April 2012: Dr. Matt Poteet (Part 1)

by on April 23, 2012

JOHN: We are privileged to have Matt Poteet with us this month. If there is on one thing I am good at, that’s spotting talent. I have seen some of Matt’s knowledge shine through on various internet boards, and I think you’ll see why as we go! Matt, thank you for joining us and please tell our readers more about yourself, what you do, and what you are passionate about.

MATT: Good morning, John! First off, I’d like to thank you very much for having me over for this Q & A. I am a big fan of both what you have accomplished athletically, and your forward-thinking concepts in athletic and physique nutrition. My first love is and will always be the strength and physique culture. I can’t thank you enough for all the positives you have given to our community.

To just give everyone a little of my educational and experiential background and what brought me to where I am today; I graduated with a B.S. in Biological Science from Lee University in 1998. The next stop for me was Mercer University in Atlanta, where I graduated with my Doctorate of Pharmacy degree in 2004. Professionally, I have been very fortunate to hold positions on staff at two of the leading private, academic teaching hospitals in the southeast at Emory University in Atlanta and Vanderbilt University in Nashville. My emphasis at those two institutions were primarily acute care in nature; I spent lots of time in areas such as trauma, burn unit, and various surgical intensive cares. All were fascinating in their own way, and allowed me unique opportunities for experiential education with conditions that are not seen at a lot of the other institutions in the country.

Currently, I am the director of an ambulatory infusion center treating many patients which suffer from some of these conditions. I am able to reach a few patients this way, but there is so much more I would like to do. I guess that’s kind of where my forum posts come from. It allows me to speak to a vast audience about a huge array of nutritional issues; from serious chronic illness, to psoriasis, to fun stuff like bringing out your serratus or optimal training recovery. Hopefully it has helped a few readers with their various dietary issues. I know that some of the questions they ask are excellent and challenging, which allows me to learn as well. It is a very symbiotic relationship!

But more fulfilling to me personally was the opportunity to become truly immersed in our modern health care system and to understand what is at the core of most of our society’s current health problems. The conditions, which are disparate and seemingly unrelated on the surface, all come from one common etiology; the complete perversion of our modern nutritional system. Heart disease, stroke, certain cancers, diabetes, various chronic autoimmune conditions, dermatological conditions, many orthopedic conditions are only a very brief list of dietary-induced or dietary-influenced disorders. The true list of dietary-related conditions would be overwhelmingly large, if one were crazy enough to put a comprehensive list together. The good news is many of these conditions can be completely resolved with the proper (key word) dietary intervention. I am very passionate about getting that message out to all that will listen with an open mind.

JOHN: Right on! Let they food be thy medicine! I too believe that the root of most degenerative disease lays in faulty nutritional thinking backed up by shaky (at best) science.

Can you give us 2 or 3 of the biggest examples of nutritional dogma that take people down the wrong path for health?

MATT: Well, it’s difficult to quantify without first laying the groundwork up front that the entire mainstream concept of nutrition is completely flawed. Nearly everyone thinks of nutrition in what is called a reductionist manner. That is to say, reducing nutrition down to easily quantifiable and categorizable parts. This is the way we have all been taught since our seventh grade chemistry class to think about science. The problem is it just doesn’t work for nutrition. Just because we know how many calories, protein, carbs, fat, vitamins and minerals something is supposed to have in it doesn’t mean that we have quantified the food, it just means we know what its mostly made of. Its a lot like trying to quantify a fighter plane by saying it has “wings, a jet engine, a throttle and some jet fuel.”

JOHN: Now wait a minute, are you saying a calorie is not just a calorie??

MATT: I am so glad you brought that up, John. This actually is at the crux of a very important point. A calorie technically is a calorie, in that it is a unit of heat, but food is more than calories. The saying “a calorie is not just a calorie” perfectly illuminates where the breakdown lies in society’s thinking on nutrition. If we were to walk outside the office to the corner and ask 100 people the question “What is food?” probably 90+ of them would say “fuel for the body”. Of course this is true, but it’s only part of the story. Food is also what we are made of. We require so much more than the macronutrients and known micronutrients in order to thrive. Modern nutritional science is nowhere close to grasping the totality of natural substances our bodies need from our diet in order to make the tiny biochemical minutia we require, such as interleukins, prostaglandins, chemokines, and various neuropeptides and transmitters. The actual list could fill a textbook. Many people are robbing their bodies of these substances by simply not grasping that food is what you are. The human body is an extremely adaptive organism, and it will survive with deficiencies of a lot of these substances, but it will not thrive. It will hobble along for a while and then you start to see these deficiencies take their toll in the form of chronic disease. I see it every day, and it is so sad and so easily preventable, but our modern fast food culture makes it so hard to get through to these folks.

Nutrition is biochemistry, and that means it’s not only what it’s made of, but how its constituent parts interact with each other and the body that ingests it. This will, of course, never be adopted by the mainstream. They believe it’s just too complicated for people to understand. I agree that it sounds complicated, but the actual solution is very simple and we will get to that. But to your question, engaging in this reductionist view of nutrition leads to the common nutritional dogma mistakes you mentioned. There are many that we could explore, but the three on the top of my mind right now are:

  1. Counting macro and micro nutrients in an effort to assemble complete nutrition.
  2. Using supplementation in an attempt to manufacture sound nutrition
  3. Paying no attention to the quality of the food that they consume.

JOHN: Yea I think this is a great point to apply to our endocrine system, hormonal levels, etc. as well. The interactions of many different systems are in play here. And you can’t just for example treat low Thyroid t-4 to t-3 conversion with active thyroid 100% of the time. It may be something else entirely driving the issue.

Anyways, to get back on topic, let’s focus on point #3. You mentioned quality of food. Can you expound on that a little for our readers?

MATT: Absolutely. This is another mistake born directly from the reductionist mindset of our society’s current nutritional thinking. If you are only concerned about “hitting your marks” for you daily macronutrients and vitamins, then you are only concerned about those particular parameters. So people get them in any way they know how; frozen low-calorie dinners, sugary breakfast cereal “fortified” with vitamins, fast food joints, etc. We have heard mainstream nutritionists give the advice for years that you can put together long term healthy eating plans by eating this kind of stuff daily. They address nutrition as if its components exist in a vacuum, and we know this is certainly not the case.

We’ve known for many years that people have higher quality of life, lower rates of disease, and generally longer life spans who eat real, natural food. This is perplexing to nutritionists, who attribute it to “food factors”, or undiscovered vitamins. It probably more the case that the food is interacting biochemically in a natural, whole state that our bodies recognize from thousands of years of ingestion. Whole, natural foods simply work, to steal a catch phrase from the late Steve Jobs. Processing and refining destroys the continuity of the food, altering its natural chemical nature. As a consequence it doesn’t work as well with human bodies who have been used to the unadulterated version of the food for millennia.

And that’s just talking about the stuff that is left out of our food by processing. What about all the unappetizing things that are thrown in to the mix? Pink slime in your hamburger anyone? Its protein! That is a perfect example of what I am talking about. Pesticides are another consideration. And quality of food is even more critical to athletes and bodybuilders. Due to the increased amount of food needed for those lifestyles they are naturally going to be increasing their exposure to pesticides and other toxins in conventional food. They need to be just as vigilant about the quality as the quantity. I know that you have had that experience personally, and can attest to the difference it makes in both your physique and your health when you switch.

JOHN: One thing that we are really lucky to have (most of us) is a strong liver to filter out much of the pesticides, chemicals, etc., that are so common. Do you have a couple of suggestions for increased liver health since it’s such an important “health” organ, and also such an important fat burning organ when operating optimally?

MATT: Yes, we are very lucky to have healthy livers to get us out of our bad decisions! The liver is a fascinating organ, and I think we in the health care field take for granted the multitude of diverse functions it performs for us on a daily basis to keep us healthy and functioning. The first rule in keeping it healthy is, of course, minimize exposure to toxins. This not only means the usual suspects such as the pesticides we have discussed, but pharmaceutical agents. We simply take too many drugs in our society and many of the common drugs in our medicine chest place significant stress on the liver. So the initial piece of advice I give is “get off the drugs.” Of course, in many disease states this is not possible and I’m not telling anyone to come off of their blood pressure medicine or go against medical advice. I am mostly speaking about over-the counter medications. Situations like taking Tylenol or ibuprofen around the clock for DOMS two days after a workout. Really? Suck it up and let the body heal itself and give your liver a break. Supplement-wise, for liver health and health in general I always go back to fatty acid balance. Correcting that omega imbalance is foundational in reducing the environmentally-induced hepatic inflammation. Once that is addressed, good ole’ milk thistle can be added, which then works synergistically with linoleic acid (now that it is in the proper ratio). Lecithin has also been shown to increase bioavailability of the milk thistle, so co-administration of the two should be considered. If someone has been on long term hepatically-metabolized drugs or are coming off a poor diet I also recommend using n-acetylcycteine for glutathione replenishment.

JOHN: How much NAC and is there any particular time to take it? I used to take the powder, but man was that some sulfurous stuf, lol. I take caps now.

MATT: I am extremely impressed you kept the powder down! It is indeed some vile tasting stuff. In the acute care setting, NAC is the antidote for acetaminophen overdose. We mix it up in a soda and have to force the patients to take it. After the required 18 doses of the stuff, the taste alone usually prevents people from attempting it a second time! In regards to dosing, I see it as individualized to a patient’s environmental and nutritional status. For someone who has been on multiple medications for a long time or a chronically poor diet I would recommend up to 1.2 g twice daily for a period of time. For someone like John Meadows who eats pristinely, only 200-300 mg is probably all that’s needed. The standard dose for the average folks to reap the majority of the antioxidant benefits and homocysteine reduction is 600 mg twice daily…in capsules!

JOHN: Going back up to point #2, one other thing that I have found fascinating to say the least, is how certain supplements actually work AGAINST you. Vitamin C in certain forms has proven to be unhealthy. Vitamin A supps without a perfect balance of Vitamin D seems to cause issues. I haven’t taken a multi in YEARS because it just seems that many vitamins and minerals just seem to work better when being a part of real food. Your thoughts?

MATT: Yes, this is fascinating John and it ties right back in to what we discussed a few minutes ago perfectly. Removing substances from their natural state and purifying them, concentrating them, and taking them into our bodies alone is a terrible mistake. Applying reductionist thinking to nutrition simply doesn’t work. Food is an extremely complex biochemical entity in itself; after all it was once also a living organism. The substances in these foods exist in the ratios they are in naturally because that’s the environment that is required for them to work! There are so many examples, the vitamin A issue you just mentioned, separating reservatrol from the other polyphenols in red wine, removing the phenols and antioxidants from olive oil through processing, separating tocopherol from tocotrienol and the rest of the vitamin E analogues… all of these little experiments are not only complete failures, but in some cases have had significant negative health consequences. The scientists were simply dumbfounded that their isolated reservatrol studies didn’t solve the French paradox for them. It’s so hard for me to understand how they keep missing the boat and literally throwing the baby out with the bath water with these issues. Why mess with perfection? Simply use what nature has made over the many thousands of years. We simply cannot do better than nature when it comes to nutrition.

JOHN: What about antioxidants after training. There seems to be a lot of conflicting evidence here, and I guess the train I am on now is to actually not take them postworkout as I don’t want to block the inflammatory response to training, and if I do take them, I only take ALA or r-ALA. I try to get Vitamin A, C, and E through foods. Any thoughts?

MATT: This is a good point, and where athletes have to diverge temporarily from where the rest of our community is regarding inflammation. Strictly speaking, building muscle is an inflammatory process. Without it, there simply isn’t a whole lot of muscle being produced. If you are a strength or physique athlete, your thoughts need to be along the lines of “how do I use this to my advantage without getting into dangerous inflammatory territory?” And I think that you have hit on the answer in allowing the acute inflammatory response to happen immediately after training. Let the body do its thing for the first 6-8 hours post training. Save any antioxidants to either the next morning or that night, depending on when you train. You have the benefits of the acute inflammatory response on muscle hypertrophy without it spilling over into chronic inflammation and potential health concerns. I realize this is a hot button issue, and there is evidence on the opposite side as well. We are throwing off a lot of radicals when we train. It comes down to a question of “what is most important to you?” Physique and strength athletes obviously place a high priority on muscle size and strength, and we are probably the only subset of people who even have this decision. The rest of society really do not care about muscle size and power, so their choice is to reduce inflammation immediately. We can’t make that choice, so I believe the scenario I described above is the best compromise for our goals of big muscles and optimal health.

JOHN: Speaking of inflammation, I think you know I blieve it is basically the root of all evil. What kind of steps can we take to lower that chronic low grade inflammation that eats away at our health? Are there any tests we can take such as a high sensitivity C-Reacitve protein test to detect this???

MATT: To quote Kathy Bates from The Waterboy, inflammation “is the devil!” Beside the immediate, very narrowly-scoped benefit to muscle growth for acute inflammation described above, chronic inflammation is turning out to be the scourge of our modern society. We all are well aware of the cardiovascular implications by now, but chronic inflammation is also the man behind the curtain for many prominent chronic gastrointestinal, orthopedic, dermatological, pulmonary, and neurological disorders. In fact every organ system in the body is seriously adversely affected by chronic inflammation. These are the “diseases of civilization”, a term coined by the 18th century missionary physicians who had the unique opportunity to see isolated tribes and their health before and after the introduction of refined western foods. Introducing the refined foods literally blossomed never-before-seen diseases such as cancer, heart disease, gall stones, appendicitis, and diabetes. We have found that most of these conditions are either directly attributed to inflammation or are related in some way to the inflammatory process, the smoking gun sure appears to be modern refined foods.

For me, managing chronic inflammation in modern society always starts with correcting the fatty acid ratios. Everyone pretty much knows about fish oil and EPA by now, and even people with passive interest in health are popping fish oil capsules. But there is so much more to the story than just fish oil capsules. People’s first order of business should be to drastically reduce their omega 6 intake. Since we are after the optimal ratio of omega 6 to omega 3, then reducing high omega 6 intake will do at least as much good as adding extra omega 3. That’s a hard message to get out because the mainstream media hypes omega 6 as “good fat”. It can be a good fat, but only in the correct ratio with omega 3. The next question I get is “If I stop eating all these omega 6, what do I eat?” Simply replace it with neutral, non-reactive natural saturated fats. The other important player in the chronic inflammation story is GLA. GLA is somewhat controversial in its efficacy, but it plays the important role in moderate doses of increasing DGLA without increasing arachidonic acid (AA) which is the progenitor of the pro-inflammatory prostaglandin series. So, reducing dietary consumption of omega 6, adding supplemental omega 3 to the correct ratio of 2:1, and then adding 500-750 mg of GLA as evening primrose or borage oil is a great start on drastically reducing whole body chronic inflammation.

In regards to testing, yes hr-CRP testing is very useful for determining this type of chronic inflammatory condition. It’s a wonderful tool that we didn’t have available not too long ago. ESR is another test which tells us about the inflammatory condition of the body. Whether or not I recommend them though depends on the patient. If the patient is coming to me fresh off a lifetime of the standard american diet and has a spare tire around their abdomen, I think it would be a waste to look at it at that time. They are going to be high, no doubt about it. After working with them for 3-4 months, then the test is going to tell us some usable information about their inflammatory status. It can then be drawn yearly to make sure things remain on the correct path.

JOHN: We are just getting warmed up folks – stay tuned for Part II next month with Matt!