Jonathan: Let me go to some questions that have been written in here. One that’s been written in is, “How do you prevent saggy skin when you lose weight? I am talking about a forty-to-fifty-pound weight loss eventually.” I love this question because it is actually a very common occurrence that individuals face when going SANE long term because going SANE long term can’t not work, or to phrase that less clumsily, has to work because at the end of the day, we’re talking about eating more vegetables, proteins, wholefood fats in place of addictive and toxic substances and while we always will tell you, while that’s going to take longer than just starving yourself, who cares? Because starving yourself is horrific and it is deadly and it is toxic and it will make you fatter in the long term because it’s conditioning your body to store fat long term.

What SANE is actually doing is it’s healing you at a metabolic level and it’s going to help with the excessive skin in two ways. One is, it will enforce a safe and sustainable rate of fat loss versus weight loss. What I mean by that is, if you are losing a half pound of fat – fat; not weight, fat -– per week. One that might seem slow by the biggest loser standards but as we’ve seen in the New York Times and as we’ve seen in studies over the past thirty years, nobody has a problem temporarily losing weight. It’s fine. The problem is weight maintenance. We’re not here to starve ourselves. We’re not here to do things for twenty-one days only to have everything get worse on day twenty-two. That’s not helping us. All of us that are on this call and all of us that are watching this call have lost weight successfully at least once, if not many times. We already know how to temporarily lose weight. What we don’t know is how to have a lifestyle – a long-term lifestyle that makes it enjoyable and energizing and easier over time to maintain an optimal weight and body fat percentage. That’s what SANE will enable you to do.

SANE is going to focus on fat loss rather than weight loss and it’s going to do that at a safe and sustainable rate. Now, this is going to help with saggy skin because, one, you’re not going to burn off muscle tissue; in fact, you’re going to build muscle tissue. This is why we don’t want to be laser focused on weight loss because if you drop a half pound of fat and you gain a half pound of lean muscle tissue, one, your weight isn’t going to change at all; two, that’s going to take care of your saggy skin problem one hundred percent because that lean muscle tissue is going to help to give you that firm toned look rather than the deflated balloon look, which is what happens if we just starve ourselves. Further, when you lose weight at a healthy rate, it gives your skin time to adapt.

Now, if you lose a hundred and fifty pounds, which we’ve seen repeatedly, of course, that’s going to take two years. If you’re losing a hundred and fifty pounds faster than that, watch out because that could be causing some long-term damage inevitably. If you’re losing a hundred plus pounds, surgery may be required for the excess skin but in the forty-to-fifty-pound range, which is a wonderful goal to have for, like, one year from today, I’d honestly prefer it to not be a forty-to-fifty-pound weight loss; I’d rather it be about body fat percentage. We talked about that a lot on the last call and it’s also in your step-by-step program.

The gist is, when you go SANE and when you get eccentric –- let me put it this way –- so we’ve been programmed and conditioned to say, “I want to lose fifty pounds.” I think what we really want –- please correct me if I’m wrong –- is, “I want to feel like and look like what I think fifty pounds lighter means.”

So let me unpack that a little bit. If hypothetically, you weigh two hundred pounds right now and you envision in your mind what it would feel like to weigh a hundred and fifty pounds and what you would look like at a hundred and fifty pounds, you probably have a sense of what you’d look like and what you’d feel like. Now, if you could look and feel that way and, better, and weight a hundred and seventy pounds, I don’t think you’d care because unless you wear your weight around your neck, which nobody does unless you’re on a reality television show, the only thing that matters for all intents and purposes, I think –- and please correct me if I’m wrong -– is, how you feel and, let’s be honest, how you look. We all care how we look so –- how you feel and how you look.

If we can get you to feel and look like you’ve lost fifty pounds, whereas in reality, you may have only lost, let’s say, thirty pounds but you’ve gained lean muscle tissue; you’ve healed your metabolism; your doctor has now taken you off of myriad medications because you’ve restored your health, well then, the saggy skin actually isn’t going to be a problem for three reasons -– one is, you’ve flooded your body with nutrition so that’s actually going to help with the elasticity of your skin.

For example, we talked about protein. We talked about healthy fats. That really helps with skin in general so it’s going to restore skin elasticity. Two, you’re going to give your body enough time for the skin to adapt to changes in the way your body is structured. Three, you’re not starving and dehydrating yourself; you’re actually staying hydrated and you’re actually developing lean muscle tissue. Those three things put together are going to help to prevent saggy skin. Hopefully, that is helpful.

Let me just see real quick if anyone had any follow-up questions on that specific point. All right, I’m getting a little bit behind here with the questions. I apologize.

All right, cool. Next question is one that was written in that says, “I am a female and I lift heavy weights concentrically in the gym.” This is actually a rather long question. The summary is, “If I’m already weight training, which exercises should I do as I start to get eccentric and how many sets and how often? I like the idea of spending less time in the gym and getting better results.” I’m going to answer this question in a kind of way that I think is going to be helpful for all of us, no matter where we’re at in terms of our exercise experience.

First point, that’s really important to keep in mind –- really important to keep in mind is there’s so much talk on the Internet and on the news in terms of what is the best form of exercise. Which form of exercise is the best? I think one of the biggest SANE mindset shifts we can make, which honestly is I think the most helpful part of this program because once you get your mindset right and then you get the correct eating and exercise information and you get the correct and helpful and loving SANE social support –- those four pillars -– holy moly -– that turbo charges things.

The SANE mindset shift here is in the inSANE typical world, there are conversations about which exercise is best. The sort of statement of, “This exercise is best” is a little bit like the statement, “This outfit is best.” What do I mean by that? I think we can all agree that there is no such thing as “the best” outfit. If you’re going to the beach, the best outfit for the beach is totally different than if you’re going to a wedding. That best outfit at the beach might be horribly inappropriate at a job interview. What is the point here? The point is that the context or the goal matters. We can never say what is the best outfit without knowing the context in which the outfit will be worn or the goal of that outfit. So what is the best outfit to wear to a job interview for a job at a law firm? Totally, we can help there.

The same thing applies to exercise. The question of, “Which form of exercise is best?” is only half the question we need to ask or maybe even a third of the question we need to ask. The question we need to ask is, “Which form of exercise is best for goal X, Y, Z, given my age, my limitations, so on and so forth?” In the SANE lifestyle, the SANE lifestyle is all about long-term metabolic healing. It’s really important to unpack that. Long-term means, honestly, we don’t care what happens over the next twenty-one days. We only care about what happens over the next twenty-one days to the extent that it helps us live better for the next twenty-one years.

What I mean by that is, I think we can all agree that losing ten percent of your body weight in twenty-one days only to gain all of that back and more is worse than doing nothing. I think that’s common sense and it’s proven by the medical literature. You would be way better off from a health perspective, never losing weight than if you had lost weight only to gain it all back. Even if you don’t gain more than you lost back, just gaining it back -– that act of yo-yo dieting can be very, very damaging to our metabolic system.

What we’re always concerned with is long term. We’re concerned with long-term metabolic healing. For example, burning calories does not contribute to metabolic healing. We burn calories; it’s energizing. We need to do it but it’s not healing us. The way we heal ourselves is by changing our hormonal balance, by flooding our body with nutrients, by healing the damage that has been incurred by our digestive system; and healing neurological inflammation that has been caused by toxic additives and things like MSG, things like those.

Exercise can be used powerfully to help with long term metabolic healing but the key is to first say, “Hey, it’s really important that we all acknowledge and embrace that having an exercise goal of long term metabolic healing is a totally different goal than, let’s say, becoming a better basketball player or becoming a better marathon runner or becoming a better golfer. Those are all different things that you could use exercise to become better at but they’re different so we’d exercise differently.

Why does this matter? This matters because when we actually look at the scientific research and we look at how exercise can contribute to long-term metabolic healing, we see two really profound and little-known discoveries. The first is long term. There is no question that exercising –- the faster we move our bodies — so think about it this way. The faster you drive a car, the more likely it is that someone can get hurt. That’s why we have speed limits. Driving at two hundred miles an hour is more risky than driving at twenty miles an hour. Fair?

For example, if you’re on a bicycle and you want to increase the intensity of being on a bicycle and the way you do that is by pedaling way faster, you will absolutely increase the intensity of riding on the bicycle but you’ll also increase risk. Why is this relevant? The more risk we incur, the more likely we are to get injured. The more likely we are to get injured, the less likely we are to be successful long-term.

The first thing we need to do is we need to look at the research. We need to say, “What form of exercise is the least risky or has the least risk of injury?” Since we know that there is a direct relationship between the speed at which an object moves, especially a human being and their likelihood of injury, then we know that we need to find a form of exercise that favors slow and controlled movement rather than fast, explosive movement. It doesn’t mean that fast explosive movement is bad. It’s not bad to drive sixty miles an hour on the freeway. I think we would all agree though that it is riskier than driving six miles an hour.

If our goal is long-term safety, we know we need to move slowly. That’s actually really good news because when we also look at the research and we look at how do we accomplish the most in metabolic healing, the way we accomplish the most metabolic healing is by triggering the strongest hormonal responses in our body.

One of the amazing things that the right form of exercise can do that nothing else can is, it can trigger the release of really powerful hormones. It’s called the metabolic cascade. You have things like healthy natural doses of testosterone which, of course, exists in women’s bodies as well, just in much lower doses; adrenaline, noradrenaline. These hormones almost serve as like a Drano or liquid plumber to our metabolic system to flush out a lot of the nonsense and dysregulation that is going on.

Now, here’s where this all comes together. The way we trigger that maximum hormonal response is by exercising in a way that activates the most muscle and the most of the individual fibers within those muscles as possible.

If you’ve dug into your step-by-step program, I think it’s right around the SANE 201 lesson timeframe, where we start to talk about the different muscle fibers and how traditional forms of exercise that are done for long periods of time and frequently only activate one or two of the four types of muscle fibers you have. This is really exciting. Can you imagine, for instance, if you never, ever, ever worked your leg muscles in your whole life for whatever reason? You were using a sit-down segue human transport machine. Your whole life, you never used your leg muscles and then you started using your leg muscles. Could you imagine the impact that would have on your health and the speed of results you could see?

Well, many of us -– ninety-nine percent of Americans have never activated, for example, their Type 2b muscle fibers. These are the types of muscle fibers that only get activated when our muscles have to generate a maximum amount of force. For example, no amount of walking ever will cause your Type 2b muscle fibers to be activated; just like no amount of walking will stimulate your bicep muscles because that muscle group is not active in walking. I mean, of course, you’re swinging your arms but you get my point, right?

Similarly, when you’re walking, while your leg muscles are working, only one type of the fiber in your leg muscles are getting activated. When we train eccentrically -– eccentrically is when we train very slowly; that’s the safety and we train with heavy resistance. We can move very slowly but we can use more resistance so that we activate all the muscle fibers. By activating all the muscle fibers, we trigger the most of the hormones which trigger metabolic healing. Because we’re moving slowly, we can do that long-term -– long-term metabolic healing.

Bringing that back to the original question -– “Which exercises should I do? How many sets? How often?” For all of us, the exercises we should do first, no matter which exercises we do, we should focus on doing them slowly with the maximum amount of resistance that we can use safely for doing about six repetitions where each repetition is going to take about eight to ten seconds on the eccentric portion of the contraction.

A lot of words there –- let me unpack that a little bit. If you’re doing bicep curls, for example, which is actually only going to be working your bicep muscles so we want to –- probably that’s a bad example. When we want to work our big leg muscles, for example, but when your muscle contracts, that’s called concentric and when it extends, that’s called eccentric. For example, when you sit down, that’s an eccentric contraction and when you stand up, it’s a concentric contraction.

Like a lot of things, it’s unfortunate because even the term weightlifting is pointing us in the wrong direction because our muscles are actually stronger when we’re lowering weights rather than when we’re lifting weights so that’s the eccentric contraction rather than the concentric contraction so we should really be focused on lowering weights rather than lifting weights.

The point is that we always want to activate the most muscle and the most muscle fibers possible. Sixty to seventy percent of all the muscle in your body is below your waist so we want to spend sixty to seventy percent of our time working the muscle below our waist. If you’re spending ten minutes working your tiny bicep muscle, that’s great. If you want to strengthen your bicep muscle but if what you’re trying to do is to trigger a maximum hormonal response for long term metabolic healing, then activating all of the muscle fibers in your big leg muscles are going to trigger a way bigger hormonal response than working just the relatively small bicep muscle.

We always want to pick exercises that work the most muscle possible. These are things like leg press, squats, lunges -– things are going to work all of our leg muscles. The next biggest muscle group is your back -– your back muscles. These are things like rows and pull-ups. There’s obviously way more information about this in the program. Next is your chest muscles and then your shoulders and then your arms and then your abs because, again, it’s great to have a strong core but having a strong core is a different goal -– I’m not saying better or worse -– it’s a different goal than the long term metabolic healing. What we’re trying to do is long-term metabolic healing.

So which exercises should I do? You should do exercises that activate the most muscle fibers possible in the biggest muscle groups possible. In order, that’s legs, back, chest, then shoulders, then arms. What that means is, you should never do an arm exercise until you’ve done your leg exercises because you’re going to get way more metabolic benefit from those leg exercises than you would for your arms.

How many sets? How often? One set to what’s called a complete eccentric failure. You can read more about this in the program and watch videos on it. It is self-limiting. What I mean by that is, if I were to tell you to go run a marathon and then sit down for five seconds and then go run another marathon, you’d be like, “That’s crazy. I can’t run two marathons back to back. It’s self-limiting.”

Exercise is self-limiting when done properly. When you exercise eccentrically, it is so effectively and potently working your muscles that, let’s say, you were to do an exercise and you were to lift and lower a hundred pounds and you were to do that properly eccentrically as we do not have time to cover in this call but it’s covered in detail in your program. If you tried to go in and do that five times a week, it would be physically impossible because your Type 2b muscle fibers can take anywhere from four to twelve days to fully recover because the more force a muscle fiber generates, the longer it takes to recover.

This is why we recommend in the program, you’re going to be doing one eccentric exercise session per week and one smarter interval training session per week. How many sets is usually, its one set of six repetitions at a slow tempo. Again, this is covered in detail in the program. You are doing that once a week simply because if you try to do it more than once a week, it’s physically impossible because your muscle fibers haven’t had time to recover. Hopefully, that is helpful.

All right, so next question here is — how to eat SANE with an ileostomy? Real quick –- we cannot give medical advice. An ileostomy is a surgery where modification is made to the digestive system but this is a great question to unpack what SANE is. I love earlier the comment -– forgive me –- I forget who said it but you know who you are and you get bonus points. He said “the SANE way of being.”

Whether or not you’ve had an ileostomy, whether or not you have cholesterol problems, whether or not you’re pre-diabetic, whether or not you’re pregnant, whether or not you’re going through menopause or andropause for males and females respectively, you always want to work with your primary care physician when making any lifestyle change.

What’s really cool about this is, for example, for the SANE family member who’s had an ileostomy, what you get to do now, which is so cool, is, you don’t have to go to your primary care doctor and be like, “Hey, I’m going to go on the grapefruit/cabbage soup diet, which is like “You eat exactly this and then I’m going to take these fifteen pills that this person on the Internet sold me. Is this safe? Is this safe for me?” Which is totally a valid question because, like, just eat cabbage soup and grapefruit and take this thousand dollars’ worth of pills which aren’t regulated by the FDA and –-Woo! I don’t know if that’s going to be good for us.

What you get to do now is, you get to go to your doctor and you get to say, “Doc, you know my medical history. My goal over the next — forever –- that’s the first point. It’s not your goal over the next twenty-one days -– “My goal for the rest of my life because I want to live the best of my life for the rest of my life -– I don’t want to do something for fourteen days because if I only do it for fourteen days, what the heck happens on day fifteen?” I want to make small, sustainable progress that I can maintain for the rest of my life.

“Doc, are you ready? Are you ready, Doc? I am going to try to eat so many vegetables –- in this order, Doc, in this order -– I am going to try to eat so many non-starchy vegetables. Doc, when I say non-starchy vegetables, I mean, things you could eat raw. I’m not necessarily going to eat them all raw but, Doc, you know, like potatoes and corn, we can eat those raw. That’s because they’re not vegetables; they’re starch.” Your doctor would be like, “Hey, that’s a good point.” She’ll be like, “Yeah, that’s a good point.”

“I’m going to try to eat the vast majority of my food as non-starchy vegetables -– things like green vegetables, broccoli, mushrooms, asparagus, peppers –- all of that beautiful colors of the rainbow -– those vegetables. Then I’m going to try to eat nutrient-dense protein –- so these are white wild-caught seafood whenever possible, humanely raised meats, dairy products that are higher in protein and much lower in sugar. Then I’m going to try to get quite a bit of my energy from wholefood fats because I know that nuts and seeds and eggs, for example, are a great source of energy and they don’t cause a huge insulin or hormonal reaction in my body.

I’m going to try to eat so those non-starchy vegetables, nutrient-dense protein, and wholefood fats in that order and I’m of course going to enjoy maybe some of that low-fructose fruits as well, like blueberries and strawberries and citrus fruits. Doc, I’m going to try to eat so many of those foods in that order that I’m just too full of processed starches and processed sweets and processed trans-fats. Do you think that’s okay, Doc?” I promise you –- I mean, I know not all docs –- I mean, you can become an MD in the United States without taking a single class on nutrition -– but if you say that to your doc, you’re going to get a resounding “That’s a good idea.”

What your doc can then help you to do is refine that SANE template for your unique medical concerns. For example, if you have problems with kidney stones, you might adjust the certain types of vegetables you’re eating to reduce oxalate intake. If you have a peanut allergy, obviously you’re not going to be eating peanuts even though they’re right in the middle of the SANE spectrum. The cool thing is, with any pre-existing medical condition, you always want to work with your physician.

What we’re talking about with a SANE lifestyle is eating so much of foods that fill you up with abundant nutrition that have been proven over tens of thousands of years and that have been proven in thousands of peer-reviewed research to help heal your body, eating so many of those that you’re too full for processed starches and sweets, and in some ways, that’s a little bit like going to a relationship counselor and saying, “Hey, I’m going to do everything in my power to be more loving and more trusting and more considerate to my partner and I’m going to try to be so loving and trusting and considerate that I don’t have time to be critical of them anymore and I don’t have time to do sort of annoying things. Do you think that would make my relationship better?” They would be like, “Oh yeah, I think that’s a pretty good idea.”

Of course, they might need to do some customization based on your unique partnership but it’s the same thing here. The basic SANE framework is, at the end of the day, it’s saying, “Look, we were told that “X, Y, and Z is “healthy” in the 1960s. That was wrong and it’s now being widely acknowledged as wrong. We have fifty years of science that has updated our definition of healthy. Our definition of healthy is now –- I mean, the word healthy has become meaningless honestly. If you ask ten people, what’s a healthy food, you’re going to get ten different answers.

Instead, we’ve spent the past fifteen years coming up with new criteria that is actually measurable and actually based on science and we call that SANE -– satiety, aggression, nutrition, and efficiency. Non-starchy vegetables, nutrient-dense protein, wholefood fats, and low-fructose fruits are just point blank the most satisfying, unaggressive, nutritious, and inefficient high water, fiber, and protein foods on the planet. If we eat more of those in place of things that are addictive and toxic like processed starches, processed sweets, and processed fats, it’s impossible not to get healthier.

Just like breathing in more clean air will make you healthier. If you do that in place of breathing in polluted toxic air and secondhand smoke, same thing here, man. More clean purified water in place of toxic polluted water –- always going to help your health. You can do it with confidence. You can do it with confidence if you’re seventy years old; if you’re seven years old; if you’re male; if you’re female; if you’re pregnant; if you’re trying to get pregnant; if you’ve never been pregnant. There are all these different things because it’s just about doing what is actually healthy for your body. Hopefully, that is helpful.

Let me see if we’ve got some written in questions here. “If I make my own kefir, would I base it upon the percentages in mil or do I need to run down the effect of the fermentation?” Leslie, if you’re making your own kefir, I would say you’re a rock star and keep going. I’d look at the raw ingredients and if they’re mostly fat, we’d call it a whole-food fat. If they’re mostly protein, we’d call it a protein. Honestly, I think you’d just get a hundred bonus points for making your own kefir because that’s awesome so I would focus on the fact that you’re rocking your kefir and take it from that. I would not run down the effect of the fermentation. I don’t know if that’s going to be a big issue long term.

Victor -– “Is it okay to use resistant potato starch as a prebiotic in SANE? How often and how much?” If the only way you’re getting in resistant potato starch is by eating potatoes, then I would say no, it is not. Let me be very clear. I love how you phrased this question, Victor, and I really appreciate how you phrased this question. “Is it okay?” Is it okay? Yes. You can do whatever you want. I mean that genuinely because some of us have different goals than others.

Even within the SANE plan, there’s ultimate SANEity –- sixteen servings of vegetables. Then there are other individuals like my mother, who’s a great example, she’s like, “Jonathan, I’m happy with where I’m at. I don’t want to deteriorate but I’m happy with where I’m at.” She’s saying, “If I’m going to eat some potatoes, I’m going to eat some potatoes.” She’s happy with those results. So that’s all good.

SANE isn’t here and I’m not here to say, “That’s okay” or “That’s not okay.” What I am here to tell you and what SANE is here to tell you is that potatoes have a lot more non-SANE things in them than other things you could be eating. For example, if your goal is to take in prebiotics, there are other sources of prebiotics that don’t have all the hormonal implications –- negative hormonal implications –- that potatoes have. I mean, if you’ve been through the program a little bit, potatoes are inSANE.

Bottom line -– potatoes are inSANE. If you look at them relative to non-starchy vegetables, nutrient-dense protein, wholefood fats, they just have lower satiety, higher aggression, lower nutrition, and higher efficiency. It doesn’t mean they’re bad. This isn’t a moral judgment. It’s just that based on the SANE framework, we have a very simple quantifiable framework.