March 2025

Casey Means, MD, earned both her undergraduate and medical degrees from Stanford University. She completed her residency as a head and neck surgeon at Oregon Health and Science University before leaving traditional medicine to focus on the root causes of why Americans increasingly suffer from chronic diseases. "Good Energy" was written with Dr. Means's brother Calley Means, and it was published in 2024.

During her surgical residency, Dr. Means treated patients with numerous chronic conditions, such as migraines, sinusitis, tonsillitis, and various other ailments. Typically she would prescribe various medications to treat the problem, and if those did not work she would perform surgery. Eventually she realized that she was treating the symptoms rather than fixing the underlying root cause. This prompted her to leave her position as a chief resident at OHSU and open her own practice. Establishment medicine tends to treat every condition separately, without realizing that all the processes in the body are interrelated. As the author states, "...inflammation-which leads to disease, pain, and suffering-takes root because core dysfunctions occur inside our cells, impacting how they function, signal, and replicate themselves." She also correctly points out that, "...every institution that impacts health-from medical schools to insurance companies to hospitals to pharma companies-makes money on 'managing' disease, not curing patients."

Dr. Means makes the distinction between "bad energy" and "good energy." "Bad energy" is when normal metabolic function has tipped into dysfunction, and is largely the result of three things: mitochondrial dysfunction (in which the powerhouse of the cell is overburdened and cannot produce enough ATP), chronic inflammation (mitochondrial dysfunction is perceived as a threat and the body formulates a fighting response), and oxidative stress (free radicals cause damage to the cells and lead to dysfunction). Mitochondrial dysfunction can be caused by many things, namely chronic overnutrition, a sedentary lifestyle, chronic stress, sleep deprivation, medications and drugs, and nutrient deficiencies. When mitochondria do not function properly, they cannot convert food energy into cellular energy, which can lead to chronic disease. On the other hand, "good energy" can be measured by looking at five markers that are typically tested during an annual check-up. The author says that you should strive for a triglyceride level of less than 80 mg/dL, HDL cholesterol of 50-90 mg/DL, a fasting glucose level of 70-85 mg/dL, blood pressure of 120/80, a waist circumference (depending on your ethnicity) of less than 37 inches for men and 31.5 inches for women, and a triglyceride-to-HDL ratio of 1. This would indicate that your cells are functioning optimally and you have achieved true metabolic health.

The book is divided into three sections. Part 1 is "The Truth About Energy", Part 2 is "Creating Good Energy", and Part 3 is "The Good Energy Plan." I particularly liked chapter five, which covers some principles of proper nutrition. The author does a nice job of explaining the inherent dangers of the contemporary Western diet that is filled with processed foods, and she discusses omega-3 and omega-6 fats and their respective roles in biological function. Dr. Means says that we should look at eating as a means of matching our cells' needs with our oral inputs, and that food is how we communicate with our cells. The most important advice that the author gives is to focus on eating unprocessed food and not worry about diet philosophy. Many different diets will work, provided you eat plenty of protein, vegetables and fruits, and essential fats, while avoiding sugars and processed foods. If you are satisfying your vitamin, mineral, and trace element requirements, it doesn't really matter what template you follow.

I enjoyed reading this book. Dr. Means includes helpful grids for each micronutrient and food sources where they can be found. There is also an exhaustive list of foods to avoid. The author provides other helpful lifestyle strategies, such as how to incorporate movement into your daily routine, managing stress, optimizing sleep by minimizing exposure to artificial light, and explaining the benefits of exposure to hot and cold temperatures. In the back of the book there are recipes that you can follow for breakfast, lunch, dinner, and snacks that are healthy alternatives to fast food and the prepackaged stuff so commonly found in grocery stores. My only point of contention with the good doctor is over her strength training recommendations. I believe that a frequency of three times per week is too much, and that the Total Results methodology is superior. However, I do agree with the author that strength training should be considered an essential component of everyone's life.

How can this book help you? It will educate you about the real reasons why the number of people suffering from chronic (and preventable) diseases has skyrocketed over the last forty years, and it should crystallize for you how the medical establishment, pharmaceutical companies, and big agriculture profit by keeping you sick. If someone as accomplished and respected as Dr. Means walked away from a lucrative specialty practice, that should tell you something. I encourage all of you to read this book and utilize the strategies put forth to optimize your health and independence. You can and should feel amazing, no matter your age.

There are many different ways to measure and track exercise performance. We create a spreadsheet (either in Microsoft Excel or Google Sheets) for each client and record the order and selection of exercises, their machine settings, weight (resistance), time under load, and make note of any recurring form discrepancies that are committed for each workout. Our exercise philosophy is the same for every client, but every individual is different; this is why we tailor each exercise routine to meet the needs of each person that is under our tutelage. Naturally, every client wants to perform at his or her best in every workout that they undertake, but different factors can make that an impossibility. There are physiological and mental considerations that have a positive or negative effect on one's exercise performance. How you approach this on an ongoing basis will have a great impact on your level of sustained success.

Some of these factors have been discussed in previous articles, but I thought this was important enough to merit a separate article on the topic. We all have individual differences, which I believe should be celebrated. Metabolically, everyone uses energy at different rates, which means that from one person to the next recovery and exercise frequency can vary. This is why some Total Results clients exercise once per week, while others come twice per week. Some train more intensely than others, which also necessitates a reduced volume and frequency of exercise. Some clients, if they have genetic advantages, can get away with things that others cannot. Since I have a genetic propensity for leanness, I could probably still make decent progress while making poor dietary choices, but I choose not to do that. It would likely catch up to me sooner or later in any event. Just because you can get away with doing certain things that are detrimental to your progress doesn't mean that you should.

Here are five factors that can significantly impact your performance.

Mental state. Attitude is everything! I often refer to the old Henry Ford quote: "Whether you think you can or think you can't, you're right." A positive attitude is absolutely necessary when you are dealing with the adverse circumstances and discomfort that a Total Results workout entails. If you are distracted (and let's face it, that is a battle that most of us have to fight every day), you will struggle. Shut everything else out of your life for 20 minutes and focus on completing something that is truly tangible and meaningful. Show no fear! Accept the fact that what you are about to do will be difficult and uncomfortable, but the realize that the reward comes on the other side in the form of accomplishment, empowerment, and independence from the sick care system.

Proper sleep. Matthew Walker's book "Why We Sleep: Unlocking the Power of Sleep and Dreams" is one of the most useful books that I have read in the last decade, and I have recommended it to scores of clients. Walker recommends getting between seven to nine hours of sleep per night, and says that anyone sleeping for less than seven hours per night on a consistent basis is functioning at a much more diminished capacity than they realize. Eventually, it catches up to you and can lead to a whole host of health problems. Sleep is important for so many reasons, but especially for recharging your mental batteries and helping to facilitate tissue repair after a workout. Sleep soundly and sufficiently for a few nights in a row prior to a workout, and you will notice a tremendous difference in your performance.

Nutrition. You wouldn't put low-octane gas into a sports car, so why eat junk food before a workout? Do not pay attention to government guidelines, their food pyramid, or most of the commercials that you see on TV. Just like a car needs fuel before a road trip, your body needs to be properly fueled in order to do the things you want it to do. Consume single-ingredient whole foods, select high quality sources of protein (1 to 1.5 grams per kilogram of body weight), and find good sources of saturated fat. Fruits and vegetables should be your primary source of carbohydrates. Avoid processed junk and minimize sugars. Simply put, you should consume the foods that will provide the vitamins, minerals, and other raw materials that you need for optimal energy and recovery.

Protein intake. Most people do not eat enough of it! I touched on this in the previous section, but you should strive to take in 1 to 1.5 grams of protein per kilogram of body weight. Simply divide your body weight by 2.2 and you will have your ideal number. In order to build muscle (which should be a goal for everyone), you need protein to repair the tissue that has been broken down in the course of a workout. Good sources of protein include beef, chicken, pork, fish, and eggs, and some protein should be consumed with every meal. If you are a vegan this will be a challenge, but there are alternative sources of protein that you can consume such as flaxseed, lentils, and tofu. I should point out that plant-based sources are incomplete proteins, meaning that they do not contain all of the essential amino acids, so variety will be key.

Activity level. Movement is important for our health, but it is very easy to overdo it. I believe that sitting for long stretches of time is unhealthy for your mind and body, but it also bears noting that our recovery systems can be somewhat fragile. Less is often more, and if you are running or biking three or more times per week your Total Results workouts can suffer. Low-level movement, such as walking, traditional yoga, or golf probably won't negatively impact you too much, but do exercise good judgement when deciding other activities to pursue.

The good news is that all of this is within your control. You have the power to do what it takes to ensure lasting success and robust health. Please let us know how we can help you on your journey!