Winning the Battle Against Metabolic Disorders: Iñigo San Millán at TEDxMileHigh (Transcript)

Dentists love them, by the way. So it’s time to really start using – that’s perfection. And that’s where we can really start changing gears and start using that reference as anything else in life. Now why do elite endurance athletes have the highest performance and they’re so good? Well, for the past 20 years, I’ve been working with elite endurance athletes around the world, and I’ve been able to study their metabolism and physiology. And one thing that I see as a secret for their performance is that it resides in their cells.

And within the cells, it resides in the mighty mitochondria. The mitochondria are the areas in the body where we burn fuels to energy. That’s where we burn glucose, where we burn fat, where we burn protein for energy. Now, elite endurance athletes, they need to really perform at the highest level seen in humans, and for that, you need the best mitochondria there. They have the most developed mitochondria of any human.

Lactic acid, or lactate, a key element for endurance performance, is the byproduct of glucose utilization. So with exercise, we use glucose and therefore we produce lactate. Now, not lactate, per se, but the hydrogen ions associated with lactate, it builds up in the muscle, and eventually, it decreases performance. That’s key. And I have 20 years worth of data seeing that those ones with the highest lactate clearance capacity, they’re the best ones out there.

And where do you clear lactate? In the mitochondria as well. So they have an amazing mitochondria. And that’s perfection. On the opposite metabolic pole, we see recent, but overwhelming evidence from researchers around the world, working with these different cardiometabolic diseases like type 2 diabetes, obesity, cardiovascular disease, even Alzheimer’s, soon to be called the new type 3 diabetes, showing one thing in common in all these diseases: a mitochondrial dysfunction. Those mitochondria are not working properly.

And then, we have a big metabolic problem. When the mitochondria is not working properly, we cannot burn the glucose. At rest levels, that’s when we burn the glucose. It’s a complex process, but ultimately, glucose is burned in mitochondria. And when mitochondria’s not functioning properly, the pancreas is going to release insulin to try to get the mitochondria in, but it’s a faulty mechanism in the mitochondria, so the glucose is going to end up building up, giving rise to insulin resistance, and eventually type 2 diabetes.

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The same thing happens with fat. The fat can only be burnt in the mitochondria. If the mitochondria’s dysfunctional, we cannot burn fat properly and it’s going to be building up, giving rise to a wide array of pro-inflammatory responses related to cardiovascular disease, weight gain, and also, probably cardiovascular disease. So that’s why we have a big problem here, and that’s where we have to see that’s imperfection. And we need to know what perfection is, because everything seems to be related at the mitochondria.

So why do elite endurance athletes have such an incredibly developed mitochondria? The main reason is exercise. They train like nobody else on the planet. And exercise is the stimulus mitochondria need to grow and to function properly. Without exercise, mitochondria atrophy. Going back to the example of nutrition.

If you go in this country, in the US, to a dietitian, and say, “Hey, I want to be healthy, I want to be away from these diseases, but, I want to eat twice a day, and every day of the week, white bread, white pasta, and white rice,” they’ll shoot you. They’ll say, “You’re crazy.” Right, there’s no way, that’s the worst thing you can have.

And well, this is exactly the diet all these societies that historically have lived longest and with the lowest incidence, have on a daily basis. And that’s historically because things are changing, and they’re just starting to develop these societies. But why are they protected and they don’t die eating bread and pasta and carbohydrates? Because they move and they walk. They walk to work. They walk to the grocery store. They walk to buy wine. They needed to have the wine. They walk to do errands. And by walking, that hour a day, that’s the stimulus, that’s physical activity. That’s the stimulus the mitochondria need to keep proper functioning, keep growing and not die.

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On the other hand, what do we walk in America? Here in the US, except for some urban areas like Manhattan or San Francisco, where by the way, they have one of the lowest incidences of these diseases in America, we can’t walk anywhere. We don’t walk to work, we can’t walk to the grocery store, we can’t walk to do errands. We need the car for everything.

And we end up for years, sitting on our butts, going to and from work, plus sitting on our butts at our desk for many years. And that causes mitochondrial dysfunction. We know very well with athletes that well-trained athletes, we know from research that if they stop and become sedentary for two months, their mitochondria decreases by 40%. Imagine if you haven’t exercised in 20 years. There’s no way you’re going to have mitochondria right? Very difficult.

And that’s very important to know. On top of that, of course, throw all the extra nutrition, we’re over-fed in our society, you then keep overloading those mitochondria. The problem that we have nowadays is that in this country about 33% of the people already have pre-diabetes or diabetes. The projections by 2020, that is tomorrow, is that 52% of the adult population in the US is going to be pre-diabetic or diabetic. And let’s not forget that being pre-diabetic is already having that metabolic disease.

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