Episode 48: Dr Tommy Wood, part 2, discusses insulin resistance and the role of diet in athletic performance

// Oct 10, 2017

Today’s episode features the second of our two-part interview with Dr. Tommy Wood, a U.K. trained MD/PhD who now lives in the U.S.

Part one covered Tommy’ background and education and what led him spend most of his academic career studying multiple sclerosis and ways to treat babies with brain injuries.

Part two of our interview focuses on Tommy’s other passions: nutritional approaches to sports performance and metabolic disease.

But before we get into Tommy’s background, we want to take a moment to thank our listeners for helping STEM-Talk win first place in the science category of the 12th Annual People’s Choice Podcast Awards.

The international competition featured more than 2,000 nominees in 20 categories. STEM-Talk also was a runner-up in the People’s Choice Award, the grand prize of the competition.

As we mentioned earlier, Tommy is U.K. trained MD/PhD who received an undergraduate degree in biochemistry from the University of Cambridge before attending medical school at the University of Oxford. He recently completed a PhD in physiology and neonatal brain metabolism at the University of Washington. He is now a senior fellow at the university researching neonatal brain injury.

In part one of his STEM-Talk interview, Tommy also talked about how he is the incoming president of the Physicians for Ancestral Health, an international organization of physicians, healthcare professionals and medical students that specializes in ancestral health principles for the prevention and treatment of illness.

Tommy’s interest sports performance stems from his background as an experienced rowing, endurance, and strength coach who combines evolutionary principles with modern biochemical techniques to optimize performance. He primarily performs this work with Nourish Balance Thrive, a functional medicine clinic based in California that works largely with athletes, where he is the chief medical officer.


Physicians for Ancestral Health –

Physicians for Ancestral Health –

Nourish Balance Thrive –

NBT automated performance analysis:

Primal Endurance podcast (ketogenic diets, athletic longevity, etc.):

2) High Intensity Health podcast (ketogenic diets and gut health):

Show notes:

3:37: The interview resumes.

3:43: Ken discusses how many, perhaps even most, adults are now insulin resistant to some degree, which negatively impacts many aspects of both health and performance, and is associated with most modern chronic diseases. Ken then asks Tommy if there are any underlying processes that he can see that tie these diseases together.

7:27: Ken comments on how in 1927 they had the sensible practice of starting a diabetic patient on a low-carb diet, which is still not current practice now in many places.

8:04: Tommy discusses how it is good to have symptom control with diabetes. Ken and Tommy discuss the many advantages of donating blood.

10:16: Ken asks Tommy if he has any issues giving blood in the United States given that he is from the UK which experienced mad-cow disease.

11:40: Ken asks Tommy if he checks his athletes’ ferritin levels and tries and keep them in a certain range, and if so, if he has a preferred range.

12:17: Dawn discusses how in addition to Tommy’s academic work at the University of Washington, he is also very active as the Chief Scientific Officer of Nourish Balance Thrive (NBT), an online company using advanced biochemical testing to optimize performance in athletes. Dawn asks Tommy to discuss Nourish Balance Thrive, and how the company works to optimize the health and performance of athletes.

14:41: Ken comments on how Tommy has a relatively homogeneous population if he is focused on endurance athletes, making it particularly interesting because people often confuse athletic performance with health.

15:37: Dawn mentions how Chris at NBT has been training machine-learning algorithms to predict biochemical patterns in athletes. She then asks Tommy to talk about how this fits in with his current work and why he thinks it is an important approach for the future of medicine in general.

17:52: Ken comments on how Chris is using XG Boost, a well-regarded open-source software library, as the machine learning tool. Ken mentions that XG Boost is an implementation of gradient boosting which is a form of supervised learning which has enjoyed broad success.  Another nice feature of XG Boost is that its open source, allowing one to integrate it with a variety of other software packages.

19:25: Ken says how a sensible next step may be to identify another relatively homogeneous population and do it again.

20:48: Dawn comments on how over-training, under-recovery, nutrient deficiencies, or hormonal imbalances seem to be much more prevalent today. She then asks Tommy if this is because we can spot or diagnose these more regularly, because athletes are training at a higher intensity and volume, or because of changes in the environment.

22:39: Dawn asks Tommy how NBT’s biomarker panel was developed in the first place, and how he chose the specific markers and data that he is collecting for the panel.

25:16: Dawn discusses how she has done a fair amount of work looking at biomarkers of different disease processes and injury, and how one topic that arose several times was variability. She then asks Tommy how he can address this potential for variability, and if he is collecting data for long-term analysis.

27:14: Ken and Tommy briefly discuss the ŌURA Ring.

28:32: Dawn asks Tommy if he sees genetic testing playing a larger future role in his work with athletes.

29:47: Ken comments on how this is going to be a growing area. It was initially over-hyped, such as people looking at a particular gene that would determine effectiveness in a sport. However, more variants of specific genes are being validated with respect to human performance and resilience.

31:33: Dawn notes that it is sometimes difficult to get actionable results from genetic testing.

32:03: Dawn asks Tommy how he might use carbohydrate restriction in his work with athletes, and if there are any contexts where the low carbohydrate diet could be detrimental.

34:33: Ken comments on how the discussion reminds him of Jeff Volek’s phrase, “well-formulated ketogenic diet.”  Ken also stressed the importance of blood testing for ketone levels.


36:29: Dawn comments on how Tommy and Chris have developed a product called Phat Fibre. She then asks Tommy to discuss why he prefers it to other MCT oils and powders found in the market.

38:34: Ken comments how he is a huge fan of Phat Fibre, and how he shared the product with his friend who is a cyclist.

38:57: Dawn asks Tommy to discuss another product he and Chris created, Hormetea.

42:10: Dawn asks Tommy to talk about Nourish Balance Thrive’s podcast.

43:05: Ken discusses how ketogenic diets naturally bring insulin down in many athletes, and as a result, they experience a decrease in electrolyte retention. Ken then asks Tommy if he has also seen this decrease in electrolyte retention and the need for many athletes to supplement electrolytes.

44:23: Ken asks Tommy about carnitine supplementation for those on a ketogenic diet.

45:21: Ken asks Tommy if he usually recommends both common forms of carnitine supplementation for his athletes.

45:40: Dawn asks Tommy if he has any thoughts on the supposedly ‘lifespan” or “healthspan” enhancing supplements, such as NAD or nicotinamide riboside to increase NAD+ levels?

48:11: Dawn comments on how there are now ketone salts on the market and there will soon be ketone esters also. She then asks Tommy what his thoughts are on exogenous ketones in the context of human performance, health span, and disease.

51:47: Ken comments on how it would be surprising if the effects of ketogenic diets and exogenous ketones are identical. He goes on to assert that this is an area where the research needs to happen soon and asks Tommy about his thoughts on this.

54:02: Dawn discusses how Tommy has mentioned that exercise is a key trigger for longevity and yet there are people who assert that exercise is detrimental to lifespan. She then asks Tommy what he would say to those people and if there are any types of exercise that have the upside without the negatives associated with some forms of exercise.

56:40: Dawn asks Tommy what he would propose as an approach for investigating whether an intervention has an impact on human longevity.

1:00:56: Ken says there may be a placebo effect for someone who is convinced that they exercise more than their peers.

1:01:13: Ken asks Tommy about ruinous empathy.

1:03:06: Ken says that he would note that context is important when engaging in radical candor.

1:03:42: Ken asks Tommy if he thinks there is a dogma displacement inertia problem in science and medicine, and if so, whether there anything to do about it other than be patient.

1:06:19: Ken and Dawn thank Tommy for joining them.