The Right Way to Reframe the Glycemic Index for Gut and Brain Health - An Interview With JJ Virgin

What follows is a transcript for the podcast Gut-Brain Connection - JJ Virgin - Mind Body.

Topics within the interview include the following:

• The link between traumatic brain injuries and mood disorders
• An out-of-the-box approach for recovering from a traumatic brain injury
• Why the current glycemic index needs a serious overhaul
• How mindset impacts a healthy lifestyle

JJ Virgin Shares Her Son’s Experience With a Traumatic Brain Injury 

Dr. Dan Stickler: Welcome to Collective Insights. I am Dr. Dan Stickler. I am the medical director here at the Qualia, and we have a great guest today, one that many of you know. This is JJ Virgin. She's been an acquaintance of mine for many years and a good friend of my wife, and she just has fascinating stories on every subject. But today, we're going to venture into something that is a little bit different. We're also going to talk about some of her new ventures and her new book. But as a background, she's triple board certified a nutrition expert, fitness Hall of Famer, author of four New York Times Bestsellers, and a prominent TV and media personality.

JJ Virgin is a passionate advocate of eating and exercising smarter. JJ helps people stay fired up and healthy as they age, so they feel the best they ever have at the age of 40 plus. This is an area that I'm passionate about, the age rejuvenation piece of it. JJ, you've kind of started to venture into more in-depth work in age rejuvenation as well, haven't you?

JJ Virgin: Well, it's interesting as you get older, what you decide to focus on, right? Because I was hearing 40 plus, I'm like 40? That's nothing.

Dr. Dan Stickler: Keep moving the goalpost.

JJ Virgin: But I'll tell you what, Dan, it is so amazing the difference in people when they take care of themselves and they start using all of these strategies. You'll see someone who's your age and they look 10 to 20 years older.

Dr. Dan Stickler: Oh, I know. It's scary.

JJ Virgin: Right?

Dr. Dan Stickler: I'm seeing it out there. My mother is 75 years old this year. She's still doing CrossFit and active and social and just has a great time.

JJ Virgin: Right on, mom doing CrossFit. My mom is not doing CrossFit, but she's 91.

Dr. Dan Stickler: Well, hopefully, my mom will continue to do CrossFit by that time. But let's get on with what we are here to talk about, and as a preview into this, love to have you share your story of your experience with your son's traumatic brain injury.

JJ Virgin: Yes. Boy, all the things you find out after the fact that I'm kind of looking at it going, why aren't we, when we start to notice things like depression or anxiety, aren't we looking back and going, boy, did you hit your head? Because if you hit your head, you hurt your brain. Now, my son really hit his head and really hurt his brain. When he was 16 years old, and my other son, Bryce, was 15 years old. Grant was 16. He was crossing the street at dusk and he was hit by a car. We are not totally sure what happened because it was a hit and run. The neighbor just saw the woman get out of her car, gasped, get back in her car and drive off. So, all we know is that she was probably going about 40 miles an hour.

My son is one tough kid is what I would have to say, because literally he had 13 fractures, multiple brain bleeds. He was in a deep coma, and he had a torn aorta, and he was airlifted to the local hospital. When we got there, the doctors ushered us into a conference room. I mean, I'm sitting here going, I know nothing of what's happened, Dan. I just know that my son was airlifted, so you know it's not a broken leg, and we've been ushered into a conference room. The doctor looked at me, and we've got to realize first where I was.

I was in Palm Springs, California. The doctor was used to a very different population than a 16-year-old boy, and so his perspective was so different. He said, your son has been in a very serious accident. He has a torn aorta, and sometime in the next 24 hours, it's going to rupture. If it isn't repaired, but we can't repair it here, it's a very specialized surgery, and he also has multiple brain bleeds, he's in the deep coma, and he'll never survive that airlift to the next hospital. Even if he were to survive that airlift to the next hospital, he wouldn't survive the surgery. Then, even if he were to survive both those things, he'd be so brain damaged, it wouldn't be worth it.

My son Bryce is looking at this doctor, and fortunately, my son has been raised, both my sons have been raised with a super positive mindset and also a family that are all either doctors or medical malpractice attorneys. So, the doctor isn't up on the pedestal and my son is looking at this doctor kind of like confused. He says, "Well, sounds like maybe there's a 0.25% chance he'd make it." Now, my son is now getting his PhD in math. He's very, very analytical. The doctor's looking at him like with this very grim facing, "That sounds about right, son." He goes, "Well, that's not zero. We'll take those odds."

So, we airlifted Grant to the next hospital and the whole situation was so different when we got there. There were five surgical teams waiting. One of the doctors had accepted the case at midnight, had gotten hold of a stint that had been discontinued. It was in a study then, and they no longer were doing the study. He wanted that stint. Wasn't approved for children. He said, "I figured I'd asked for forgiveness." And he assembled four other surgical teams. We had a double orthopedic team fixing his broken legs. He had 13 fractures and a crushed heel. Dealing with the stint, we had a neuro team, we had peds critical care team.

The difference there is the doctor walks up to me and says, "You're the mom?" And I'm like, it's like, what gave it away here? He says, "I do this all the time." He said, "We had a guy thrown off the overpass last week and I fixed him. You don't have to worry, I've got this. Let me just show you where I'm going to fix them up," and gets me out of the room where they're all getting them ready for surgery, and literally comes back a couple hours later and said, "All right, it's all done. Aorta is perfect. He goes, "Now, I don't know if he'll ever wake up." That's the neurosurgeon. I was standing next to Grant, and it was about 24 hours in, so I'm a little delirious at this point.

I'm holding his fingers, because literally, everything is either got road rash, it's got a cast, so I've got two fingers of his and I'm talking to him, and I'm telling him he's a warrior, his name means warrior, and that I love him. The nurses are kind of looking at me with pity. He can't hear. I don't know about you, but I've always been fascinated with near death experiences and comas and all of that.

Dr. Dan Stickler: For sure.

JJ Virgin: I didn't really want to experience it this way, but I always felt like they can hear you, and you hear enough of those stories where they say they could hear everything, so I'm just going with that, and I said, "Bryce, your brother, Bryce, loves you so much." And Grant squeezes my finger, and I'm thinking, Dan, I'm just exhausted. Clearly I'm delirious. Then I say, "Your grandma loves you," and nothing happens, and I said, "Your girlfriend, Mackenzie loves you." And he tries to pick my fingers off the bed. That's when I just got into my head, I go, I am just going to stay focused on Grant being 110%.

I said, "Grant, you're going to be 110%. I need you to fight. I'm going to pull in all the resources to get you there, you just keep fighting. Because I figured, as long as he's alive, I still have options. That's how we proceeded. It's been a long time. What I'll tell you that's so frustrating about brain injuries is they are so common. Now, Grant's is the extreme. This is obvious, he had a brain injury. What's scarier to me is all the ones that we don't realize out there, that a kid on the playground hits his head, and all of a sudden, they're angry or they have unstable moods or they're depressed and no one puts it together. It turns out it's the leading cause of death in kids.

There's something like 5 million people in America at any time that are struggling with a traumatic brain injury, yet there's really not a lot of resources. What I was told in the hospital is, when he wakes up, it'll be ugly. Now, I thought it would be ugly for like an hour. I didn't realize it would be ugly for years. Right?

Dr. Dan Stickler: Yeah, and you make a really good point about those undiagnosed. I mean, we had five boys that all played ice hockey and lacrosse, and we they had one or two concussions at most without loss of consciousness, but yet, we did brain maps on them and we identified two of them that had pretty significant evidence of TBIs, and they did have different aspects of their personality that were indicative of that.

JJ Virgin: Yeah. There's this whole thing, while he didn't lose consciousness, I'm like, you hit your head, and I love, Dr. Daniel Amen says this so well, it's like, you hit your head, you hurt your brain. That's it. It's like a sloshy little egg instead of this thick shell, like you hit your head, you hurt your brain. Just because you didn't lose consciousness, doesn't mean you didn't hurt it. I was in a big car accident where somehow I got rear ended and hit in the front, like bam, bam on the freeway. I didn't lose consciousness, but man, it took me a year to get my brain back from that. Yeah, so one of the key things, I think, there were so many things that helped Grant, and we pretty much threw everything I could find at him.

But one of the things that helped him before it ever happened, and I think is so important for people to realize, is that you don't know when you're going to hit your head. It's not like you usually plan for it. I mean, you might decide you're going to be an MMO, a wrestler or something, then you kind of know. But for Grant, it wasn't like this was planned. I already had him on a good dose of fish oil, and I know that was part of the reason he got through this because it protects your brain. So, this is another reason, yet another reason to be on fish oil, beyond all the other ones.

Dr. Dan Stickler: What year was that?

JJ Virgin: That was 2012. It was September 10th. I remember thinking that he's going to die on September 11th. That was my, oh my gosh. So, we're coming up on year nine. Throughout the years, we took him out the first hospital early and moved him to a rehab center, and then we took him out of that. It was Children's Hospital LA, and moved him back home, because I felt like he would do better there, and we could also do things we couldn't do in the hospital. It's like, we had no access to hyperbaric in the hospitals. We couldn't do acupuncture. We couldn't do neurofeedback, some of the things that you would think in a rehab hospital you would be able to do. So, couldn't do stem cells. I'm sure now that's changed. But back then, we were kind of in the first group of patients that did intrathecal stem cells, where we harvested his stem cells, adipose tissue.

And then we had them expanded in a lab, and then we had them injected into his spine. We also did laser guided stem cell work. Unfortunately, now his stem cells are sitting locked up in a lab because we're not allowed to do that anymore, but the stem cells were pretty crazy. Because the first time we did stem cells, 72 hours after the stem cells, Grant started to act like he was coming out of coma again. If you haven't seen someone come out of a coma, they lose their internal editor. This could be really fun or really scary. You never know what's going to happen. Someone might get outrageously angry or have really weird sexual behavior or whatever.

For Grant, sometimes he would laugh hysterically and that was fun, and sometimes he would get super angry, and it was like the incredible Hulk. In fact, so much that when he was in the second hospital, we had to have him in a zip-up bed and we had to put them into a wheelchair where he could not get out of the wheelchair. We had to strap him in. Then if he started to get a little bit of a furrow in his brow, literally like the incredible Hulk, like the little green tinge is happening, we would hit them with a cocktail of Haldol all Benadryl and Ativan in order to keep him from going crazy. I mean, it would knock you and I out for probably a day, him, it just calmed him down.

The trick was, you didn't want to do it so much so his brain couldn't heal, but after we did the stem cells, we started to notice, about 72 hours in, he started getting like that again. And I just figured, you know what? That just means we're healing more. We're just waking up new brain cells and this is what we're getting first. So, it definitely made a big difference, but we had to ride it, ride that storm a bit.

The Link Between Traumatic Brain Injuries And Mood Disorders

Dr. Dan Stickler: Yeah. It's very cool to hear of the treatments that were used in 2012. When I was a surgeon, when I was in surgery residency, I did six months in trauma and critical care during the late '90, and we dealt with a lot of brain injury then, and I look back at the things that we did. Some of the things were actually somewhat detrimental, and some of them were kind of cutting edge, but we would hyperventilate people to constrict the blood flow to the brain to reduce swelling. We're just like doing these things, everything we could that we knew of to preserve at that time. But the thing was, we were archaic in what we were able to do.

We were focused on tube feeding, but didn't recognize the roles of the gut. We were working on respiratory mechanics and not really paying that much attention to the CO2 as we should have been. Now, we have all this data, and I mean, the gut brain connection now is a big area that they're focusing on in the critical care setting for all aspects of trauma, but especially for TBI.

JJ Virgin: Well, even in 2012, I mean, I had to fight to get them to give him fish oil, and they wouldn't go over two grams because he was on a blood thinner, and I brought all the research in from Barry [Cyrus 00:15:01]. He gave me all of it, and they said, oh, it would have to go for the IRB. I'm like, I do not have time for this. I mean, it was crazy. Luckily, he spit out his feeding tube. He de-intubated himself. And then I was like, all right, game on, I'm going to do this behind your backs then if you're not going to let me do it. I can never take him back and do it both ways thankfully, but he started to talk when we took his fish oil from two to 20 grams, like the next day. Maybe it was just a coincidence, but kind of hard to believe.

Dr. Dan Stickler: Well, the interesting aspect of all of this is that we've ... I think the reason we've been so slow in the progress of really helping the human system, I mean, we're in this disease model where you have to be diseased before we can do anything. We don't look at the health of the system as a whole, and looking at it from a complexity standpoint where we have all these things interacted to create the outcome. I mean, when we're dealing with the brain, everybody was focused on the brain itself and not on these aspects of like the nutrition, the gut health, the stress components of all the different inputs that are creating the process that's going on, or the process that is going on that is creating dysfunction in other systems in the body.

But we're starting to actually come around to that. Even now, in the post TBI state, we've come up with a lot of new interventions that are more holistic in a sense that they're addressing all aspects of the human system and approaching how we can get these post TBI patients into a more normal state, because I mean, as you know, I mean, post TBI, there is some definite long-term aspects of stress cognition, gut microbiome, all of that, that are going to be disrupted.

JJ Virgin: Oh my gosh. We did so much for his gut microbiome, but just in a hospital, you have someone who's got a brain injury, would it make any sort of sense to give them Ensure or Crystal Light? You know that artificial sweeteners can make them have, potentially more seizure activity. You've got a potential possibility with seizures because you've had a brain injury. I had to argue with them about Crystal Light. They're like, what is he going to drink? I said, he's going to drink water. It'll be great. Then they wanted to give him Ensure, and I'm like, we need to have them on a keto diet in here right now, because that's how his brain is going to be able to have some nutrition in there and some energy.

Dr. Dan Stickler: I'm sure that went really well in 2012.

JJ Virgin: It's just crazy though they were just insistent that they were going to feed him this hospital food. One of the first things that Grant said was that I just went, oh my gosh, this is like, my son is back, he said, "That's disgusting," and pointed to the hospital food. I was like, we're not feeding them the hospital food. I would bring in things from Whole Foods. I had a NutriBullet. I was making smoothies. I was giving him extra aminos because he was so catabolic, just the things that you would think were obvious that it was like, I was completely talking a foreign language. It's like, how could this be?

Dr. Dan Stickler: Yeah, I can remember when we were doing IV and oral nutrition in the ICU through the feeding tubes. We were focused so much on the carbohydrate content in the form of dextrose, typically, giving all this extras because the body was so hypermetabolic, but we were creating, probably a great deal of inflammation with that at the time. Then on the fats, the only thing we focused on in the fats was how it would affect the respiratory numbers that the patient had. It wasn't a focus on any other aspect of how the fats affected the system.

That is an area that really there's a lot of research going into right now with trauma and TBI, both where they're looking at studies using the ketogenic diet, because there's been good animal studies on showing the benefits of the ketogenic diet, and there's been some human studies that were informative of just saying that it appears to be safe to use, but then, is there a benefit? I know there's a couple of studies ongoing right now that are looking specifically at that to see if there is a true benefit from the ketogenic diet and really healing the acute TBI and in treating long-term.

The Power of an N-of-One Approach to Traumatic Brain Injuries

JJ Virgin: Well, I can tell you from just being able to watch it, you can pretty much see when you're working through this, what's working and what's not really quickly. Granted it is an N of one, but I looked at everything, and that's what I was trying to explain to the hospital. I'm like, I look at the risk reward here and there's really low risk, really high reward. Like, let's do it. Let's do these things. Let's kick up this fish oil. Let's get rid of this gross hospital food and have them do this. I can see him being more aware. He's making eye contact. You can tell. You can see it immediately. So, sadly enough, these things are always slow to shift, but [crosstalk 00:20:35].

Dr. Dan Stickler: Well, that N of one is the important thing, and this is what we have to start paying attention to, is N of one in all aspects of human health, because we are not a monoclonal race of humans. I mean, the mice studies and the rat studies, they typically use monoclonal, so they're all the same. So, they're really getting an N of one over a hundred N of ones. It's not like it's looking at the heterogeneous population in general, and then you've got to come up with an average. I think there's a lot of people, especially in the industry, we run in where the N of one has become the standard, rather than what we call the protocol or standards of care that exist in medicine right now.

It does, it works. I mean, you try stuff, like you said, you gave the fish oil and you saw the response immediately. So, why would you say, okay, well, we can't do that because this isn't allowed? You say, well, it's working, so why don't we try this and see where it goes from here.

JJ Virgin: Well, especially when it's something like they're going, oh, we can't do it because he's on warfarin, I go ... What I would do is, every time I knew they were going to run this blood and check his ProTime, I would pump up his fish oil, no change. I was going, it's not changing anything, which is all the papers and data I gave you said the same thing, but if that's the risk and it's not having a risk, why wouldn't we do this? It's just crazy stuff, but I mean, it's no different with everything going on right now. So, same silliness out there in the world.

Dr. Dan Stickler: I don't even know where that came from, because when I was doing general and vascular surgery, my patients would always say, I got this list from the hospital, they said, don't take fish oil prior to surgery. I was just like, why? Why does that exist? I mean, fish oil is ... I have no problem operating on somebody with fish oil, or I didn't. It didn't make any sense to me, but the thing is we don't question these things. Dogmatic and we quit questioning the why's of why we're doing it.

JJ Virgin: Well, it's just like being told to eat six times a day.

Dr. Dan Stickler: Yeah.

JJ Virgin: Right?

Dr. Dan Stickler: I say, why not just eat when you're hungry? That's not a real difficult one to pay attention to, listening to the body, which-

JJ Virgin: Well, when you really learn how to discern that you're hungry, and that's one of the challenges, is we've so messed up the food supply to create all this false hunger that's not really hunger. It's a craving, that if you tell people to eat when they're hungry, they have gotten so out of touch with what hunger really feels like. I'd say, eat when you're hungry, when you've waited it out, you feel hungry, then you go have some water. Then you wait it out for another 30 to 60 minutes, to see if you're really hungry, because you probably aren't even actually hungry. You just saw a commercial or you went into Starbucks and you saw a muffin, and all of a sudden, you triggered everything and you're not hungry at all.

Dr. Dan Stickler: Right. We call that interoception in our clients. We train them to be interoceptive in understanding what these signals are. Do I feel sleepy? Do I have to go to the bathroom? Do I feel hungry or do I feel thirsty? And understanding when those are true signals versus the, like you said, that they're triggers that are happening. But let's talk about that. These false dogmatic beliefs in nutrition, we could talk about the belief of how we have to take so much simple sugars in. We have to follow glycemic index rules. Low-fat is the way to go to be healthy. I mean, where are we now with these rules? I mean, what's happening with them?

False Dogmatic Beliefs in Nutrition

JJ Virgin: I feel like instead of us just really figuring out what works best for you, we keep swinging to different rules. Like, one will come into Vogue and then it will go out. I still remember, because I was in my 20s, when all of the stuff came out, that fat makes you fat and, or I'm sorry, that fat, yeah, fat makes you fat. That sugar is your energy source. That's what you should eat, that you should never let yourself get hungry, by the way, because that's when you get in trouble. That you should have breakfast, a snack, lunch, a snack, dinner and a snack before bed. You should not go to bed hungry.

Which is just the craziest idea ever of this, and that you want to eat very low fat and as close to vegetarian vegan as possible and super high carb. Do you remember, oh God, what was her name, Susan Powter? Who would stop the insanity. I still remember all of that. I was in doctoral school for exercise science, and so we were not really addressing all of this. I remember using all this. I was in my 20s. I was personal training and working out probably four to six hours a day, and my body fat, I remember we were trying to figure out body fat. We were doing all the different body fat measurements at USC and calibrating, and my body fat was reading like 24%, 25%.

Now, I'm working out hours a day, I'm doing HIIT training, I'm doing resistance training, I'm doing all sorts of stuff, but I'm eating carbs, carbs, carbs, carbs, carbs, carbs all the time. I'm 58. I'm 13% body fat. I work out maybe 20 to 40 to sometimes 60 minutes a day, and I eat two to three times a day, and I eat low carb, high fat. So, you tell me, what's going on. But where all that stuff came from, you still see it swinging around. I mean, you still see these diets coming out, telling people that they should be eating all throughout the day to keep their blood sugar stable, but they don't mention that, that just keeps your blood sugar up.

Dr. Dan Stickler: Yeah, I heard that.

JJ Virgin: So, it's highly stable.

Dr. Dan Stickler: Do you remember Dr. Crayhon?

JJ Virgin: So, he is actually who got me into nutrition way, way, way back when. I was already studying it, but I wasn't like deep into it, and I had a client whose nutritionist in New York, he was her mentor. So, I'm talking to this nutritionist and she said, you should read this book Nutrition Made Simple by Robert Crayhon. I read it, called him, and ended up working, he was part of a company called Designs for Health. That's how I ended up with Designs for Health because I wanted to learn everything he had to say, and that's when I really started studying. I ended up with, he'd worked with Loren Cordain. I ended up in a room for three days with Loren Cordain for eight hours a day. Learning from him, I mean, it was amazing, amazing stuff. Back then, the things that they were saying were like the opposite of everything being taught out there.

Dr. Dan Stickler: Exactly.

JJ Virgin: I mean, no one really knew what the paleo diet was back then.

Dr. Dan Stickler: Yeah. I went to a talk in 2000 that Crayhon put on and he talked about the caveman diet, and I was like, what is this?

JJ Virgin: Yeah. Wow, was that Boulderfest?

Dr. Dan Stickler: I can't remember which one it was. It's just so long ago, but it completely changed my thinking on nutrition after hearing him. I think he's been an underappreciated kind of icon of the past that really helped to launch a lot of this industry.

JJ Virgin: He did, because he was ... Sadly, he's no longer with us. I don't know if you're aware of that.

Dr. Dan Stickler: Right.

JJ Virgin: He was one of my best friends for a couple of years. He taught, he made everything so simple to understand, and he gave you things so you would remember them. He didn't try to complicate it, he didn't try to confuse you, he didn't try to use big words. He just simplified it down. I remember one of his lines and with that, that makes so much sense, he said, "I want competition for my food. If you put margarine outside, the bugs are not going to touch it. This is a problem." I'm like, these are such simple concepts that anybody can understand. Just some things that he would say, because people go, everything in moderation. He goes, "I'm sorry, but artificial sweeteners should not be in moderation. Damaged fat shouldn't be in moderate moderation. These things hurt you. They're basically toxic to you. There's no amount of them that should be okay."

How Sugar Impacts The Gut Microbiome and Brain Function

Dr. Dan Stickler: What kind of sugars do you recommend with people you do nutritional consulting with?

JJ Virgin: It's funny. If you'd said to me 12 years ago, you're going to be one of the big people talking sugar, I'd go, no. I kind of stumbled upon food and tolerance, because I was doing something with Designs For Health, where we'd taken some metametrix testing and we put it into ... I created this way to teach it to them. DFH had done a deal with them to create testing where it would spit out recommendations, and I put it together on how to teach it to doctors to use with their patients. One of the tests was a food sensitivity test. What I saw was that, we'd been using elimination diet, and I was like, why do we have citrus and berries in here? Why do we have all this stuff in here?

I'm looking at food sensitivity tests, and it's always dairy and eggs and there are corn soy peanuts. Then of course, you looked at gluten differently, but gluten was the big thing causing a lot of the leaky gut problems. That's where virgin diet came from, and the only reason sugar got added into that at the time, because when I first started working with this, what I call a simplified elimination diet, was I didn't take sugar out. When I told people to pull these six foods out, guess what they ate? I was like, I don't have a sweet tooth, so it would never dawn on me if you say, hey, you can't eat that bagel, that I would go eat some gluten-free cupcake or something horrible. Once I started realizing that, I pulled sugar out too, and let's look at sugar.

Sugar, especially artificial sweeteners, are going to mess up your gut microbiome and they're going to make you more glucose intolerant, and same with fructose, can make your gut leak. Sugar is going to disrupt your gut microbiome and create more food intolerance as well. But once I wrote that, the biggest challenge people had was with sugar, because they're either confused. They think, oh, it's honey, it's agave. It's natural. It's all good. I can have that. Or they're just addicted. They can't get rid of it. We've done like genetically, there are some people, when I was on Freaky Eaters, we do this genetic test to see if people had a sweet tooth or were sweet taste. There all those people that just have a sweet tooth, and then there's those people who, the more sweet they eat, the more sweet they want. We all have a little bit of that.

That exposure equals preference. But some people just genetically have that exponentially. Then of course, there's disrupting the gut microbiome or maybe having candida, that's going to make you crave more sugar, and then there's stress that's going to lower your serotonin and there's sleep problems that are going to make you crave more sugar. Then there's just the processed food that creates addiction. I mean, you look at like cereal and milk, Captain Crunch or Cocoa Puffs with milk, I mean that's like the addiction trifecta, gluten, dairy and sugar, this is like an opiate slam on your brain.

Reframing The Glycemic Index For Both Gut And Brain Health

JJ Virgin: I didn't really think that I'd be writing this book about sugar, but I really do believe that we've looked at sugar all wrong, and it all started with the glycemic index. This isn't to bash the people that did the glycemic index, because it gave us a great first step, but that's what it is, it's a first step. If you solely look at the glycemic index, you get in trouble, because the glycemic index has a couple challenges with it. The first one being that they're pulling a 50 gram serving of a food, an isolated food, and then you're checking the blood response to it, which I'm always wondering, with the blood sugar response, you've got to have someone who's very metabolically healthy too, because otherwise, that's going to vary.

So, they're looking at the blood sugar response to that food in isolation, and the challenge is we don't eat that way. No one's going to sit down and eat 50 grams of broccoli or 50 grams of carrots. They might eat 50 grams of potato chips, so probably 200 grams of potato chips. But more likely, we're going to eat some carrots and maybe some chicken and maybe some broccoli and some rice. We'll eat some combinations of foods, so we've got to look at the combination. The other challenge with it is that we've got to look beyond just blood sugar and look at insulin too, because you've got foods like agave, something that's super high in fructose. So, agave, apple juice concentrate, they aren't going to raise your blood sugar like you would expect, and so they look like they're a great food, and that's why agave ended up, in crystalline fructose, ended up being these things that everybody thought were so great, except they're not great.

They don't raise blood sugar, which looks great, but it's actually even worse, because now this is going straight to the liver, where if it can't be converted to glucose and stored as glycogen, and it can't, because there's not a lot of room there, so it's already full most likely, then it's going to be stored as fat. And it's also more glycating than any of the other sugars, more aging, seven times more, and also can make your gut more permeable. So, it's a super problematic one, but it's also nice and sweet, so it's great for the food companies to use. And it was easy for the food company to say, hey, low on the glycemic index. Or they can do apple juice concentrate and say no added sugar, and create all of these problems.

When I looked at sugar, I really wanted to reframe the way we looked at it because I think we have to look at all carbs, because all carbs turn to sugar. It's just whether we're making them slowly from the food we eat. There's a big difference between broccoli or a bagel, or we're mainlining it, we're making it quickly. So, we want to make sure that carbs are eating, and remember, all carbs, but we're pulling fiber out, doesn't count, all carbs are going to turn to sugar. We want those ones that are going to be made slowly from the foods you eat. We know what those are. I mean, it's non starchy vegetables at the top, and that you're not mainlining them.

Then, to really look at these foods and go, all right, these foods that are mainly carbs, what's their nutrient density look like, how much fiber do they have? These are the reasons that we're eating them. What's their phytonutrients. Then you contrast that with how do they impact your blood sugar and/or insulin? How much fructose do they have? Because fruit dose is going to be super problematic there. The reason that's important is then we can look at something that has no calories and looks like it's awesome, one of these artificial sweeteners that we were looking at it going, why is it that people that drink a diet soda a day, as contrast with people that drink a regular soda a day, have an [inaudible 00:35:45] waist circumference? How is it that people who are drinking a diet soda every day have a 33% increase risk in diabetes?

What is going on that would do those things? At first, it was, oh, well they must be having the diet Coke and thinking they can have cookies. That is not what's happening. What happened is, is that it's changing the gut microbiome, making them more glucose intolerant. They showed that happening within a week. It also changes like, when you eat sweet, you want more sweet. So, I have a challenge with all of the different sweeteners, because I think when you start to eat sweet, especially if you're one of those sweet tasters, you can get yourself in trouble because you'll want more and more and more sweet. So, just because it's stevia or monk fruit or allulose, doesn't give you ... It's not a free pass.

Dr. Dan Stickler: Well, the availability of sugars in general, ancestrally, was extremely low. I mean, it was basically honey that was the main sweetener or fruits that ...

JJ Virgin: Right. No added sugar ancestrally, like the paleo diet, there was no added sugar, and the realistic thing here, and this is super interesting when you look at this. When did we have the majority of fruit available was in the summer. In the summer, we have the longest days. We have the longest days, we're sleeping the least. We're sleeping the least, we're more insulin resistant, so we can take the fructose from the fruit. We can easily get better at storing fat so that we can then access that store fat when we're more insulin sensitive in the winter when we're sleeping more.

Dr. Dan Stickler: How about milk? We get all of our clients off of milk, but I still see a lot of people in the medical industry that are real promoters of milk intake and it boggles my mind.

JJ Virgin: Well, it does a body good, Dan.

Dr. Dan Stickler: Oh yeah.

JJ Virgin: Remember The Milk Moustache? I was on Dr. Phil doing his weight loss challenges when Dr. Phil came out with The Milk Moustache, I'm like, how do I deal with this? How do I address this situation here? It's one of the first foods that I pull people off of when I run those food sensitivity tests. Dairy and eggs are the top two culprits. Eggs makes me sad, and I think it's really because if you're eating a pastured egg, it's an entirely different food than what we've done to these eggs. But for dairy, especially like, what's the single worst thing you could do with dairy? Skim milk. Take out the fat and then skim it, so you just basically are liquid sugar. Right?

Dr. Dan Stickler: Exactly.

JJ Virgin: I just find so many people react to it and create inflammation from it, and that creates so many cravings. It's one of the easiest things I can pull out of the diet and see a big impact from, and let's face it, now, when I first wrote The Virgin Diet, it was really hard. I was like, okay, swap out gluten dairy, eggs, corn, soy peanuts, sugar, and artificial sweeteners. There weren't the options there are now. Now, I'm not saying go eat a bunch of processed stuff, but at least there are all these nice options, like Kite Hill has a great almond freestyle yogurt. You know how to now make like cashew cream cheese. There's all sorts of things that you can do here and avoid dairy. It's really pretty easy to get the dairy out. Plus, even back when I wrote it the first time, you could only find coconut milk in the Asian food aisle in a can. Now we have a lot of options.

Dr. Dan Stickler: I have to share this story cause you will enjoy this. In the early 2000s, when our children were in elementary school, I went to the school board dietary meeting where they were talking about the meals for the school plan. One of the things that they had on the plan, and it was bothering me is they had this stuff called moon milk. Have you ever heard of that?

JJ Virgin: Moon milk. I don't know. Is it like chocolate milk? Is it milk with added sugar?

Dr. Dan Stickler: It is sweetened milk. Yeah. So, they take these little cartons that are generally like, I think they were 90 calories and they make them to 160 calories.

JJ Virgin: Why? why did they do that?

Dr. Dan Stickler: Well, this is what I said. I said, "Why do you have sweetened milk on the menu?" The dietician that was there said, because studies have been shown that they'll drink more when it's sweetened.

JJ Virgin: Why do you want them to drink more?

Dr. Dan Stickler: That's what I said, and we want them to drink more? And she goes, "Well, it prevents rickets." And I said ...

JJ Virgin: Rickets.

Dr. Dan Stickler: I said, "I've been in the medical industry for about 15 years and I don't think I've ever seen a case of rickets." I could see her nodding her head, like uh-huh, see, I told you, and then I said, "But I see diabetes in children now."

JJ Virgin: Oh my gosh.

Dr. Dan Stickler: I said, "So, this doesn't make any sense to me." But it was getting nowhere.

JJ Virgin: Wow. Wow. That is so disappointing. I remember in school we had one girl who was overweight, and now she'd probably be considered normal, by the way, not overweight, but she was the one girl who was overweight. Oh my gosh, she was teased relentlessly. Now you go in, I mean, what is it now? One in four children are obese, like kids. Come on.

Dr. Dan Stickler: Well, and I asked them about vegetable servings on the offerings for the menu.

JJ Virgin: Oh, tater tots and ketchup.

Dr. Dan Stickler: Yeah, or peaches and syrup [crosstalk 00:41:13] they produce.

JJ Virgin: The challenge is we're training our kids early on these things. First of all, you know that if you are an overweight kid, the likelihood of being an overweight adult is like 70%. But the other part of it, on the exposure equals preference, if you learn these foods when you're young and you don't learn how to eat things like broccoli and fish and that stuff, you are set up for trouble. I did that show Freaky Eaters. When I first auditioned for that, I'm like, there's no way the show is a show. We won't have enough people. But literally, I could still be doing that show.

I could run that show 52 weeks a year and never run out of people. You'd be amazed how many people, especially who are addicted to things like French fries, that's all they would eat. I'm like, how did that happen? I remember having a mom come to me and she goes, "My son will only eat microwave bacon. That's all he will eat." I'm like, "Well, does he have a car and a credit card? How's this happening? I don't understand. Have you let him get hungry?"

Dr. Dan Stickler: Chicken nuggets and French fries were like the staple where we lived initially and all the kids, that's all they ever ate, chicken nuggets and French fries.

JJ Virgin: Wow. Yeah. Isn't it funny how like, one of the things with The Virgin Diet was like, wow, look at what we eat for breakfast. The stuff for breakfast is dessert. That muffin, if you take ... Take the frosting off a cupcake, it's a muffin. But then you look at the restaurants and the kid's menu, and the kid's menu is just like, there's nothing healthy on a kid's menu.

Dr. Dan Stickler: Yeah. I think they're making some progress in that area, but it's still way, way behind.

JJ Virgin: My kids had never had cereal. Then they went to grammy's. Now, I, growing up, my nickname was Poppy because I loved Pop-Tarts. I had either Cocoa Puffs, Captain Crunch, Pop-Tarts, or like sweet rolls for breakfast pretty much every day. Then at age 12, I completely rebelled against all of it and stopped it all, and started studying nutrition and drove my mother crazy. But my kids, so my kids were having like burger patties and chicken and fruit and dat for breakfast, and then they go to my mom's, and my mom, they have cereal. You can imagine what happened after that, the challenge that I had.

Dr. Dan Stickler: Well, my sister sent me a package one Christmas, and it was all of the foods that we ate as children. It was disgusting to actually look at. I mean, I would eat three bowls of Golden Grahams with milk every morning for breakfast.

JJ Virgin: Oh, those Golden Grahams, I've heard about those.

Dr. Dan Stickler: Come home from school, I got a Ho-Ho or a Twinkie, and then I'd make a Chef Boyardee pizza in the oven, eat the whole thing. Then the meals that my mother would prepare were always healthy and good healthy meals, but it was the stuff in between that I was just ... I mean, I don't know how, when we were younger, how we did that. I think the activity level compensated quite a bit for for what we were doing, but I look back at it, and I was just like, how did we survive childhood with the kind of foods that we ate?

JJ Virgin: I know. Hostess pies, Ding-Dongs, Twinkies, Ho-Hos.

Dr. Dan Stickler: Yeah.

JJ Virgin: Yep.

Dr. Dan Stickler: Now I want to shift a little bit here and talk about stress and mindset. This is an area that I know you talk about a lot, and when it comes to nutrition and really healthy lifestyle, and mindset plays an enormous role in that.

How Mindset Impacts a Healthy Lifestyle

JJ Virgin: Well, Dan, mindset plays like the starring role in everything. It's so funny when I went to write Warrior Mom, which was a story about how I showed up during all that was happening with Grant, and that will be a really easy way to explain it, how I see mindset and health. The publishers were like, but you're a diet book author. I'm like, read my book, because the first thing I talk about is mindset. That is step one with all of these things. You getting really clear on why this is important, seeing yourself already there, like, what is your life like when you don't have gas and bloating, when you have great energy, when you can focus, when your mood is stable? How does that change your life? What are you going to be able to do?

Then you just put yourself there already. When Grant got hit, and I was describing that like first 24 hours in the hospital, I remember standing there, I had gone back. I'd had like a two hour rest and I was back now, and it was the second night and I'm standing in the hospital, and I'm surveying the situation that I'm now in, now that he's survived. I'm in the hospital, he's going to be in the hospital, we have no idea for how long. He's in a coma. We have no idea. So, I'm not going anywhere except to go somewhere to sleep every single night. I have my other son who's now two and a half hours away, who's 15, who just saw his brother on a stretcher, with bone sticking through his skin, not knowing if he was going to survive an airlift.

My ex-husband went back to stay with him, and I have The Virgin Diet coming out. The launch is in a couple of weeks, and I've invested everything into the book, and I'm the financial support of my family. It's all on me. So, if the book doesn't go, I'm bankrupt and I will not be able to help Grant. So, I'm standing there going, all right, how do I make this work? I asked the right question, which I think in mindset, number one, it's like, it has to do with the questions you ask. If I'd said, how do I help Grant survive? That's a very different question than, how do I help Grant get to 110%? And then, how do I do this? What's my part here. I went, in order to pull this off, I have to put my self care above all else, because I can't walk into this ICU if I have a sniffle.

I had to walk in, I had to be gloved. I had to be masked, I had to be in a gown. So, I couldn't be sick. I had to be there. I was getting there usually 6:00, 7:00 AM, and I was leaving there sometime between seven and 9:00 PM every night. I just said, the only way I'm going to pull this off is to get anything that's not important off my plate. Anything that does not save my son's life and help him be 110%, make sure my son is taken care of, and crush this book so that success is no longer optional. I can afford to do anything I need to do for my son. Everything else is off the plate.

I put my self-care at the top of the list and made sure I got my sleep every night. Every night I was getting eight hours of sleep. I had people, when they asked me what they could bring, I had them bring food from Whole Foods, and I made sure I worked out every day, whether it was running up and down the hospital stairs, I found a gym that was a quarter mile away, and I just snuck stuff in. I thought to myself, wow, The Virgin Diet, it was drop seven foods, lose seven pounds in just seven days. It was built around weight loss, because no one had really looked at how an elimination diet can help with weight loss. But I realized, I walked in at the peak of my game. Right?

I thought, gosh, we never know when something challenging is going to hit us. The amount of stress that I was under at that time was crazy. One of my doctor friends, Hyla Cass walked in with just like a bag full of stress supplements for me. But I think, what if I hadn't been at the top of my game? What if I'd been one of those people that always says, hey, I'll start that tomorrow? When you look at this, when I queried my community a couple of years ago, and I said, if you're not where you want to be with your health and with your weight, why not? The number one thing I heard was I don't feel like I'm worthy, I'm good enough. That is your first start. You have to treat yourself as the amazing divine person that you are, that's here to do huge things.

So do those huge things, in order to show up when it's challenging, because it's the one thing we know for sure, there's going to be challenges, you have to take care of yourself. You owe it to yourself and you owe it to the world. You can't do that tomorrow because you never know what's going to happen. I would never have guessed in a million years what I was going to go through, but I was ready for it. That's what I think we need to do with our, I know we need to do with our mindset, is your mindset's a muscle. It needs to go to the gym, just like everything else. It's something that you must work on every single day. Because if you don't, I mean, just witness this last year of fear and negativity that's gone on, that's taken down the world, right?

Dr. Dan Stickler: Yeah. I love that. You're speaking my on that because I mean, the mindset is one of the biggest pieces we work with. We work with all aspects of it, but if you don't have the right mindset, you're not going to make progress. I mean, one of the first things we do is we get people to dispense with any titles or diagnoses, like if they come in and they say, "I'm diabetic," I'm saying, "No, you're not diabetic. You have insulin resistance and we're going to work on that with lifestyle." When they get rid of those tags, that's one aspect of mindset that we use, but also having the mindset of we're not broken. Everybody comes in and they're all talking about how broken they are. I'm just like, we're not a broken. Don't look at yourself as broken. Let's look at how we can be more optimized with where we are.

Let's tap into that potential that's within us, rather than trying to run away from something negative. Let's move towards something positive. Your whole story is really in alignment with what we talk about on the stress piece too, with going beyond even resilience into taking Nassim Taleb's wording, become antifragile, where I see resilience as coming into a stress area in your life in whatever way it is. I mean, classically, this COVID has been the perfect example in the last year. You come into this and you can face these challenges, and if you're good and resilient, you can face the challenge, take the impact, and then come out of it back to baseline. Whereas antifragile people, and this is what I would classify you as, is somebody who can come into a challenge, face that challenge, and actually come out of it with an emergent trait of being stronger than they went into it with.

JJ Virgin: I love that you just said that, because that is the reality when you really start to look at people who are successful. When I define success, it's like you're winning at life. You are able to be around the people you want to be around, make the impact you want to make. What I've noticed is, with all of those people, they have not had an easy, and you think it was just the opposite. You think, oh, that person over there that's so successful, they just got lucky. The reality is most of them have been more unlucky than most, and they've gone through bigger challenges than most. Every single time, it's like they went to the gym, lifted a bunch of stuff and got a lot stronger every single time.

When I went through this, I was sitting down with my sons, Grant and Bryce, and my ex-husband, John, and we were sitting around talking a couple of years ago about how much better we all are, how much stronger we are, how much better we are as a family, how much better we are at life. I mean, when you go through something like this, most of the stuff that people get concerned about, it's not even a blip on my radar screen anymore. I'm like, you're about that, who's dying here? That is much more of my litmus test on this, right?

Dr. Dan Stickler: Yeah. That is something that I would love to see people start paying more attention to, is really, are you in that state where you become strong? I mean, it's classic too. I mean, people think that stress is bad, but stress is really, it can be a good thing. It allows the system to adapt. Just like you said, exercise. You go to the gym, I mean, exercise is a major stressor in your day. I mean, you follow your stress scores on your watch or your HRV, and you see it really impacts those. But then your baseline becomes higher as far as low stress and higher recovery response the more you do that. That's the anti-fragility, and this can be applied across the entire spectrum of our life.

JJ Virgin: We've got to teach people that stress done correctly is good. Reframe it.

Dr. Dan Stickler: Yeah, I love that.

JJ Virgin: It's why I love high intensity interval training. Think what it teaches your body how to do handle high-level stress recover, handle high-level stress recover. Right?

Dr. Dan Stickler: Yep. What would you recommend for people to get started down this whole path? I mean, we've talked about a lot of things, but it is a lot of things. Health is not just one thing. What's your guidelines on getting people started on this?

JJ Virgin: It's funny. I wrote out a roadmap a while ago that I've been really messing with. If I were going to start all over just today and go, okay, it's time to get healthy, where would I start? What would be my number one thing? Well, my number one thing would be to commit, because nothing happens without a commitment. So, that always has to be number one, is that decision and that commitment. Ideally, if you look at, how do people make a commitment? It's time or money or both. So, if you're listening, you're going okay, it's really time that I do something. I say, find that person who you resonate with and hire them, and then block out the time that you're going to do.

I just went to a Joe Dispenza seven-day meditation workshop. I was sitting there with my husband going, all right, we have to mark this out in our calendar and just make this commitment that we are going to be doing meditation at home every day, and then we're going to go back so that we make sure that we really do this. So, how do you commit? And then really see that future life of like you are committing now and you're committing, and why are you doing this? What is the outcome that you're looking to achieve, and put yourself already into that outcome?

I always start with the mindset first. I think that it's key critical. Then the next thing that I think that's probably very different than how most people approach this is, I think that you add you take away, and this is a Robert Crayhonism is like, what if, before you started looking at all the things you needed to take out, and I like to swap rather than remove. If you're eating a gluteny something, like gluten bun switch to a gluten-free bun before we switch to lettuce leaves. It's like, we'll just do levels of swaps. But the first thing is, what would happen if you just went, you know what? I am just going to make sure that I eat more non-starchy vegetables every day. I make sure I get five plus servings of organic, non starchy vegetables. That's step one.

Number two, I'm going to make sure I'm starting to getting water every single day, clean water every day. I'm going to start with eight classes, then I'm going to make sure I get enough clean protein in every day. Like, you just start it with those things, you'll start to push out some of the other stuff. Yeah. Add before you take away.

Dr. Dan Stickler:  Is your book on The Warrior Mom, would you recommend that to get started on really getting the mindset going to the [crosstalk 00:57:09]?

JJ Virgin: The mindset is definitely, because when I was writing that book, Dan, I didn't know if my son was going to survive. He was in that place. One of the things with traumatic brain injuries that they don't tell you is they have a really high suicide rate in the first couple of years as their brain is really unstable. So, I didn't know if he's going to make it. It was a really scary time. I wrote the book to show how you show up during challenges, how you make that commitment to yourself, how you put yourself in your self-care first, that it's not selfish and selfless. You have to own that mindset first in order to be strong enough when all these things come up, where people will try to drag you into things you don't necessarily want to do or take your time away, etc. It's great for setting those boundaries and really getting committed to yourself first.

Dr. Dan Stickler: That's awesome. I love that. Well, as usual, our conversations are ... I always come away with tons of new knowledge, so I certainly appreciate it, and I know our listeners are going to really want to do some deep dives into a lot of the stuff we mentioned. So, is there a best way to get involved with anything that you're doing now or [crosstalk 00:58:20].

JJ Virgin: Sure. My podcast is easy. It's just subscribetojj.com. How do you like that? Subscribetojj.com, and of course, I've got my website, jjvirgin.com, that's got everything. Everything over there, up there, I'm in the process of working on my next book. I always say my final book, I'm in the process of my final book. The Virgin Anti-Diets coming out next year, and it really is to help reframe the way that we look at diets. I believe that diets do work. We just are using them incorrectly. We use a diet short-term therapeutically for information to help put together a personalized eating plan that will work for you.

As things come up that you want to address, you focus on what shifts you might need to do, and you see if they work or they don't work for you, and you put them into your everyday life rather than trying to live your life on different diets, which then sets you up for failure.

Dr. Dan Stickler: Excellent. Well, thank you very much for your time today, and I look forward to our future conversations.