right? I'm a type A over committer, you know, go, go, go. I don't understand. What are you talking about?
Right. You know, more is more, always. And willing to kind of silence the feedback of my body and white knuckle for perfectionism. And one of my favorite mantras that I use in the book, actually, that connects to the whole conversation, I believe, is the concept of doctrine creates disconnect. When we get very indoctrinated and we tunnel vision, whether it's keto, whether it's Paleo, when we make these very rigid rules of on, off, myopic, tunnel vision, we start to lose the connection of the feedback of our body.
And when we are following our body's hormone cycles, for instance, we'll see that women need different caloric intake and different macros actually in [00:06:00] their luteal phase from their follicular stage. And then we know that women in perimenopause and menopause. Have different needs of macros and calories based on transition and shift.
So when we're looking at the connection of cortisol, the big way that I connect this is into the HPA axis, what stands for the hypothalamus pituitary adrenals. And this is a feedback loop, essentially, of whether you are in fight or flight, sympathetic nervous system response. Or you're in rest, digest, I would also add regulatory for hormone, thyroid, metabolism, sleep cycles, body temperature.
All of that is optimized when we're in this parasympathetic space. So if the body is perceiving the need to survive based on mental stress or emotional stress, it could be a silent infection in the body like dysbiosis or a viral infection like Edstein [00:07:00] Barr. All of these things, toxicity can drive a stress response that throws the body and kind of starves it from the ability to be in that regulatory mode.
And that's when we'll see either excessive cortisol or over times what goes up must come down and we'll see depleted cortisol. And on both ends of the spectrum we can see metabolic disruption.
JJ Virgin: I look at this and you know, most of my friends are working moms. And some of them are single working moms, which I was for a long period of time.
And I was the only financial support and I had a special needs child. So when you look at these things, I don't know how, unless you really have done the work, which I didn't even start to look at what this work was until a couple of years ago, how you are not in sympathetic drive all the time. You think about it and you know, you named things like these low grade chronic stressors.
Like a virus, or I'd say [00:08:00] even things like you've got gluten intolerance and gluten is coming in. We also have these obvious ones, especially women. We've just somehow acquired the household duties, the child duties, the CEO of the healthcare for the family, the financial duties, none got taken off the plate.
More things just got added and that alone can do it. So then you just compound it because. It's not just one thing. All of these things can do this. How would someone know? Cause I, I remember back when I was seeing people when I won, people don't come in when they're in that first high stage for the most part, because man, they're on fire.
That's the adrenaline junkie myself. You're on fire. Now, they might start getting frustrated because they're craving sugar, or they've got bloating, or they seem to be getting belly fat. But generally, I found it was when the crash happened that people came dragging in. Hopefully with this, we're going to both have people avoid the [00:09:00] crash and also teach them how to rebuild it after the crash.
And full disclosure on my story is I would crash repair, crash repair, and finally I went, just stop doing that, you know, just stop it. Without doing something like, say, a adrenal salivary index, how are you helping people discern that this is an issue for them?
Ali Miller: Well, there's some things that would be safe add ins on wherever you are in the adrenal story to just tonify and support the adrenal glands.
And so something that I would definitely lean into would be vitamin C.
JJ Virgin: Before that, wait, wait, wait, wait, back up. How would someone even know they had a problem? Because I think one of the challenges is when you're in the first parts of this. Which, you know, this isn't a problem that happened overnight. It happens over time and habits dictate hormones.
However, most people aren't going to start to really look at it as an issue until it's been going on for a while and really created some problems. So how would you be able to. Know [00:10:00] that this is an issue for you.
Ali Miller: So without looking at, like you said, a salivary assessment of the adrenals, which would look at cortisol and DHEA, we would think of the primary influences of an over or under drive.
And so overdrive might be experiencing insomnia. You mentioned also belly fat can be seen. We can see agitation and irritability. I'll call it incredible Hulk syndrome, even when individuals have high skyrocketing DHEA, we'll see that where they're feeling this physiological like chest bumping amount of energy.
We can also see agitation and anxiety or irritability, shorter fuse with those around us when we are in a high adrenals. And we can see elevated blood sugar levels. So cortisol itself is a glucocorticoid or it actually has mechanisms to create blood sugar spikes. And that in itself can create an elevation of A1C, so you might have a new diagnosis of [00:11:00] prediabetes, but yet you eat very low carb.
JJ Virgin: So you'll see the triglycerides and you know, triglycerides will look totally fine, yet your blood sugar's up. And you know what their diet's like. So that's one that I've always used as an indicator. I think it's really important.
Ali Miller: And there's two mechanisms. Your liver independently dumps sugar as a fight or flight survival response.
And then that cortisol keeps those sugars elevated. And so you kind of have a double edged sword there. And especially those that wake with elevated fasting blood sugar, that's this dawn phenomenon where it's that cortisol surge, getting them out of bed. And that. Excessive cortisol will create a blood sugar spike.
So if your A1c is good, for instance, but your doctor says, huh, for whatever reason, your fasting glucose is always 112 or 115, but your A1c is 5. 2, that could be more of an adrenal imbalance or so than a diet.
JJ Virgin: That would be a great use of a CGM too.
Ali Miller: Sure, absolutely. Because then you would see, especially if listeners are dealing with intermittent waking in the middle of the [00:12:00] night, whether they're having a hypoglycemic blood sugar crash.
Or they're having a blood sugar spike from a cortisol surge. And we really tie insulin resistance into hot flashing as one of the primary mechanisms. Inflammation, insulin resistance, and then of course the decline of estrogen and testosterone. But cortisol excess would be kind of that too much bundled up excess.
In the world of cortisol insufficiency or adrenal insufficiency overall, we can see flatness, apathy, depression, chronic fatigue. We can see aches in the body, kind of mimicking like a fibromyalgia because cortisol itself has anti inflammatory elements. So if it gets too low. Our body is generally going to be more inflamed, and this is where we can also see bloating.
You'll see more belly fat accumulation from high cortisol, but you'll see more dysregulated bloating from too low of cortisol. Cause that has to do with the fluid shifts and more of an inflammatory response to food. So. [00:13:00] More reactions to food sensitivity would be an indicator also of adrenal insufficiency.
And then just having dysregulated energy in general, feeling like brain fog flat and you don't have that vigor. You're definitely not cartwheeling or chest bumping like you are in the other end of the spectrum where you have too much in your tank.
JJ Virgin: And if you are in the first one right now and kind of going, I don't want to do anything about this because I'm really happy about how I'm feeling right now, you're going to go to the other.
It's a false energy that's really damaging, as you just described, what it's doing to the body with the insomnia, of course, the belly fat, the elevated blood sugar, like it's not innocuous.
Ali Miller: Well, and it can drive down more aggressively hormone transition, right? And so when we're getting back to that HPA axis, and we said if you're regulated and parasympathetic, you're going to have optimal hormone balance and optimal thyroid.
Well, if you're dysregulated, again, whether those adrenals are in an excessive output or a low output, the brain is focusing its energy on stimulating the [00:14:00] adrenals versus your FSH and LH, which regulates your menstrual cycle. And we know that that's one way that we test perimenopausal shift is the impact of our FSH going up to try to stimulate the follicle that's reducing as we age.
We know that we can see impacts on prolactin and impacts on oxytocin. And oxytocin is a beautiful antidepressant, bliss, safety, reward mechanism that can help with food cravings. But that gets thrown off when we're stimulating those adrenals too much. Our hypothalamus will have body temperature dysregulation, so we don't have that good thermogenesis to burn calories, and we can also have irregular swelling and flashing.
So there's just so many mechanisms that we can see the thyroid releasing hormone being depleted, which is made by the hypothalamus, and the thyroid stimulating hormone getting off, and that's made by the pituitary. So how our body stimulates other glands, ovaries, thyroid, if the body is focusing too much on only stimulating those adrenals, We're not going to see good [00:15:00] balance and regulatory function, which impacts metabolism and hormone health ultimately.
JJ Virgin: It's just too bad that really evaluating cortisol, because what you see in the labs is they have someone do a morning cortisol, right? Talk about the issue with a morning cortisol. And then, you know, I kind of glossed over what would you look at if you couldn't look at the salivary index, but I think the salivary index is such a useful tool.
It just isn't used.
Ali Miller: Yes, and you know, one thing that people can advocate for that's more accurate is a DHEA sulfate or DHEA S. This is a lab that many doctors will run in this perimenopausal, postmenopausal phase if requested, generally you have to request it, but this is accurate. That form of this steroidal hormone is actually an accurate assessment and DHEA is truly a metabolic miracle.
So, this is also made by the adrenal glands and it can respond in a similar trend to cortisol, so high when we're under high heightened stress. Over time can [00:16:00] deplete and it does naturally decline with age and DHEA plays a huge role in a building block of estrogen and testosterone. So it has a huge direct role on sex hormone.
It plays a huge role on cognitive function. In fact, we liken it to have. Stem cell, like activity for brain. So very anti-aging in that effect, and it supports lean body mass and muscle maintenance. So we tend to see more sarcopenia or muscle wasting with insufficient D H E A and for many women bringing in D H E A and optimizing and managing and watching this value can be sufficient enough to help with a very eased hormonal transition without the necessity of bioidenticals.
JJ Virgin: That is so huge, and it's so interesting that that just isn't the first line, right? It is.
Ali Miller: Yes. And very affordable, I will say, you know, of many supplements on the market, I mean, you can get a quality DHEA 25 milligram for like less than [00:17:00] 20 a month, and it can have such an influence on, again, your metabolism, your muscle, and your sex hormone.
JJ Virgin: And we always like to go as upstream as possible to get your body to do what it needs to do rather than going to the end result. Yeah. Talk about the adrenals role in menopause, because I think when people talk to me about what do I need to do to prepare for menopause? I'm like, get your adrenals working as well as possible.
And so how would you explain how critical that is?
Ali Miller: The adrenals, because they can rob the production of sex hormone, can exacerbate or create earlier menopause. I mean, it can even create when the adrenals are off amenorrhea or loss of menstrual cycle in someone in their twenties. So when the adrenals are not managed, we're going to see a more kind of cliff drop, if you will.
Or more remarkable drop off of sex hormone production because the body simply doesn't feel safe to reproduce. And then we have that [00:18:00] standard clock of time ticking and the calendar, and we can see a more remarkable decline. And so that's what I would say would be the biggest thing. If you want a more gentle aging process, a more slow slope versus cliff drop, ensuring that your stress levels are regulated to the best of your ability.
You are tonifying those glands. We can speak nutritionally in a moment of approaches there, and you're ensuring that your adrenals aren't stealing from your sex hormones is absolutely key. And we call this the pregnenolone steal. There's this master hormone that connects to the building blocks of progesterone, estrogen, testosterone, DHEA, and cortisol.
And again, when we are in an insufficient state. The body wants to hold up the pillar of survival more than it cares about a gentle aging transition. And so it's saying, you know, this lady, screw it, hot flash, vaginal dryness, estrogen decline, we're not prioritizing bone density, muscle mass, we're prioritizing [00:19:00] survival.
So we really have to get those ducks in a row so that we can then provide support for those other shifting elements.
JJ Virgin: So, yeah, let's talk a little bit and then we'll get into insulin resistance, diet, and other approaches to really getting your adrenal glands dialed in, to paying attention to this.
Because I feel like, you know, this is kind of that lost area in health that we gloss over. It's like, okay, because we can really quantify, I can go to the gym, I know how much I'm lifting, but this one's a tough one. Like I started meditating a couple of years ago and I'm like, how the heck do you know if you're doing this right?
It's like, where's the heart rate monitor or the dumbbell?
Ali Miller: Am I wasting my time yet for a go getter?
JJ Virgin: Nothing's happening here.
Ali Miller: And your body's like, no, this is good.
JJ Virgin: Well, Ali, here's what's funny. My team, after about a year of doing this, they go, you know, we have tracked you for the last year and we would like you to keep doing it.
Okay, good. I'm like, okay.
Ali Miller: And we do see in research studies, cortisol regulation through meditation. [00:20:00] And so I think that's key. And I think JJ, you kind of nailed it on the head when you said that women wear many. So one of the things that I look at when I'm looking at harnessing the adrenal glands or supporting resilience in the adrenal glands is what's called the allostatic load.
And what this basically refers to is our stress threshold, right? So Think of your stress demands as a wardrobe, okay? If your wardrobe is full, if you want to buy a new outfit, you have to donate a couple items. And so if you think of your stress bucket as this allostatic load, and you're going through an early divorce, or there's been, God forbid, a loss, or you were dealing with elderly parents, and some of these elements that maybe we can't directly change, but we know are a heightened stress response.
Then we have to think of the elements that we can impact. Like, maybe we can impact that gut dysbiosis and do a gut cleanse because that's more objective than the [00:21:00] subjective dynamics of interpersonal emotional stress. That's a bigger hat to take off, if you will, or to really process through. Maybe we can be mindful of the amount of stressors that we are doing in our health journey.
So, things like cold plunges, or things like HIIT training, or things like interim fasting. Each of those three can absolutely, as a hormetic stressor, yield health beneficial outcomes. But if that wardrobe is filled, and we're trying to layer in these additional stressors, we may not get the beneficial outcomes.
And that may actually throw us way over and that's going to create an imbalanced adrenal response. So what I mean by that is lifting a weight is going to yield in theory, muscle gains by tearing and repairing those muscle fibers. But if you had to lift a five or 10 pound weight for seven hours straight, you would get such severe catabolism and [00:22:00] damage to that tissue that it could be injured beyond repair.
Same thing as when we're looking at fasting, some fasting of food restriction can be good to yield insulin sensitivity, but if the body feels that it is underfed and undernourished over time from too much restriction, that can actually kick that allostatic load into overdrive mode and not allow the adrenals to get into a safe regulatory space.
JJ Virgin: And I'm glad you brought that up too, because again, when we look at You know, a Type A wants to do everything, wants to do it perfectly. And that's why I mentioned these things are all tools. I have seen some issues. Now, I will tell you, I think it's kind of ridiculous, this idea that intermittent fasting is eating for 12 hours.
No, that should be how we eat. That's regular. Right? Regular eating. We should eat within a nine to 12 hour window. That's normal. I don't know how you grew up, but when I grew up, you got up, [00:23:00] you had breakfast before you left for school. So like an hour, hour and a half later, you had lunch at school. You came home, maybe had an afternoon snack.
But if it was too close to dinner, my mom wouldn't let me. And then you had dinner and then you stopped eating and the kitchen was closed and you went to bed and you think like, I was a very hip kid, I guess, cause I was intermittent fasting, but you know, it's kind of ridiculous. Like to me, I look at fasting as a continuum.
Could be anything from doing that one a day, two a day. But what's interesting, I'm seeing with some of my friends that really doubled down on OMAD, which sounds so hip and cool. Doesn't it? Like I, I do OMAD. Is they've lost muscle. Yes, their body fat's up, their muscle mass is down. And that's frightening because at the age of 40, we start losing 1% of our muscle every year and we don't need to facilitate this.
We need to fight against it. And I'm seeing that in my friends and I'm like going, have you monitoring this? Cause this is not working. I don't know what the goal is here.
Ali Miller: And I think it's two mechanisms. One, they're protein deficient because [00:24:00] you can't truly assimilate the amount of grams of protein that you need in OMAD, meaning one meal a day, right?
JJ Virgin: You couldn't even eat enough of it in one meal, much less assimilate. Like, how could you do it?
Ali Miller: Right. And that's where, again, we get kind of myopic. You see a study on autophagy and EBTOR and you get real nerdy and you think that less is more and. Your body's grumbling and making all these sounds and you're just white knuckling through it.
I think that A, malnourishment, and especially, namely, protein deficiency is at bay in those individuals, but also this hormone known as leptin. And leptin pairs very closely with insulin trends in the body. Leptin itself is actually insulinogenic, and so for individuals that run low leptin, which would often be those that are at a low body fat and those that maybe are doing a time restricted eating because we get leptin from fat in the diet and then from the liberation of fat in our body.
Okay, so leptin, [00:25:00] when it crosses the blood brain barrier, tells the body that it's fed and that it's satiated. And we tend to see with those that have insulin resistance that they have leptin resistance. So an individual that was eating too many grams of carbs, or maybe isn't using their muscle mass to activate that glucose coming into the cells.
Or maybe it's an individual that has too much body fat. These people do really well to help to do a tighter keto approach, maybe prolonged fasting. So maybe they're doing 16 or 18 hours, but they're at least getting a grass fed whey protein shake with a bunch of botanicals and whole foods, and a meal a day, and then maybe even another protein delivery in bone broth or collagen in their tea or something like that.
Those individuals need to bring their leptin down for that satiety response. But many listeners that are here are probably also with too little leptin. And excessive fasting can make leptin deficiency. And actually, that kicks up the HPA axis. [00:26:00] Because leptin docks in the hypothalamus, the H of this regulatory system.
We have leptin receptors on our thyroid and on our ovaries, go figure. And so, when we over restrict, we see those glands start to say, Hey, I'm not getting the juice. So if someone doesn't have enough body fat to liberate in a fasted mode, they're going to get leptin depleted. And this is where I actually, with metabolic flexibility, will use things like carb cycling or adjustments in carbs based on menstrual cycle, especially for individuals that are really looking to hone in and perfect on that last five to ten pounds and don't have a lot of body fat reserves.
JJ Virgin: So, you just brought up so much gold in like a couple of minutes. I definitely want to talk carb cycling, but I took you off the subject of eating to really help with cortisol balance. And one of the things you just said that I want to emphasize is… You know, I think we tend to think, oh, more is better.
More autophagy is better. Realize that if you're exercising, you're triggering autophagy, but if all you're doing is autophagy, you're going [00:27:00] to die. You know, if you're like mTOR low, I'm like, no, mTOR should be high. Then mTOR should be low. Like insulin needs to be high, insulin needs to be low. So all of these things.
Work in balance. They have to be able to go up, come down at the right times. You know, if our blood sugar never moves, we have a problem. If your cortisol doesn't come up, you're not getting out of bed. So these things all work in rhythms for someone under stress. You mentioned, and I think this is so important.
Some of these things that we do that HIIT training. Like cold plunging, I hate every second of it, but man, and saunas are great, but if you did way too much of them, you'd be very catabolic and high stress. What about Diet. What foods, what type of diet play a role here?
Ali Miller: Sure. To support hormone, health, and adrenals, we definitely want to use a moderate to abundant, depending on how we define this, amount of whole food [00:28:00] fast.
That master hormone requires, pregnenolone requires fat. And so when we're already in a space of low hormone production with age, we need to fuel with fat. Now this is going to be potentially moderate and some individuals will actually want to lean into protein more than the grams of fat. Which, when we're looking at macros, that's quite dynamic, because fat is 9 calories per gram, whereas protein and carbs are 4.
But generally speaking, if someone is dealing with high stress time and adrenal issues, I would never have them fast beyond 16 hours. And so that would mean that they would have an 8 hour eating window, and I would want them to eat something 3 times throughout that day. An ideal distribution would be where we're eating more in like a 10 to 6 versus that noon to 8 that people like to do.
Or maybe, yeah, or maybe even an 8 to 4. I know that's even less popular. Working with our actual metabolic timer would be key as well, so that the body isn't in that over [00:29:00] restriction, over compensation. Metabolically speaking, to eat your largest meal in the evening doesn't work best. And that's not going to support a healthy insulin response or metabolic output, but not over restricting and getting at least three times a day of ringing the bell of food intake would be really key for these individuals.
Whole food fats and more of a Mediterranean keto approach, so you're not, you know, dumping the bottle of MCT oil on everything. You're not going to the butter stick. What I'd prefer is… And we're women!
JJ Virgin: I don't know about you, but I can't dump a whole bunch of MCT oil on things. Like, it just doesn't work.
Ali Miller: For like half an avocado on your salad with your salmon. We're looking at maybe if you're doing a little bit of fat as a pre workout, olive oil on a plate with coarse salt, or doing olive oil with lemon as a shooter, as a liver stimulator, but also as a good little fat flush. Could be very tonifying for the adrenals.
Olive oil as a base for your salad dressings, and then using [00:30:00] quality fats like pasture raised lard would be appropriate and fine in your cast iron skillet if you're cooking a protein. And then nuts and seeds can be great choices as well. But this population, we'd also want to ensure they're getting enough Protein, because especially as you mentioned, that sarcopenia or muscle wasting that occurs starting at age 40, we need to feed the muscle mass to ensure that we're not breaking down.
And actually we've seen studies in perimenopausal women that whey protein, independent of exercise, can actually not just aid in muscle maintenance. But muscle gains, so this would be a really good population that could go for a nourishing smoothie where maybe we can put an avocado in there, some cacao powder, some maca.
Maca is an adaptogen that tonifies that pituitary gland and can support libido and can also support sex hormone production. that in your smoothie could be beautiful. Could also do probably like a half banana and then maybe a tablespoon of coconut oil or [00:31:00] almond butter, and that would work really beautiful with a scoop and a half of grass fed whey.
JJ Virgin: It's interesting. Like if you look at the research, it's protein in general too. It's like even just eating protein. Now we're, both of us are not going to say, don't just eat protein and sit on the couch, but just making sure that you have optimal amounts of protein can help your body put on more muscle.
What are you looking at when you're giving protein prescriptions? What are your ratios?
Ali Miller: Sure. So we can go even upwards of if we're looking for active weight loss, right? If we're looking for active weight loss, I'll go upwards of a gram per pound of body weight for an individual. We're often under eating with protein.
Now, once we have more than 50 pounds of weight to lose, we're not going to be matching by pound the amount of protein we need, then we're going to have to be making some adjustments there. But generally speaking, that's a good goal, especially if you've seen any hair loss, that's remarkable, especially in a season of higher stress or in a time of active weight loss, because you really need to harness that [00:32:00] muscle mass support and the anti aging effects that are bound to that muscle.
JJ Virgin: And to be clear here, when you're saying that, the important thing is that's not something you're eating in one meal. Yes. You're dividing it between those three meals. Yeah, super important.
Ali Miller: So if we're thinking of, you know, 140 pound, 130 pound individual, we're breaking this up so that we're looking at, you know, getting about 14 ounces of protein, or again, that's why I like to lean into something like a quality grass fed whey because you can get something like 36 grams of protein, which would equate to seven ounces, you know, seven ounces will be in 42, but very close.
That we're getting right away off the bat in that protein shake. It's easy to assimilate. We know that it, that means it's easy to absorb or for the body to use. And then that way you can get about three eggs and maybe a turkey patty or something like that, that you do with sauteed greens on your plate.
And then you do a grass fed burger or a piece of salmon filet with a salad for your evening meal. And you're pretty rock and roll [00:33:00] at hitting that goal.
JJ Virgin: Yes, I think that protein shakes are really for the win, really for the win. I use either. If someone is not dairy intolerant, I think whey can be an amazing thing, but the dairy intolerant, I've been doing bone broth concentrates, and we still do a plant based, but I'm really trying to move people off of this.
And I'd love to hear your feelings about that. And then we can dig into a little bit on metabolic flexibility and insulin sensitivity. All right. What I'm seeing here, and I think a lot of it has to do with the lucine is when we have someone who is very focused on being a vegan, there's so much extra work that you have to do.
And so I always ask them, is this a spiritual issue or is it a religious, like, what's the reason for it? If you're doing it for health, let's look at the facts. And if you're doing it because of a religious thing, then let's look at what we need to do to supplement. To make sure that you're getting what you need.
What are your thoughts on plant [00:34:00] based and what do you do when you're addressing this with a client?
Ali Miller: I get that question all the time because the anti anxiety diet itself is quite paleolithic and we do use. Ketogenic approaches because when ketones cross the blood brain barrier, our brain function is optimal.
And people ask, do you have a vegan option or do you have a vegetarian option? And I honestly feel for brain health and mood and metabolism that vegetarian can work, but when we remove, because I always say, well, will you eat egg yolks? Will you eat probiotic rich dairy? Where's the line? Yes, yes. The problem is, especially we're talking about things like gut health and joint pain and joint inflammation, we can't get collagen peptides without hide or without bone.
We can't get gelatin also, you know, derived in that family to support elasticity in our tendons. We can't get carnitine in a vegetarian form and carnitine drives body fat shuttling of metabolism and aids [00:35:00] in ketone production. So the word carnese in carnitine is a meat derived amino acid. You know, you called out leucine, which is, that's why whey is the highest in leucine of all of the protein powders out there.
Key protein powder will be one that they'll show of the vegetarian forms to have some amount of leucine, but you're not gonna get the bone benefits you're gonna get, which are also, I think, very important. You're not gonna get immunoglobulins that you can get in a non denatured way. There are just things that animal products provide in a more bioavailable form.
Even looking at, for instance, omega three. When we get that ALA, it requires 16 and 18 different configurations of desaturase and elongase biochemical pathways in your liver and your kidneys as tag team to make EPA and DHA. And so our liver and kidneys have a lot of things to deal with in this toxic environment that we live in an industrialized world.
I don't want to give them another job. I want to give myself the active EPA and DHA that fish has [00:36:00] done from eating the algae or plankton and get that really bioactive health supporting compound. And so I think that yes, ethically, we're continuing to see more and more on, you know, environmental role of regenerative agriculture, really demanding that synergy of animal and plant.
And I sit pretty strong in the sense that an optimal human diet has two things that are important. One, the access of ketones. So we haven't robbed our body from the ability to make ketones from eating too high glycemic, too high carb regularly. And so being in that hybrid state of using fat as fuel and glucose as fuel.
And then the second thing I believe really is the balance of omnivore consumption and incorporating, not in the world of carnivore, because I could demystify a bunch of methods there, but I do think that an antioxidant rich, but also quality animal source diet is really dealing with the optimal human design and how we best metabolize and best digest.
JJ Virgin: Yeah, we just need to [00:37:00] put a vegan diet together with a carnivore diet and then we'd have it. So then you hinted at metabolic flexibility, which is so important to me. It's like, you know, having the Prius that can have gas and electrical, right? I'm like, that's what we want. We don't just want one or the other.
You know, if you just have electrical and the grid goes down, you got a problem. If you just have gas and the gas companies shut down, we got a problem, but you got to have both. So how do you teach people to become metabolically flexible?
Ali Miller: So kind of like you said, JJ, in the beginning of any diet. In order to get into metabolic flexibility, you have to start in some form of rigidity to teach your body what ketones are and to start to produce ketones.
So, I do believe that you have to put in tunnel vision to begin to prime the metabolism to become insulin sensitive enough. And to start to produce ketones. So some individuals will have to jump in a tighter carb control because based on their metabolic handicap, like if they have pre diabetes or [00:38:00] diabetes, we're going to have to move that needle for them to be able to understand or their body to be able to become a hybrid in the first place.
And so, you know, getting fat adapted is key, but if we stay too tight of carb restricted, we can see imbalance over time. And like I said, fluctuations in cycle, fluctuations in stress. And even using carbs as what would be called a hormetic stressor or kind of a challenger or a reset button for our body can be very appropriate.
And what I mean first off by metabolic flexibility is that it's not this tunnel vision of this pie chart of macros saying a keto diet means you have to be 60 70% fat, 20 30% protein, and less than 10% carbs. It means that for someone, they're going to produce ketones at 45% fat. At 35% protein and at 20% of carbs.
And that's going to be based on that individual's muscle mass. Based on their activity factor and [00:39:00] based on how much body fat they have, which comes in hand with how much insulin sensitivity they have. So for instance, for me, I can eat 45 to 60 grams of carbs, which means a half cup of roasted sweet potatoes in my evening meal.
This means a cup of berries, even half a banana gasp in my smoothie. And I'm making ketones at that level, right? And so metabolic flexibility to me means not getting myopic and tunnel vision on ketosis having a yes or no food list. But understanding how your carb threshold works with your blood sugar metabolism.
JJ Virgin: Beautifully said. Now, are you using things like maybe a lumen or a CGM, a breathalyzer? How are you?
Ali Miller: We use CGM and then finger sticks. And I'll start people off with just urine strip testing for ketone because it's affordable. It's easy. And it just helps for accountability to kind of get in the gates to know, okay, I'm in and then it's [00:40:00] pain free.
And so I like to get people motivated. And then when we want to troubleshoot and explore the metabolic flexibility, that's where CGM is beautiful as well as finger sticks. And what's interesting is some people will see better metabolic outcomes in a less is more approach, meaning eating more calories and potentially more carbs relative, right, to where they were over restricting.
JJ Virgin: Mm hmm. And you mentioned briefly carb cycling, you know, as a tool, how are you using that?
Ali Miller: So in a woman that's menstruating, the way that we would use a carb cycle is in the luteal phase. This is the timestamp of the cycle actually where we're burning more calories and where leptin is at a high demand post ovulation.
So generally around like day 19 or 20 will be a time that I'll schedule a carb up or a carb cycle. And that will actually help to refill our leptin so that the body's sex hormone and thyroid is optimized. So an individual might carb up or [00:41:00] do a carb cycle adding about double of what their general carb threshold is.
So like I said, you know, if I'm at 45 to 60, a carb cycle for me might be 90 grams of carbs. And then that next day I would go right back in to my tighter carb control. And that little bit of that blip of that radar, like I said, leptin, it translates. To the word thin actually in the Greek language. So it's such a huge metabolic regulator, but it also plays a role with stress.
When we have optimized leptin, the body feels safe and nourished. And so that's where, as we were saying before, too much restricting, too much fasting, chronic under eating, you'll get leptin depleted. And then your adrenals go haywire from that type of response. And so getting that little bit of that leptin reset can be very appropriate.
We can also do this socially for women that are perimenopausal or postmenopausal. If they want a structured approach, I'll tell them to follow the moon or if they have phantom action. So if they're getting ovarian cramping or action like that, we would [00:42:00] track that and watch what's happening in their body, how that's impacting energy and appetite.
And then see if we want to follow a phantom cycle, and that's what I'll do often is after that ovulation action, then we would do a carb cycle about 10 days following, or we could follow the moon. And so we think of the full moon as ovulation, we think of the new moon as menstruation, and so we would carb cycle potentially 8 to 10 days after a full moon.
Or we could be super liberated and follow a social calendar and say twice a month, I'm going to carb cycle because I have a baby shower and a party, or I'm going to Italy and I want to plan this day. And I think that that's all reasonable approaches. It's just watching your behavior of if that creates an all or nothing mindset or cheat mentality, as long as we have a healthy perspective and we're still eating anti inflammatory.
That switch up metabolically is likely going to yield better effects than staying stagnant within your macros.
JJ Virgin: And you had to mention the cheat. [00:43:00] Mentality. Yes. Nothing gets me more upset than when I see the, I'm going to have a cheat day, because it just falls into all that diet stuff of I've been good, I've been bad.
And I'm like, and you always cheat with the thing that then just lights up your taste buds and just sets you down a really bad path.
Ali Miller: Yes. Yes. Because the word cheat is deviant. So then you make it a bad choice on purpose. And I really like with my approach to metabolic flexibility and kind of. How I set apart from a lot in the keto space and keto and women's hormones is that I don't do any non caloric sweeteners.
And so when I'm out of that, again, this isn't a keto bar. This isn't a keto shake, a keto snack. I would prefer to use a half of a banana in a recipe of muffins instead of a half cup of erythritol. I would prefer to use a date or raw honey or grade B maple, nourishing sweeteners that actually have some antioxidants, have some hormone regulation effects like the chrysin in [00:44:00] honey, which is beautiful for estrogen dominant, or B vitamins that we're getting from there, or antioxidants in our berries.
I much prefer, Choosing foods that are nourishing to satiate our palate cravings, and then over time, moving that dial to be more savory, because when we use hyper palatable processed foods to reach for, it disrupts our ability of enjoying natural whole foods. And so if you're cheating with craps, you're going to stay on that cycle of desiring and wanting crap.
And so when we're doing a carb cycle, we would still like to ideally select nourishing whole foods.
JJ Virgin: I love that because it happened first. I remember like early on when I was pulling people off of gluten and they'd be marching back in with gluten free, oh my gosh, everything. Like, what is this? Now it's the keto ones.
And it's like any food that you eat that you have what should have been a completely satiating amount. And you are like, Got to have more, [00:45:00] got to get rid of it. Never one time happens with salmon. I have never said, you know what, I binged on salmon. I binged on Brussels sprouts. Like, none of us do that.
They're self limiting. Right. Yeah, they're self limiting. These hyper palatable foods are made to… Completely make your brain go, woo. So if you are doing that, walk away from that, get it out of the house, get the enemy out of the house. Now you are going to give everybody a week of your food is medicine.
Keto meal plan. I'm going to put that at, A L I M I L L E R that's so easy. So, you'll be able to get that week of meal plan, which I love, who doesn't love a good meal plan? It makes it so much easier to just follow. So thank you. I appreciate that. We did another podcast, didn't we?
Ali Miller: We did. Huh. I believe two years ago or something like that.
JJ Virgin: It was way too long ago, obviously. So we'll link to that. We'll link to your books. We'll link to all your social stuff too. Parting last words for [00:46:00] everybody listening. We covered, first of all, thank you so much. We covered, So much here from adrenal health to metabolic flexibility to carb cycling, like all over the board.
So like amazing information. What would you like to leave everybody with?
Ali Miller: I would just leave it with, you know, the most about yourself of any health practitioner out there. And so you have to keep yourself in the story of your health journey and you have to stay connected with when you're making changes, whether it's an eating style change, a supplement or exercise change.
Do a little brain dump once a week. I love to do this with my clients where you just check in, you know, whether you're sitting outside on a chair and you've got your hand on your high heart and your low heart, and you take a deep breath and you think, how's my sleep been? How's my gut been? How's my mood been?
And what's different this week from three weeks ago? Cause then you can look back and say, Oh. When I was doing that lemon shooter, that really gave me energy and I see I wasn't having that afternoon coffee, which was killing my adrenals. Or, [00:47:00] oh, when I was getting more leafy greens in, my bowels were more favorable.
So stay connected with yourself in your wellness journey. Be inspired with different health leaders. But at the end of the day, it's how your body responds that should guide you in your process.
JJ Virgin: Fabulous. Nothing I can add to that, you just said it all. That was beautiful. Love it. Thank you so much, Ali for being with me today.
Ali Miller: My pleasure. It's always fun.
JJ Virgin: Be sure to join me next time for more tools, tips, and techniques you can incorporate into everyday life to ensure you look and feel great. And more importantly, that you're built to last and check me out on Instagram, Facebook, YouTube, and my website, And make sure to follow my podcast so you don't miss a single episode at See you next time.

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