Dr. Tom Bilella – Nutrition secrets and natural solutions to the drug epidemic – Podcast #119

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Dr. Justin Marchegiani and Dr. Tom Bilella talk about nutrition and ending the drug era in this special podcast episode where they go into nutrition secrets and natural solutions available in the modern world.

They discuss about sugar and how it affects our health in ways leading to nutrient deficiency. Find out about carbohydrates portions and intake at different times of the day and how such factors contribute to achieving healthier body. Learn about intermittent fasting as well as its effects on different types of people. Get valuable information about nutritional timing, pre- and post work out nutrition, the essential amino acids and its effects on body systems which in turn help people improve their performance and attain lean body mass.

Dr. Tom Billela

In this episode, topics include:

01:40   Avoiding sugar

13:02   Nutrient Debt

23:16   Intermittent Fasting and Macronutrient

33:42   Nutrition for building muscle

43:16   Movement patterns for building muscle

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youtuve

 

 

Dr. Justin Marchegiani: Hey, there! It’s Dr. Justin, welcome back to Beyond Wellness Radio. I have a good friend and awesome physician here, Dr. Tom Bilella and Tom likes to drop what are called Bilellaisms. Say that ten—

Dr. Tom Bilella: Yeah.

Dr. Justin Marchegiani: Times fast. Lots of brain candy will be a dropped throughout the show, sugar-free though, sweetened with Stevia. How we doin’, Tom?

Dr. Tom Bilella: I love it, man! Again, great opportunity with you. Haven't seen you in a while from our success summit. We had a great time around some great, you know, great minds in functional medicine. So thanks for the opportunity. Loving this.

Dr. Justin Marchegiani: I’m just waiting for the knowledge to be dropped, baby.

Dr. Tom Bilella: Well, now’s a little pressure, but that’s fine, man. So I’m sitting here in Red Bank, New Jersey. It just snowed but it's cleaned up. I’m feeling good. It’s a Motivational Monday and we’re ready.

Dr. Justin Marchegiani: Awesome! Well, why don’t you just walk me through just kinda your—your biggest. Well, it’s only Monday here. Why don’t we go through last week? What was your biggest clinical success last week with a patient?

Dr. Tom Bilella: Yeah, I’ll tell you right now. Call him Big Al. Big Al is from New York, now he relocated to New Jersey here, but Big Al is a 60-year-old Italian guy, diabetic for 15 years, the belly fat, the whole 9 yards. His son was a success client. He finally got his dad to commit to come in. Hemoglobin A1c on medication about 8-1/2.

Dr. Justin Marchegiani: Oh, my God!

Dr. Tom Bilella: Triglycerides through the roof. I’m not gonna bore with all his, you know, blood chemistry. You know, what I’m talking about and this guy was fatigued. He had 14-hour days because he commuted to his business in New York, etc. Long story short, eight weeks later he’s down 22.5 pounds of fat and his blood work improved tremendously. His hemoglobin A1c went from like 85 to 68. But here's the story.

Dr. Justin Marchegiani: Yeah.

Dr. Tom Bilella: He went to his—back to his medical doctor about a week and a half ago, waited an hour and half to see the doctor. Doctor comes in, puts him on the scale and loses 22 pounds, and he tells the doctor. He says, “Listen I’ve been seeing a clinical nutritionist.” You know what the medical doctor said to him?

Dr. Justin Marchegiani: What?

Dr. Tom Bilella: Well, if you’re seeing a nutritionist, you should have lost a lot more body fat than that.

Dr. Justin Marchegiani: Oh, my God.

Dr. Tom Bilella: Condescending, non-supportive, and Al was blown away. And Al made up his mind at that point; he’s not coming back. He then told me the whole story. We looked at his blood work. The point is Dr. Justin is that great success story—his medications are cut in half. We’ve—we’ve changed his life. We’re probably saving his life and did not get the support from his medical doctor. I got a video on that that’ll blow your mind. So that was my biggest success of last week, diabesity—it’s out of control. This drives me crazy.

Dr. Justin Marchegiani: And you know, the conventional medical doctors this day and age, they’re really not equipped on the diet and lifestyle and nutritional and supplement changes that have to be made to get their patients the next level, just—and a case in point, a few years ago I had a patient who went to the cardiologist and said, “Hey, I’m thinking about making these diet changes to the kind of this Paleo-lower-carb-type of diet, etc., etc., what you think?” And the cardiologist he was seeing for about five years and the cardiologist turned him and said, “Well, you know what, that's exactly how I eat, but personally, legally, I can't tell you that because I’m bound by the American Board of cardiology—

Dr. Tom Bilella: Oh.

Dr. Justin Marchegiani: And that's not quite what our board allows us to say. So a lot of these doctors, they’re hamstrung, especially if they work in a hospital setting. So it's tough. People like us, we’re like, you know, we’re—how should you say it—we’re—we got no ball and chain on our legs so to speak.

Dr. Tom Bilella: Yeah.

Dr. Justin Marchegiani: So we can go out there and just call it like we see it and give the information.

Dr. Tom Bilella: Exactly right and thank goodness there’s more people like you and I, and you’re doing your podcast, you know, getting people inspired and doctors inspired to do more functional medicine so we can make these type of changes, because you know what? I ain’t gonna happen in the White House. It’s gonna happen in your house.

Dr. Justin Marchegiani: Love it.

Dr. Tom Bilella: And I’m—I’m all about inspiring other doctors, functional medicine doctors or chiropractors, whomever, to start doing more functional nutrition functional medicine, so we can support people at different level because you know this healthcare system is broken. It's backwards. People are suffering and they’re ticked off.

Dr. Justin Marchegiani: Exactly, and you really talked about getting people gonna get—ending that—ending the drug era. I think it’s, I know it’s like—

Dr. Tom Bilella: Yeah.

Dr. Justin Marchegiani: Like 20% of fifth graders are on some type of ADD/ADHD medication and you really talked about getting people off the lifestyle drugs, but not just pulling them off but fixing the root underlying cause—

Dr. Tom Bilella: Yeah.

Dr. Justin Marchegiani: Of why they’re on it to begin with. Let’s start with that—

Dr. Tom Bilella: Yes, well I—yeah, I don’t have to explain the premise of functional medicine, it’s getting to the roots. You know, not trying to glue the leaves back on the trees when they fall off, like you know looking for a meditation.

Dr. Justin Marchegiani: Love it.

Dr. Tom Bilella: You know, looking for more glue to—to glue it back on the—the tree branch. Hello? You go to the roots. So I—you know, I’ve been doing this for 28 years now, seen thousands of patients and if we’re gonna drug era in our lifetime, you know, it’s gonna take a collective effort and it's happening but here's a story. The drug era started in 1983 when this country or someone allowed pharmaceutical companies to advertise on TV. That’s when the drug era started. You can trace it back to then. America's 4% of the world’s population, consuming up to 54% of the medications, the majority of which are lifestyle induced medications. It's an outrage.

Dr. Justin Marchegiani: Only 2 countries. I think us and Australia.

Dr. Tom Bilella: Yeah, I think its—

Dr. Justin Marchegiani: Right?

Dr. Tom Bilella: Australia or New Zealand, exactly are—

Dr. Justin Marchegiani: Yeah, it’s one or the two.

Dr. Tom Bilella: It’s—or allowed to advertise. Now let’s take a step further. So now you’re a 9-year-old kid or 11-year-old kid. You’re watching these commercials. You know, even 4 years old and you see this lady with a pounding headache, she goes to her medicine cabinet, pops 2 pills, 8 seconds later she's on the tennis court with her husband, enjoying an iced tea. So then this poor kid gets to high school, 14 years old having some stress and some difficulties, and remembers back in the brain probably subconscious that tells her the answer. And you wonder why we have all these young people on drugs and medications. So it's a real problem, Dr. Justin.

Dr. Justin Marchegiani: It is. It totally is, and you know, I always tell patients, drugs don't have side effects. They have effects.

Dr. Tom Bilella: Yup.

Dr. Justin Marchegiani: And again what are these drugs doing? They’re typically blocking enzyme or reuptake ports in the biochemistry. So the difference is when we’re doing nutrition and diet and lifestyle and functional medicine interventions we’re about up regulating and enhancing the physiology where a lot of these medications are about down regulating and suppression—suppressing. But in the short term, that may be okay if someone has an acute issue, but then what are we gonna do to transition them off? The conventional medical system has no path for that. There’s no conveyor belt that puts them on to a functional medicine. So can you talk more about the things that you're doing to get to the root cause with some of these common medications?

Dr. Tom Bilella: Sure. Yeah, well, it starts for me—it starts with good paperwork, thorough cons—

Dr. Justin Marchegiani: Uh-hmm.

Dr. Tom Bilella: Thorough paperwork—

Dr. Justin Marchegiani: Chemistry.

Dr. Tom Bilella: Coming in for a comprehensive consultation and lifestyle analysis, of course, we do a body comp analysis here and I do a nutrition exam. You know, checking hair, skin, nails. Checking things you gotta check, palpating the thyroid, okay? Looking for—looking for—looking into nail beds. Looking at postural faults.

Dr. Justin Marchegiani: Huge.

Dr. Tom Bilella: And then I use functional chemistry. You know, I’m running a full thyroid panel to everyone and I’m screening for antibodies. I’m free T3, reverse T3. I'm looking at, of course, homocysteine C-reactive protein. We’re looking at hormonals, hormonal levels that are men and women. So it starts to me with functional chemistry. I'm a big advocate of food sensitivity testing, about 80% my patients choose they get it. I explain it becomes like a nutritional pilot light to reduce the inflammatory effect of certain foods. It could be a good food, Justin, but not good for this particular person and I'm a big advocate of vitamineral analysis. You know, typically through a SpectraCell or maybe an organic acid testing. So if you're not testing, you’re guessing, alright? And I explained this to my patients so in doing such a way where they totally get it. So it starts with the labs. They come back for their second visit. We talk about what's most pertinent and there's three phases of my program. I call it the education phase. They always leave the first visit with some homework and some reading and the education diagnostic phase I have to say. Get the diagnostics. They come here for their second visit and we typically launch with the cleanse phase, and I just say, “Think of the word clean. It’s not like a cleanse or fasting. We’re gonna get the good foods in, rid out the bad foods, take care of these nutritional potholes that you have with all these vitamineral deficiencies, do that for 2-3 weeks, and then talk about what’s called their transformation phase. Continue to working on the imbalances in their chemistry.” So we have really good results here, really good compliance because what’s—how we educate our patient visit to visit.

Dr. Justin Marchegiani: I love it. I love it. And it's really interesting because I work with lots of patients as well and the big thing that I hear over and over again is I've never had a doctor spend that much time with me. I never had a doctor roll up their sleeves and dig in deep and look at like the nail beds, you know? Let’s look at protein—

Dr. Tom Bilella: Mmm.

Dr. Justin Marchegiani: And fat soluble vitamins. Let’s look at—

Dr. Tom Bilella: Uh-hmm.

Dr. Justin Marchegiani: The skin. Let’s look at the hair. Let’s dig in and try to connect the dots—

Dr. Tom Bilella: Uh-hmm.

Dr. Justin Marchegiani: To the outer exterior to what's going on the physiology and I love because we operate outside of that insurance model where we don’t have that ball and chain holding us back, again just like on the nutrition side, too.

Dr. Tom Bilella: Yeah, exactly and what I’m proud of is I also have a nice team here and I have health coaches that will work with me, not all at the same time. I'm always working with my health coaches who’s helping me educate these patients, allows me to see up to four people an hour, after the first and second workup, and they’re getting this 30 minutes worth of service, 15 minutes with me. I tell my clients, “I’m the Why, she’s the How, I’m the good cop, she’s the bad cop, yeah? But we work together to get you to your goals.” And it’s a really good system I created here where you can help a lot of people, be profitable, but our patients are getting an end result which is educating them

Dr. Justin Marchegiani: I love it and you know, it’s interesting because I’m around a lot of healthy people and their kids still not—not eat so well so to speak.

Dr. Tom Bilella: Mmm.

Dr. Justin Marchegiani: And it’s—you kinda tiptoe around it. You showed me—

Dr. Tom Bilella: Mmm.

Dr. Justin Marchegiani: A video last year of your daughter who’s like a little YouTube celebrity, talking about sugar and then you are—I think you were offering her sugar and she kinda went off in this little speech educating you on why that's not good. You wanna talk about that?

Dr. Tom Bilella: Yeah.

Dr. Justin Marchegiani: We’ll post the video on the notes, too. That’s a good one.

Dr. Tom Bilella: Yeah, so Sofia Bilella, she’s now 9. I’m really proud of her. She does an adlib and I’ve been teaching since she’s a young girl, you know, proper diet, not being you know, not too crazy. But between the ages of 1 and 2, I made it a point not to give her any sugar because I once read that that's when a young—

Dr. Justin Marchegiani: Huge.

Dr. Tom Bilella: Young person's palate is forming.

Dr. Justin Marchegiani: Huge.

Dr. Tom Bilella: And if you—if you can keep the sugar out their body from ages 1 to 2, they’re not gonna create this sugar—I hate to say almost addiction or—or need.

Dr. Justin Marchegiani: Yup.

Dr. Tom Bilella: So we did that, okay? And now she’s allowed maybe, you know, maybe one little treat a day but it has to be a treat, but the point is that in school in the second grade, she won the contest where she had to count how many Smarties were in the jar.

Dr. Justin Marchegiani: Oh yeah?

Dr. Tom Bilella: So it was like 100. So the prize that the second-grade teacher gave out, she got 100 Smarties. She brought them home. I come home; I see 100 smarties in a bag. I’m like, “Oh, baby.” So my—my Sofia knows the kind of, you know, she doesn’t hide anything. She’s got great confront and I said Sofia we gotta do a video. And part of the video which you’ll see is that she's ticked off and she tells me because there's red dye in there, okay? It causes childhood obesity. She tells—and she was 8 at the time, alright? And there's been other considerations. Her first grade teacher was giving out little marshmallows for math assignments and my daughter told me this, either write a letter or an email to the first grade teacher but Sophia Bilella, little kid natural here so to speak, is—is on the same page. She’s educating and she's totally into it. It’s not an act.

Dr. Justin Marchegiani: Exactly. I think the big thing is, too, when you get yourself healthy, you can't help but create that ripple effect, the health—your—your spouse, your family members, and your—and your kids as well which is great.

Dr. Tom Bilella: And it's got this—this next generation, you know, it's really important that we have this—we disseminate this information because last glance like a 4th grader on 55% of the calories is in the form of sugar—

Dr. Justin Marchegiani: Oh, my God.

Dr. Tom Bilella: And there’s a gross protein deficiency, a gross vitamin D deficiency, gross essential fatty acid deficiency in our culture with you know, with young people and what drives me insane is when the—the parents as well. Well, my pediatrician said, you know, we don't really need them. You can take a multivitamin or Flintstone. I’m like, “Were you checking the kids’ vitamin D?” No. It’s an outrage. Pediatricians by and large are still telling the parent we are the wealthiest nation on earth and we have the best. Don’t worry about it. Are you kidding me?

Dr. Justin Marchegiani: Yeah, it's terrible. We have an excess of calories but the problem is a lot of calories, but the problem is a lot of calories aren’t attached to nutrition these days. You can get a ton of calories with virtually zero nutrition. People forget that when you give your body a whole bunch of sugar, it has to run them through glycolysis in the Krebs cycle and it actually takes nutrients to metabolize sugar, so you can actually go into nutrient debt. It’s like using your credit card when you don't have enough money in the bank to pay for the bills. It’s the same thing when you do all this extra sugar as you know.

Dr. Tom Bilella: Yeah, and then let’s augment nutrient debt and then like—

Dr. Justin Marchegiani: Uh-hmm.

Dr. Tom Bilella: A young woman who then starts menstruating—

Dr. Justin Marchegiani: Yup.

Dr. Tom Bilella: Six months later, she’s totally iron deficient. She's depressed and fatigued, and unfortunately conventional medicines do one of two things—birth control pill and/or an anti-psych drug.

Dr. Justin Marchegiani: That’s it.

Dr. Tom Bilella: I mean this is what's happening out there, ladies and gentlemen. So I’m not saying you never need a birth control pill or anti-psych drugs have your place, but that should not be first line of therapy when you have 14-year-old girl who is tired, fatigued, and depressed. Let’s check her nutrition.

Dr. Justin Marchegiani: And I guarantee—I know I saw the stat of 25%, 20% of 5th graders are on some type of like ADD, Adderall, Ritalin, etc. If—and I believe firmly, if you look at the research, this starts with the sugar and the inflammation. If you get up, the nutrient density and you drive down the sugar and the inflammatory foods, these kids’ brain chemistries are gonna be so much better and they’ll be able to focus better in the classroom, too.

Dr. Tom Bilella: Yeah and we’ll—what I do as a clinician when a parent comes in, is we have some call the Healthy Kids Club. And of course—

Dr. Justin Marchegiani: Yeah.

Dr. Tom Bilella: Sofia Bilella is president of the Healthy Kids Club.

Dr. Justin Marchegiani: Right.

Dr. Tom Bilella: But I have a really—a really easy 2-page sheet. It’s actually one page that I give to the parent. It'll say, you know, child's name, weight, height, any medications, how proteins a day, how many fruits and vegetables a day, how many rounds of—rounds of antibiotics and are they currently taking probiotics? They bring it back to me. I say, “Hey, listen, your most important job as a parent is making sure your child is developed well.” That doesn't mean another karate class or another soccer tournament. I—I don’t say that. Sometimes I do.

Dr. Justin Marchegiani: Right.

Tom Bilella: I’m like, “Listen, fundamental. Let’s get your child—here’s what I’m recommending. A multivitamin, some—probably some extra vitamin D, certainly a fish oil, and periodic probiotics. If we can just—every person, if every parent understood that you just work with the fundamentals and I do believe in nutrition shakes. My daughter since she's 2 years old has been on a nutrition shake 1 to 2 a day over the last 7 years. My daughter is 9 years old. I don’t wanna brag but she’s like a beef. She’s so strong. She’s so solid. She's smart and I'm telling you nutrition is a big part of that.

Dr. Justin Marchegiani: I agree. I’m a big fan of the shakes, too, because one, if you're in a rush in the morning, you can have those things pre-made in a shaker cup ready to go. You walk out the door and you shake it. You’re good to go. You can make it taste sweeter with a little bit of Stevia and some berries so you pack the nutrition—

Dr. Tom Bilella: Yup.

Dr. Justin Marchegiani: But you keep the sugar low and you can sneak in some veggies and some high quality amino acids, and a lot of people got low—

Dr. Tom Bilella: Yup.

Dr. Justin Marchegiani: Hydrochloric acid, so it makes it very absorbable.

Dr. Tom Bilella: Yeah, and with my daughter I negotiate, too, man. She loves her gluten-free pancakes in the morning—

Dr. Justin Marchegiani: Uh-hmm.

Dr. Tom Bilella: And gluten-free French toast. So the deal I have with my wife and my daughter, as long as you’re getting some organic fruit with that and your nutrition shake, I’m cool. Okay? She loves her—the organic maple syrup on her pancakes. It used to drive me crazy. I said, “Listen, you get some fruit with that and your shake, that's a good way to start the day.”

Dr. Justin Marchegiani: Yeah, yeah, I agree and how are you looking at your patients and examining outside of the lab testing the essential fatty acid and the protein deficiencies.

Dr. Tom Bilella: Good. So with the essential fatty acids, I am doing a red blood cell membrane essential—

Dr. Justin Marchegiani: Okay.

Dr. Tom Bilella: Fatty acid test, okay? And most everyone comes back less than 5.5% of the—

Dr. Justin Marchegiani: Yup.

Dr. Tom Bilella: Red blood cell membrane deficient EPA, DHA, DPA, alright?

Dr. Justin Marchegiani: Yup.

Dr. Tom Bilella: So I’m using that test. I’ve got to mention that. So then I can look at vitaminerals in fish oil, etc. and as far as from protein standpoint I’m using in body, I‘m doing a body composition test on every—

Dr. Justin Marchegiani: Yup.

Dr. Tom Bilella: Single person. I’m looking at their lean body mass and I'm using that number as a kind of reference or barometer of how much protein I believe they need for their dietary protein, okay, and of course questionnaires and other considerations will clue me in including blood work if they have the digestive capacity, i.e. hydrochloric acid to digest this. But I gotta teach the mindful eating, chew your food, not a lot of liquid when you're eating your solids.

Dr. Justin Marchegiani: Yeah.

Dr. Tom Bilella: So it comes back to the fundamentals, man, you know chewing your food. Even my daughter, nine years old, I go, “You have to chew your food nine times before you swallow. When you hit 10, it’s gonna be 10 times.” There’s little—little reference there. But back to your question, you know, teaching them what they need to do and getting very specific without overwhelming them. I go, “And here’s your body composition analysis, Mrs. Joe and your hundred pounds of lean body mass, we a hun—80 to 100 grams of protein per day, but we’re gonna pulse that through the day. And then I’ll say something like remember 3 x 3, 5 x 9.” They go, ”What are you talking about, Dr. Tom?” And I show my little PowerPoint, by 3 PM you better have three feedings and by 9 PM, you better have 5 feedings. It’s not diet and exercise. It’s eating and training.

Dr. Justin Marchegiani: Love it.

Dr. Tom Bilella: Teaching you to feed your—yeah, teaching you to feed your body through the day and if you need 80 grams of protein, I might say, “Hey, you know, up to 15 to 20 grams of protein, 4 or 5 times a day.”

Dr. Justin Marchegiani: I love it, very good, and you know, one of the old adages I learned from a Paul Chek, he always said, “If you’re a health advocate, a physician, you should be able to go deliver your health talks in a—in a—a thong so to speak, and like you know, kinda be able—

Dr. Tom Bilella: Yeah.

Dr. Justin Marchegiani: To expose yourself and show, “Hey, this is the product of my health advice.” One of the things I appreciate you being in this business for a long time, 30+ years. You were a bodybuilder as well. You did it the healthy way and—

Dr. Tom Bilella: Uh-hmm.

Dr. Justin Marchegiani: Even in your 50s, which you look 15 years, you know, younger than what you do, easy.

Dr. Tom Bilella: Yeah.

Dr. Justin Marchegiani: You’re still walking the talk, talking the walk so to speak and I'm just curious, can you just walk-through for some of the listeners, some of the simple things you're doing—

Dr. Tom Bilella: Uh-hmm. Good.

Dr. Justin Marchegiani: To stay healthy, to stay ripped and lean.

Dr. Tom Bilella: Yeah, so thanks, Justin. I wouldn’t say I’m ripped anymore. I’m about 16% body fat, you know, back in 1995, I was—I did a Natural Bodybuilding show, when I’ve been, you know, a graduate _____ in 1988, but you know, what I do is, you know, I—I try to eat super clean Monday through Saturday, and I can't really tolerate the amount of carbohydrates I used to.

Dr. Justin Marchegiani: Yeah.

Dr. Tom Bilella: I’m still working out 4 to 5 times a week but it’s only for 30 minutes. I'm a big advocate of burst training.

Dr. Justin Marchegiani: Yup.

Dr. Tom Bilella: And some that’s even a one-minute workout where I’m warming up but then I’m just doing 1 minute on a stationary bike which is 2 minutes, 20 seconds, 2 minutes, 20 seconds, 2 minutes, 20 seconds. The 1-minute being the intensity component. So I work out 4 to 5 days a week, 30 minutes at a clip. I get each body part once a week. I’m all about muscle preservation now, alright. But during the course of the week, I'm eating clean, up to 2 shakes a day, and I'm usually keeping my cards pretty low now like under 80 to 100 grams were years ago I could do 300 grams.

Dr. Justin Marchegiani: Right.

Dr. Tom Bilella: And I’m also relying on oftentimes some exogenous ketones, some keto—

Dr. Justin Marchegiani: Yup.

Dr. Tom Bilella: OS through the day.

Dr. Justin Marchegiani: Yup.

Dr. Tom Bilella: Usually twice a day to really help with that duel fuel, you know, using ketones as a fuel. You know, ketones are 4-carbon fatty acid that can be—

Dr. Justin Marchegiani: Yup.

Dr. Tom Bilella: You know, it's a fantastic fuel. So I'm doing that and on Sunday quite frankly, I give myself a little wiggle room, alright.

Dr. Justin Marchegiani: Yeah.

Dr. Tom Bilella: And when I'm really, really, really good which is most of the time, I’m gluten or grain-free.

Dr. Justin Marchegiani: Yup.

Dr. Tom Bilella: There are occasions where I will have a non-gluten bagel this and that, on a very rare occasion, Justin, I’m gonna tell you, sometimes gluten sneaks in, oh my goodness, it’s not a felony, folks, okay? But listen we all know that grain-free is the way to be, and of course, wheat, gluten is not your friend in this country. So that's what I do, man.

Dr. Justin Marchegiani: Yeah.

Dr. Tom Bilella: 6 days a week and you know, with my patients, I give them a pearl. Because another problem patients have—

Dr. Justin Marchegiani: Yeah.

Dr. Tom Bilella: Is the whole alcohol thing because alcohol is sugar, maybe even do one or two drinks a night or a couple a week. I like the ak—exercise alcohol rule.

Dr. Justin Marchegiani: Yup.

Dr. Tom Bilella: Never have more alcoholic beverage a week than exercise sessions. So these are little pearls that I, you know, disseminate, explain to my patients, but me personally, I try to stay clean 90% of the time.

Dr. Justin Marchegiani: Love it. Now with—with your carbohydrates, what does that look like? Because typically veggies will get you—if you’re doing like a veggie or two at each meal, you’ll be—be maybe around 20 or 30 grams of carbs especially if you minus the net fiber in there.

Dr. Tom Bilella: Yeah.

Dr. Justin Marchegiani: How’d that look for you? What do—what do your carbs look like?

Dr. Tom Bilella: Well, yeah, I pretty much—pretty much go low carb all through the day. I'm doing my veggies and at night, I’ll oftentimes get a starch.

Dr. Justin Marchegiani: Yeah.

Dr. Tom Bilella: Potatoes, sweet potato, okay. Because I sometimes just feel a lot better with that starch in with my veggies and my protein. I think health my serotonin levels. I think it really helps my cortisol curve, you see. So oftentimes—

Dr. Justin Marchegiani: I agree.

Dr. Tom Bilella: If I do my starch I’ll do it at dinner. A lot of people thing you should do it breakfast and if that works for you, fine. But I like my protein and my fats through the day and at night I’ll do a carb. Now quite frankly, if I do a body composition analysis or I’m gonna be speaking or going somewhere and I wanna get a little bit leaner, I might even reduce my carbs further. But as a general rule, I like to get my clean carbohydrate at dinner, and I like to eat my protein first. I like to eat my protein food first then have my carbohydrate to blunt that insulin spike.

Dr. Justin Marchegiani: I 100% agree, a lot of research on carb back loading, we’re a little more insulin sensitive at night. We have more cortisol in the morning, mobilizing sugar, so we don’t need the extra carbohydrate converting the sugar in the a.m. Done studies on firefighters, they took the carbohydrate portion, spread it out evenly for one group, took the other group, had it all at night and they were already obese to begin with, and the other group lost the most weight. Same calories.

Dr. Tom Bilella: Absolutely. Yeah, I mean, you ever watch Seinfeld? Remember George the day he did everything opposite his impulses—

Dr. Justin Marchegiani: Mmm.

Dr. Tom Bilella: Sometimes the opposite, you know, instead of oh, do carbs at night, you know, if you remember Seinfeld, George did the opposite impulse. He told George Steinbrenner off when he got the job. He was at the diner. He went right up to the girl and he said, “I—I'm—am unemployed and I live at home,” and he got a date with the girl. So the point is that in nutritional medicine, you know, be open-minded. Because I would have never said that 5 or 10 years ago. I’d be like, “No, you gotta get protein and veggies at night and go to sleep.” Not everybody and especially if there’s an HPA axis dysfunction.

Dr. Justin Marchegiani: Yeah.

Dr. Tom Bilella: Oftentimes that carbohydrate night is crucial.

Dr. Justin Marchegiani: Right and the same thing in—in real world. If you’re getting conventional, medical or nutritional information, right? Eat 11 servings of grains a day.

Dr. Tom Bilella: Ugh.

Dr. Justin Marchegiani: Do the opposite, you're better.

Dr. Tom Bilella: Yeah.

Dr. Justin Marchegiani: You know, high cholesterol is gonna cause all these problems, do the opposite.

Dr. Tom Bilella: Do the opposite.

Dr. Justin Marchegiani: You know, eating eggs is gonna cause problems. Do the opposite, right? Bacon. Do the opposite.

Dr. Tom Bilella: Yeah, someone once said, that’s better than me, the masses are Asses. Now I hate to say that, but if you’re doing what everyone else is doing, there might be a problem there. But be , you know, the point is be open-minded. And I like what JT that once said on a—on a podcast. He’s a naturopath.

Dr. Justin Marchegiani: Uh-hmm. Yeah.

Dr. Tom Bilella: You know, the perfect diet 22:50 e to one set on up on a podcast is not the math you provide is ever found it's created you know so you like to my client be open-minded weren't work together for it was best for you: Leah macronutrient way you know or you need to use key tones you know I'm at eugenic I use misogynist key tones in your program so I'm very open-minded I certainly have some you know some backbone things are some rudimentary things but is different

Dr. Justin Marchegiani: Love it love it it's really good know what your take on skipping breakfast in the morning got so you know in fasting was first introduced of a Giambrone years ago I like that set against the like you know bodybuilding.

Dr. Tom Bilella: Yeah. So you know intermittent fasting was first introduced by John Breadrid. Talk about it years ago. I was like dead set against it because I came from the old body building school, like “Oh, you gotta use the one hour waking up and uhmm–so you know and then people do had HP axis dysfunction. You gotta be careful you know because you can't stabilize your sugar if you naturally, if you have low cortisol because you have phase III. You gotta be really careful. Yeah-Uhm but some people do well with it. But I will say this too. I also will see people come to see me, a lot of cross fitters who ranges helps fitness things. They start getting fatigue or they start getting performance deficits then they come see me. I run their blood work and it's atrocious. I mean reverse T3 is high, their thyroid is down, their testosterone levels are down, their C rec to protein levels are up. They are overstressed. They are training too intensely, not eating and they are going too long between meals. These people, they need to start eating in like often times, start training less.

Dr. Justin Marchegiani: Yes

Dr. Tom Bilella: If I recommend missing breakfast, maybe using some ketones in the morning or coconut oil. Okay. But uhmm I'm having success with some ketones in the morning. I think there’s something too with 12 or 16 intermittent fasting especially those with insulin resistance. If you got a guy at 3rd percent body fat and his insulin level is really high, you gotta get them down.

Dr. Justin Marchegiani: Yeah

Dr. Tom Bilella: So you get him to go 12-14-16 hours without eating in the beginning, your gonna see good changes physiologically.

Dr. Justin Marchegiani: I appreciate that. I think it's important to talk to clinicians about these things because we're not into jamming a square peg in a circle hole. We are about giving the right information for the right patient. We know different things work at different times. You got a lot of people online where intermittent fasting work for them therefore some in that everyone has to do without any exceptions or you know metabolics, specifics, have this issue or adrenal or female hormones. So like how you add the clinical aspect. You really tailor it. It's really important.

Dr. Tom Bilella: Yeah. And I have some clients who actually need 25 percent of their calories at breakfast. I have the opposite. I have people who have a hard time keeping at all their health in check, hunger energy cravings. Okay, so their health is not in check. And I then would have to say, “listen, I want you getting five to six hundred calories at breakfast with a good macronutrient breakdown and like “Oh, Doctor Tom, I felt so much better all day long”

Dr. Justin Marchegiani: Oh, I agree. And I think you kinda valued it to Sunday being your cheat day. I think once you get really healthy you can play around with and cheat a little bit. Like you see guys in the major leagues with this crazy swing and this and that. Well they had to get the fundamentals down first once you get the fundamentals, you can always cheat and kind of you know, adlib if you will.

Dr. Tom Bilella: Yeah, I agree a hundred percent. What I'd like to do, though and I think people should try this. Every year, I get this from my friend Shawn Philips. I try to get the best shape of my life at that timeframe. So I used to start mid March and go to Memorial day and I got a good body in mind and every year we do a physique transformation challenge and we gotta get my buddies to do it. We do body comps, we do before pictures and we do a 10-week program. So for this10 weeks, I don't have a cheat meal on Sunday. I'm trying to go for maybe 17% body fat down to 12-13% body fat. So once a year, I try to get in really good shape for me and for the rest of the year, I give myself some wiggle room.

Dr. Justin Marchegiani: Got it. And when you're doing that, are you counting calories at all? Or more focused on the carbs?

Dr. Tom Bilella: Good question, man. Uhm, in the beginning I keep a food journal which I recommend all my clients in the beginning. In the beginning I usually am, uhmm until it starts to get like instinctual going okay that I do my weekly body comps. If I feel like I nailed it with my macros, okay. Then I'm just like gonna ease up but good question. The first couple of weeks, I'm gonna chart everything. I'm gonna add up my calories, I'm gonna add up my protein, carbs and fat. I'm usually gonna do my body comp at 180 pound lean body mass, weigh about 216. So I'm really gonna target getting about 180 grams of protein for today. And I will kinda do some carbohydrate patterning. Some days higher, some days lower. So it's all different and every year it's interesting I'll be 53 my body changes. So what worked three years ago, might not work with me today.

Dr. Justin Marchegiani: Interesting. And with your carbohydrate or with your calorie consumption, do you ever go so low calorie where you’re hungry throughout the day.

Or you try to just have enough so you feel satiated?

Dr. Tom Bilella: Yeah, I never try to get hungry especially from working because if I'm hungry and working, it's not good for the client or the staff or me.

Dr. Justin Marchegiani: Yeah, hungry. Yeah.

Dr. Tom Bilella: But uhm but you know this year, Uhm the first year I'd probably be incorporating some exogenous ketones. So you don't really get hungry on those. So it's kind of a secret weapon.

Dr. Justin Marchegiani: It is.

Dr. Tom Bilella: If I do need to drop my calories and I think you can do that from time to time. Maybe two days a week. Uhm to get that extra fat loss. Uhm it's not gonna, it doesn't pain you at all. You don't feel the actual cravings when you got the therapeutic exogenous ketones.

Dr. Justin Marchegiani: And you mix that in your coffee?

Dr. Tom Bilella: Uhm sometimes I do. They do make cute little cream but typically I'm gonna put it mid morning – mid afternoon. Uhm I'm just gonna ring my ketones.

Dr. Justin Marchegiani: God. People wanna get more information about the keto OS. Beside with that, you have info on it?

Dr. Tom Bilella: Yeah. At my site, which is nutritioncenter.com, there's a site and I believe it's, I have a thing. At the end I have shopketontc.com but I'll get the exact email site for you. But yeah and there's something called the five-day experience pack. If you're interested, we could mail you the uh five pack and see if you're noticing what most people notice which is simply this, direct improvement, mental focus and clarity, unlimited flow of energy and significant appetite control. And that's what you will notice with the ketones.

Dr. Justin Marchegiani: Yeah, I like it too because you don't have to go low calorie to get there, right. There's nutritional ketosis and there's starvation ketosis, right? So you can get there whether its with like the betahydroxybutyrate ketones or high dose MCT. Uh the great way is to get your ketones up. And you measure them at all?

Dr. Tom Bilella: I sure do. Uhm I actually don't even do the urine anymore. Coz urine is not that accurate. I use the ketonic meter, I use the breath meter. And when I chose to uhh a ketogenic product to drink- exogenous ketones. I actually did the research and then bought them and determine which one raise my ketone levels the most. Coz we're all walking around with some ketones, right?

Dr. Justin Marchegiani: Yeah

Dr. Tom Bilella: You're a .3millimolar. You gotta get to like 1.0 to 1.5 to be in a therapeutic ketones, to feel the therapeutic benefit from a central nervous system stand point. And one dose of the Keto OS typically raise you 0.5 and that's gonna put you in your sweet spot. So to answer your question, absolutely, I love the ketonic breath meter. Super convenient, not quite as accurate as the blood droplets. But you know me Just, you know me I'm a quick guy from Jersey, I like to get things done fast. So I don't have the time, well I do have the time but I prefer not to do the blood droplet and wait so I just blow into the meter, within two minutes I get data.

Dr. Justin Marchegiani: It's not quantitative, right? It more gives you the color and tells you what zone meant.

Dr. Tom Bilella: Exactly. Blue, yellow, green and red. Red indicating ketoacidosis which will never probably happen in the therapeutic ketones. But, right so you're not gonna get a 1.3 millimolar read out.

Dr. Justin Marchegiani: Yeah.

Dr. Tom Bilella: But you do know and you can feel it as long as you get into the yellow which is trace and uhm blue which is moderate, you're measuring acetone in the breath which is an indication direct correlation with betahyroxybutyrate in the blood.

Dr. Justin Marchegiani: Exactly. And here's the other meter I use. The precision xtra by Abbott.

Dr. Tom Bilella: That's the best.

Dr. Justin Marchegiani: Yeah.

Dr. Tom Bilella: That's the best for sure.

Dr. Justin Marchegiani: And I find like in the morning I sit between a .5 and 1 on the millimoles and I feel phenomenal with that and I agree with the Keto OS I've seen it, I've done experiments and videos where I can get it to pop up uhm .3 – .5 millimoles

Dr. Tom Bilella: Yeah, exactly. And people like Tim Ferriss, you know, he actually will only write and do lab at his work when his ketone level and his blood is at a certain point coz he knows that's the most efficient time for him.

Dr. Justin Marchegiania: Absolutely. And if you have image neurological damage, whether it's Parkinson's or severe insulin resistance, you're gonna have to do synthetic extra ketones as well because the brain, the minerologies, dysfunctional maybe even uhm destroyed. It has lesions in the brain and those fuel centers aren't quite ready to pick up glucose anymore so that's where it's really important. Especially, the Alzheimer's data is quite compelling.

Dr. Tom Bilella: Yeah, I think we're really scratching the surface right now on the therapeutic benefit of ketones for the neurodegeneration, the neurodegenerative disease. But well you know the whole ketone thing started years ago with seizures. But uh yeah, there's no doubt about it. There's a lot to it and uhm I think the research is gonna grow stronger. And oftentimes, the first time that you get your ketones at a certain place at 1.0, something happens in your brain. It's like, to me its the biggest nutritional breakthrough since creatine monohydrate times a hundred.

Dr. Justin Marchegiani: Yeah, I agree and I was looking at Mayo Clinic in 1910-1915 unreal over hundred years ago, they were using ketogenic diets for epilepsy.

Dr. Tom Bilella: Absolutely. Yeah

Dr. Justin Marchegiani: It's crazy. I see kids with epilepsy they weren't even told about ketogenic diet by their conventional medicine. This stuff has been in the medical journal for over a hundred years. And folks, frankly your medical doctors aren't educated in nutrition so you really have to understand where their specialty is which is trauma and acute care medicine but outside of that, you really gotta see a functional nutritionist.

Dr. Tom Bilella: Represent, man. And that's why you know I'm all about helping as many doctors increase their practice profitability and really their productivity capacity and skill to see more people through my legends club so we can help more people. We were at seminars together and the stat was this is at you know, a hundred million people in this country who need functional medicine. And there's only like ten thousand or twenty thousand practitioners max that do what we do. No, it's not even that. I’m sorry, like twenty thousand patients for every one functional medicine functional nutrition doctor. We can't handle all this. And the problem with most functional medicine doctors only seeing seven patients a day. This is from the IFM report, okay. Tom Blue did the research, 7.2 patients a day, okay. You're not gonna change the world seeing twenty patients a week. So we know that nutritional medicine, functional medicine it's here. It works it gets to the root cause and it changes lives.

Dr. Justin Marchegiani: Love it, love it. Now you did a post on Facebook a few months ago and I love it. It was like your top seven ways to build muscle and get back in shape. Uhm may I put you on the spot right now uhm we can pull up your Facebook and reference it if you need to but you remember those top seven things?

Dr. Tom Bilella: Well, yeah. Basically I did a book with Sean Philips years ago. Sean Philips started from the EAS camp, okay. So was it building muscle or getting leaner or both?

Dr. Justin Marchegiani: I think it was both but you talked about carbohydrates, you talked about post work out and pre work out, nutrition. I wanna pick your brain on that. You have that dialed in.

Dr. Tom Bilella: So interesting, much is as much as we talk about therapeutic ketones, there's still something to nutritional timing. And for my young athlete high school and college who are looking to increase lean body mass and performance. There's still something about pre exercise snack, protein and carbs and then during the workout, drinking a glucose electrolyte solution with some branch chains. Then post workout within 30-4 minutes, getting a carbohydrate protein drink with a certain ratio to actually promote an insulin spike with the right amount of leucine and branch chains to evoke protein synthesis, okay? So that's really what I was really probably talking about in that post don't still underestimate the value of nutrient timing as taught or the research on the VA University years ago. The research there was 4:1 ratio carb:protein for aerobic.

Dr. Justin Marchegiani: Aerobic?

Dr. Tom Bilella: Yeah, That was anaerobic, but if you anaerobic uhm football player, soccer player I dial it in maybe 2:1 or maybe 2.5 : 1 carb:protein post workout or depends on how lean the athlete is to actually, you know kind of getting the chemistry right to quench cortisol. And you quench cortisol by increasing insulin right cortisol insulin or indirect. So you can start brining cortisol levels down by spiking insulin. Insulin is still the most anabolic hormone in the body.

Dr. Justin Marchegiani: It is.

Dr. Tom Bilella: And as long as you have the essential amino acids, like leucine, you're gonna actually turn on the mTor pathway which is how actually you make protein in the body or make muscle. So that was that post was about getting the right amount of calories, you know, frequent eating. Make sure you're actually burning more calories a day than you actually burn, okay. So that's again for that person whose sole purpose increase in body mass, you know, coming from a body building background you know as a former Jets nutritionist, New York Jets nutritionist years ago.

Dr. Justin Marchegiani: Oh yeah.

Dr. Tom Bilella: So these are things we had to apply for these athletes.

Dr. Justin Marchegiani: That's great. So kinda reader's digest version, what is the best pre workout nutrition of like, do you add creatine in there? Branch chained amino during or after or before?

Dr. Tom Bilella: Good. So let's just start with the macros. I like to get easy about 20-35 grams of carbs so you can use something like apple sauce. And about 10 grams of protein, like uh half a scoop of protein powder. Some people do an orange and uh a hardboiled egg. Quite frankly do you wanna talk to me he best pre exercise it's generation UCAN, okay. So generation UCAN is a superstar which is a proprietary product that's the slowest releasing carbohydrate you can get. You put some protein with that. So 30 minutes before you wanna tap off glycogen level, get some carbs in there, some protein and then during the workout you're actually you're consuming uhm protein and carbs during the workout. So you're raising glycogen, raising glucose and you're putting amino acids in your body. So while you're training, you're almost like recovering as you're exercising. Coz exercise is catabolic.

Dr. Justin Marchegiani: Yeah.

Dr. Tom Bilella: Recovery is anabolic. Catabolic means your body is breaking down. So you wanna actually have a pool of amino acids and carbs to draw from by not depleting glycogen and amino acid reserves.

Dr. Justin Marchegiani: So what kind of protein powder during the workout? Is that a branch chain amino? Is it whey protein MCT?

Dr. Tom Bilella: That's a good question. You can do any of those man. I mean using this branch chain amino acid with a 2:1 ratio leucine to valine isoleucine. You could do something simply easy.

You can do a product and put uhm, like, I use a product Endure or you can do many different products. Like a little bit of whey protein in there and drink it like a creamsicle.

Dr. Justin Marchegiani: And how much branch in amino, do you uh 20 grams?

Dr. Tom Bilella: No, during the workout, you just need about 6 grams. 4-6 grams during the workout with approximately 25 grams of carbs, uhm depends on the size of the athlete.

But as a general rule, during the workout, 25-30 grams carbs and about 6 grams of protein or ideally 4-6 grams of branch chains. Now for example, whey protein is a really great protein for building muscle because it's 11 % leucine. Whey has the highest branch chains in leucine.

Dr. Justin Marchegiani: why?

Dr. Tom Bilella: Yeah, which is why- yeah right. Whey protein is like the gold standard and when I teach my staff or my health coaches like what's the most important amino acid for protein building, it's leucine remember. I love leucine. Well-

Dr. Justin Marchegiani: Ha ha

Dr. Tom Bilella: So the point is its that it's actually probably better to just do the straight branch chains but as long as you're, you know getting pre exercise while you're training you're consuming water and glucose electrolyte solution and what do I mean by that? Some sort of carbohydrate. The one I use is glucose polymers and a crystalline fructose with sodium chloride, magnesium glycinate. So you're getting glucose, electrolytes and branch chains or essential amino acids. And then post workout to top it all start the recovery program. Start the recovery program with a post workout shake.

Dr. Justin Marchegiani: That's great. And a post workout shake can be any like, let's say 30 or 40 grams protein is fine?

Dr. Tom Bilella: Yeah. At least 20.

Dr. Justin Marchegiani: I know Polycom was doing a lot of the cytomax. Like a lot of the-

Dr. Tom Bilella: Yeah, cytomax. I was uh watching uhm a quick video from the society of the weight training injuries specialist at —I speak there a year, almost every year and Darryl Willoughby, I think his name is.

Dr. Justin Marchegiani: Uh huh

Dr. Tom Bilella: One of the authors of the sport nutrition book. A minimal about 3 grams of leucine necessary to start protein synthesis. So if you're doing 20 grams of whey protein, that's like 2.2 grams of leucine so wanting to bump that up to about 30 to ensure about 3 grams of leucine. I'm talking for a guy here. For a woman it might be a little bit less but post workout 30 grams of protein, they say “Tom, how many carbs?” Depends on the individual, depends on the sport, might be 30 grams of carbs, might be 120 grams of carbs post workout.

Dr. Justin Marchegiani: God. So you're doing some maybe half a scoop pre then you do protein/BCAA during and you have another post shake right after the workout.

Dr. Tom Bilella: Yeah. Just one correction there. During its BCAs and glucose electrolyte solution.

Dr. Justin Marchegiani: Got it. Uh- No I mean uh

Dr. Tom Bilella: You're still getting carbs and protein each time-pre, during and post.

Dr. Justin Marchegiani: And where does creatine fit in there?

Dr. Tom Bilella: Yeah, creatine again love creatine. Uhm certainly before and after it's an excellent time to take creatine. So after we talk with the macros, I've work with the high school athletes and I work with some of the best college athletes in the country. You know we get that down. But creatine is not just for building muscle its certainly for recovery and explosive power, okay- So I like to do creatine before and after workout.

Dr. Justin Marchegiani: How many grams?

Dr. Tom Bilella: Yeah, depends on the size of the athlete. But a general around 10 grams a day if you say for a 150 lb., male athlete. And of course research shows that if you do a lot of load phase, you can saturate yourself with creatine and I do believe the load phase works. I used to do a load phase in my body building days and that could go up to 25-35 grams of creatine for 5-7 days. So I've seen good results with power lifters and body lifters. But as a general rule, using creating 5-10 grams more to 10 grams a day. 10 grams if you work out, 5 grams when you don’t' work out is a good fundamental protocol for creatine.

Dr. Justin Marchegiani: That's great. And the major benefit is that you're giving extra fuel source for the muscle for the high intense movements but also doesn't it increase growth hormone, too?

Dr. Tom Bilella: They say yeah- lot of benefits. I don't know the exact research on that but I believe that it's true. You're certainly getting new fuel source and you know-creatine gets into the muscle and there's a solubilizing effect where water will then follow creatine and the muscle cell be actually larger and better hydrated which is less likely to get to catabolic process. Well you actually get creatine as an energy source per 6 seconds of explosive activity or running can be actually drawn from creatine before you go on ATP.

Dr. Tom Marchegiani: Yes, right.

Dr. Tom Bilella: You can break down the creatine phosphokinase so you can release, you know energy from the ethyl phosphokinase. I guess it is phosphocreatine I'm trying to say.

Dr. Justin Marchegiani: Yeah, yeah.

Dr. Tom Bilella: And then going through ATP then run glycolysis. Alright.

Dr. Tom Marchegiani: I love it.

Dr. Tom Bilella: So you're getting a new, you're getting a fuel source that maybe wasn't there until you do exogenous creatine.

Your body makes creatine but I think the Russians and the Eastern Europeans showed 50-75 years ago the benefit of creatine.

Dr. Justin Marchegiani: Love it. And now you've been doing like doing a kre-alkalyn or monohydrate?

Dr. Tom Bilella: Yeah. I was uh- recommending a kre-alkalyn a buffer creatine. You tend to eat less and it's easier on the digestive tract.

Dr. Justin Marchegiani: Love it. See, these are all actionable bits information. You're not gonna hear these anywhere, folks. Love it. Very cool. So we got the performance nutrition aspect. What are the key movement patterns you're doing in? Coz you got 30 minutes exercise. I love that. It's efficient. It's practical. What are the movement patterns that you're doing?

Dr. Tom Bilella: Okay, good. So I uh- Good question. So I'm trying to get to different phase of cardio or to this phase, right. I never do the cardio late in the same day. Yes, I'll do a warm up and yes I spend a lot of time rolling and stretching. So as I get older, I realize you need everything. But if I'm doing a weight training, I'm actually I uh- oftentimes I do a 4-4-4 program. Something I kinda came up with which is 4 sets per body part and this is what you're at too. 4 steps per body part. I'm doing chest, might be 2 sets of a bench press and 2 sets of say, flies. Now that's after warm up set or two. A lot of people are doing 8-10-12-14 set for a body part. I've seen people do 30 sets. It's ridiculous. But the 4-4-4 is the four second concentric, that is where your muscle is shortening, okay. So if you're doing a bicep curl when you're hand comes up to your shoulder, that's concentric. And then eccentric is the opposite. When you're going down against gravity. If you're doing a 4-second concentric and a 4-second eccentric, that's a lot of time of tension on the muscle. That's time of tension training. You have to use 30% less weight. Easy on the joints- four seconds up, four seconds down, four sets per body part. You're done.

Dr. Justin Marchegiani: I love it. And isn't it also known as lactic acid training, as well?

Dr. Tom Bilella: Yeah. I don't, I don't know if it's exactly like the lactic acid training. But we do know that lactic acid training is highly effective in getting lean but I think there's some crossover there. I just know this is more time of tension training. We know that on an eccentric contraction, you're breaking more muscle. This is for hypertrophy, Justin. This will not be for like a college football player looking to get faster, okay. This is for hypertrophy training and hypertrophy means getting the muscle bigger using free weight or dumbbells. Easy on the joints and you're getting and improvement in insulin sensitivity, okay. So you're actually getting muscle isolation. Coz a lot of people on the gym when they're training, they're just using momentum. They're just throwing the weight up and then let it drop down. If I put EMG on the muscle man, that's not an 8 second contraction. That's maybe a .5 second.

Dr. Justin Marchegiani: Right.

Dr. Tom Bilella: So you get done in 4 sets but some of these people are doing in 16 sets.

Dr. Justin Marchegiani: Love it. So we got the 4-4-4. That was a question I actually texted you. Thanks for answering that. That's great.

Dr. Tom Bilella: Yeah, You got it.

Dr. Justin Marchegiani: And what are some of the other movements? Are you doing like squats, are you doing deadlifts, lunges?

Dr. Tom Bilella: Yup, I'm squatting, you see, every week still. I don't go up real high anymore. I used to go up high instead uh- Believe it or not once I did 315 for 29 reps.

Dr. Justin Marchegiani: Holy God. That's crazy.

Dr. Tom Bilella: Ha ha.. It's crazy. 27 actually, no- 37. I was sore for 2 weeks. It was a contest against my friend but that's another story. I know go up to 225 maybe 245-50. From going very slow and controlled, alright. So I'm squatting, see, twice a month. The other two days a month, I might be doing trap or deadlifts. Trap or deadlifts , so I'm in there and very controlled. So I'm not putting a lot of load on my spine anymore and little load on my spine maybe be two times a month and barely go above 240-250, alright. I used to do a lot more on my body building days. I do believe that there's something very important and special about the squat. And I only go as low as my body takes me. I think of this and go, ” You gotta get your butt down to your feet”. Not at 52, man. I stretch and if I try to get parallel, great. If I'm just slightly parallel, so what? It doesn't matter. I'm not going to stress my joints and my biomechanics because trainer next to me at 30 years old is going, “get your butt to the ground”. That's ridiculous. So I'm still doing compound movements. I bench yesterday. So I'm doing maybe 3, 2-4 sets of bench, trap or deadlifts. I'm doing barbell squats. Uhm that's what I'm doing.

Dr. Justin Marchegiani: Now, what's your take on back squats vs. front squats?

Dr. Tom Bilella: Good question. I used to do front squats. I don't anymore because they're too dang hard. And uhm but I think there are some benefit to front squats. A lot of the cross fitters are doing the front squats. Uhm again, I think the risk does not weigh the benefit for some people with that with respect to the stability because what is the first rule of exercise, Doctor Justine, don't get hurt.

Dr. Justin Marchegiani: Right

Dr. Tom Bilella: That's the first rule of exercise. Second rule is progressive and variable. I don't think most people need to do front squats unless you're going to a cross fit game or front squat competition. Does it change the forces and the activated muscles? Of course it does. But for me, I like the stability of the barbell on my back. You know, up my back and below my traps where it feels more stable. I can engage my core, I can contract my lats and I can go up and down slowly. So for me, I like the back squat.

Dr. Justin Marchegiani: It was a bit with the front squat is you start to fatigue in the upper arms before you, before your glute and your legs get tired.

Dr. Tom Bilella: Yeah. And if you look at basic primal motions, if you had to put something and lift it up, you will never put it in your front. You'd put it on your back.

Dr. Justin Marchegiani: You would've have to put it over your back and you'd hold it that way.

Dr. Tom Bilella: You would put it over your back, you know. Paul Cheng would say that, right. So you would, you would put it over your back. That would be more of a primal movement and pattern than putting it on the front. Doesn't make a lot of sense. Uhm but again, it's all about the person's goal and if you know they feel better with the front than in the back then maybe that works for them. But I like the back squats.

Dr. Justin Marchegiani: Love it. I'm ready to go to the gym right now work out, man. I'm pumped, love it.

Dr. Tom Bilella: Yeah

Dr. Justin Marchegiani: So let's transition back to functional medicine coz you do a lot of different lab test. What are you big, what are your favorite lab test and why for your patients coming in?

Dr. Tom Bilella: Well the big question. Well what I do and this is kind cool uh I started doing this a month ago. A lot of my clients are coming to me for fatigue and weight loss resistant, right. So when I'm looking at my functional chemistry, I now take a red dot. And every time there's some marker, like low ferritin, high cerebroprotein, low vitamin D, low 3T3, high homocysteine, okay. I'm putting a red dot right there and on that red dot, a little sticker I put fat burner and put an X through it. I'm saying “Mrs. Jones, you did not have a chance of burning any fat or having good energy because uh look at your labs.” So I'll actually go, “you have 5 or 6 crucial indications in your blood chemistry why your fatigued and you can't burn fat.” They inevitably say what my doctor told me this. And I'm used to taking the high road now, Justin – I'm 52. When I was 24 doing this, I didn't take the high road and I would just kinda say, well- doesn't matter what I said. Now uhm like “listen, we're doing specialized test. If you're not asking the right questions, you won't get the right answers”. Or sometimes I'll say “your doctor is running ante graded blood work” or “here she just haven't interpret them”, if I need to go there. But the point is, I just need to name some things that are very important markers on blood chemistry that are crucial for longevity, fat burning, etc. alright. So I think that's my best answer.

Dr. Justin Marchegiani: Love it, love it. Very cool. Outside of that, I mean kinda cropping up here, is there anything else you wanna address or kinda bring to the listener ‘s that we haven't already addressed so far?

Dr. Tom Bilella: Yeah. Well a little plug if you don't mind. You know my passion is help as many as people as I can to live a healthier, more productive life.

Dr. Justin Marchegiani: Yeah, yeah.

Dr. Tom Bilella: That's my mission-my nutrition treatment center practice mission. But my other mission now is to help end the drug era in our lifetime.

And you know, I wanna help as many practitioners as I can uhm be successful means more profitable and have a mission to help as many people as they can. And that's my legend's club. Doctor TomBillela.com, that's B-I -L-E-L-L-A .com If you want more information, let this club, just shoot me an email we're gonna phone for 50 minutes like explain my program. It's super cost effective. Every two weeks, we do a module. We do a live —cal every two weeks. It's a twenty-week program and it’s the fundamentals, the essentials of business uhm in your practice. So I little plug there coz I think, united we're better and uhm if someone would like to try the ketones like at side here it's NTC.shopketo.com

Dr. Justin Marchegiani: We'll put all the links below.

Dr. Tom Bilella: Yeah, yeah. Perfect.

Dr. Justin Marchegiani: To all listening, just click it, it will be right there for you.

Dr. Tom Bilella: Yeah. So that's really it, man. And I would just like to recognize and appreciate your work. We met at some seminars, I was impressed with you the first day I met you-with your knowledge and with what you're doing. I encourage people to go on your website and just keep tapping in to what you're doing. You're actually just pretty darn young just you're a leader in functional medicine and this podcast is an example of that.

Dr. Justin Marchegiani: Well I appreciate that. And also, are you seeing patients virtually at all?

Dr. Tom Bilella: Not yet. I'm actually, I'm just starting now. Believe it or not. I'm actually doing something called an MRT macro program where people can actually get on my site and get a food sensitivity test. And they can be anywhere and I or whoever we do the food test. To be test, I get on the phone and I help them dial in their macros but I'm certain do more zoom and Skype coz I'm having patients travel over so. It's not a big component of my practice. If someone is interested in an MRT macro program, like “Hey Tom, let's figure out how I should be eating”. They can go on nutritioncenter.com click the shop button, boom we'll send you an MRT kit. That's a food sensitivity kit. We can phone a couple of times or with zoom or Skype, and I go listen- let's dial in your program.

Dr. Justine Marchegiani: I love it. Love it. That makes so much sense. Alright, last question here. You're stuck in a dessert island. You can only bring one supplement with you. What is it?

Dr. Tom Bilella: You know Justin, I like to question most severances, you know vitamin D. But if I'm in an island I hope I'm getting some sun. You know, I'm gonna bring a B-complex, man. Because, you know, B Vitamins so important for your Krebs cycle. I wanna make sure I make an ATP and I don't want any micronutrient deficiency and there's lot other benefits of B vitamins. Just making sure its co factor in your Krebs cycle. So I'm gonna be probably bringing my B Vitamins but a close second is my keto OS. If I get ketones floating in my blood, maybe I can have energy just to swim off the island and get to the mainland.

Dr. Justin Marchegiani: Plus if there are any coconuts on the island you can always eat that coconut meat. That will give you a lot of XCT.

Dr. Tom Bilella: So I used to say B vitamins but now I might have to say the fourth macronutrient with my keto OS to give enough fuel to do what I need to do- to fight the cannibals and I can go up the mountains and make a hammock.

Dr. Justin Marchegiani: I love it. love it. It's very cool. And what's your website again, Dr. Tom?

Dr. Tom Bilella: nutritiontreatmentcenter.com all one word. And for legends club its DoctorTomBilella.com Uhm if you wanna get my newsletters, you know I do what's ticking off Dr. Tom a lot. You can watch a Sophia Bilella videos. It’s really entertaining. We get a point across and the last one is NTC.shopketo.com You'll have the links there. But I really appreciate this platform. I had a good time.

Dr. Justin Marchegiani: Awesome, Doctor Tom. Well I appreciate you. You're an inspiration to myself. Being at your age, with your energy and your health and just kind of overall uhm presence with uhm how much muscle how just overall good shape you're in. I love it, I really appreciate it. It gives a good kinda bullseye to attain when I'm there.

Dr. Tom Bilella: Thank you so much.

Dr. Justin Marchegiani: Thanks, Doctor Tom. You have a great day.

Dr. Tom Bilella: You too.

 

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