Podcast: The High Performance
Published Date:
Mon, 28 Aug 2023 00:00:32 GMT
Duration:
1:30:23
Explicit:
False
Guests:
MP3 Audio:
Please note that the summary is generated based on the transcript and may not capture all the nuances or details discussed in the podcast episode.
This episode contains the roadmap to a longer, healthier life.
Dr. Peter Attia is a physician, focused on the applied science of longevity and on a mission to unlock the secrets of extending human life. In this episode, he takes Jake and Damian through the 5 pillars of health, exploring the impact of nutrition, exercise, sleep, stress and supplementation.
These five essential aspects of our lives are the building blocks upon which our overall wellbeing is constructed. By analysing each of these pillars, Peter explains how they can be utilised to transform our lives and overall health and wellbeing.
Peter provides tangible actions that your future self will undoubtedly thank you for. Discover how setting goals for the final decade of your life can become a powerful source of motivation for making positive changes in your life today; “the seeds you sow in your youth, are the same flower that come to harvest later on”. Peter discusses how to improve your emotional wellbeing, including finding honest, fulfilling relationships and being able to properly regulate your emotions.
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# Podcast Episode Summary:
## "The Road to a Longer, Healthier Life" with Dr. Peter Attia
### Key Insights:
- **Five Pillars of Health:**
- Nutrition: Focus on eating less, prioritizing protein, and avoiding excess energy intake.
- Exercise: Prioritize movement and physical activity.
- Sleep: Ensure adequate and restful sleep.
- Stress Management: Find healthy ways to regulate emotions and manage stress.
- Supplementation: Consider exogenous molecules (supplements) to optimize health.
- **Focus on Quality of Life:**
- Longevity is not just about extending lifespan but also enhancing the quality of life.
- Prioritize activities that improve your life today, and the bonus is that it often leads to a longer life.
- **Nutrition:**
- Caloric restriction, dietary restriction, and time-restricted eating are strategies to manage energy intake.
- Avoid grocery shopping when hungry and focus on the perimeter of the store for healthier options.
- **Performance-Based Approach:**
- Engage children in discussions about performance and energy levels to encourage healthy eating habits.
- **Emotional Well-being:**
- Find honest, fulfilling relationships and develop emotional regulation skills.
- **Eulogy vs. Resume:**
- Aim for a eulogy that celebrates a life well-lived rather than just a resume of accomplishments.
### Additional Points:
- **Four Horsemen of the Apocalypse:**
- Heart disease, cancer, neurodegenerative diseases, and metabolic diseases are the leading causes of death.
- Delaying the onset of these diseases through lifestyle interventions can extend lifespan.
- **Exercise and Sleep:**
- Data suggests that exercise is more important than nutrition for overall health.
- Prioritize sleep as it plays a vital role in health and longevity.
- **Supplementation:**
- Exogenous molecules, such as supplements, can be used to optimize health.
- A personalized approach is essential, considering individual needs and goals.
### Overall Message:
- By focusing on the five pillars of health, individuals can improve their overall well-being, delay the onset of chronic diseases, and potentially extend their lifespan.
- Emphasizing quality of life and performance-based approaches can help individuals make healthier choices, especially for the younger generation.
- Cultivating emotional well-being and striving for a eulogy that reflects a fulfilling life are important aspects of a holistic approach to health and longevity.
**The Longevity Blueprint: A Comprehensive Guide to Living a Longer, Healthier Life**
**Podcast Episode Summary**
In this episode, Dr. Peter Attia, a physician focused on the applied science of longevity, takes Jake and Damian through the five pillars of health: nutrition, exercise, sleep, stress, and supplementation. These essential aspects of our lives are the building blocks upon which our overall wellbeing is constructed. By analyzing each of these pillars, Peter explains how they can be utilized to transform our lives and overall health and wellbeing.
**Key Points:**
* **Nutrition:**
* The modern food environment is designed to drive us to overeat, leading to an imbalance in our fat storage and an increased risk of disease.
* Eating a diet rich in nutrient-dense foods and avoiding processed and sugary foods can help maintain a healthy weight and reduce the risk of chronic diseases.
* It's never too late to make positive changes to your diet and improve your health.
* **Exercise:**
* Exercise is the most important tool for extending life and improving quality of life.
* High muscle mass, strength, and cardio respiratory fitness are key factors in reducing the risk of all-cause mortality.
* The "centenarian decathlon" concept encourages individuals to define their non-negotiable activities for the last decade of their life and work backward to maintain the fitness levels required to perform those activities.
* **Sleep:**
* Sleep is essential for physical and mental health, and poor sleep can increase the risk of various health problems.
* Aim for 7-8 hours of quality sleep per night to optimize your overall health and well-being.
* Create a relaxing bedtime routine and avoid caffeine and alcohol before bed to improve the quality of your sleep.
* **Stress:**
* Chronic stress can have a negative impact on our physical and mental health.
* Find healthy ways to manage stress, such as exercise, meditation, or spending time in nature.
* Building strong social connections and relationships can also help buffer the effects of stress.
* **Supplementation:**
* While a healthy diet and lifestyle can provide most of the nutrients we need, certain supplements can be beneficial for specific individuals.
* Consult with a healthcare professional to determine if any supplements are right for you.
**Conclusion:**
By focusing on the five pillars of health, we can take control of our overall wellbeing and increase our chances of living a longer, healthier life. The key is to adopt a comprehensive approach that addresses all aspects of our lifestyle and makes positive changes that we can sustain over time.
## Podcast Episode Transcript
**Introduction**
This episode contains the roadmap to a longer, healthier life. Dr. Peter Attia, a physician focused on the applied science of longevity, is on a mission to unlock the secrets of extending human life. In this episode, he takes Jake and Damian through the 5 pillars of health, exploring the impact of nutrition, exercise, sleep, stress, and supplementation.
These five essential aspects of our lives are the building blocks upon which our overall wellbeing is constructed. By analyzing each of these pillars, Peter explains how they can be utilized to transform our lives and overall health and wellbeing.
Peter provides tangible actions that your future self will undoubtedly thank you for. Discover how setting goals for the final decade of your life can become a powerful source of motivation for making positive changes in your life today; “the seeds you sow in your youth, are the same flower that come to harvest later on”. Peter discusses how to improve your emotional wellbeing, including finding honest, fulfilling relationships and being able to properly regulate your emotions.
**The Five Pillars of Health**
1. **Nutrition:** Peter emphasizes the importance of eating a nutrient-dense diet, rich in whole, unprocessed foods. He highlights the benefits of consuming plenty of fruits, vegetables, and healthy fats, while limiting processed foods, added sugars, and refined carbohydrates.
2. **Exercise:** Peter advocates for regular physical activity, emphasizing the importance of finding an exercise routine that you enjoy and can stick to. He explains how exercise not only improves physical health but also has a positive impact on mental and emotional wellbeing.
3. **Sleep:** Peter stresses the significance of getting enough quality sleep, explaining how sleep deprivation can have detrimental effects on both physical and mental health. He provides practical tips for improving sleep hygiene, such as establishing a regular sleep schedule, creating a conducive sleep environment, and avoiding caffeine and alcohol before bed.
4. **Stress:** Peter acknowledges the role of stress in modern life and discusses the importance of finding effective strategies for managing stress. He suggests techniques such as meditation, mindfulness, and spending time in nature as ways to reduce stress levels and improve overall wellbeing.
5. **Supplementation:** Peter discusses the potential benefits of certain supplements, such as fish oil, vitamin D, and magnesium, in supporting overall health and longevity. He emphasizes the importance of consulting with a healthcare provider before taking any supplements to ensure they are appropriate and safe for individual needs.
**Additional Insights**
* **The Importance of Setting Goals:** Peter highlights the power of setting goals, particularly in the context of health and longevity. He encourages listeners to consider their aspirations for the final decade of their life and work backward to identify the steps they need to take now to achieve those goals.
* **The Value of Emotional Wellbeing:** Peter emphasizes the importance of emotional wellbeing and mental health in achieving overall health and longevity. He discusses the role of relationships, self-care, and therapy in promoting emotional wellbeing and resilience.
* **The Interconnectedness of the Five Pillars:** Peter emphasizes that the five pillars of health are interconnected and interdependent. Neglecting one aspect can have negative consequences for the others. By focusing on all five pillars, individuals can optimize their overall health and wellbeing.
**Conclusion**
Peter Attia's insights on the five pillars of health provide a comprehensive and actionable framework for individuals seeking to achieve a longer, healthier life. By incorporating these principles into their daily lives, listeners can take proactive steps towards improving their physical, mental, and emotional wellbeing, ultimately enhancing their overall quality of life.
# Podcast Episode Summary: The Roadmap to a Longer, Healthier Life
## Introduction
- Dr. Peter Attia, a physician focused on the applied science of longevity, shares his insights on extending human life.
- The discussion covers five essential pillars of health: nutrition, exercise, sleep, stress, and supplementation.
- The goal is to provide actionable steps for listeners to transform their lives and overall well-being.
## Key Points
### 1. The Pillars of Health:
- **Nutrition:**
- Focus on a balanced and nutrient-rich diet.
- Prioritize whole, unprocessed foods.
- Consume adequate protein, healthy fats, and complex carbohydrates.
- Limit processed foods, sugary drinks, and excessive amounts of saturated and trans fats.
- **Exercise:**
- Engage in regular physical activity.
- Include a combination of cardiovascular exercise, strength training, and flexibility exercises.
- Aim for at least 150 minutes of moderate-intensity or 75 minutes of vigorous-intensity aerobic activity per week.
- Incorporate strength training exercises for major muscle groups at least twice a week.
- **Sleep:**
- Prioritize quality sleep.
- Aim for 7-8 hours of uninterrupted sleep per night.
- Create a conducive sleep environment: dark, quiet, and cool.
- Establish a consistent sleep schedule and stick to it as much as possible.
- **Stress:**
- Recognize and manage stress effectively.
- Practice relaxation techniques such as deep breathing, meditation, or yoga.
- Engage in activities that promote relaxation and enjoyment.
- Seek support from friends, family, or professionals when needed.
- **Supplementation:**
- Consider targeted supplementation based on individual needs and potential deficiencies.
- Consult with a healthcare provider before starting any supplements.
- Common beneficial supplements include vitamin D, EPA/DHA omega-3 fatty acids, and probiotics.
### 2. Emotional Stability:
- Emotional health is crucial for overall well-being.
- Healthy relationships and strong social support systems contribute to emotional stability.
- Emotional maturity involves understanding and managing one's emotions effectively.
- Therapy and self-reflection can be valuable tools for improving emotional well-being.
### 3. The Power of Setting Goals:
- Set long-term goals for the final decade of life to provide motivation for positive changes today.
- Consider the legacy you want to leave and the experiences you want to have in your later years.
- Break down long-term goals into smaller, achievable steps.
- Celebrate progress and milestones along the way.
### 4. Additional Insights:
- Being outdoors and connecting with nature can have positive effects on mental and physical health.
- Adequate protein intake is important for maintaining muscle mass and overall health.
- Avoid multitasking and focus on one task at a time to improve productivity and reduce stress.
### Conclusion:
- By optimizing the five pillars of health and cultivating emotional well-being, individuals can enhance their quality of life and potentially extend their lifespan.
- Making small, consistent changes in daily habits can lead to significant improvements in overall health and well-being.
# Dr. Peter Attia's Guide to a Longer, Healthier Life: The Five Pillars of Health
In this podcast episode, Dr. Peter Attia, a physician focused on longevity, takes us through the five pillars of health: nutrition, exercise, sleep, stress, and supplementation. These pillars form the foundation of our overall well-being, and by optimizing each one, we can lead longer, healthier lives.
## Nutrition: The Building Blocks of Health
Dr. Attia emphasizes the importance of a balanced, nutrient-rich diet. He advises against fad diets and quick fixes, instead promoting a long-term approach to healthy eating. This includes consuming plenty of fruits, vegetables, and whole grains, while limiting processed foods, sugary drinks, and unhealthy fats.
## Exercise: Moving Your Body for Longevity
Regular exercise is essential for maintaining a healthy weight, reducing the risk of chronic diseases, and improving overall fitness. Dr. Attia recommends a combination of cardiovascular exercise, strength training, and flexibility exercises. He also stresses the importance of finding activities that you enjoy, as this will make it easier to stick to a consistent routine.
## Sleep: The Foundation of Restoration
Quality sleep is crucial for physical and mental health. Dr. Attia explains how sleep helps the body repair and rejuvenate itself. He provides practical tips for improving sleep, such as establishing a regular sleep schedule, creating a relaxing bedtime routine, and avoiding caffeine and alcohol before bed.
## Stress: Managing the Silent Killer
Chronic stress can take a toll on our physical and mental health. Dr. Attia discusses the importance of managing stress effectively. He recommends techniques such as meditation, mindfulness, and spending time in nature. He also emphasizes the importance of building strong relationships and having a support system to help us cope with stress.
## Supplementation: The Final Piece of the Puzzle
While a balanced diet and lifestyle can provide most of the nutrients we need, Dr. Attia acknowledges that supplementation can be beneficial in certain cases. He discusses the potential benefits of supplements such as fish oil, vitamin D, and creatine, but cautions against relying on supplements as a replacement for a healthy lifestyle.
## The Road to Longevity: A Holistic Approach
Dr. Attia concludes by emphasizing the importance of a holistic approach to health. He explains that optimizing each of the five pillars of health is essential for achieving long-term well-being. By making positive changes in our diet, exercise, sleep, stress management, and supplementation habits, we can unlock the secrets of extending human life and living healthier, more fulfilling lives.
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[00:29.640 -> 00:33.360] Hi there, you're listening to High Performance, the award-winning podcast that unlocks the minds of some of the most fascinating people on the planet.
[00:33.360 -> 00:38.160] I'm Jay Comfrey, and alongside Professor Damian Hughes, we learn from the stories, successes
[00:38.160 -> 00:44.080] and struggles of our guests, allowing us all to explore, be challenged, and to grow.
[00:44.080 -> 00:47.280] Here's what's coming up today.
[00:47.280 -> 00:53.700] If you want to live longer, by definition you have to delay death. The four horsemen
[00:53.700 -> 00:58.480] really are the adversaries you're going up against in the length of life part of the
[00:58.480 -> 01:03.520] discussion. If you understand that those are the horsemen and you want to live longer,
[01:03.520 -> 01:10.080] part of that strategy is what drives each of them and what do I need to do to delay their onset. The
[01:10.080 -> 01:15.600] seeds that you sow in your youth are the same flowers that that come to harvest
[01:15.600 -> 01:20.160] later on. Sometimes you're eating at a rate that exceeds your ability to sense
[01:20.160 -> 01:24.040] appetite. The data would say that nutrition does matter but it's not
[01:24.040 -> 01:29.440] nearly as important as exercise. If there's a person who's listening who's saying, I don't know step one, then
[01:29.440 -> 01:34.600] I would say, maybe it doesn't matter. How about just pick one? Is my eulogy going to
[01:34.600 -> 01:37.760] be better than my resume?
[01:37.760 -> 01:43.040] So welcome to a conversation with Peter Atia, MD, the founder of Early Medical and someone
[01:43.040 -> 01:46.720] who practices medicine 3.0, which is really looking at life, not through the founder of Early Medical and someone who practices Medicine 3.0, which is really
[01:46.720 -> 01:50.680] looking at life, not through the lens of when you're ill, how do you get better, but how
[01:50.680 -> 01:53.920] do you stop yourself from getting ill in the first place?
[01:53.920 -> 01:58.400] Peter actually left medicine feeling frustrated, but since then he's gone on to host The Drive,
[01:58.400 -> 02:02.040] one of the most popular podcasts covering health and medicine in the world, and he's
[02:02.040 -> 02:09.300] just released his most recent book, Outlivelive the science and art of longevity already a New York Times number one
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[02:13.000 -> 02:17.100] interventions techniques for optimizing exercise and sleep and tools for
[02:17.100 -> 02:21.000] addressing your emotional and your mental health we talk about the fact
[02:21.000 -> 02:24.040] that in the last decade of someone's life they need to still have the
[02:24.040 -> 02:27.440] quality of life to actually make that the best 10 years they've ever
[02:27.440 -> 02:33.520] had. He's on a quest to do that. And he's also on a quest to help you be healthy forever.
[02:34.160 -> 02:38.160] Here he is, Peter Atiyah, MD, on the High Performance Podcast.
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[05:29.520 -> 05:35.040] apply see Mint Mobile for details. Peter thank you very much for joining us. Gentlemen thank you so much for having me. What is high performance? For me
[05:35.040 -> 05:40.280] personally it's shifted so much so it used to be about the here and now it
[05:40.280 -> 05:44.000] used to be about my performance in cycling or boxing or whatever it is that
[05:44.000 -> 05:45.300] I was doing. Today it's a hundred percent focused on what about my performance in cycling or boxing or whatever it is that I was doing today
[05:45.300 -> 05:50.680] It's a hundred percent focused on what does my performance look like in the last decade of my life?
[05:50.680 -> 05:55.360] If I can be sure that that is exceptionally high performance
[05:55.360 -> 06:01.840] I'm confident that everything I'm doing before then will be at the highest level. It can be we want some
[06:02.000 -> 06:05.840] We want this to be the sort of the ultimate conversation really for your
[06:05.840 -> 06:12.320] average listener to a podcast to hear a conversation and feel empowered to do something about
[06:12.320 -> 06:16.080] it. So what would your message be at the very beginning to those people who are already
[06:16.080 -> 06:21.760] thinking are a doctor, an expert in wellness and health and fitness and longevity like
[06:21.760 -> 06:28.760] is this really for me you know surely my time on this earth is fixed. What would you say to the people who are coming to this conversation with that
[06:28.760 -> 06:30.320] kind of mindset at the very start?
[06:30.320 -> 06:34.400] So, I think there's two things, right? I think, one, your time on this earth is actually not
[06:34.400 -> 06:40.400] really that set in stone. I think there is some malleability to it. But I also don't
[06:40.400 -> 06:43.620] believe in science fiction. So, I don't think that, you know, there's some people out there
[06:43.620 -> 06:48.960] that say, oh, we're going to be immortal and you know, science is going to cure everything or at the opposite end
[06:48.960 -> 06:53.480] of the spectrum, none of this stuff matters because your genes are your destiny.
[06:53.480 -> 06:54.920] Neither of those extremes are true.
[06:54.920 -> 07:00.520] We can, we can move the scale quite a bit, but the thing that really isn't remotely fixed
[07:00.520 -> 07:02.040] is the quality of your life.
[07:02.040 -> 07:12.240] That's the part that everyone's born with pretty much a clean slate, no matter what their genes might speak to as far as the length of their life. And if a person really
[07:12.240 -> 07:17.360] focuses on the quality of their life and takes that as the most important metric, as opposed to
[07:17.360 -> 07:24.000] say the length of their life, I just don't see any reason why that shouldn't be the highest focus.
[07:24.000 -> 07:25.600] And why, by the way, when you do that,
[07:25.600 -> 07:29.760] you get bonus time as well. You do actually extend life by focusing on quality.
[07:30.720 -> 07:35.040] What are the kind of questions that we should be asking you to help our listeners understand
[07:35.680 -> 07:37.840] about how they can improve the quality of their life?
[07:38.800 -> 07:42.880] Look, I think you guys know your audience the best. What would you want to know?
[07:44.000 -> 07:47.640] The first thing that I would feel is improving the quality of my life is
[07:47.640 -> 07:51.280] complicated because I feel there's a million bits of information out there.
[07:51.800 -> 07:55.400] I don't know whether I start by eating better, sleeping better, lifting weights,
[07:55.440 -> 07:57.600] doing cardio, spending time with my kids.
[07:58.160 -> 08:01.480] Uh, I, I literally would not know step one.
[08:02.160 -> 08:05.640] You've actually picked up on all the things that do matter and all the things that you
[08:05.640 -> 08:09.280] have some control over. If there's a person who's listening, who's saying, I don't know
[08:09.280 -> 08:15.560] step one, then I would say, maybe it doesn't matter. How about just pick one and get a
[08:15.560 -> 08:20.400] win. We could debate which one you should pick first, but that's a second order question.
[08:20.400 -> 08:24.160] Maybe the one you pick first is the one for which you have the greatest opportunity to
[08:24.160 -> 08:30.000] succeed. Maybe the answer is right now I'm not doing well on any of those things. How about I just
[08:30.000 -> 08:35.600] start figuring out a way to be active 30 minutes a day? That's the one I'm going to put some
[08:35.600 -> 08:41.200] success into. After a couple of months of doing that, I'm definitely going to feel better,
[08:41.200 -> 08:44.720] and that's probably going to empower me to maybe eat a little bit better.
[08:44.800 -> 08:45.600] going to feel better. And that's probably going to empower me to maybe eat a little bit better.
[08:49.840 -> 08:55.440] And maybe along the way, I also realized, oh, I could probably be a bit more present when I'm home. How about when I'm at home, I put my phone away and I just decide for an hour when I get
[08:55.440 -> 09:02.480] home, all I'm going to do is talk to my wife and my kids and not be glued to my phone and check in
[09:02.480 -> 09:07.840] my email and looking at social media or whatever. So again, I just don't think there's like a right way to wrong way to do this,
[09:07.840 -> 09:12.040] but I do think that it can be overwhelming if you try to do everything.
[09:12.040 -> 09:14.440] And I think for most people that doesn't work.
[09:14.440 -> 09:16.760] I used to try to do that with our patients.
[09:16.760 -> 09:17.800] I used to sort of say,
[09:17.800 -> 09:21.560] all right, well, here are all the things that we need to do.
[09:21.560 -> 09:23.720] Let's do all of them in parallel.
[09:23.720 -> 09:26.060] And there's probably
[09:26.060 -> 09:29.900] some people for whom that works, but I think for most people that's really overwhelming
[09:29.900 -> 09:35.800] and it can actually set them back. So I would much rather a person start slow, become successful,
[09:35.800 -> 09:41.580] gain confidence and then start adding to it. So that's a great place to start. I'm interested
[09:41.580 -> 09:45.760] in the why people should even start on that journey
[09:45.760 -> 09:51.200] and you speak around the four horsemen of the apocalypse for in our in terms of
[09:51.200 -> 09:56.000] our lives would you explain what they are so people could understand why
[09:56.000 -> 10:01.560] starting is such an important imperative you know the word longevity gets thrown
[10:01.560 -> 10:05.800] around a lot and it's a bit of a confusing word because
[10:05.800 -> 10:08.180] I think sometimes people hear longevity and they
[10:08.180 -> 10:10.800] just think about how long they live or maybe they
[10:10.800 -> 10:12.360] just think about quality of life, but really it's
[10:12.360 -> 10:13.080] all of those things.
[10:13.080 -> 10:16.460] So longevity really speaks to lifespan, which
[10:16.460 -> 10:18.600] is how long you live and healthspan, which is
[10:18.600 -> 10:19.800] the quality of your life.
[10:20.680 -> 10:23.880] The four horsemen really are the adversaries
[10:23.880 -> 10:26.300] you're going up against in the length of life
[10:26.300 -> 10:28.600] part of the discussion.
[10:28.600 -> 10:34.220] If you want to live longer, by definition, you have to delay death.
[10:34.220 -> 10:39.860] To delay death, it makes sense to understand what drives death.
[10:39.860 -> 10:48.500] In the world today, this is not true 150 years ago, but today we die from chronic diseases. And
[10:48.500 -> 10:54.300] if you exclude smokers, and I am excluding smokers from this because yeah, I realize
[10:54.300 -> 10:57.900] a lot of people smoke, but usually the people who are smoking are not the ones that are
[10:57.900 -> 11:08.040] interested in longevity. So let's just simplify the analysis and say for a non-smoking population, what are the things that are going to kill basically 80% of them?
[11:08.400 -> 11:10.760] It's going to be heart disease, cancer,
[11:11.240 -> 11:15.280] what are called neurodegenerative diseases of which Alzheimer's disease is the
[11:15.280 -> 11:16.120] most common.
[11:16.760 -> 11:21.120] And then all of the metabolic diseases that run the gamut from something called
[11:21.120 -> 11:23.680] insulin resistance all the way to type two diabetes.
[11:24.280 -> 11:27.800] If you understand that those are the horsemen and you want to live longer,
[11:28.100 -> 11:34.100] part of that strategy is what drives each of them and what do I need to do to delay their onset?
[11:34.300 -> 11:39.700] Because that's the magic in having a slightly longer life, not an infinite life,
[11:39.900 -> 11:44.200] but you can live 10 years longer by delaying the onset of those diseases.
[11:44.800 -> 11:49.840] Because we're obsessed with finding out whether we're ill and if we're ill,
[11:50.100 -> 11:53.780] treating the illness. This is a very different way of looking at health, isn't it?
[11:53.780 -> 11:58.540] This is treating those illnesses decades before you even have them.
[11:59.280 -> 12:00.120] Exactly.
[12:00.200 -> 12:09.300] The problem with those diseases is that they differ a lot from a ruptured appendix or pneumonia.
[12:09.800 -> 12:14.400] Those illnesses, you can treat them when they show up.
[12:15.200 -> 12:18.900] This is not an opinion. It's simply just an observation of fact.
[12:19.300 -> 12:24.200] We have made virtually no progress on extending life
[12:24.300 -> 12:25.000] by treating
[12:25.160 -> 12:27.040] chronic diseases in that fashion.
[12:28.080 -> 12:29.200] This is kind of stark.
[12:29.200 -> 12:30.680] And in fact, I think it's so,
[12:30.680 -> 12:34.280] there are very few pictures in my book because, you know,
[12:34.280 -> 12:36.240] there just wasn't enough room to put all my favorite
[12:36.240 -> 12:38.560] pictures in, but this is one of the pictures that's in
[12:38.560 -> 12:43.560] there, which is a figure that shows what human mortality
[12:43.960 -> 12:47.000] has looked like in the developed world since,
[12:47.000 -> 12:57.260] oh, about 1890 or so, 1880 until today, with and without the inclusion of infectious diseases
[12:57.260 -> 13:07.800] and communicable diseases. So if you just look at all diseases, life expectancy has gone from about 40 to about 80 years.
[13:07.800 -> 13:13.080] We've about doubled lifespan by taking care of these acute illnesses.
[13:13.080 -> 13:19.480] If you strip the top eight causes of communicable and infectious diseases out of the analysis,
[13:19.480 -> 13:21.280] it's a flat line.
[13:21.280 -> 13:23.460] We have not extended life very much.
[13:23.460 -> 13:27.160] So that tells you right there that we're we're doing a little bit
[13:27.160 -> 13:29.880] I don't want to suggest that people don't live longer today
[13:30.400 -> 13:36.520] Because we have better treatments for heart disease and cancer and things like that. We do but it's not dramatic
[13:36.520 -> 13:42.820] It's not like decades of difference. You talk about five pillars of health in your book
[13:43.200 -> 13:45.800] Which maybe can make the difference.
[13:45.800 -> 13:48.960] Maybe for someone listening to this podcast, this could be the conversation that makes
[13:48.960 -> 13:53.400] the difference for them or their parents or their children, who knows? Can we go through
[13:53.400 -> 13:54.400] them?
[13:54.400 -> 14:00.560] Yeah. So the five things that I think constitute the activities or the pillars, the vectors,
[14:00.560 -> 14:06.360] you can talk about it my way. So one of them is nutrition. So basically what you eat, when you eat,
[14:06.360 -> 14:08.240] how much you eat, all those things factor
[14:08.240 -> 14:09.800] into your health.
[14:09.800 -> 14:13.240] Exercise and movement, sleep, all the things
[14:13.240 -> 14:16.160] that you do around managing your emotional health.
[14:16.160 -> 14:19.640] And then the final one is all of the molecules,
[14:19.640 -> 14:21.840] pharmaceutical agents, hormones, supplements,
[14:21.840 -> 14:23.840] drugs that you would take.
[14:23.840 -> 14:27.360] I call that exogenous molecules, it's just a fancy way to describe that.
[14:27.360 -> 14:28.960] Exogenous means from outside the body.
[14:28.960 -> 14:30.160] Makes you sound very clever.
[14:30.160 -> 14:34.960] So those are your big five things that you have control over.
[14:34.960 -> 14:37.120] Okay, can we go through them individually?
[14:37.120 -> 14:37.760] Sure.
[14:37.760 -> 14:40.160] Let's start with nutrition.
[14:40.160 -> 14:42.640] What would you share with us about nutrition?
[14:42.640 -> 14:45.300] The data would say that nutrition does matter, but it's not nearly as important as exercise. What do with us about nutrition? The data would say that nutrition does matter,
[14:45.300 -> 14:47.800] but it's not nearly as important as exercise.
[14:47.800 -> 14:49.600] What do we know about nutrition?
[14:49.600 -> 14:52.700] Well, we know that too much of it and too little of it is a problem.
[14:52.700 -> 14:57.100] But we also know that for most of human history,
[14:57.100 -> 14:58.700] the problem was on the too little side.
[14:58.700 -> 14:59.800] Right?
[14:59.800 -> 15:02.700] If you go back 200 years, 300 years, 400 years,
[15:02.700 -> 15:04.600] I mean, for most of human history,
[15:04.600 -> 15:05.760] we didn't have enough food.
[15:06.880 -> 15:12.480] And so how did our species get here? I don't think anybody would dispute the fact that we are sort of
[15:12.480 -> 15:18.320] the apex species of this planet, for better or worse. And what enabled that was really the
[15:18.320 -> 15:23.200] development of our brain. We're not the biggest, we're not the strongest, we're not the fastest,
[15:23.200 -> 15:27.600] so why do we run the planet? We run the planet because we're the smartest, right? We have the most
[15:27.600 -> 15:36.720] advanced brain. And the brain is a very energy demanding organ. It's actually staggering,
[15:36.720 -> 15:47.560] but your brain makes up about 2% of your body weight and it's consuming about 20 to 25% of your total calories. So for us to have the brain we did
[15:47.560 -> 15:50.140] in a nutrient scarce environment,
[15:50.140 -> 15:51.800] which is what the world looked like
[15:51.800 -> 15:55.960] for 99.999% of existence,
[15:55.960 -> 15:57.840] we had to figure out something important.
[15:57.840 -> 16:01.200] And that something important was how to store energy.
[16:01.200 -> 16:06.680] So this is something where humans have become really good. We are very good at storing energy. So this is something where humans have become really good. We are very good
[16:06.680 -> 16:12.840] at storing energy and most of that energy we store as fat. We can't store much carbohydrate
[16:12.840 -> 16:18.620] and outside of our actual muscles, we don't really store protein. So every excess calorie
[16:18.620 -> 16:24.040] we have, we store as fat. And up until very recently, this was not a problem. This was
[16:24.040 -> 16:26.040] a very good thing.
[16:26.040 -> 16:30.480] It's only a problem, like I said, roughly in the last hundred years where energy and
[16:30.480 -> 16:36.160] food have become so abundant that we now have too much. So evolution was solving a problem
[16:36.160 -> 16:40.460] that existed for hundreds of thousands of years. It had no anticipation of the world
[16:40.460 -> 16:45.040] we live in today. And so now most of us are walking around with too much energy,
[16:51.440 -> 16:55.520] restoring too much of it. And that excess amount of energy is indeed problematic. And it is underpinning so much of the disease that we have. All of those diseases we talked about,
[16:55.520 -> 17:01.120] those metabolic diseases, the insulin resistance, the type two diabetes, those are diseases of
[17:01.120 -> 17:05.840] excess energy. And they amplify the risk of every one of the other ones we talked
[17:05.840 -> 17:10.400] about of the other horsemen, right? So that's amplifying your risk of heart disease, cancer,
[17:10.400 -> 17:16.960] Alzheimer's disease, dementia, et cetera. So for many people listening, and frankly,
[17:16.960 -> 17:22.400] for myself included, the bigger issue is excess energy. So it's how do we eat less?
[17:22.400 -> 17:26.080] And it's not just eating less of everything. It's primarily
[17:26.080 -> 17:29.880] eating less in terms of total energy, but not eating less protein. Because the other
[17:29.880 -> 17:34.720] thing we have to manage with nutrition is making sure we get enough protein to support
[17:34.720 -> 17:39.560] our muscles. We'll come to that more in the exercise discussion. But with nutrition, it's
[17:39.560 -> 17:49.060] very challenging because again, we're trying to figure out a way to eat fewer calories without restricting protein. So how do you eat fewer calories?
[17:49.660 -> 17:54.020] If the objective is eating less, you have three strategies to go about doing it.
[17:54.020 -> 17:56.340] The one is directly doing it.
[17:56.780 -> 17:59.100] So I talk about that and I call that caloric restriction.
[17:59.100 -> 18:01.420] You can just say every time I eat,
[18:01.420 -> 18:03.760] I'm going to pay attention to what I'm eating and I'm going to reduce the total
[18:03.760 -> 18:04.600] amount.
[18:04.620 -> 18:09.040] There's something called dietary restriction, where you just say, I'm going to limit certain
[18:09.040 -> 18:10.360] things that I eat.
[18:10.360 -> 18:15.560] So I'm going to stop eating meat, or I'm going to stop eating carbohydrates, or I'm going
[18:15.560 -> 18:17.680] to stop eating this or stop eating that.
[18:17.680 -> 18:23.720] The more restrictive you make that, the more you tend to restrict calories along the way.
[18:23.720 -> 18:26.600] Then the third strategy is time restricted eating.
[18:26.600 -> 18:28.980] And that says, I'm gonna restrict the window
[18:28.980 -> 18:30.120] in which I eat.
[18:30.120 -> 18:32.500] So I'm gonna make it smaller and smaller
[18:32.500 -> 18:34.780] so that I can basically eat less and less.
[18:34.780 -> 18:37.160] Some people call that intermittent fasting.
[18:37.160 -> 18:39.040] And those are basically your three strategies.
[18:39.040 -> 18:41.920] Each one of them has a strength and a weakness.
[18:41.920 -> 18:43.560] I talk about that in the book,
[18:43.560 -> 18:45.800] which one might be right for you and they can be combined.
[18:45.800 -> 18:46.500] Which do you do?
[18:46.900 -> 18:50.400] Mostly dietary restriction for me. I'm
[18:50.500 -> 18:53.300] more conscious of what I'm eating than when
[18:53.300 -> 18:55.600] I'm eating or how much I'm eating, but I've
[18:55.600 -> 18:58.600] done all of them to extremes. So I can speak
[18:58.600 -> 19:01.100] to all of them in extremes. I mean, I've gone
[19:01.100 -> 19:03.500] through phases of my life where I was incredibly
[19:03.500 -> 19:08.680] calorie restricted, basically every month going three days without eating and every three
[19:08.680 -> 19:12.040] months going seven days without eating. I've gone through periods of my life where
[19:12.040 -> 19:16.080] I've only eaten one meal a day. So, you know, I've gone very extreme on all of these
[19:16.080 -> 19:20.440] fronts. And truthfully, if I'm going to give myself a grade on eating, like I don't
[19:20.440 -> 19:24.920] put nutrition as my A, like I'm not scoring A's in nutrition. I'm probably a B student.
[19:22.000 -> 19:23.600] Like I don't put nutrition as my A. Like I'm not scoring A's in nutrition.
[19:23.600 -> 19:25.300] I'm probably a B student.
[19:25.300 -> 19:30.900] I mean, that fits with, we interviewed a Spanish academic called Hector Garcia
[19:30.900 -> 19:32.800] that has lived out in Japan for many years.
[19:32.800 -> 19:38.500] And he's written a book around long life in some of the Japanese communities.
[19:38.500 -> 19:41.400] And the conversation was around the concept of ikigai.
[19:41.400 -> 19:44.500] And one of the things that they talk about there is that
[19:44.500 -> 19:46.040] they have an 80% rule
[19:46.040 -> 19:48.560] that when you're 80% full, stop eating.
[19:48.560 -> 19:51.840] Yes, I think that's a fantastic rule by the way.
[19:51.840 -> 19:56.840] And I'm constantly amazed at how much better I feel
[19:57.400 -> 20:01.760] if just before I'm full, I stop eating and wait a minute.
[20:01.760 -> 20:04.040] And sometimes, and I don't know what this comes from.
[20:04.040 -> 20:06.360] I think it kind of comes back to my medical
[20:06.360 -> 20:08.400] training when you never knew when you'd get
[20:08.400 -> 20:11.320] to eat, uh, or if like a trauma was going to
[20:11.320 -> 20:12.640] come in and you weren't going to get to eat.
[20:12.880 -> 20:14.920] I developed this awful habit of eating
[20:14.920 -> 20:18.600] incredibly fast. And sometimes you're
[20:18.600 -> 20:21.080] eating at a rate that exceeds your ability
[20:21.080 -> 20:23.440] to sense appetite. If you can be kind of
[20:23.440 -> 20:25.280] mindful when you're eating and pay attention to your appetite,. If you can be kind of mindful when you're eating
[20:25.280 -> 20:28.520] and pay attention to your appetite,
[20:28.520 -> 20:30.840] I think you can end up in this great place.
[20:30.840 -> 20:34.000] And I think that's absolutely brilliant advice.
[20:34.000 -> 20:36.200] So can you also offer us some advice
[20:36.200 -> 20:38.720] that you do touch on in the book
[20:38.720 -> 20:41.720] for anyone listening to this that is maybe thinking
[20:41.720 -> 20:44.840] one of the first pillars I'm gonna address is nutrition.
[20:44.840 -> 20:48.640] When they walk into a supermarket, because one of the first pillars that are going to address is nutrition when they walk into a supermarket because one of the things
[20:48.640 -> 20:52.620] you acknowledge is the fact that our brains have created a system where we
[20:52.620 -> 20:58.280] can store food, we can we can make it tasty and we can make it in surplus all
[20:58.280 -> 21:02.260] over. So when we walk into a supermarket where do you advise that we should be
[21:02.260 -> 21:05.500] shopping from? Yeah there's two pieces of advice I have here.
[21:05.500 -> 21:09.300] So the first is actually don't grocery shop hungry,
[21:09.300 -> 21:13.100] because I think most people who have done this will recognize
[21:13.100 -> 21:16.400] that you will make worse choices when you're hungry than when
[21:16.400 -> 21:16.800] you're not.
[21:16.800 -> 21:20.100] You know how the brain has three parts, right?
[21:20.100 -> 21:23.200] You have kind of the brainstem and then the midbrain and then
[21:23.200 -> 21:25.520] the upper part, which is the most advanced part of the brain. Okay, the lowest part, the brainstem is kind of the brainstem and then the midbrain and then the upper part which is the most advanced part of the brain
[21:25.880 -> 21:31.320] Okay, the lowest part the brainstem is kind of responsible for like, you know eating and you know
[21:31.520 -> 21:33.840] Like digestion and all of those things, right?
[21:33.840 -> 21:40.460] So you want the most advanced part of your brain doing the grocery shopping not the least advanced part of the brain
[21:40.460 -> 21:42.640] So take that part kind of offline a little bit
[21:43.440 -> 21:45.360] the second piece of advice is,
[21:45.920 -> 21:52.800] if you can just walk the outside perimeter of the grocery store and only buy what's there
[21:53.360 -> 21:58.800] and not go up and down the aisles, you're going to do a lot better. Because what you're probably
[21:58.800 -> 22:05.000] going to end up eating is vegetables, fruit, meat, eggs, dairy, cheese.
[22:06.440 -> 22:10.640] Like you're going to not get into processed foods very much.
[22:10.640 -> 22:12.440] Whereas if you get up and down the aisles,
[22:12.440 -> 22:14.320] you're going to end up in a lot more processed food.
[22:14.320 -> 22:18.560] Now, look, not all processed food is necessarily harmful.
[22:18.560 -> 22:20.580] It's much more nuanced than that,
[22:20.580 -> 22:24.520] but it becomes a very convenient, you know, heuristic
[22:24.520 -> 22:27.940] to just simplify your life a little bit if you're trying to think like
[22:27.940 -> 22:34.740] Am I better off having yogurt or chocolate pudding? You're probably better off having yogurt, right? That's a great tip
[22:34.740 -> 22:40.540] Thank you. The problem I guess with nutrition is that you know calories for example, don't tell us the whole story. So
[22:41.220 -> 22:45.680] Drinking diet coke doesn't give you any calories, but it also doesn't do a great deal for you
[22:45.840 -> 22:50.120] My biggest issue and my wife is exactly the same is trying to be really well behaved all day
[22:50.560 -> 22:56.100] Being I think probably calorie deficient come the end of the day having some raging hunger about 9 p.m
[22:56.100 -> 23:00.860] And I'm attracted to the crisps kind of getting over these kinds of hurdles these are
[23:01.360 -> 23:04.280] They are they at home. Are you at home when you have these ratings?
[23:04.280 -> 23:04.680] Yeah
[23:04.680 -> 23:06.920] so this is another thing that I go back to is,
[23:06.920 -> 23:09.000] and I'm not saying this from a place of judgment
[23:09.000 -> 23:11.320] because we have the same issue at our house,
[23:11.320 -> 23:13.520] but I mean, I have three young kids.
[23:13.520 -> 23:17.280] And so our pantry today looks much worse
[23:17.280 -> 23:21.040] than it did 15 years ago before we had kids.
[23:21.040 -> 23:22.520] And that's one of the challenges.
[23:22.520 -> 23:25.400] But one of the struggles that my wife and I have is,
[23:25.680 -> 23:28.800] how can we have the fewest bad food choices?
[23:28.800 -> 23:31.880] Because I think there's this important concept of,
[23:32.200 -> 23:36.600] how can you spend as little time relying on willpower as possible
[23:37.120 -> 23:41.400] and spend more time letting the default environment set the stage?
[23:42.160 -> 23:44.960] So if you're hungry at 9 p.m.
[23:48.960 -> 23:49.480] and there is no biscuit and there are no crisps and
[23:53.520 -> 23:54.120] There's like fruit and carrots and stuff like that
[24:00.700 -> 24:01.400] You'll nibble on them a little bit. You're not gonna overindulge in that stuff. You simply couldn't the reality of it is like
[24:04.240 -> 24:06.160] If I have ice cream sitting in front of me, I'm going to eat it too. I think more about
[24:06.160 -> 24:12.160] how can I put the right food choices in the environment so that I'm better off. So for
[24:12.160 -> 24:18.400] example, like today I'm carrying around like my venison jerky sticks and my nuts and that way it's
[24:18.400 -> 24:22.880] like I don't have to eat something else. But what if like someone brings out a beautiful chocolate
[24:22.880 -> 24:25.400] brownie when we finish this chat and it's on the table out there
[24:25.400 -> 24:28.040] Well, it's a lot easier for me not to eat it because I'm not starving
[24:28.040 -> 24:32.680] I think people sometimes want really simple solutions, but you have to understand
[24:33.240 -> 24:36.920] There are two very powerful forces working against you
[24:37.920 -> 24:38.960] evolution
[24:38.960 -> 24:46.000] Right. We have a billion years of evolution that is trying to make us survive by eating all the time,
[24:46.000 -> 24:50.000] because that is in our best interest up until about 100 years ago.
[24:50.000 -> 24:56.000] And then on top of that, you have the commercial interests of what I call it in the United States.
[24:56.000 -> 25:00.000] I call it the standard American diet, but the truth of it is it's the standard developed diet,
[25:00.000 -> 25:08.360] which is very tasty, very energy dense, not nutritious, highly caloric, easily transportable.
[25:08.360 -> 25:10.440] I mean, it has all these things working against us.
[25:10.980 -> 25:16.360] If you have two very big foes standing in front of
[25:16.360 -> 25:18.880] you, you should expect to do a little bit of work
[25:18.880 -> 25:19.520] to get out of the way.
[25:19.760 -> 25:20.040] Yeah.
[25:20.320 -> 25:22.760] And I think that's just the price we pay to live
[25:22.800 -> 25:24.560] in a modern world that comes with many other
[25:24.560 -> 25:25.360] benefits. Can I ask you a question, Peter, around, like you say, you've got three young children yourself And I think that's just the price we pay to live in a modern world that comes with many other benefits
[25:29.680 -> 25:32.760] Can I ask you a question Peter around like you say you've got three young children yourself and I'm a father of two as as is Jake and
[25:33.240 -> 25:36.960] I sometimes despair when I see for the next generation how
[25:37.280 -> 25:44.680] Easy and accessible and cheap some of these foods are that are not doing the next generation any favors
[25:43.080 -> 25:45.600] some of these foods are that are not doing the next generation any favors.
[25:45.600 -> 25:49.400] To get a 14 or 15 year old kid to almost think
[25:49.400 -> 25:52.560] towards the end of their life is just too inconceivable.
[25:52.560 -> 25:53.840] It's too abstract.
[25:53.840 -> 25:58.420] So what kind of questions, what kind of approaches
[25:58.420 -> 26:00.600] would you suggest that we could use
[26:00.600 -> 26:03.640] to get them to start to make better decisions
[26:03.640 -> 26:05.560] without trying to frighten them more.
[26:05.560 -> 26:07.280] I think it's focusing on performance.
[26:07.280 -> 26:10.760] Like I know when our daughter was born, she's our oldest,
[26:10.760 -> 26:14.360] I was much more fixated on my food back then.
[26:14.360 -> 26:17.680] And I think that even today,
[26:17.680 -> 26:19.840] we pay attention very much to what we eat
[26:19.840 -> 26:21.080] and what our kids eat.
[26:21.080 -> 26:23.800] We pay very much attention to how much exercise
[26:23.800 -> 26:25.120] we're getting and by extension,
[26:25.120 -> 26:30.520] we want them to do the same. Until I wrote this book, I honestly don't think my kids
[26:30.520 -> 26:35.440] had a lick of a clue like what I did. They knew dad was a doctor, but basically what
[26:35.440 -> 26:43.520] we get them to focus on is performance. So if you eat protein, you will be stronger.
[26:43.520 -> 26:45.200] And our kids all play sports.
[26:45.200 -> 26:48.500] So they get that like, oh, the way I eat impacts
[26:48.500 -> 26:50.000] the way I perform.
[26:50.000 -> 26:51.700] Okay, that makes more sense.
[26:51.700 -> 26:55.100] You will have more energy if you eat this food
[26:55.100 -> 26:56.800] versus that food.
[26:56.800 -> 26:59.200] And I don't think we should shy away from that.
[26:59.200 -> 27:01.600] I don't, I, you know, people say, well, oh, you know,
[27:01.600 -> 27:02.800] is that sort of judgmental?
[27:02.800 -> 27:05.920] And I'd say, yeah, it is judgmental. And it's okay to be judgmental.
[27:05.920 -> 27:09.600] It's okay to say that this food is better than that food.
[27:09.600 -> 27:13.680] And it's okay to say that performing well is something we should aspire to.
[27:13.680 -> 27:14.480] But I think you're right.
[27:14.480 -> 27:19.760] I mean, I don't think my kids would even understand what diabetes is or what cancer is
[27:19.760 -> 27:21.680] or what it means to live longer.
[27:21.680 -> 27:24.080] I think that's so abstract and not particularly meaningful.
[27:24.080 -> 27:24.480] Yeah.
[27:24.480 -> 27:27.760] Oh, and what are these modern diets doing to our bodies,
[27:27.760 -> 27:29.960] this hidden cost, I guess?
[27:29.960 -> 27:32.200] I think, unfortunately, nutrition science
[27:32.200 -> 27:35.520] is still a very difficult science
[27:35.520 -> 27:38.840] to draw enormous insights from.
[27:38.840 -> 27:40.800] I wish I could sit here and tell you,
[27:40.800 -> 27:42.480] down to the molecular level,
[27:42.480 -> 27:46.220] this particular problem with a soda versus a diet
[27:46.220 -> 27:50.620] soda versus, you know, this drink versus that drink and this food versus that food.
[27:50.620 -> 27:56.260] At the highest level, what we know unquestionably that is the biggest problem of the modern
[27:56.260 -> 28:00.060] food environment is it drives us to overeat.
[28:00.060 -> 28:02.880] And that is the fundamental problem.
[28:02.880 -> 28:06.220] Everybody has the ability to store fat. If you didn't have that ability,
[28:06.220 -> 28:09.060] that's a very bad disease called lipodystrophies,
[28:09.060 -> 28:11.740] and it's a healthy thing to be able to do,
[28:11.740 -> 28:14.580] provided you store it in the right place.
[28:14.580 -> 28:16.660] So the right place to store fat
[28:16.660 -> 28:19.480] is in the subcutaneous layer of tissue.
[28:19.480 -> 28:22.760] So right under your skin, you have these fat cells,
[28:22.760 -> 28:27.520] and that's where we like to be able to store fat. So think of your
[28:27.520 -> 28:34.880] capacity to store fat as a bathtub. A bathtub has water that comes into it and water that goes out
[28:34.880 -> 28:40.000] of it. So the water that's going into it is what you're eating. The water that's coming out the
[28:40.000 -> 28:47.160] drain is the energy you expend. Some of that through exercise, some of that through movement, just daily living.
[28:47.160 -> 28:49.480] Most of that, frankly, just by being alive.
[28:49.480 -> 28:51.040] If you laid in bed all day,
[28:51.040 -> 28:52.680] you would still be draining the bathtub
[28:52.680 -> 28:55.400] because it requires so much energy just to live.
[28:55.400 -> 28:57.000] If you are in balance,
[28:57.000 -> 28:58.520] the amount of water going in
[28:58.520 -> 29:02.020] is about the same as the water going out, no problem.
[29:02.020 -> 29:04.400] You can have a higher level or a lower level,
[29:04.400 -> 29:06.480] i.e. be more fat, less fat.
[29:06.480 -> 29:13.980] If it's in balance, it's pretty reasonable. What happens is when that bathtub starts getting
[29:13.980 -> 29:20.720] so much water in relative to what's going out that the water starts spilling over the
[29:20.720 -> 29:28.820] tub and now you can picture the damage that water could do in that bathroom, in that house. That's what happens when the fat cell is no longer in balance.
[29:28.840 -> 29:30.920] When the fat cell is no longer in balance,
[29:31.480 -> 29:36.440] fat starts leaking out of that subcutaneous fat where we're meant to store it.
[29:36.960 -> 29:40.960] And it starts going in places where we're not meant to store it. The liver,
[29:41.880 -> 29:45.000] the pancreas into into the muscles themselves,
[29:45.960 -> 29:47.760] around the heart.
[29:47.760 -> 29:50.880] When fat accumulates in those areas,
[29:50.880 -> 29:54.200] that is the hallmark of disease.
[29:54.200 -> 29:57.140] That's the underpinning of everything going wrong.
[29:57.140 -> 29:59.920] That type of fat called visceral fat,
[29:59.920 -> 30:03.560] or fatty liver, intrapancreatic fat,
[30:03.560 -> 30:06.680] that's what's leading to the inflammation
[30:06.680 -> 30:09.000] and resistance of insulin in the muscles
[30:09.000 -> 30:12.040] and all of these things that predispose the disease.
[30:12.040 -> 30:15.800] So the real problem with eating potato chips
[30:15.800 -> 30:18.840] or whatever other snacks that all of us love to eat
[30:18.840 -> 30:21.780] is we end up eating a lot of them.
[30:21.780 -> 30:23.580] And this is, by the way, kind of controversial.
[30:23.580 -> 30:25.500] It's not entirely clear why.
[30:25.500 -> 30:26.940] There are many different theories.
[30:26.940 -> 30:30.900] So one theory is we just eat more of it because it tastes good.
[30:30.900 -> 30:31.900] Okay.
[30:31.900 -> 30:33.740] That probably explains some of it.
[30:33.740 -> 30:40.900] Another theory is we just eat more of it because it's so low in nutrient density and our bodies
[30:40.900 -> 30:44.940] are wired to get a certain amount of nutrients.
[30:44.940 -> 30:49.540] And if the density of nutrient is so low, you have to eat many, many more calories to
[30:49.540 -> 30:51.500] get the same amount of nutrient.
[30:51.500 -> 30:54.120] That's possible, but that explains part of it.
[30:54.120 -> 30:58.480] Another theory is that we are hardwired to get a certain amount of protein.
[30:58.480 -> 31:00.780] Again, evolutionarily, we needed protein.
[31:00.780 -> 31:02.780] It was a very important nutrient.
[31:02.780 -> 31:07.920] And again, today's food environment has a lot of diluted protein sources in it.
[31:07.920 -> 31:10.760] A lot of the foods that are most palatable to us
[31:10.760 -> 31:14.240] are carbohydrates and fats, less on the protein side.
[31:14.240 -> 31:16.640] So again, we might be overeating
[31:16.640 -> 31:19.800] to indulge more of a need for protein.
[31:19.800 -> 31:21.720] And then of course you have other factors
[31:21.720 -> 31:31.180] like the less active you are, the more sedentary you are, the less your brain is able to sense the satiety factors, the factors that come
[31:31.180 -> 31:35.440] from your gut to tell your brain you have eaten enough.
[31:35.440 -> 31:37.660] Those are actual chemical signals.
[31:37.660 -> 31:42.520] And the less active a person is, the more those signals are blunted.
[31:42.520 -> 31:45.000] So there's just so many different things
[31:45.000 -> 31:47.760] that are going on that are getting hijacked
[31:47.960 -> 31:50.280] by eating quote unquote the wrong foods.
[31:50.320 -> 31:51.480] And can we unpick this?
[31:52.160 -> 31:55.200] So at 44, if I've overeaten for 30 years of
[31:55.200 -> 31:58.200] my life, can I stop and reverse that damage?
[31:58.520 -> 31:59.040] Absolutely.
[31:59.200 -> 31:59.440] Yeah.
[31:59.680 -> 31:59.920] Yeah.
[32:00.000 -> 32:01.400] That's the most important message perhaps.
[32:01.800 -> 32:02.080] Yeah.
[32:02.120 -> 32:04.920] I mean, this is, it's never really too late
[32:05.160 -> 32:07.240] to kind of do something about this.
[32:07.240 -> 32:09.560] And there are lots of stories that you'll see.
[32:09.560 -> 32:11.760] I'm sure anybody listening to us has, you know,
[32:11.760 -> 32:14.000] seen these remarkable stories of people
[32:14.000 -> 32:14.820] who have just, you know,
[32:14.820 -> 32:15.980] completely changed their lives, right?
[32:15.980 -> 32:18.480] They've, you know, been sedentary their whole life.
[32:18.480 -> 32:20.360] They've been, you know, eating everything.
[32:20.360 -> 32:22.300] And all of a sudden they just one day wake up
[32:22.300 -> 32:23.200] and decide I've had enough.
[32:23.200 -> 32:24.400] Or they have a heart attack
[32:24.400 -> 32:25.000] or something
[32:25.200 -> 32:28.040] Catastrophic changes in their health and they realize that's you know, that's enough
[32:28.160 -> 32:34.200] So I'm interested in some people that might think they're living a healthy life. I'll go. I'm not carrying a lot of extra weight
[32:34.840 -> 32:36.400] What's the hidden?
[32:36.400 -> 32:42.680] Cost then and how do we discover whether what we're doing is taking its toll internally? Yeah
[32:42.680 -> 32:48.580] no, it's a very good point you raise because the assumption is that your body weight
[32:48.600 -> 32:51.760] is the best indicator of your health.
[32:51.780 -> 32:57.400] The truth is, it's a very crude indicator of your health.
[32:57.420 -> 33:01.000] Now, the reason body weight is sort of the main metric
[33:01.020 -> 33:03.000] that's used at the population level
[33:03.020 -> 33:05.960] is it's kind of the best we can do.
[33:05.960 -> 33:09.440] I mean, it's better than your age or your sex
[33:09.440 -> 33:13.160] or your hair color, but like don't confuse it
[33:13.160 -> 33:14.000] for what good is.
[33:14.000 -> 33:17.100] It's just the least bad thing that we can measure.
[33:17.100 -> 33:20.120] In the United States, where we have a significant
[33:20.120 -> 33:24.400] obesity epidemic, I don't know how significant
[33:24.400 -> 33:26.240] it is here, truthfully, I would guess it's
[33:26.240 -> 33:27.680] not as bad as the U.S.
[33:27.680 -> 33:28.640] That's still bad.
[33:28.640 -> 33:30.720] Yeah, I'm sure it's getting bad everywhere.
[33:31.360 -> 33:34.640] But, you know, it's possible we would have
[33:34.640 -> 33:36.720] of the developed nations, the highest rates
[33:36.720 -> 33:44.080] of obesity. Um, about 20% or so of obese people
[33:44.080 -> 33:46.320] are actually very healthy.
[33:46.320 -> 33:51.520] What I mean by that is if you do the really deep analysis and look at all of those other
[33:51.520 -> 33:53.640] things, do they have liver fat?
[33:53.640 -> 33:55.240] Are they insulin resistant?
[33:55.240 -> 33:56.240] Are their triglycerides elevated?
[33:56.240 -> 33:57.800] You go and do all that other stuff.
[33:57.800 -> 34:08.000] No, actually 20% roughly of people who are obese are quite healthy. And interestingly, of the people who are not obese,
[34:08.000 -> 34:12.640] yeah, about 20, 25% of those people are very unhealthy
[34:12.640 -> 34:14.920] if you do the deep dive and look at them.
[34:14.920 -> 34:16.980] And so for that reason,
[34:16.980 -> 34:18.360] we don't really spend a lot of time
[34:18.360 -> 34:20.440] looking at a person's body weight or BMI.
[34:20.440 -> 34:21.640] In fact, I don't think I could tell you
[34:21.640 -> 34:23.600] how much one of my patients weighs.
[34:23.600 -> 34:28.580] It's simply not a metric I care about. Because're just going to immediately go and look at these other things
[34:28.580 -> 34:33.440] We're going to look at how much muscle mass. Do you have how much fat do you have in your liver?
[34:33.480 -> 34:35.800] How much fat do you have around your organs?
[34:36.480 -> 34:42.160] What are your insulin levels look like? What's your blood glucose look like? What how high are your triglycerides?
[34:42.160 -> 34:46.640] We're gonna look at all these other things blood, that are much more indicative of your health.
[34:46.640 -> 34:51.920] So let's move on then to something which is absolutely linked to this and really important,
[34:51.920 -> 34:58.880] the next pillar of health, which is exercise. Can we talk about your concept of being an athlete
[34:58.880 -> 35:04.400] for life? I've always been sort of heavily focused on some sort of physical goal for
[35:04.400 -> 35:06.000] all of my life, at least going back to
[35:06.000 -> 35:12.960] when I was about 13. As such, you're always training with some specificity. If you're a
[35:12.960 -> 35:18.320] footballer, you have a very specific way that you train, and it wouldn't just be go out on the pitch.
[35:18.960 -> 35:21.600] You would still probably want to be doing some running. You would still want to be doing some
[35:21.600 -> 35:24.080] strength training. You would still want to be doing some agility work. You would still want
[35:24.080 -> 35:25.120] to be doing this type of conditioning, that want to be doing some strength training, you would still want to be doing some agility work, you would still want to be doing this type of conditioning,
[35:25.120 -> 35:31.200] that type of conditioning. So the training of the best of the best is very specific.
[35:32.000 -> 35:38.480] When I was in my early 40s and I kind of hung it up, the last sport that I did sort of
[35:38.480 -> 35:46.800] competitively was riding a bicycle. When I decided I don't want to do this competitively anymore, it's taking up a lot
[35:46.800 -> 35:53.360] of time. My second child had been born and I was traveling so much more for work. So then this
[35:53.360 -> 35:57.200] turned into this idea of the centenarian decathlon, which is I'm going to create the
[35:57.200 -> 36:02.240] objectives. I'm going to define what the activities are in the last decade of my life.
[36:02.800 -> 36:06.840] And I had to put a lot of thought into this, Like, what do I really want to be able to do?
[36:07.700 -> 36:09.540] In other words, what are the non-negotiables?
[36:09.660 -> 36:12.240] What are the things that if I can't do these
[36:12.240 -> 36:15.360] in the last decade of my life, I will be very
[36:15.360 -> 36:18.500] disappointed. I will feel less alive.
[36:18.560 -> 36:19.740] What are those things?
[36:20.180 -> 36:21.960] And those would be different for the three
[36:21.960 -> 36:22.600] of us, right?
[36:22.600 -> 36:24.200] That the whole goal is to do this in a
[36:24.200 -> 36:25.100] personalized way.
[36:25.100 -> 36:25.600] Yeah.
[36:25.800 -> 36:27.900] But this is what I loved about it in the book,
[36:27.900 -> 36:30.800] because I think you, like, you include 10 of,
[36:30.800 -> 36:34.200] and you said it extends to 50, the list.
[36:34.200 -> 36:38.000] But what kind of questions, or how would you help our listeners
[36:38.300 -> 36:41.600] to be able to come up with their own definitive list
[36:41.600 -> 36:45.400] of what they'd like to be doing when they get into that final decade.
[36:45.400 -> 36:51.800] I think there's two ways to go about doing this. One way is to project forward and one way is to
[36:51.800 -> 36:59.920] project back. Okay, so let's talk about both. So projecting back is if you are fortunate enough
[36:59.920 -> 37:07.000] to know somebody in the last decade of their life, or you've watched somebody who you were very close to
[37:07.000 -> 37:09.600] and you saw them during that period of time and they've died.
[37:10.300 -> 37:14.900] Can you put yourself in their shoes and ask these questions, right?
[37:15.100 -> 37:18.000] What am I no longer doing that I used to do?
[37:18.200 -> 37:22.000] What am I no longer doing that I wish I could be doing?
[37:22.200 -> 37:25.480] So you sort of work your way from the back to
[37:25.480 -> 37:29.520] the present. And I think this requires being
[37:29.520 -> 37:32.240] quite circumspect and it requires, I think,
[37:32.540 -> 37:36.000] being thoughtful because there are many things
[37:36.000 -> 37:37.760] that people in the last decade of their life
[37:37.760 -> 37:42.080] can't do that all of us just take for granted.
[37:42.080 -> 37:44.300] I mean, how much do you take it for granted
[37:44.300 -> 37:45.540] to be able to put your shoes on?
[37:46.020 -> 37:48.580] Like, how easy is it for you to tie up laces
[37:48.580 -> 37:49.300] on your shoes?
[37:49.840 -> 37:51.300] Do you know how many people can't do this?
[37:52.700 -> 37:55.300] How easy is it for you to sit on the floor,
[37:56.020 -> 37:57.900] play with your kids, just sit with them for
[37:57.900 -> 37:59.380] 10 minutes and then stand up.
[37:59.860 -> 38:02.460] You start to do an inventory of these things
[38:02.460 -> 38:05.480] and you realize, oh my God, there are a lot of things most people aren't able to do an inventory of these things and you realize, oh my God, there are a lot
[38:05.480 -> 38:07.900] of things most people aren't able to do in
[38:07.900 -> 38:10.480] their eighties that if I couldn't, if I took
[38:10.480 -> 38:12.780] them away from you today, how miserable would
[38:12.780 -> 38:15.600] you be? And then you want to do the, okay,
[38:15.600 -> 38:18.240] now fast forward or come to the present and
[38:18.240 -> 38:20.680] ask, what are things that give you great
[38:20.680 -> 38:23.480] pleasure today? And how many of those things
[38:23.480 -> 38:29.060] do you want to be able to do in the future? And so for me, I love archery. I mean,
[38:29.120 -> 38:31.420] I, I, every day that I'm not traveling, I'm in
[38:31.420 -> 38:34.900] my backyard shooting a bow and arrow, and I
[38:34.900 -> 38:36.660] don't think I'll be able to shoot a bow the way
[38:36.660 -> 38:39.680] I do now, because today I shoot a bow that's 75
[38:39.680 -> 38:42.780] pounds when you pull back on the compound, but I
[38:42.780 -> 38:44.940] think I could be able to shoot a 40 or 50 pound
[38:44.940 -> 38:45.160] bow in the final decade of my life. That's a much lighter, by the way, it's very nonlinear when you pull back on the compound. But I think I could be able to shoot a 40 or 50 pound bow
[38:45.160 -> 38:47.200] in the final decade of my life.
[38:47.200 -> 38:48.640] That's much lighter, by the way.
[38:48.640 -> 38:49.720] It's a very nonlinear scale.
[38:49.720 -> 38:52.720] So 40 to 50 pounds is much lighter than 75 pounds.
[38:52.720 -> 38:55.400] I love driving race cars.
[38:55.400 -> 39:00.440] And I don't have any reason to believe I'll be as fast
[39:00.440 -> 39:02.960] in the last decade of my life as I am today.
[39:02.960 -> 39:08.880] But if you look at Paul Newman, I mean, he was barely,
[39:09.340 -> 39:13.200] he was almost driving his fastest at the end of his life.
[39:13.200 -> 39:15.180] It is possible.
[39:15.180 -> 39:18.340] So for me, I'd say, look, I'd like to be within 5%
[39:18.340 -> 39:20.740] of my driving times today.
[39:20.740 -> 39:21.980] And by the way, even today,
[39:21.980 -> 39:23.880] I can tell how physically demanding it is.
[39:23.880 -> 39:25.200] I get out of a car. I'm exhausted
[39:25.200 -> 39:31.420] So I know how much work it's going to take to maintain that level of fitness like you
[39:31.420 -> 39:35.400] I love being able to play with my kids and I know I've done the math
[39:35.400 -> 39:37.760] I know that in my last decade of my life
[39:38.120 -> 39:43.680] My grandkids will be of the age where I will want to do that stuff with them
[39:44.080 -> 39:47.180] So this to me provides the motivation.
[39:47.220 -> 39:49.440] This to me provides the objective.
[39:50.000 -> 39:54.080] The question is now what are the strategy and what are the tactics to make that
[39:54.080 -> 39:54.920] happen?
[39:55.240 -> 39:57.000] Thank you. Thanks for sharing that. That's powerful.
[39:57.000 -> 39:59.520] So what are yours then? What are the things that you're doing?
[39:59.880 -> 40:00.680] Would you mind sharing?
[40:00.680 -> 40:03.440] Yeah. So the strategy is basically,
[40:03.440 -> 40:05.400] it has to be comprehensive, it has to be comprehensive
[40:05.400 -> 40:08.680] and it has to be built around these four pillars
[40:08.680 -> 40:11.200] of strength, stability, aerobic efficiency
[40:11.200 -> 40:15.200] and anaerobic peak or aerobic peak basically
[40:15.200 -> 40:17.680] slash anaerobic power.
[40:17.680 -> 40:21.520] The reason for it is those are basically
[40:21.520 -> 40:30.200] the defining features of what allows us to move and what allows us to do so pain free and what allows us to do so at a high level of performance.
[40:30.240 -> 40:36.240] So I'm guessing most people kind of understand vaguely what I mean by strength and cardio respiratory fitness.
[40:36.240 -> 40:39.160] Stability is a bit of a foreign concept to people.
[40:39.320 -> 40:42.120] I think I devote an entire chapter to stability in the book.
[40:42.120 -> 40:46.000] I don't remember what chapter is, might be 13, but there is an entire chapter.
[40:46.000 -> 40:48.000] By the way, the book is 17 chapters.
[40:48.000 -> 40:50.000] Exercise gets more
[40:50.000 -> 40:52.000] coverage than anything. I think
[40:52.000 -> 40:54.000] exercise is 3 of the 17 chapters,
[40:54.000 -> 40:56.000] which speaks to my
[40:56.000 -> 40:58.000] belief that it is the most important
[40:58.000 -> 41:00.000] of the tools, and it
[41:00.000 -> 41:02.000] has the most potential to
[41:02.000 -> 41:04.000] both extend life and
[41:04.000 -> 41:05.520] improve quality of life.
[41:05.600 -> 41:08.320] Well, there's a stat you give as well, Peter, that I think is worth sharing.
[41:08.320 -> 41:16.000] If you said exercise has been proven more than any pharmaceutical drug to
[41:16.000 -> 41:18.320] improve the quality of your life and reduce illness.
[41:19.040 -> 41:20.160] It's not even close.
[41:20.240 -> 41:24.640] I mean, just to give you a sense of it, if you took a person who's completely
[41:24.640 -> 41:25.140] sedentary, this is a person who's completely sedentary,
[41:25.160 -> 41:27.940] this is a person who doesn't lift a finger all day,
[41:28.380 -> 41:32.840] and you can get them to just do light intensity,
[41:32.860 -> 41:38.320] very modest amounts of activity for 90 minutes a week,
[41:38.700 -> 41:41.900] you reduce their risk of all-cause mortality,
[41:41.920 -> 41:44.940] death from any cause, by almost 15%.
[41:45.000 -> 41:45.840] That's the tip of the iceberg. risk of all cause mortality, death from any cause by almost 15%.
[41:47.240 -> 41:51.260] That's the tip of the iceberg. I mean, if you actually get people to really boost their fitness,
[41:51.600 -> 41:55.740] it's a about a 50% reduction in all cause mortality.
[41:56.040 -> 42:01.040] There is no intervention we have pharmacologic or otherwise that has as much of
[42:03.440 -> 42:07.800] an impact on the length of your life as having high muscle mass,
[42:07.800 -> 42:10.600] high strength, high cardio respiratory fitness.
[42:10.600 -> 42:12.000] And that's just for your age and sex.
[42:12.000 -> 42:13.200] So people might hear that and say,
[42:13.200 -> 42:14.400] Oh, what do I have to be a bodybuilder?
[42:14.400 -> 42:16.300] No, no, no, no, it doesn't mean that at all.
[42:16.300 -> 42:19.100] And there are, you know, very clear, and I, in the book, I lay these out,
[42:19.100 -> 42:23.200] very clear criteria by age and by sex for what those metrics look like.
[42:23.200 -> 42:27.000] But one of the things I've considered to be a superpower of yours is
[42:27.000 -> 42:30.000] your innate curiosity. You started out being a boxer,
[42:30.000 -> 42:34.000] you do archery, you do motor racing.
[42:34.000 -> 42:38.000] Now, what would you advise for anyone that may be thinking about this,
[42:38.000 -> 42:42.000] that maybe is looking at doing aerobic fitness,
[42:42.000 -> 42:45.100] but wants to explore the right thing for them.
[42:45.100 -> 42:48.100] Because I think the curiosity of trying different things
[42:48.300 -> 42:49.900] is something that might be helpful.
[42:50.000 -> 42:52.200] So, I mean, I think it's important to find something
[42:52.200 -> 42:53.800] that you will enjoy doing.
[42:53.800 -> 42:56.900] So, I do most of my cardio training
[42:57.200 -> 42:59.200] these days on a bike.
[42:59.400 -> 43:01.400] And for me, that's just something that I enjoy.
[43:01.400 -> 43:03.700] But if a person enjoys walking,
[43:04.000 -> 43:07.200] or running, or swimming, that's great. So, step one is just something that I enjoy. But if a person enjoys walking or running or swimming, that's great.
[43:07.200 -> 43:09.820] So step one is find something that you enjoy.
[43:10.440 -> 43:13.360] The second thing is you have to know where you're starting from.
[43:13.360 -> 43:16.780] So I assume from your question, we're going to assume we're starting with a
[43:16.780 -> 43:18.960] person who isn't doing anything right now.
[43:19.500 -> 43:22.380] So then you have to also keep in mind principle number one of
[43:22.380 -> 43:23.640] exercise is don't get hurt.
[43:24.160 -> 43:29.600] So the mistake that a lot of people make is they kind of go out and go too hard. So for a person who
[43:30.400 -> 43:37.200] hasn't exercised at all, simply walking quickly would constitute a great form of exercise.
[43:38.080 -> 43:42.560] And the way you can tell if you're exercising hard enough from a cardio perspective at this
[43:42.560 -> 43:45.920] first level, which is called zone two is, um,
[43:46.560 -> 43:51.680] if it's difficult to speak while you're doing it, but you still can, that's the, that's the
[43:51.680 -> 43:55.920] litmus test. I, in the book, I talk about the very scientific ways that you can measure that.
[43:55.920 -> 44:02.480] And I use far more precision when I'm defining this for myself, but honestly, like I think 95%
[44:02.480 -> 44:07.040] of people would be just as happy to use the what's called
[44:07.040 -> 44:11.120] rate of perceived exertion test, which is the talk test.
[44:11.120 -> 44:18.080] So if you can be out there talking like this, you're not going hard enough.
[44:18.080 -> 44:22.800] If you can't talk except in a few words, you're going too hard.
[44:22.800 -> 44:26.700] Another benchmark, a guy by the name of Phil Maffetone
[44:26.700 -> 44:31.980] described this as maximal aerobic fitness. He uses a formula for starting this, which
[44:31.980 -> 44:38.540] is estimating it at 180 minus your age is the heart rate to target. So for someone like
[44:38.540 -> 44:44.620] me who's 50, that you would start at about a heart rate of 130 as the estimate. And then
[44:44.620 -> 44:46.600] you would adjust up or down based on the level
[44:46.600 -> 44:49.780] of exertion before we finish talking about the exercise element
[44:50.560 -> 44:52.240] I'd like to just
[44:52.240 -> 44:54.040] return to your
[44:54.040 -> 45:00.540] Centurion decathlon idea I would love to know some of the things that you would love to be doing when you're at that age
[45:01.240 -> 45:04.200] What you're doing now to make sure you get there, but also
[45:05.620 -> 45:09.160] you're at that age what you're doing now to make sure you get there but also the level to which you're doing it because I can only assume that if you're no matter
[45:09.160 -> 45:15.260] how hard you go at this when you're 89 you will not be able to do it to the
[45:15.260 -> 45:20.400] level that you are now not your analogy of you know being an archer so can you
[45:20.400 -> 45:23.580] run through some of the exercises some of the tests some of the ways you're
[45:23.580 -> 45:25.640] checking all the time can I do this right?
[45:25.640 -> 45:28.000] Then I'm going to get to 89 and I'm going to be okay.
[45:28.240 -> 45:28.500] Yep.
[45:29.100 -> 45:33.520] So let's start with one of the most important ones, which is just VO2 max.
[45:33.520 -> 45:39.120] So, um, you know, VO2 max is a bit of a complicated topic to explain,
[45:39.140 -> 45:41.560] but it is kind of an important one to understand.
[45:41.560 -> 45:43.640] And I do explain it in depth in the book.
[45:43.960 -> 45:46.800] It's a number that represents the maximum
[45:46.800 -> 45:49.000] amount of oxygen that you can use.
[45:49.040 -> 45:50.680] It's normalized by your weight.
[45:51.200 -> 45:54.040] So if we're going to look at the best.
[45:54.880 -> 45:57.200] Endurance athletes in the world, they
[45:57.200 -> 46:00.800] might have a number of 80 to 90 milliliters
[46:00.800 -> 46:03.440] of oxygen per kilogram per minute.
[46:03.720 -> 46:05.500] That's how much oxygen they can use.
[46:05.500 -> 46:07.500] And that'd be like a Tour de France winner or something like that.
[46:07.500 -> 46:11.500] Exactly. So, Teddy Pogacar, Jonas Vindegard, I mean,
[46:11.500 -> 46:15.500] the best of the best, that's the level they're going to be at.
[46:15.500 -> 46:20.000] If you look at somebody my age, so someone who's 50,
[46:20.000 -> 46:24.000] who's in the top 2% of their age,
[46:24.000 -> 46:32.000] would probably be at a level of 53 or 54 milliliters per kilogram per minute.
[46:32.000 -> 46:40.000] That number declines as you age. It could decline roughly 10% per decade.
[46:40.000 -> 46:47.840] Once that number gets to a certain level, you begin to really struggle at doing things.
[46:48.280 -> 46:53.640] Now, the absolute floor, once that level gets to the high teens,
[46:54.520 -> 46:56.760] and there are unfortunately going to be people listening to this
[46:56.780 -> 46:59.420] who might even be there or even know people there,
[47:00.080 -> 47:01.840] it's hard to walk.
[47:02.040 -> 47:05.100] If your VO2 max is
[47:10.960 -> 47:11.660] 15 milliliters per minute per kilogram you would not be able to walk four kilometers per hour
[47:16.820 -> 47:17.440] You would have a very hard time walking up a flight of stairs in my view And I you know
[47:17.440 -> 47:22.280] I have a table in the book that shows all of the different activity levels that you will lose
[47:22.640 -> 47:25.000] Once your fitness level gets below them.
[47:27.720 -> 47:31.000] For me personally, I never want my level to be below 30 because for the types of activities I
[47:31.000 -> 47:34.160] want to do, when my VO2 max goes below 30, I
[47:34.160 -> 47:35.480] will lose the ability to do them.
[47:35.840 -> 47:37.480] So for example, I always want to be able to
[47:37.480 -> 47:38.880] walk up four flights of stairs.
[47:39.080 -> 47:40.680] I always want to be able to walk on an
[47:40.680 -> 47:41.880] inclined surface.
[47:42.400 -> 47:47.040] I always want to be able to carry 20 pounds and walk, you
[47:47.040 -> 47:54.320] know, things like that. Okay. So just as we think of a glider and you have, let's say
[47:54.320 -> 47:59.800] you're the glider pilot, you see where you want to land that glider. You know, if you're
[47:59.800 -> 48:08.960] starting here very low, you're not going to make it. The only way to guarantee that you're going to hit that spot is to start high enough because
[48:08.960 -> 48:12.200] gravity is working whether you like it or not.
[48:12.200 -> 48:20.480] So if I want my VO2 max to not be below 30 to 32, when I'm in the ninth decade of my
[48:20.480 -> 48:26.000] life, I've reverse engineered how high it needs to be when I'm 50.
[48:26.000 -> 48:29.000] So that's how I know what I'm training for today.
[48:29.000 -> 48:32.500] That's how I know the level of fitness I need to have today,
[48:32.500 -> 48:36.500] because I've baked it into the calculation of what the decline is.
[48:36.500 -> 48:40.000] And I've done the same calculation for everything.
[48:40.000 -> 48:47.000] For how many seconds I need to be able to dead-hang on a bar, for how much weight I need to be able to carry.
[48:47.000 -> 48:48.600] What are they at this, at your age?
[48:48.600 -> 48:50.200] Well, I can tell you the standard,
[48:50.200 -> 48:52.200] I hold myself to a slightly higher standard
[48:52.200 -> 48:54.400] just because I'm an overachiever.
[48:54.400 -> 48:56.200] What should our listeners be thinking?
[48:56.200 -> 49:02.000] Yeah, so for example, a male who is between the ages of 40 and 50
[49:02.000 -> 49:04.000] should be able to dead hang,
[49:04.000 -> 49:05.600] so just hang on to a bar and hold
[49:05.600 -> 49:12.640] themselves for two minutes. A female should be 90 seconds. Why? That's a great marker of grip
[49:12.640 -> 49:19.760] strength. Why is that important? Because it's a great indication of upper body strength and it
[49:19.760 -> 49:27.780] correlates very well with the ability to connect the hands through the elbows into the shoulder
[49:27.780 -> 49:33.060] and the scapula. You see, everything we do in life, every force we transmit to the outside
[49:33.060 -> 49:37.180] world and we transmit back to ourselves really comes through our hands and feet. So a lot
[49:37.180 -> 49:42.140] of this stuff has to do with how well you use your hands and feet. Another metric that
[49:42.140 -> 49:46.720] we have for males between the ages of 40 and 50, they
[49:46.720 -> 49:53.160] should be able to carry their body weight 50% in each hand for a minute. So if someone
[49:53.160 -> 49:59.480] weighs 90 kilos, they should be able to put 45 kilos in each hand and walk for a minute.
[49:59.480 -> 50:03.780] And if it's a female, it should be three quarters of their body weight for a minute if they're
[50:03.780 -> 50:06.780] in that age bracket. And that's again, that's a great
[50:07.020 -> 50:10.100] indication of upper body strength, but also of
[50:10.100 -> 50:11.980] balance and coordination, because when you're
[50:11.980 -> 50:14.540] carrying that much weight, it's actually not
[50:14.540 -> 50:15.900] trivial to be able to walk.
[50:16.580 -> 50:18.460] See, cause that was something that jumped out
[50:18.460 -> 50:20.540] on me that I'd never considered it till I read
[50:20.540 -> 50:23.940] your book of the grip test and the importance.
[50:23.940 -> 50:25.900] And even if you relate it to the simplest
[50:25.900 -> 50:28.040] things of being able to carry the shopping
[50:28.040 -> 50:29.760] when you're a certain age.
[50:29.760 -> 50:32.120] Yeah, being able to open a jar, being able to
[50:32.120 -> 50:34.060] hold a handrail when you're walking down a
[50:34.060 -> 50:36.560] flight of stairs, being able to catch yourself
[50:36.560 -> 50:37.400] if you slip.
[50:38.160 -> 50:40.880] So what can we be doing to work on that and
[50:40.880 -> 50:42.200] make sure that that is?
[50:42.480 -> 50:44.720] You know, it's funny when people see how
[50:44.720 -> 50:47.080] strong the correlation is between grip
[50:47.080 -> 50:50.560] strength and health. And, and by the way, it's enormous, right? I mean, if you,
[50:50.560 -> 50:53.280] there's a, there's one of the other graphs I have in there is a,
[50:53.440 -> 50:56.960] shows the relationship between grip strength and the risk of dementia,
[50:57.320 -> 51:00.760] both death and incidence of dementia. And it's profound.
[51:00.760 -> 51:04.840] So if you take people with the highest grip strength compared to the lowest grip
[51:04.840 -> 51:11.500] strength, the people with the highest grip strength have a 70% lower chance of getting and dying from dementia.
[51:12.300 -> 51:15.540] So I would never have related grip strength and dementia.
[51:15.660 -> 51:16.780] Well, here's the thing.
[51:16.820 -> 51:20.340] And on the surface, you'd be right to say, what does that have to do with it?
[51:20.700 -> 51:24.380] But what it has to do with is grip strength is not about grip strength.
[51:24.940 -> 51:27.840] It's a proxy for total body strength.
[51:28.200 -> 51:30.480] It's a proxy for muscle mass.
[51:30.760 -> 51:35.080] It's a proxy for what you had to do to get that grip strength.
[51:35.520 -> 51:38.120] So that's why when somebody says, Oh, grip strength, great.
[51:38.120 -> 51:42.040] I'm going to go buy a little squeezer and just sit at my desk all day and do it.
[51:42.080 -> 51:43.160] That's not what it means.
[51:43.600 -> 51:45.720] It's what do you have to do
[51:45.720 -> 51:48.440] to develop such insane grip strength?
[51:48.440 -> 51:51.480] You've been carrying very heavy things.
[51:51.480 -> 51:54.320] You've been lifting very heavy things.
[51:54.320 -> 51:59.120] Similarly, the association between high VO2 max
[51:59.120 -> 52:02.360] and low VO2 max is staggering.
[52:02.360 -> 52:06.840] When you take somebody, and this is for all sexes, ages, like if this
[52:06.840 -> 52:14.000] is across the board, right? If you say, what is the difference in the risk of death between
[52:14.000 -> 52:26.760] someone at the top 2% versus the bottom 25% for VO2 max, it's 400% difference in all-cause mortality, meaning at any point in time,
[52:26.780 -> 52:30.120] the person in the bottom 25%
[52:30.140 -> 52:34.760] has a 400% greater chance of dying of any cause
[52:34.780 -> 52:38.480] in the following year relative to the person in the top 2%.
[52:38.500 -> 52:39.840] And again, you might say,
[52:39.860 -> 52:42.880] why does VO2 max matter that much?
[52:42.900 -> 52:49.160] And the reason is what you need to do to have that much of a VO2 max is
[52:49.160 -> 52:50.840] what is making the difference.
[52:51.040 -> 52:51.760] Does that make sense?
[52:51.800 -> 52:52.520] Yes, absolutely.
[52:52.520 -> 52:57.080] The VO2 max is the integrator of the signal that produces that benefit.
[52:57.240 -> 53:00.880] If there was one measure then, and I hate sort of trying to box you in on
[53:00.880 -> 53:04.800] these kind of binary questions, but if there was one measure that a listener
[53:05.120 -> 53:12.320] of box you in on these kind of binary questions, but if there was one measure that a listener could say, that's going to be my target, that I'm teleological, I want to go after a goal, what
[53:12.320 -> 53:19.040] one measure would you advocate would be the target that we should be looking? So by the numbers,
[53:19.600 -> 53:26.840] the first one would be high VO2 max. So VO2 max by the numbers is the highest predictor
[53:26.840 -> 53:29.240] of reduced all-cause mortality.
[53:29.240 -> 53:32.560] The second would be high muscle strength,
[53:32.560 -> 53:35.360] followed shortly by high muscle mass.
[53:35.360 -> 53:36.200] Those-
[53:36.200 -> 53:38.500] All my time spent measuring my waistline.
[53:38.500 -> 53:41.640] Trivial compared to that, just trivial compared to that.
[53:44.760 -> 53:48.100] Today's podcast is brought to you in association with AG1,
[53:48.100 -> 53:50.800] my foundational daily nutrition supplement
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[57:51.640 -> 57:59.800] Mint Mobile for details. Let's move on to the third pillar, if we may, of the five.
[57:59.800 -> 58:08.500] Can we talk about the importance of sleep? Sure. Let's lay it bare for people listening to this. What does a lack of sleep do for us?
[58:08.500 -> 58:12.500] There's some short term consequences and there are some long term consequences.
[58:12.500 -> 58:18.500] I think in the short term, anybody who's being really honest with themselves can speak to what's happening, right?
[58:18.500 -> 58:20.500] You're not performing at your best.
[58:20.500 -> 58:24.500] So, Matthew Walker, I don't know if you guys have had Matthew Walker on the show.
[58:24.500 -> 58:26.060] So Matthew's written about
[58:26.060 -> 58:27.680] this stuff quite eloquently and he's
[58:27.680 -> 58:29.960] talked about how, you know, even just
[58:29.960 -> 58:33.560] mild sleep deprivation can be akin to
[58:33.580 -> 58:36.200] alcohol intoxication. And there's
[58:36.200 -> 58:38.840] effectively like, you know, I forget the
[58:38.840 -> 58:40.860] exact number, call it two consecutive
[58:40.860 -> 58:43.280] nights of, you know, significant sleep
[58:43.280 -> 58:46.520] deprivation is akin to driving legally
[58:46.520 -> 58:50.720] drunk. It's much more difficult to consolidate memories when you're sleep deprived. Your
[58:50.720 -> 58:56.900] judgment is impaired when you're sleep deprived. Your cravings for garbage food will go up
[58:56.900 -> 59:02.020] when you are sleep deprived and you will be more insulin resistant when you are sleep
[59:02.020 -> 59:05.920] deprived. So of all the things that happen, this is probably the most interesting to me
[59:05.920 -> 59:08.200] because of the physiologic manner and accuracy
[59:08.200 -> 59:09.680] with which we can measure this.
[59:09.680 -> 59:12.080] Your capacity to dispose of glucose,
[59:12.080 -> 59:14.280] which is one of the single most important
[59:14.280 -> 59:16.360] physiologic jobs we have,
[59:16.360 -> 59:18.900] is to put glucose from our circulation
[59:18.900 -> 59:21.160] after we eat something into our muscles.
[59:21.160 -> 59:28.880] Your capacity to do that after a week of sleeping four hours a night is reduced
[59:28.880 -> 59:30.840] by 50%.
[59:30.840 -> 59:33.280] These are these short-term consequences.
[59:33.280 -> 59:35.840] And if compounded, lead to the long-term consequences.
[59:35.840 -> 59:41.800] And the two most long-term consequences that we have insight into are the impact that sleep
[59:41.800 -> 59:46.500] deprivation has on cardiovascular disease and Alzheimer's disease.
[59:47.400 -> 59:49.900] It's a less clear relationship to cancer,
[59:50.100 -> 59:53.500] but I think there's an undeniable link to dementia
[59:53.700 -> 59:57.300] and to heart disease and how either short sleep,
[59:57.500 -> 01:00:00.200] disrupted sleep, fragmented sleep, incomplete sleep,
[01:00:00.200 -> 01:00:04.000] all of these things are causally increasing your risk
[01:00:04.000 -> 01:00:05.000] of those other diseases.
[01:00:05.000 -> 01:00:11.000] I don't, I honestly can sit here and rack my brain and not work out how and why that would be the case.
[01:00:11.000 -> 01:00:13.500] Well, probably through some different mechanisms.
[01:00:13.500 -> 01:00:17.500] So, it's first important to understand what sleep is and what sleep isn't.
[01:00:17.500 -> 01:00:20.500] I think there's a belief that sleep is a passive thing, right?
[01:00:20.500 -> 01:00:23.000] And that sleep is a time to rest the body.
[01:00:23.000 -> 01:00:26.840] But the truth of it is that it's actually not, right? And that sleep is a time to rest the body. But the truth of it is that it's actually not right.
[01:00:26.840 -> 01:00:30.140] Sleep is a very important period of time for the brain
[01:00:30.620 -> 01:00:33.740] to do a lot of repair. And there's a
[01:00:33.980 -> 01:00:36.940] a system in the brain called the glymphatic system.
[01:00:37.460 -> 01:00:40.160] And I'm borrowing this analogy actually from Matthew
[01:00:40.180 -> 01:00:43.260] Walker. But the glymphatic system is a system
[01:00:43.260 -> 01:00:49.200] that cleans out the cellular debris that surrounds neurons.
[01:00:49.200 -> 01:00:53.000] So Matthew describes this kind of like the street sweepers
[01:00:53.000 -> 01:00:56.000] at night that come around and move out the trash.
[01:00:56.000 -> 01:01:01.000] And when your sleep is disrupted or is too short or you're
[01:01:01.000 -> 01:01:04.200] not getting the right stages of sleep, that system gets
[01:01:04.200 -> 01:01:05.200] impaired. And when that system gets impaired.
[01:01:05.200 -> 01:01:07.080] And when that system gets impaired,
[01:01:07.080 -> 01:01:12.080] you have less cellular cleaning of this debris in the brain.
[01:01:12.120 -> 01:01:14.900] And that's leading to an accumulation of these things.
[01:01:14.900 -> 01:01:18.880] Some of them are things such as like amyloid beta or tau
[01:01:18.880 -> 01:01:23.880] that are conditions that produce the changes in the neurons
[01:01:24.240 -> 01:01:26.720] that lead to these neurodegenerative
[01:01:26.720 -> 01:01:31.040] changes, including Alzheimer's disease, but also other forms of dementia. And by the way,
[01:01:31.040 -> 01:01:37.360] I think on the brain front, I think it's also impacted by the metabolic changes as well.
[01:01:37.360 -> 01:01:41.680] So anything that's dysregulating, insulin signaling and glucose metabolism is also going
[01:01:41.680 -> 01:01:46.580] to have a negative consequence on the brain. And I suspect that that's also what's happening
[01:01:46.580 -> 01:01:48.500] for cardiovascular disease.
[01:01:48.500 -> 01:01:49.380] There may also be,
[01:01:49.380 -> 01:01:51.040] although I don't think the link here is as clear,
[01:01:51.040 -> 01:01:53.100] there may be a relationship between cortisol levels.
[01:01:53.100 -> 01:01:56.780] So higher cortisol levels when you're not sleeping well,
[01:01:56.780 -> 01:01:58.060] that's been established.
[01:01:58.060 -> 01:01:59.920] And of course, the relationship between high levels
[01:01:59.920 -> 01:02:03.540] in cortisol and cardiovascular disease has been established.
[01:02:03.540 -> 01:02:06.000] So I think there's probably a causal relationship
[01:02:06.000 -> 01:02:10.280] through hypercortisolemia, as well as through hyperinsulinemia,
[01:02:10.280 -> 01:02:12.320] insulin resistance, metabolic dysfunction,
[01:02:12.320 -> 01:02:15.600] and then this lack of capacity to kind of,
[01:02:15.600 -> 01:02:17.040] you know, if you will, for lack of a better word,
[01:02:17.040 -> 01:02:20.920] clean out the cellular debris around neurons.
[01:02:20.920 -> 01:02:22.560] So to ask you a personal question then,
[01:02:22.560 -> 01:02:24.080] that when you were a medical student,
[01:02:24.080 -> 01:02:40.000] again, I've heard you speak quite powerfully about how there was almost this brutal culture of working ridiculous long hours and then having to make smart decisions that involve life and death for many people, doing that on a lack of sleep.
[01:02:40.000 -> 01:02:46.360] You've almost been a guinea pig in testing some of this stuff out. What does it do to your ability to make better decisions?
[01:02:46.360 -> 01:02:53.480] And I mean, yeah, I shudder to think about what sort of the the horrible experiences I had with with so much sleep deprivation
[01:02:53.480 -> 01:03:00.420] You know, fortunately, I don't think that physicians train under nearly such extreme conditions today. I think
[01:03:01.040 -> 01:03:06.080] 20 years ago in 2003 the rules at least in the United States, began to change.
[01:03:06.080 -> 01:03:11.200] And I suspect that it's significantly different today. I don't think anybody would go through
[01:03:11.200 -> 01:03:19.440] what we went through, but it is really unfortunate to imagine how many medical errors took place due
[01:03:19.440 -> 01:03:28.500] to basically the arrogance of a system that viewed sleep deprivation as a rite of passage and a badge of honor.
[01:03:28.500 -> 01:03:34.700] And frankly, a tool that was used to determine your worthiness, right?
[01:03:34.700 -> 01:03:48.000] Like, did you have the... were you tough enough to go for five years sleeping rarely more than a few hours a night. I still think that pervades lots of our culture today.
[01:03:48.000 -> 01:03:53.500] The idea of going without sleep is a sign of passion.
[01:03:53.500 -> 01:03:56.000] It's that hustle culture.
[01:03:56.000 -> 01:03:57.000] Yeah, it's interesting.
[01:03:57.000 -> 01:03:59.000] I mean, you guys would know this better than I do.
[01:03:59.000 -> 01:04:10.760] I'm guessing that there are probably still some corners of the world where that's true Do you still see that with high performers because I would I would think that by this point in 2023
[01:04:11.520 -> 01:04:13.480] most high performers
[01:04:13.480 -> 01:04:19.040] Really understand that that's that's a detriment that by the way, I don't just mean athletic performers
[01:04:19.040 -> 01:04:21.760] I mean anyone who's trying to be top of their game
[01:04:21.760 -> 01:04:26.720] I would think at this point in time, isn't playing that game anymore.
[01:04:27.600 -> 01:04:30.240] And this is only anecdotal,
[01:04:30.240 -> 01:04:33.400] I'd probably say those that have got to high performance
[01:04:33.400 -> 01:04:36.120] have had to learn the lesson so they would understand it.
[01:04:36.120 -> 01:04:40.000] I think those that maybe aspire to high performance
[01:04:40.000 -> 01:04:42.080] need to still learn it.
[01:04:42.080 -> 01:04:43.080] Interesting.
[01:04:43.080 -> 01:04:45.600] What should we be aiming for and how do we get it?
[01:04:45.600 -> 01:04:49.200] How do we get people to a point where sleep is doing
[01:04:49.200 -> 01:04:51.320] for them the things it needs to do?
[01:04:51.320 -> 01:04:53.360] I mean, the first thing you have to do is
[01:04:53.360 -> 01:04:55.080] you have to realize you can't force sleep.
[01:04:55.080 -> 01:04:57.200] You can't just snap your fingers and make sleep happen.
[01:04:57.200 -> 01:04:58.880] You have to prepare to sleep
[01:04:58.880 -> 01:05:00.520] and you have to give yourself the right amount of time.
[01:05:00.520 -> 01:05:03.840] So you really do need to give yourself about eight hours
[01:05:03.840 -> 01:05:09.280] to make this thing happen. So meaning you got to really plan to have eight hours to be in bed. Eight hours in bed?
[01:05:09.280 -> 01:05:14.480] Yeah. And of that, you might sleep seven hours, seven 50, seven 30. So you're right out of the
[01:05:14.480 -> 01:05:17.440] gate. The first mistake people are going to make is they're not going to give themselves enough
[01:05:17.440 -> 01:05:21.200] time to sleep. If you're only going to give yourself six and a half hours to sleep, you
[01:05:21.200 -> 01:05:25.840] already made a mistake. So time is the first component to this. The second
[01:05:25.840 -> 01:05:34.400] thing I think is you will make your life infinitely better if you can be quite consistent in when
[01:05:34.400 -> 01:05:38.400] that eight hours occurs and make it occur the same time every time, weekends included.
[01:05:39.040 -> 01:05:44.160] So one of the big problems that young people have is something called social jet lag, where,
[01:05:44.720 -> 01:05:48.580] you know, they have jobs, so they have to get up early in the, during the week,
[01:05:48.580 -> 01:05:50.100] but on the weekends they want to sleep in.
[01:05:50.100 -> 01:05:54.600] And so they're dramatically changing their circadian rhythm between weekday and
[01:05:54.600 -> 01:05:59.520] weekend. And this is actually one of the advantages I think we have as parents is
[01:05:59.920 -> 01:06:04.420] we get up at six every single day because our boys get up at six every single day,
[01:06:04.560 -> 01:06:09.040] no matter what. Another thing that's very important is what is the room?
[01:06:09.060 -> 01:06:12.400] What is the experience like? Is it cold? Is it dark?
[01:06:12.720 -> 01:06:16.920] Is it otherwise unstimulating? Right? All of this matters.
[01:06:16.920 -> 01:06:21.200] You'd be amazed at how much distraction people can have in their bedrooms,
[01:06:21.400 -> 01:06:23.200] how much light there can still be in the bedroom,
[01:06:23.440 -> 01:06:28.000] how much they're doing in the bedroom that's not sleeping, you know, and I get it. Sometimes you live in a,
[01:06:28.000 -> 01:06:30.720] you know, you live in a city like London or you live in a city like New York where you have to
[01:06:30.720 -> 01:06:35.840] also have your office in your room. And so you associate many things with being in the bedroom
[01:06:35.840 -> 01:06:41.120] that go beyond sleeping. But in an ideal world, you really just want to kind of keep that room
[01:06:41.120 -> 01:06:48.800] dark, keep that room cold and keep that room conducive to sleep. A very important thing is how do you prepare to sleep?
[01:06:48.800 -> 01:06:51.800] So let's just say right up until this point a person's like,
[01:06:51.800 -> 01:06:53.400] I'm with you Peter, I got it man.
[01:06:53.400 -> 01:06:57.000] I'm going to be 11 to 7 every day.
[01:06:57.000 -> 01:06:58.000] I've got it dialed.
[01:06:58.000 -> 01:07:00.500] Okay, if you do all that stuff, great.
[01:07:00.500 -> 01:07:04.900] But if you're on your phone checking social media until 1059
[01:07:04.900 -> 01:07:08.000] and then you hop in bed and just check one more thing
[01:07:08.000 -> 01:07:16.000] and then put the phone next to you, you haven't prepared yourself to sleep. So you have a restless racing mind as you try to go to sleep.
[01:07:16.000 -> 01:07:25.700] That's just not going to make much of a difference. And by the way, a lot of people I think used to make a ton of hay about how you shouldn't be looking at any light
[01:07:25.700 -> 01:07:28.400] or electronic surface before bed.
[01:07:28.400 -> 01:07:32.680] But it turns out that phones are disproportionately bad.
[01:07:32.680 -> 01:07:36.580] And in fact, they seem almost consistently worse
[01:07:36.580 -> 01:07:39.280] than say TVs.
[01:07:39.280 -> 01:07:41.460] And you can't make the argument
[01:07:41.460 -> 01:07:43.380] that the light is that much different.
[01:07:43.380 -> 01:07:46.200] It's probably much more the nature of what you're doing.
[01:07:46.900 -> 01:07:50.000] You know, if you sit down to watch a movie on TV,
[01:07:50.100 -> 01:07:53.800] that can... I'm not suggesting that's necessarily a good sleep hygiene practice,
[01:07:54.100 -> 01:07:59.300] but it's probably far less negative than, you know, checking email from work.
[01:07:59.400 -> 01:08:01.000] Well, I think you're detached from your life, right?
[01:08:01.100 -> 01:08:01.300] Yeah.
[01:08:01.400 -> 01:08:03.600] You watch a film, you're detaching yourself from reality.
[01:08:04.000 -> 01:08:05.680] What do we mainly have on our phones?
[01:08:05.680 -> 01:08:12.160] Our work email, our social media accounts, and the news, which is directly in your life.
[01:08:12.160 -> 01:08:14.280] So you can understand that.
[01:08:14.280 -> 01:08:15.320] Yeah, yeah.
[01:08:15.320 -> 01:08:21.600] So those would be kind of like the, what I call kind of like the big bases of sleep hygiene.
[01:08:21.600 -> 01:08:24.160] So what's your routine in the evening?
[01:08:24.160 -> 01:08:29.640] It's everything I just said. I mean in addition to that I really like to sauna and and and cold plunge
[01:08:29.640 -> 01:08:33.960] before bed as well. That yeah so getting my body temperature up, cooling it down
[01:08:33.960 -> 01:08:37.680] and and kind of getting into bed. It's it's pretty boring actually. I'm not
[01:08:37.680 -> 01:08:44.160] phoning the bedroom? No. And also I don't even use my work phone in like the two
[01:08:44.160 -> 01:08:45.000] hours before bed
[01:08:45.560 -> 01:08:52.160] But that leads us into the other area of that you touched on in the introduction Peter, which is around. How do you detach work from home?
[01:08:52.800 -> 01:08:53.440] and
[01:08:53.440 -> 01:08:56.640] for like you say for a lot of people maybe the bedroom is
[01:08:56.880 -> 01:09:00.600] Also doubles up as the office if we're living in a flat in a big city
[01:09:00.600 -> 01:09:03.520] So it probably leads us to that next question
[01:09:03.520 -> 01:09:06.000] Which is what lessons and tips
[01:09:06.000 -> 01:09:09.920] and hints have you learned about being able to create that clear demarcation?
[01:09:09.920 -> 01:09:15.200] I would say this is my hardest area. So I mean, I think, you know, most people would look at me and
[01:09:15.200 -> 01:09:21.200] say, wow, that guy really, he he's got his exercise routine down to a science and, and he eats pretty
[01:09:21.200 -> 01:09:28.040] well and sleeps well. And I think those things are true. I would say the thing that I struggle with the most by far
[01:09:28.040 -> 01:09:30.480] is working more than I should.
[01:09:30.480 -> 01:09:34.640] And I think that I just have to be constantly at war
[01:09:34.640 -> 01:09:39.240] with myself over this and constantly setting boundaries.
[01:09:39.240 -> 01:09:40.080] And, you know, for example,
[01:09:40.080 -> 01:09:43.200] like having two phones has been a very big help.
[01:09:43.200 -> 01:09:46.160] This was something I just figured out a year ago,
[01:09:46.160 -> 01:09:48.000] maybe less, which was, oh my God,
[01:09:48.000 -> 01:09:50.480] if I just got that second phone,
[01:09:50.480 -> 01:09:52.160] I could still have a phone with me
[01:09:52.160 -> 01:09:53.320] if I want to be able to take pictures,
[01:09:53.320 -> 01:09:56.200] if I'm out with my kids, if I'm, you know,
[01:09:56.200 -> 01:09:58.240] like, unfortunately, like now half the electronics
[01:09:58.240 -> 01:09:59.720] in the house all work off the phone, you know,
[01:09:59.720 -> 01:10:01.040] there's like an app for that.
[01:10:01.040 -> 01:10:05.440] So I could still have that, but not have the phone. Right. So that,
[01:10:05.440 -> 01:10:06.920] that became a very powerful tool.
[01:10:06.920 -> 01:10:07.760] What did that do for you?
[01:10:08.440 -> 01:10:10.240] Oh, it was so fantastic. It made such a
[01:10:10.240 -> 01:10:13.060] difference. That was a huge, again,
[01:10:13.060 -> 01:10:14.000] it might sound silly. Like,
[01:10:14.000 -> 01:10:15.800] why would you buy another phone to not have
[01:10:15.800 -> 01:10:17.360] it be a phone? Um,
[01:10:17.360 -> 01:10:19.800] but what it did for me was allow me to go to
[01:10:19.800 -> 01:10:23.280] bed without thinking about work or seeing a
[01:10:23.280 -> 01:10:25.840] text message that would annoy me or upset me or
[01:10:25.840 -> 01:10:29.440] seeing an email that would chirp me or anything like that. Like it was just not doing that.
[01:10:29.440 -> 01:10:31.920] So it was a phone purely for like...
[01:10:31.920 -> 01:10:34.960] It was a 100% decision I made for just mental health.
[01:10:34.960 -> 01:10:37.280] Right, but it's not a phone that you use to connect with the outside world.
[01:10:37.840 -> 01:10:41.520] What do you use that phone for then? Your non-email phone? Like what do you...
[01:10:41.520 -> 01:10:45.180] Nothing. I use it to have to have a camera it has my calendar
[01:10:45.180 -> 01:10:48.580] So if I'm out and I need to know how to get somewhere, you know, that's it
[01:10:48.580 -> 01:10:52.220] I have music on it. So I take that that's the phone if I'm out like today at the gym
[01:10:52.220 -> 01:10:56.460] That's the phone I had with me. Can we talk while we're on this subject about distress tolerance?
[01:10:56.660 -> 01:10:58.660] Would you explain that to our audience?
[01:10:58.700 -> 01:11:05.280] Yeah, it's an idea that basically as its name suggests is how much are are we at any point in time able to
[01:11:06.220 -> 01:11:10.840] buffer ourselves against adversity against emotional distress, which is
[01:11:11.400 -> 01:11:13.400] You know having two phones is a way of doing that
[01:11:13.920 -> 01:11:15.920] Correct. Yeah, so basically
[01:11:16.160 -> 01:11:20.520] Half of what I'm trying to do in life is figure out a way to buffer myself
[01:11:20.680 -> 01:11:26.280] Against the distress that my other the other half of my life creates. See I... It's a bit unwise. But I spend my
[01:11:26.280 -> 01:11:28.760] life going hey deal with distress,
[01:11:28.760 -> 01:11:30.160] high-performance is pushing through
[01:11:30.160 -> 01:11:32.880] challenge you know it's a bit like um a
[01:11:32.880 -> 01:11:34.320] bit like taking a vaccine you need a
[01:11:34.320 -> 01:11:37.160] little bit of this to insulate you from
[01:11:37.160 -> 01:11:39.800] being derailed by it if that makes sense.
[01:11:39.800 -> 01:11:42.160] So how do we get the balance right
[01:11:42.160 -> 01:11:45.840] between having resilience and tolerance and being
[01:11:45.840 -> 01:11:47.680] able to cope with like sometimes life shit?
[01:11:47.680 -> 01:11:48.680] Yeah.
[01:11:48.680 -> 01:11:52.980] Well, I think it's different for everybody, but the in the final analysis, it just comes
[01:11:52.980 -> 01:11:55.160] down to how are you doing?
[01:11:55.160 -> 01:11:56.160] Yeah.
[01:11:56.160 -> 01:11:57.160] Right.
[01:11:57.160 -> 01:11:58.760] I mean, from a hormetic standpoint, we need stress.
[01:11:58.760 -> 01:12:08.000] I think a stress free life, a life with no stress would be relatively unfulfilling and quite boring. So, you know,
[01:12:08.000 -> 01:12:12.000] if I were purely optimizing to have no stress in my life, I wouldn't be doing what I'm doing.
[01:12:12.000 -> 01:12:16.880] I would choose another path. And so most of us have chosen the path we've chosen, presumably
[01:12:16.880 -> 01:12:22.080] not to minimize distress, but nevertheless, distress comes into our life. So we're not,
[01:12:22.080 -> 01:12:26.860] we're neither trying to maximize nor minimize distress. We're trying to optimize around something else
[01:12:26.860 -> 01:12:28.600] and distress happens to be the collateral
[01:12:28.600 -> 01:12:29.640] that comes with it.
[01:12:29.640 -> 01:12:33.380] And so the question is,
[01:12:33.380 -> 01:12:37.400] are you under more distress than you're capable of handling?
[01:12:37.400 -> 01:12:39.400] And I think you know the answer to that question
[01:12:39.400 -> 01:12:43.040] based on how the rest of your life is going.
[01:12:43.040 -> 01:12:46.300] I mean, if you can't sleep because of too
[01:12:46.300 -> 01:12:51.100] much distress and you attribute that, for example, to, well, I can't seem to get my
[01:12:51.100 -> 01:12:55.300] phone off my mind, then maybe what we just described becomes a great trick for
[01:12:55.300 -> 01:12:59.060] reducing distress. What were the other ones that you identified for yourself or
[01:12:59.060 -> 01:13:03.700] how do we go about identifying? Well, I mean, I think, you know, exercise is a very
[01:13:03.700 -> 01:13:06.900] important part of distress tolerance for me.
[01:13:07.040 -> 01:13:09.040] So there's a really important
[01:13:09.680 -> 01:13:10.880] physiologic
[01:13:10.880 -> 01:13:18.320] component of what exercise does from a hormonal standpoint that I think for almost any human being will
[01:13:18.320 -> 01:13:20.320] increase distress tolerance.
[01:13:20.680 -> 01:13:25.400] Basically anything that you can do to improve your physical health.
[01:13:25.400 -> 01:13:29.520] So sleeping better, eating better, exercising better, all of those things are improving
[01:13:29.520 -> 01:13:30.520] it.
[01:13:30.520 -> 01:13:34.720] On the sort of less obvious things, for me personally, and I think there's reasonable
[01:13:34.720 -> 01:13:39.680] data on this, I think cold exposure is quite beneficial.
[01:13:39.680 -> 01:13:46.000] It stimulates the parasympathetic nervous system, which is part of the automatic or autonomic nervous system
[01:13:46.000 -> 01:13:49.700] that is responsible for more of the rest and digest function.
[01:13:49.700 -> 01:13:52.000] So when you activate the parasympathetic system
[01:13:52.000 -> 01:13:53.300] and the vagus nerve,
[01:13:53.300 -> 01:13:54.900] which is just one of these big nerves
[01:13:54.900 -> 01:13:56.400] that runs through your chest,
[01:13:56.400 -> 01:13:57.500] when you activate that system,
[01:13:57.500 -> 01:14:00.600] you're kind of lowering the amount of fight-or-flight
[01:14:00.600 -> 01:14:02.400] activity that you feel.
[01:14:02.400 -> 01:14:06.280] Back home, I do this by sitting in a cold plunge
[01:14:06.280 -> 01:14:08.880] for five or six minutes a day.
[01:14:08.880 -> 01:14:12.880] For some people, meditation becomes a fantastic tool
[01:14:12.880 -> 01:14:16.920] by which they can sort of build up distress tolerance.
[01:14:16.920 -> 01:14:19.880] And I think the way for people who haven't meditated
[01:14:19.880 -> 01:14:23.040] to think about that is at least one form of meditation
[01:14:23.040 -> 01:14:27.020] really has you fixating on an object of meditation.
[01:14:27.020 -> 01:14:31.520] Usually the breath is the most common one. And the purpose of that exercise is not to
[01:14:31.520 -> 01:14:37.500] stop thinking, but rather to notice your thoughts. And even a person who does this for a relatively
[01:14:37.500 -> 01:14:41.520] short period of time, you don't need to be sort of an expert quote unquote meditator,
[01:14:41.520 -> 01:14:47.720] but a person who meditates for even a couple of months kind of gets into the hang of realizing
[01:14:47.720 -> 01:14:50.960] that we have a constant barrage of thoughts
[01:14:50.960 -> 01:14:54.520] that are just never leaving us.
[01:14:54.520 -> 01:14:57.720] And if you can notice that,
[01:14:57.720 -> 01:15:00.800] you can begin to notice that some of the distress
[01:15:00.800 -> 01:15:03.040] you're experiencing is nothing more
[01:15:03.040 -> 01:15:05.040] than the thought that you're allowing
[01:15:05.040 -> 01:15:10.040] to sort of fester and permeate. And by instead of trying to not have the thought by simply
[01:15:10.040 -> 01:15:15.000] observing the thought, a lot of times that thought dissipates and the distress goes away.
[01:15:15.000 -> 01:15:20.680] Journaling for me and psychotherapy, working with a therapist, hugely important parts of
[01:15:20.680 -> 01:15:22.440] increasing distress tolerance.
[01:15:22.440 -> 01:15:25.080] And does all of this get you closer
[01:15:25.080 -> 01:15:26.840] to the centurion decathlon?
[01:15:26.840 -> 01:15:28.400] Because there's part of me that thinks,
[01:15:28.400 -> 01:15:31.960] well, people's relationship with stress
[01:15:31.960 -> 01:15:35.940] and anxiety and pressure from the outside world,
[01:15:35.940 -> 01:15:37.740] we see it as a period in our lives
[01:15:37.740 -> 01:15:39.160] that we kind of have to accept
[01:15:39.160 -> 01:15:42.040] because we're in that busy life period.
[01:15:42.040 -> 01:15:43.840] But it will go when we're in our 70s
[01:15:43.840 -> 01:15:45.920] or our mid-60s when we retire, so then
[01:15:46.400 -> 01:15:50.400] I'll be okay. Is there a carryover effect from this period of our lives?
[01:15:50.400 -> 01:15:54.640] That's a great question. I would bet that there are some people who
[01:15:55.400 -> 01:16:01.800] were just incredibly hard-charging in their 30s, 40s, 50s, 60s, and somehow when they retired
[01:16:02.360 -> 01:16:04.560] it was all fine and dandy.
[01:16:05.000 -> 01:16:05.880] If I had to bet, And somehow when they retired, it was all fine and dandy.
[01:16:10.880 -> 01:16:11.000] If I had to bet, I would guess that that's a rare minority.
[01:16:13.680 -> 01:16:17.160] I would think that for the majority of people, the seeds that you sow in your youth
[01:16:17.160 -> 01:16:21.400] are the same flowers that come to harvest later on.
[01:16:21.400 -> 01:16:23.340] One of the things I think about a lot
[01:16:23.340 -> 01:16:28.080] is how will I look back at now at this moment in the
[01:16:28.080 -> 01:16:35.760] future? What will I tell myself? And almost invariably it's do less. Yeah. It's not push
[01:16:35.760 -> 01:16:41.920] harder. So I have to kind of remind myself of that, which is the guy in his last decade looking
[01:16:41.920 -> 01:16:47.120] at you now will say you're not spending quite enough time with your kids.
[01:16:47.160 -> 01:16:51.320] And even when you're with them, and even if you're with them,
[01:16:51.360 -> 01:16:54.960] not looking at your phone, your mind is somewhere else, right? Why,
[01:16:54.960 -> 01:16:59.560] why is that? And I feel lucky that I have three kids,
[01:16:59.720 -> 01:17:04.200] so I can already see the difference between a teenager and a young kid.
[01:17:04.200 -> 01:17:06.800] And I can realize how quickly things change
[01:17:06.800 -> 01:17:12.000] And I feel very fortunate that kids are a wonderful way to anchor to the aging process
[01:17:12.000 -> 01:17:18.280] Yeah, so I I know that kids are not for everyone, but I'm really glad that they're for me when again
[01:17:18.280 -> 01:17:22.800] I was reading you book Peter. So this is me projected on you and I might be wrong on this
[01:17:22.800 -> 01:17:26.000] But I saw that you were pretty competitive in terms of the sports yn eich arloesu, ac rydw i'n eithaf gwrthwyneb ar hyn, ond rwy'n gweld eich bod chi'n gymhwysol
[01:17:26.000 -> 01:17:32.000] o ran y sportau rydych chi wedi'u gwneud, roeddech chi'n ddifrifwyr, rydych chi'n gwybod, o ran
[01:17:32.000 -> 01:17:36.960] defnyddio'r hyn rhaid i chi ei wneud, lle nad oedd pobl yn ymwneud â'ch bod chi'n mynd i'r ysgol meddygol,
[01:17:36.960 -> 01:17:43.280] ond roeddech chi hefyd yn perffectionist. Ac mae hyn yn dod i'r ddyn ymlaen o hymuno'n
[01:17:43.280 -> 01:17:45.280] ein hunain ag anhygoel ymdrech. Mae pethau y gallwn i'w deall gyda nhw, ac rwy'n siŵr comes into that area about immunizing ourselves against emotional distress,
[01:17:45.280 -> 01:17:50.440] there are things that I could identify with and I'm sure lots of listeners might
[01:17:50.440 -> 01:17:55.280] often the battle for this is what goes on internally rather than the external
[01:17:55.280 -> 01:17:59.600] world. I'm interested in what kind of steps or advice or techniques you've
[01:17:59.600 -> 01:18:08.580] learned to be able to live with those impulses and harness them for the good rather than the destructive.
[01:18:08.580 -> 01:18:10.700] I mean, I don't think I could have done it
[01:18:10.700 -> 01:18:15.700] without the very intensive therapy
[01:18:15.880 -> 01:18:17.020] that I talk about in the book,
[01:18:17.020 -> 01:18:18.740] where I actually had to go away.
[01:18:18.740 -> 01:18:22.220] Because what I had to sort of come to grips with
[01:18:22.220 -> 01:18:25.440] was understanding what was the underlying driver of that.
[01:18:25.440 -> 01:18:29.240] Like, what was that behavior a response to?
[01:18:29.240 -> 01:18:32.440] Or an adaptation to, maybe is the best way to frame it.
[01:18:32.440 -> 01:18:35.240] And I think only when I came to understood that
[01:18:35.240 -> 01:18:40.440] could I then be in an equilibrium with those forces.
[01:18:40.440 -> 01:18:42.640] And I think that's really the right way to describe it for me
[01:18:42.640 -> 01:19:07.140] because I'll never be in the point where those forces won't be a part of my life. I'll never be the guy who doesn't want to work. You know, I'll never be the guy who doesn't care what the product looks like. I'll never be able to completely shed the workaholism, the perfectionism. I simply can't, but I could be in a much healthier equilibrium with them,
[01:19:07.140 -> 01:19:09.540] but only because I've gone through this
[01:19:09.540 -> 01:19:14.540] very intensive understanding of what was at the root of them,
[01:19:15.220 -> 01:19:18.860] how did they shape me, and now, the other thing is,
[01:19:18.860 -> 01:19:20.900] I have more people that help me, right?
[01:19:20.900 -> 01:19:24.240] Meaning I have an accountability stream around me.
[01:19:24.240 -> 01:19:25.560] I mean, starting with my wife, right?
[01:19:25.560 -> 01:19:29.480] My wife is my most important accountability partner. I mean,
[01:19:29.520 -> 01:19:32.080] even on this trip, she's been kind of busting my balls a little bit.
[01:19:32.400 -> 01:19:36.720] She's like fricking working a lot. And I was like, I know, I know, I'm sorry.
[01:19:36.720 -> 01:19:40.960] And, and like, you know, the other day we found out like, we have to, you know,
[01:19:41.000 -> 01:19:44.120] dress a certain way at Goodwood. And it's like, I didn't bring any nice clothes.
[01:19:44.120 -> 01:19:45.720] So I had to go shopping to look for clothes,
[01:19:45.720 -> 01:19:47.860] and I was kind of irritated doing it,
[01:19:47.860 -> 01:19:49.120] and she's sort of like,
[01:19:49.120 -> 01:19:50.440] yeah, you're letting this get in the way.
[01:19:50.440 -> 01:19:52.880] Like, this is a fun time, and she was right.
[01:19:52.880 -> 01:19:54.020] So anyway, my point is like,
[01:19:54.020 -> 01:19:57.040] having somebody who can remind me of that
[01:19:57.040 -> 01:19:58.920] is something that I now welcome,
[01:19:58.920 -> 01:20:01.320] whereas in the past, I would have been very annoyed at that.
[01:20:01.320 -> 01:20:04.560] I would be very annoyed if someone was busting my balls.
[01:20:04.560 -> 01:20:09.760] So for a listener that maybe doesn't have the opportunity or the access to
[01:20:09.760 -> 01:20:14.040] the kind of therapy that you went through though, what would you advise
[01:20:14.040 -> 01:20:19.800] would be the kind of questions they should be asking themselves in terms of
[01:20:19.800 -> 01:20:28.000] for their better emotional stability? It's a very good question and I have to be honest with you. Like I don't really know
[01:20:28.000 -> 01:20:34.360] I don't have as great a checklist here as I think I have for all the other metrics like I can tell you
[01:20:34.760 -> 01:20:37.980] exactly what metrics to look for on your strength on your
[01:20:38.640 -> 01:20:42.920] Stability on your fitness on your sleep on your nutrition all of those things. I
[01:20:43.960 -> 01:20:47.600] think it's just a general sense of what,
[01:20:48.000 -> 01:20:49.880] what are your relationships like?
[01:20:50.080 -> 01:20:54.200] I think that's probably the best barometer of, of,
[01:20:54.280 -> 01:20:55.840] of your emotional health. You know,
[01:20:56.720 -> 01:21:01.560] do you have people in your life that you can call up and talk about something
[01:21:01.840 -> 01:21:04.200] that is deeply troubling and upsetting?
[01:21:04.840 -> 01:21:08.000] Are there people who can call you in that way and can you be there for them?
[01:21:08.000 -> 01:21:11.500] How do you handle the ebbs and flows of your mood?
[01:21:11.500 -> 01:21:14.500] I mean, I think there's this misunderstanding that being emotionally
[01:21:14.500 -> 01:21:16.000] healthy means you're always happy.
[01:21:16.000 -> 01:21:18.000] I don't think that's remotely true.
[01:21:18.000 -> 01:21:24.000] You know, happiness as a sort of fleeting transient state and sort of
[01:21:24.000 -> 01:21:27.280] being emotionally healthy are quite different an emotionally healthy
[01:21:27.640 -> 01:21:34.640] Person can be quite unhappy at times, but they're not destructive when they're unhappy to themselves and to others
[01:21:35.200 -> 01:21:37.200] an emotionally unhealthy person
[01:21:37.800 -> 01:21:42.160] Will make a mistake and they'll double down on the mistake and they won't
[01:21:42.800 -> 01:21:50.160] Reconcile the mistake whereas if you're emotionally healthy, you'll make a mistake, but you'll work to rectify it. You'll fix it.
[01:21:50.720 -> 01:21:55.600] So I think probably the most important thing is just kind of taking stock of those things.
[01:21:56.400 -> 01:22:03.360] The truth of it is, I do think that this is an area where I think there are more and more
[01:22:03.360 -> 01:22:07.320] resources that are going towards getting therapy. And I do
[01:22:07.320 -> 01:22:14.240] think it's very important that people understand that a lot of our experiences when we grew up,
[01:22:14.240 -> 01:22:21.880] good and bad, really had a significant effect on shaping who we are as adults. And many of us as
[01:22:21.880 -> 01:22:27.280] adults are just big children. Like we shouldn't confuse the size of our bodies
[01:22:27.280 -> 01:22:29.480] with the maturity of our insides.
[01:22:29.480 -> 01:22:31.880] And I think I was a classic example of that, right?
[01:22:31.880 -> 01:22:35.200] I mean, I was an adult physically,
[01:22:35.200 -> 01:22:37.880] but emotionally a total child.
[01:22:37.880 -> 01:22:40.920] And I had to go back and understand my childhood
[01:22:40.920 -> 01:22:44.520] to then separate the child from the adult.
[01:22:44.520 -> 01:22:45.300] Can we just give a shout out to your wife here as well? my childhood to then separate the child from the adult.
[01:22:48.100 -> 01:22:51.300] Can we just give a shout out to your wife here as well? Because I think she's the hidden hero of your book.
[01:22:51.600 -> 01:22:52.600] She sure is.
[01:22:52.600 -> 01:22:56.200] Yeah, because there's that brilliant story that made me laugh out loud
[01:22:56.200 -> 01:22:59.000] where you describe you've done this great swim.
[01:22:59.300 -> 01:23:02.300] I think is it in Hawaii where you are at the time?
[01:23:02.300 -> 01:23:05.320] It might have been Catalina, which is off the coast of Los Angeles.
[01:23:05.320 -> 01:23:05.520] Yeah.
[01:23:05.520 -> 01:23:05.760] Yeah.
[01:23:05.960 -> 01:23:10.560] You've done the swim and she gives you some feedback in the most elegant and
[01:23:10.560 -> 01:23:11.960] sensitive way possible.
[01:23:11.960 -> 01:23:13.280] Would you tell us about that?
[01:23:13.280 -> 01:23:17.280] Because I think there's something in it about sometimes it's not what you say.
[01:23:17.280 -> 01:23:20.360] It's how you say it that really lands the message.
[01:23:20.680 -> 01:23:22.600] That's such a British thing to say too, isn't it?
[01:23:22.960 -> 01:23:23.240] Right.
[01:23:23.280 -> 01:23:24.040] Just, yes.
[01:23:24.040 -> 01:23:25.000] So, so understated
[01:23:25.000 -> 01:23:30.000] Uh, no, she just she she wanted to tell me that I was getting a little overweight
[01:23:30.000 -> 01:23:36.000] But she said it in the nicest way possible, which is I think you should work on being a little less not thin
[01:23:36.000 -> 01:23:42.000] Very good. She sounds like a special woman. She is before we move to our quickfire questions
[01:23:42.000 -> 01:23:49.640] We have a final pillar that we want to talk to you about, which is the idea of supplements and additional input into the body.
[01:23:49.640 -> 01:23:52.280] And there will be people listening to this who think you get it all from food.
[01:23:52.280 -> 01:23:54.080] If you eat right, you will have everything you need.
[01:23:54.080 -> 01:23:58.760] There will be others that are on 60 tablets a day and don't really have any idea whether
[01:23:58.760 -> 01:24:01.040] they're working or not.
[01:24:01.040 -> 01:24:06.320] So I would love to hear you talk to our audience about the power of supplementation.
[01:24:07.160 -> 01:24:29.040] Well, I mean, uh, the truth of it is, I don't know that we'll ever fully know the answer on some of these things because there's not as significant a motivation to study them the way at least there is a force regulatory manner in which we have to do the same for pharmacologic drugs, right? so we can at least have some sense of what the risks are and what the benefits are of
[01:24:29.560 -> 01:24:34.460] A certain class of drug and we might have a you know, we might be able to look at an antibiotic and say well
[01:24:34.680 -> 01:24:40.560] You know look the antibiotics clearly all come with with risks and dangers, but they also come with these benefits
[01:24:40.560 -> 01:24:41.120] and so
[01:24:41.120 -> 01:24:48.960] if you look like this and you have this infection odds are you really do want to be on this drug because of this reason and that's obviously a drug that you take it for a short
[01:24:48.960 -> 01:24:54.160] period of time we can do the same calculation for drugs that you take for long periods of time.
[01:24:54.160 -> 01:24:58.800] When it comes to supplements those studies don't exist so even taking something as simple as vitamin
[01:24:58.800 -> 01:25:08.340] D. Now I believe that vitamin D is an important hormone and I believe that most people these
[01:25:08.340 -> 01:25:12.820] days are probably deficient in vitamin D, um, on account of the fact that we don't spend
[01:25:12.820 -> 01:25:14.660] enough time outside.
[01:25:14.660 -> 01:25:17.160] And that's, again, that's just a consequence of modernity.
[01:25:17.160 -> 01:25:21.920] That's a consequence of the, in many ways, the benefits of the world we live in today.
[01:25:21.920 -> 01:25:27.880] And so the question then becomes, well, should we supplement with vitamin D? And if you turn to the literature to answer that question, you'll get a very
[01:25:27.880 -> 01:25:35.060] unsatisfactory answer, which is probably not. But if you really scrutinize those studies,
[01:25:35.060 -> 01:25:40.720] you come away realizing they've failed to ask the question correctly, right? I mean,
[01:25:40.720 -> 01:25:45.000] I can give you an example of a very prominent study that looked at this, which
[01:25:45.000 -> 01:25:48.080] took a group of people who had low levels of vitamin D measured.
[01:25:48.080 -> 01:25:53.960] So I think these people were below a level of 30, and they gave them all 2000 IU of vitamin
[01:25:53.960 -> 01:25:57.840] D, and they never really checked who took it and who didn't, and they never measured
[01:25:57.840 -> 01:26:01.960] their levels again, and then they concluded in, I don't know, five, seven years later,
[01:26:01.960 -> 01:26:04.480] it didn't have any positive benefits on their health.
[01:26:04.480 -> 01:26:06.360] The problem with that is many fold.
[01:26:06.360 -> 01:26:09.720] First of all, you don't really think of vitamin D
[01:26:09.720 -> 01:26:11.280] as something that's a fixed dose.
[01:26:11.280 -> 01:26:13.280] You think of it as a target level.
[01:26:13.280 -> 01:26:14.960] So a better way to do that study would have said,
[01:26:14.960 -> 01:26:18.200] let's take people below 30 and give half of them a placebo,
[01:26:18.200 -> 01:26:20.880] and let's give the other half whatever amount is needed
[01:26:20.880 -> 01:26:22.920] to get them to say 60,
[01:26:22.920 -> 01:26:25.460] which would be a significant enough difference comparing
[01:26:25.460 -> 01:26:27.960] people at 30 to 30 at 60.
[01:26:27.960 -> 01:26:32.040] You might also want to study them for a longer period of time, but understanding that that
[01:26:32.040 -> 01:26:34.660] might be challenging, and then you might have a better sense.
[01:26:34.660 -> 01:26:39.560] So I would be more confident saying yes or no to vitamin D if I had those type of data.
[01:26:39.560 -> 01:26:51.840] But absent those type of data, I kind of err on the side of thinking that, you know, having a vitamin D level somewhere between 40 to 60 or 70 is probably right. And therefore I supplement
[01:26:51.840 -> 01:26:55.640] to make sure that I'm in that level. And the, you know, the amount of vitamin D I need to
[01:26:55.640 -> 01:26:58.240] get there is about 5,000 IU.
[01:26:58.240 -> 01:27:02.000] What should our relationship be with supplements?
[01:27:02.000 -> 01:27:06.240] I mean, again, I think it's the, it's the most complicated thing I talk about with my patients.
[01:27:06.240 -> 01:27:10.920] And I have a series of questions that I ask them with respect to every supplement.
[01:27:10.920 -> 01:27:15.140] So if I have patients that show up in the practice taking, I mean, literally some people
[01:27:15.140 -> 01:27:20.320] show up, as you said, taking 60 different things and they can't tell me why and they
[01:27:20.320 -> 01:27:22.120] can't answer the most fundamental question.
[01:27:22.120 -> 01:27:25.600] So I will start by asking them the following question.
[01:27:32.480 -> 01:27:40.640] Are you taking this supplement because you believe it is impacting your lifespan or your health span? If it is impacting your lifespan, do you believe it is doing so through a specific
[01:27:40.640 -> 01:27:45.080] disease modulating pathway or through some broader
[01:27:45.080 -> 01:27:46.440] Giro protective pathway.
[01:27:46.440 -> 01:27:52.120] Giro protective just means targeting a biologic hallmark of aging rather than a
[01:27:52.120 -> 01:27:54.080] specific disease like cancer or heart disease.
[01:27:54.640 -> 01:28:00.120] Are there data that demonstrate the safety of this product in humans?
[01:28:00.840 -> 01:28:07.920] Are there data that demonstrate the efficacy of this product in humans? If not, how compelling
[01:28:07.920 -> 01:28:12.040] or robust are the data in non-humans? Like I just literally, it's like eight questions
[01:28:12.040 -> 01:28:17.600] or something like that. And I think by the time most people get through answering these
[01:28:17.600 -> 01:28:22.640] questions for three of the 60 supplements, they realize, okay, how about we put all the
[01:28:22.640 -> 01:28:25.800] supplements away and we come back to it through the lens
[01:28:25.800 -> 01:28:26.800] of need.
[01:28:26.800 -> 01:28:30.800] So, I think a more important way to think about this is like, what's the gap you're
[01:28:30.800 -> 01:28:31.800] filling?
[01:28:31.800 -> 01:28:36.040] So, if you can demonstrate vitamin D is not at the right level, it makes sense to supplement.
[01:28:36.040 -> 01:28:39.520] If you can demonstrate EPA and DHA are not at the right level, it makes sense to supplement
[01:28:39.520 -> 01:28:40.520] those.
[01:28:40.520 -> 01:28:44.040] If you can demonstrate homocysteine is too high, B vitamin level too low, then it makes
[01:28:44.040 -> 01:28:45.280] sense to supplement.
[01:28:47.480 -> 01:28:50.760] So, I'm not opposed to supplementation. I just think it has to be very targeted and very thoughtful.
[01:28:50.960 -> 01:28:55.160] And if I can't answer those questions that I laid out, then I don't, it doesn't make sense.
[01:28:55.160 -> 01:28:55.440] Yeah.
[01:28:55.520 -> 01:29:02.120] I mean, most people wouldn't go through the having blood tests and getting themselves looked at right to work out what supplements to take.
[01:29:02.600 -> 01:29:08.060] So is there, is there anything that you think we should should all is there like a blanket approach that we should all be
[01:29:08.060 -> 01:29:13.340] taking here take these things because it's a good insurance policy or is it
[01:29:13.340 -> 01:29:17.180] not that simple I think it's hard with supplements yeah yeah are you ready for
[01:29:17.180 -> 01:29:21.020] some quickfire questions I'm a little nervous that there's no need to be
[01:29:21.020 -> 01:29:28.040] nervous what are the three non-negotiables that you and the people around you need to buy into?
[01:29:28.760 -> 01:29:36.000] Daily exercise, almost without exception, being outdoors at some point during the day
[01:29:36.040 -> 01:29:37.600] without electronics.
[01:29:38.600 -> 01:29:42.560] So for me, like walking outside with a heavy backpack, something called a rucking,
[01:29:43.160 -> 01:29:44.400] something of that nature.
[01:29:44.400 -> 01:29:44.600] Yeah.
[01:29:42.540 -> 01:29:43.040] with a heavy backpack, something called rucking,
[01:29:44.340 -> 01:29:44.360] something of that nature.
[01:29:48.040 -> 01:29:48.640] But just being outside and being able to observe nature
[01:29:53.460 -> 01:29:53.480] and probably getting an appropriate amount
[01:29:54.640 -> 01:29:55.300] of protein per day.
[01:29:56.360 -> 01:29:56.380] These are all health related.
[01:29:57.380 -> 01:29:57.680] Yeah, yeah, they're great.
[01:29:59.940 -> 01:29:59.960] What advice would you give to a teenage Peter?
[01:30:03.300 -> 01:30:03.960] I'm sad to say he wouldn't listen to anything I would say,
[01:30:05.800 -> 01:30:08.600] but I guess I would give it to him anyway, and I would encourage him to do,
[01:30:09.000 -> 01:30:10.300] at least in his 20s,
[01:30:10.300 -> 01:30:13.300] what he waited until his 40s to do with respect to
[01:30:13.600 -> 01:30:16.100] understanding the forces that are shaping him.
[01:30:17.000 -> 01:30:19.000] If you could go back to one moment in your life,
[01:30:19.600 -> 01:30:20.800] what would it be and why?
[01:30:21.200 -> 01:30:22.500] Boy, I can answer this two ways.
[01:30:22.500 -> 01:30:24.100] There's a positive and a negative way.
[01:30:25.680 -> 01:30:27.560] Why don't you give us both?
[01:30:27.560 -> 01:30:29.800] I think the positive is I would probably go back
[01:30:29.800 -> 01:30:32.320] to the day my daughter was born again.
[01:30:32.320 -> 01:30:35.560] I think as much as I remember it now,
[01:30:35.560 -> 01:30:37.560] I mean, it was, I think,
[01:30:37.560 -> 01:30:39.960] still one of the most remarkable things ever.
[01:30:39.960 -> 01:30:41.160] So I think to be able to go back
[01:30:41.160 -> 01:30:43.800] and experience that again would be amazing.
[01:30:43.800 -> 01:30:48.820] I think there's a moment in my life when I did something that was incredibly
[01:30:48.820 -> 01:30:52.660] hurtful to someone who meant a lot to me.
[01:30:53.200 -> 01:30:55.500] And I wish I could go back and undo it,
[01:30:56.820 -> 01:30:59.380] even though that person has, has forgiven me for it.
[01:30:59.660 -> 01:31:02.260] What's the most valuable piece of advice you've ever received?
[01:31:03.820 -> 01:31:09.000] I don't know that it's advice, but it's, it's a profound statement that has helped me understand how I feel and
[01:31:09.000 -> 01:31:17.660] it's that 90% of male rage is helplessness which allows me in moments
[01:31:17.660 -> 01:31:22.820] of rage to understand why I'm so angry. Would you please recommend one book or
[01:31:22.820 -> 01:31:29.000] maybe a podcast or a TV series that you would like our audience to take a look at?
[01:31:29.000 -> 01:31:45.880] Maybe the Comfort Crisis by Michael Easter would be a great one for people to read if they need a little bit of motivation to get moving again and to sort of break out of their comfort bubble.
[01:31:45.880 -> 01:31:50.680] And the final question then Peter is, what's your one golden rule to live a high performance
[01:31:50.680 -> 01:31:51.680] life?
[01:31:51.680 -> 01:32:01.200] I mean, I think you can never take your eye off the prize and the prize is, is my eulogy
[01:32:01.200 -> 01:32:10.280] going to be better than my resume? If you think about that, I think you're going to generally make the right decision
[01:32:10.860 -> 01:32:13.700] Day in and day out. What a brilliant way to end
[01:32:14.400 -> 01:32:16.400] Peter thank you so much for your time
[01:32:19.960 -> 01:32:24.260] Damien Jake, there's loads of us to pick out from that. I think the key is
[01:32:24.940 -> 01:32:29.320] You can just ignore that and think loads of great information and carry on exactly as we are today
[01:32:29.760 -> 01:32:33.800] Or we can actually just stop and go right. What is my relationship like with my phone?
[01:32:34.320 -> 01:32:36.320] What is my relationship like with sleep?
[01:32:36.640 -> 01:32:42.680] Can I carry out some of those things he talks about like hanging from a bar and you know, should I be setting my own?
[01:32:43.440 -> 01:32:47.520] metrics and my own
[01:32:44.380 -> 01:32:48.520] parameters for doing exercise because
[01:32:47.520 -> 01:32:49.720] it's all great information but it's
[01:32:48.520 -> 01:32:52.440] only great information if you act upon
[01:32:49.720 -> 01:32:53.960] it. Yeah definitely I think what he was a
[01:32:52.440 -> 01:32:55.320] great advocate there is that famous
[01:32:53.960 -> 01:32:57.760] Stephen Covey quote that you should always
[01:32:55.320 -> 01:32:59.640] start with the end in mind and I think
[01:32:57.760 -> 01:33:02.160] we're gonna be so wherever we are at the
[01:32:59.640 -> 01:33:03.800] moment we can start but if we do that
[01:33:02.160 -> 01:33:06.080] projection forward and think about what
[01:33:03.800 -> 01:33:06.240] do I
[01:33:04.240 -> 01:33:08.680] want my later years to be like, do I
[01:33:06.240 -> 01:33:10.320] want to be able to go walking, do I want
[01:33:08.680 -> 01:33:12.080] to play with my grandchildren, do I
[01:33:10.320 -> 01:33:14.400] want to be able to go on holiday and
[01:33:12.080 -> 01:33:16.800] enjoy the experience. If we start with
[01:33:14.400 -> 01:33:19.040] that in the mind that then forces us
[01:33:16.800 -> 01:33:21.240] into looking at what we're doing today,
[01:33:19.040 -> 01:33:22.880] can we hang from bars, can we, are we
[01:33:21.240 -> 01:33:25.400] making smart choices when we go food
[01:33:22.880 -> 01:33:27.040] shopping. It's also a reminder as well that you don't stumble into this stuff
[01:33:27.040 -> 01:33:31.020] Like it takes a bit of time and a bit of preparation and a bit of thought, you know
[01:33:31.020 -> 01:33:35.680] Before the interview we sat outside and he genuinely did eat some nuts out of a pot that he brought with him
[01:33:35.680 -> 01:33:39.000] And he had four or five like jerky sticks
[01:33:39.800 -> 01:33:41.880] Venison actually that he ate and that was his lunch
[01:33:41.880 -> 01:33:46.280] So it means that we offered him a sandwich and we offered him some brownies and some fruit and some other
[01:33:46.280 -> 01:33:50.920] bits and pieces but the prep the thought the process was already there we have to
[01:33:50.920 -> 01:33:54.560] start doing that you can't just stumble through get to 17 think shit I've just
[01:33:54.560 -> 01:33:58.000] been diagnosed with something horrible I wish I thought a bit more about my small
[01:33:58.000 -> 01:34:01.520] daily decisions those world-class basics we talk about I see it in so many
[01:34:01.520 -> 01:34:09.120] different aspects of lives I don't know about you, like when you meet people that have maybe been successful financially but
[01:34:09.120 -> 01:34:13.200] they've still got that voracious appetite for more and that metaphor that
[01:34:13.200 -> 01:34:17.240] Peter used of don't go food shopping when you're hungry, yeah, is really
[01:34:17.240 -> 01:34:20.760] important that I think when I've met people that have maybe made a lot of
[01:34:20.760 -> 01:34:24.640] money but need more, it's because they never set themselves a target of how
[01:34:24.640 -> 01:34:28.120] much is enough for you, what's the quality of life you want around it. And I
[01:34:28.120 -> 01:34:34.400] think that metaphor extends whether it's like you say to exercise, well, what do you want,
[01:34:34.400 -> 01:34:39.840] what are your targets, whether it's your nutrition, what is a healthy diet for you.
[01:34:39.840 -> 01:34:41.640] Very important. Thanks, mate.
[01:34:41.640 -> 01:34:42.640] Thanks, mate.
[01:34:42.640 -> 01:34:47.760] And that brings us to the end of today's episode of the High Performance Podcast.
[01:34:47.760 -> 01:34:52.080] Don't forget you can watch these episodes on YouTube. You can also download the all-new
[01:34:52.080 -> 01:34:56.400] High Performance app which gets you closer to your own version of high performance. And you
[01:34:56.400 -> 01:35:00.560] know Peter spoke about doing those little things every day which are good for you.
[01:35:00.560 -> 01:35:09.600] And the High Performance app offers you daily boosts, daily short clips of inspiration, just to uplift you, to guide you, to help you get closer to high performance.
[01:35:09.600 -> 01:35:13.280] All you need to do is click the link in the description to this podcast or head to the
[01:35:13.280 -> 01:35:16.800] App Store to download the all new High Performance App.
[01:35:16.800 -> 01:35:20.960] Peter, thank you so much for joining us. Thank you so much for listening. And we'll see you
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