The hidden danger of modern malnutrition – with Jakub Přibyl – Trime Podcast #09

Podcast transcript:

[00:00:05] Host
Another episode of the Trime podcast begins, welcome. This time, it's a little different from what you might be used to from previous episodes. It's just me here today, and with me is Jakub Přibyl. Hi, Jakub

[00:00:17] Jakub
Hello. 

[00:00:18] Host
Kuba, as one of the founders of the Trime e-shop and the website trime.cz. Originally, Martin Jelínek, a nutrition expert who even developed an app that tracks whether a person is getting enough nutrients, was supposed to be here. But since he unfortunately couldn't make it today, we thought we’d record something that might interest you as well, and that’s the most common practical questions regarding malnutrition. This is a topic that you’re pretty familiar with, Kuba, and also something that Trime is focusing on right now, and it’s also a subject that isn’t really talked about much. So, let’s start at the beginning, Kuba, and define what malnutrition means in our, let’s say, European context.

[00:01:05] Jakub
In the broadest sense, it's a state where the body isn't getting enough nutrients, or the intake isn’t adequate, or the body’s ability to utilize those nutrients is impaired, either due to an excess of some other substances or lifestyle factors.

[00:01:25] Host
So, maybe, how is malnutrition recognized? How is it defined? But more importantly, how can we recognize the signs? Can we even say there are symptoms?

[00:01:36] Jakub
That's a good question because most people associate malnutrition with the stereotypical image of hunger in African children, which certainly evokes strong emotions. But what evokes strong emotions for me is also our modern European, or let's say, latent type of malnutrition, the hidden kind, which you might not recognize at first glance because it doesn’t manifest in any clinical symptoms. And it actually progresses quietly over years before it eventually reaches the clinical stage. So, you need to look at it as something that goes through phases. The pre-latent phase of malnutrition basically means that the body is depleting its vitamin, mineral, and other nutrient stores without adequate replenishment. So you’re functioning normally, you’re performing at a basic daily level, but you're no longer replenishing it properly. This transitions into the latent stage, where you might notice deviations from what you would consider optimal health. For example, you might become more tired, have headaches, joint pain, chronic inflammation, and the body is really lacking those nutrients. So, it can manifest subjectively, and you might also catch it in biochemistry, with changes in blood work, something like that. And then it progresses into the clinical phase, where it actually manifests as a more severe health problem. And we’re not yet talking about classic avitaminosis, where you’re deficient in a vitamin and it causes something like scurvy, a lack of vitamin C, or beriberi, pellagra, or night blindness, rickets, or cretinism – these are typically found in developing countries, but here we often encounter hypovitaminosis.

[00:03:35] Host
So, that’s actually in the latent phase, let's say?

[00:03:37] Jakub
Most often, it’s in the latent phase. And now it just changes in terms of severity, how severe it actually gets, how much you rest, how well you eat, and that's a matter of chance.

[00:03:48] Host
A common belief is that I need to eat a certain amount of calories to be okay, and when I want to gain weight, I need to take in more calories than I burn, and if I want to lose weight, less. How does malnutrition play into this? Because in some cases, with malnutrition, you can eat a huge amount of calories and still be malnourished.

[00:04:17] Jakub
Yes, it can actually get worse. Because an excess of one component can actually deplete other vitamins and minerals, increasing the need for those nutrients. This happens with athletes, and also with obese people. For example, recently in the hospital, I met a 16-year-old boy, 135 kilos, and he was actually malnourished, so they had to give him enteral nutrition, basically drinks. He had to drink his food, just like the African hunger example, but here it’s a very strong emotion because you see that with the liquid nutrition, his life is being saved because it’s in an acute life-threatening stage. But it’s quite similar here.

[00:05:07] Host
So, this actually manifests as a person having significant overweight…

[00:05:14] Jakub
Exactly, often people don’t associate that. So, you eat every day, but from the perspective of your food composition, it doesn’t meet the body’s needs for micronutrients.

[00:05:28] Host
So, we know how malnutrition can arise or manifest. Is there someone more prone to malnutrition than others? Maybe we can take this from the perspective of professions or the type of work someone does. Let’s take, for example, a manager who typically sits for eight hours or even more, sitting at a computer, whether at home or in an office, and the movement happens either in the morning before work or possibly after work, when they remember, when they’re tired enough to go straight to bed. So how does someone like that become prone to malnutrition?

[00:06:10] Jakub
It’s a complicated question, it sounds simple, but there will be groups of substances that are missing for most people. And then there will be substances where you may have higher needs because of your lifestyle. So an athlete will need something different than someone who has an excess of empty energy or sugar. For example, they might need more chromium, they might need more vitamin K2. And these are more expert questions where we’d have to discuss specific nutritional profiles. So, I can’t…

[00:06:49] Host
Let's try to take an average person, let’s say someone with a typical diet who was taught to eat five times a day, so they eat five times a day, right? And now, can such a person realistically fall into the category of latent malnutrition?

[00:07:12] Jakub
I’m sure they can. It’s a real everyday reality. You need to look at what that diet actually looks like. And we were joking here before recording, but if your diet consists of things like a sausage pie, pizza, ground animal wrapped in flour, like a hamburger – that’s the peak of gastronomy, but it doesn’t provide you with a lot of nutrients. So, if that’s the basis of your diet, you have a problem, and it doesn’t really matter how often you play golf or go to the woods. Because the basic foundation of your diet isn’t right.

[00:07:48] Host
And that foundation is, of course, always the diet itself. Can we also talk about empty calories?

[00:07:54] Jakub
Certainly, as soon as your diet is based on foods that are really junk food and fast food technology, it increases the need for some micronutrients, just because the body is burdened by the metabolism of over-processed fats and simple sugars. The body hasn’t evolved to handle that. We’ve had industrialized food for the last few decades. Let’s…

[00:08:23] Host
Let’s take a look at how a person can avoid malnutrition, let’s say. What should someone really do to prevent falling into latent malnutrition, which I think most of us are somewhat prone to, or at least have some predisposition to? How can we make sure we don’t reach that stage?

[00:08:46] Jakub
For me, it’s supplementing, period. Because it’s really popular to say that the foundation is a varied diet, but let’s look at it realistically. You drive a car, stare at screens all day, have a sedentary job, don’t get enough sun, and we’ve talked about the issue of vitamin D deficiency here – even if you went on vacation for 14 days four times a year to get sunlight in some exotic country, that still wouldn’t cover your vitamin D needs.

[00:09:26] Host
Now, let’s take the average person, right? Someone who spends the day in an office.

[00:09:30] Jakub
And now imagine you don’t have the conditions to take a vacation to recharge, so you’re really stuck with this all year round. And then, maybe on the weekends, during the summer, you occasionally get some sun, but for most of the year, you’re in trouble because this is really linked to a whole range of immune processes and body regulation in general.

[00:09:56] Host
Well, okay, supplements – one thing, but not everyone is used to taking supplements. That means a person has to get used to it somehow, I know that… or at least form a habit. Are there any recommendations, let’s say, supplements to start with, so you don’t begin by taking eight pills a day right away?

[00:10:19] Jakub
We’ve talked about this in previous episodes. Of course, the goal is to start thinking a bit about what I’m eating and what I’m really missing. That already requires some expertise or at least some knowledge, so...

[00:10:34] Host
So I should probably make a list of what I eat during the week?

[00:10:39] Jakub
Exactly. The ideal thing is to really look at what you've consumed over the week. If you see that your diet isn’t really varied enough from basic foods, that you’re not eating two servings of vegetables a day, you’re not getting quality protein sources – meaning meat, and not just chicken breasts or lean meat, but really things like organ meats, offal, bones, broths. It’s important to work with that in a sufficiently varied way. You don’t consume legumes, eggs, or only occasionally, so...

[00:11:18] Host
Or maybe you have too much of one thing?

[00:11:20] Jakub
On the contrary, you might have an excess of one particular thing. So if you balance those basic elements and we can talk about what this balance, this sufficient variety of basic foods should look like, we can put that together pretty quickly. But even then, you’ll still have problems with the intake of certain vitamins that have been lost from our food chain. Simply because the conditions in which we live have changed. That wasn’t the case in the past. So, your microbiome is changing, you’re not synthesizing enough vitamin K2, the prolonged stress increases, so you’ll have a higher need for certain factors that compensate for this – magnesium, chromium, for example.

[00:12:13] Host
What does that specifically mean? If I understand correctly, you’re saying that even if I have a better-balanced diet, I still can’t avoid supplements?

[00:12:22] Jakub
Well, you could manage without them, but in that latent form of malnutrition, because it doesn’t hurt, it’s not visible. You get used to that state. And if we were to talk about what you can do for yourself to truly live the life we’re talking about... I won’t talk about someone who’s up in the mountains, immersed in nature, working out...

[00:12:46] Host
Right, we’re talking about an urban person...

[00:12:48] Jakub
We’re talking about us. So, even if you go to work out three times a week, that’s just the basic. Walking 10,000 steps a day doesn’t fix it. That’s just the basic, and still, we have trouble sticking to it. So, I really think supplementation, adding to our lifestyle, will benefit anyone who can focus on it.

[00:13:15] Host
Now, let’s take the opposite extreme. If malnutrition has already occurred, whether it’s due to overweight or in any other way, or perhaps only in the latent stage. How can a person get out of it? I assume it’s not just about changing your diet next week and being fine?

[00:13:38] Jakub
If the problem has already developed, meaning you notice that something is wrong, you don’t feel well, then we need to talk about therapeutic doses of vitamins and minerals. And this should definitely be handled by a specialist.

[00:13:57] Host
But this is probably when the person starts noticing something in themselves, right?

[00:14:00] Jakub
Exactly, when you suspect that something is wrong, and now you’re just trying to figure out what. So it starts with diagnostics, and after that, you can’t just give blanket advice about how much to take for which symptom, for which disease. But the basis is that you can prevent the most common lifestyle diseases with just prevention.

[00:14:24] Host
It’s like... maybe that's why malnutrition is also quite a scary concept because, of course, the symptoms don’t appear right away. Sure, it could... it could show up as fatigue and similar things, but those are things that someone like us would just say, "It’s normal because I’m overworked." And it might be... it might be that. So what are the signs, and how does it actually manifest, after how many years... how does it actually look?

[00:14:51] Jakub
This is actually the biggest problem. You don’t realize it in time unless you actively pay attention. You might end up with osteoporosis, a broken femur, or hip fracture, something like that, and then you have a problem. You might have long-term consequences.

[00:15:10] Host
We’re probably talking about old age when it comes to these injuries, right? That’s...

[00:15:13] Jakub
It’s a common problem, but you don’t... you don’t want to deal with it later. If you have older parents, something like that, it’s really unpleasant when they’re not mobile anymore, and so on. And with younger generations, you also don’t want to experience the moment when your heart stops and they have to resuscitate you. And again, how does that happen? It doesn’t happen overnight. If there’s no congenital heart condition, you’re gradually moving toward it. And it happens because you’ve heard about vitamin D, so you increase the dosage, disrupting the calcium metabolism. And that can lead to calcium being deposited in soft tissues, blood vessels, kidneys. And then you have a problem elsewhere. So, if you care about it and work on prevention, like we do at Trime, you can prevent it very effectively. Even with basic dosing, these problems shouldn’t occur.

[00:16:11] Host
Should a person, or can a person, when we’re talking about supplements, should they suddenly increase the... the amount of supplements they take daily?

[00:16:23] Jakub
With some, yes. You can get some benefits from it. But generally, it’s better to go for preventive, continuous dosing of some...

[00:16:34] Host
Generally, it's about daily intake, right?

[00:16:37] Jakub
It depends. You can’t cram effective doses into a single tablet, but basically, you’ll be fine if you take a well-formulated multivitamin supplement that covers your basic needs. Selenium, chromium, I don’t know, iodine, vitamin D, vitamin K2... something that... you don’t need to fully understand, and yet it will do a great job for you.

[00:17:03] Host
So now we’re probably getting into dosing itself, and really, how should a person calculate, let’s say, how many milligrams are right for them... how do they dose it? The basic, maybe, math, once the diet is somewhat under control and now you want... now you want to talk about the supplements themselves.

[00:17:26] Jakub
With multivitamins, the manufacturer formulates it so that with basic dosing, I don’t know, in the morning, afternoon, evening, you ensure the basic intake of the daily recommended amounts. We’re not talking about what’s optimal for the body, just the basic.

[00:17:44] Host
Isn’t that just the average? Because, honestly, it feels like, I don’t know, I walk into an unnamed pharmacy, let’s say, and I buy supplements and now... and now I’m not sure...

[00:18:00] Jakub
That’s usually not the case. It’s mostly done in a way that... so you see a lot of ingredients on the label that could potentially benefit you. But this is the most difficult category. Specialists don’t usually like working with it and prefer to look at what’s missing in your diet or what your lifestyle requires in higher doses, and then they’ll advise you how to assemble the right doses from several supplements. But if we’re talking to listeners who don’t have access to specialists, or don’t need to deal with it right now in this phase of life, a well-assembled multivitamin will benefit you a lot, and then I think it’s necessary to add just a few things like omega-3 fatty acids and vitamin D, vitamin K, which is also good to increase during certain seasons.

[00:18:57] Host
So, the intake of vitamins itself probably isn’t unnecessary, but again, the person has to look at how much they’re taking, and unfortunately, in this case, it’s probably an individual thing...

[00:19:10] Jakub
Definitely, partially. It’s determined by your... your uniqueness, your nutritional profile, your genetics, and so on. But the basics can definitely be covered with multivitamins.

[00:19:24] Host
Maybe, as for malnutrition itself, do you feel like it’s a sort of negative trend that’s here and will continue?

[00:19:34] Jakub
I hope it gets better, but right now we’re in this phase. The era of DDT and Chernobyl is behind us. We have a different problem... and it needs to be addressed, constantly repeated, and brought to the public so they realize that our movement levels have decreased. We need to start compensating for that, because we’re in an abundance of food, and the body isn’t designed for that. Excessive stress, we need to learn to compensate for it, whether through breathing, being in nature, interpersonal relationships, and so on. Nutrition is extremely important, but it’s just one of those factors. Still, I think one of the easiest things is to think about how... and add to it... add to it like vitamin D, vitamin K2. Anyone can do that...

[00:20:26] Host
Thank you for the information, Jakub.

[00:20:28] Jakub
You're welcome.

[00:20:29] Host
If you have any additional questions, make sure to check out Trime’s Facebook, Instagram or you can definitely write to Jakub or other members of the Trime team, and I’m sure they’ll reply, whether it’s about nutrition or anything else. And we look forward to seeing you in the next episodes. Have a great day, goodbye.

[00:20:50] Jakub
Take care, goodbye.