Death is inevitable, but the rate of decline is very much up to us, but the drawback that young people have is they only begin to realize the inevitability of the decline when it be sets that. So your team that came in for testing that are in their 20s. When I'm looking at these results, there were issues that were uncovered, that were of concern and ignoring, it doesn't lead to a good outcome. When you're 65, but a lot of people have this issue. So, it's okay to speak freely about this. Yeah, the biggest concern is that dr. Peter a TIA, is the go to physician for high performers.
Liberty's. And anyone
serious about unlocking, the science behind a longer stronger, healthier
life? I had a big Epiphany at a funeral of a friend of mine who I realized had declined so much during their last decade. That when they couldn't do those things that gave them pleasure because of injuries aches and pains they weren't enjoying life, I called the marginal decade.
Wow. Okay. So what are the most important parts of my health? I should you thinking about the longevity. So there's muscle mass
muscle strength but we don't have a single metric of we can measure that better.
How long they will live but how high
their VO2 max, which is the maximum amount of oxygen, you can consume. And if you compare somebody who is in the top 2% to someone who is in the bottom 25%, there is a 400 percent difference in their all-cause, mortality over the coming
year but how do I know if it's an issue? Will
go into much more detail around that but the way to avoid this is to train specifically for that marginal decade. And there's so many things that we just
do wrong the sooner you start the better. So rule number one,
I find it incredibly fascinating that when we look at the back end of spotify and apple and our audio channels, the majority of people that watch this podcast haven't yet. Hit the follow button or the Subscribe button, wherever you listening to this. I would like to make a deal with you. If you could do me a huge favor and hit that subscribe button. I will work tirelessly from now until forever, to make the show better and better and better and better. I can't tell you how much it helps when you hit that subscribe button. The show gets bigger which means we can expand the production bring in all the guests. You want to see and continue to do?
Thing we love. If you could do me that small favor and hit the follow button wherever you're listening to this, that would mean the world to me, that is the only favor I will ever ask you. Thank you so much for your time back to this episode.
But to be through Tia,
what is keeping you busy at the moment? In terms of the subjects that you wrote about an out live, but the work that you do online in the work, you do in the variety of businesses that you have, what is keeping you fascinated at the moment? Like what is what is one's mind? Focus on?
I wish I could say one thing. There's probably a few things and maybe that's not good. Maybe the most successful people in life, only think about one thing. I would say. One of the things I'm thinking a lot about is how to
To translate outlive into a delivery system, obviously digitally that basically operationalizes what is in that book in a manner that allows people to with as little friction as possible, implement the solutions for themselves. So basically, how do you live a longer life? How do you age as gracefully as possible and maximize your health span? I think the other thing I'm focused on that is related to that, of course, but
Stinked which I know your team got to participate in a little bit. This week was kind of how to train people for their marginal decade, right? So this idea of we're all going to have a last decade of life. I called the marginal decade just so that we can get comfortable talking about something that people don't like to think about.
And
I'm convinced that ignoring it and not thinking about it doesn't lead to a good outcome instead if you prepare for it.
It and train for it, like an athlete trains and prepares for their sport. You'll have the best version of that
possible monsoonal decades, and cinterion decathlon. Did I say that? Correctly,
centenarian decathlon. Yes, in Sumerian decathlon. Can you explain these two terms to me? Yep. So the Marshal decade is the last last decade of life. Again, it's this weird thing where most people don't know the day, they've entered it. But most people also realize at some point when they're in it.
I thought a lot about it. This was sort of a big Epiphany that I had in 2018 when I was sitting in the in the church at a funeral of the parent of a friend of mine, who's who I realized had declined so much during the last decade of their life. That even though they were alive, they weren't enjoying life. The things that they loved to do. In the case of this individual play golf and tend to the Garden. It
Do you just physically couldn't do it right? They had injuries. They had aches and
pains and when they
couldn't do those things that gave them pleasure, they retreated from life. And I don't think there's a person listening to us who can't appreciate that because they've witnessed it, right? They've seen it in a parent, a grandparent, a loved one and I don't know there was just something about that moment which is often the case right? It's usually like years and years of thinking about something and it
Crystallizes in an instant. But in that moment, I realized aha, the way to avoid
this is to
train specifically for that decade
and the
best model for how to do that, is to look at athletes because every athlete trains with specificity. So, think of like all the different types of athletes, you would know. So, if you think about like a sprinter or a basketball player, or a football player,
They are so different and very little of their
training, looks like the other guy. And the reason for that is they're doing something very specific, right? The Sprinter has a goal, which is to move 100 meters as fast as possible. That's it. And that requires a certain set of skills, and the footballer has a totally different goal. Yes, he has to be able to run fast for short distances, but just being able to run fast would not produce and, you know, Superior results and then the basketball player would be different. And then
Skier would have a totally different set of skills. So
I said, well who's the most well-rounded athlete out there? It's the decathlete because that guy's got to do 10 different things really well.
Now, he or she doesn't have to be the
best in the world at those
10. In fact they never are but overall, they're considered the best athlete because of the diversity and breadth of what they can do.
And so I said that is our
model. So what is the
centenarian decathlon then is I say to you, Steven
one day you were going to be in your marginal decade, what do you want to be able to do physically athletically in that last decade? It's the answer so clear to me because it's associated with all the things that make me happy. So it would be being able to explore the world. Still, with my partner, my romantic partner, it would be
But I would even dig further. Tell me what that looks like. Okay. So I went to Bali and me and my girlfriend wanted to go whitewater, rafting and to get down to the Whitewater. Rafts in Bali, we had to walk down and then up again. Mmm about 100 meters of stairs. And as I went down those stairs, I had one of those moments that it sounds like you had at the funeral where I realized that my dad could not walk down these stairs. He couldn't walk down them and he couldn't walk up them. And by the way, it's a different reason.
I'm going to point this out. And I want to come back to your
Story walking down is not about endurance, walking down is about eccentric, strength in the quads, to be able to decelerate the body. As it's moving down very important. Coming up is about concentric strength in the quads and glutes and endurance. Okay. Alright, but continue
now, that's a really good point because that two different. Yep, training systems. And then, the reason why that was so important was because of the great time I had in the white water raft with my girlfriend. So going down that leg.
rupali and I thought, gosh, it was so if I hadn't
If I'm not careful and I don't think about this, I won't be able to have these experiences when I'm 60. What was involved in being in the route. Yeah, so a lot of strength required to like a row and to keep us away from the rocks to push us off when we got stuck fall in the water. Get it back in the boat. Absolutely. Think about the
scapular stability. That's required. Think about the upper body strength. You need to lift yourself back into a boat if you fall. Yeah, I mean the list goes on and on and
on and it was it was it took a long time. We were out there for two hours, going through this lake, so
Thing I think about is Christmas and I think about my nieces and my brothers a year older than me and he has three kids under the age of six and you know what, that's like these kids just Sprint off in every direction and they'll say to my dad, they'll say come and play in the garden and my dad wouldn't be able to play with them in the garden. The way that they would want to play in the garden, running around and being chased around. So my dad just watches them from the kitchen. And so I, these are just obviously, all the emotional things come to mind first because those are the things that stay with us. I'll give you
One more.
The other thing that comes to mind as a man, it's just being able to protect my family. Mmm. And I don't necessarily mean wrestling Intruder. But I mean, like, lift things and if something Falls, being able to pick it up and move it. So, those are the things that come come to mind. First, and foremost, its protection. Its memories. Its activities that create relationships and connection. That's exactly
the exercise we do, right? We take people through, give us the 10, most important things you want to be able to do so like
If you start with, I want to be able to go back to Bali and I want to be able to go down those hundred stairs. Get in the raft, go down the river, come back up the stairs. That gets broken down into very specific movement patterns playing football with the kids out back. Gets broken down into very specific movement patterns by the way, they're very different. And that one comes down much more to foot. Reactivity, lateral, movement, things like that. Being able to pick something up off. The floor is yet another set of movement patterns. It turns out
there are approximately 27, physical requirements that are necessary to do the sum total of most things. People want to do part
of the reason why I think people don't care enough is because they see aging as inevitable. So they look at that, that parents, their grandparents and go, there are mobile, they can't function properly, that's my destiny, its genetic.
Obviously, I don't agree with that, though. I have tremendous empathy for people who might feel that way, it's when you see something as ubiquitous as the decline of Untold numbers of people as they age, it would be very easy. And tempting to say that that is the inevitability of our species
death is inevitable.
Despite what some bio hackers may
tell. You decline is inevitable
but the rate of decline
Is very much up to us and the
preservation of strength stamina movement capacity. Those things are largely up to us. In fact, there are actual data that demonstrate quite clearly. In fact, I was just reading a paper yesterday in the journal cell that looked at the role of exercise in aging individuals to preserve mitochondrial function. So this is
a study that looked at older individuals and it randomized one group to a significant amount of exercise. And the other group was just sort of business, as usual being largely sedentary and then using pretty elaborate techniques. Where you biopsy the muscle, they look at the mitochondria which are the kind of the PowerHouse of the cell in these individuals and it turned out that in the people who were exercising, there was very little decline in the mitochondrial function, compared to what happened in the people who were not
Exercising now just
because your mitochondria continue to function, well doesn't mean all aspects of Aging or offset but it's a very important one to demonstrate. And this is also True by the way of strength and endurance, there's a big difference in the rate of decline of muscle mass muscle strength and cardio pulmonary Fitness in people who exercise versus who don't.
So it's all kind of
a long-winded way of saying
you have
as an individual. So much more under your control then
You realize, but you have to sort of begin to compounding the gains, I'll do it when I'm
50?
Well, look, the good news is 50 isn't too old. And I've met many people who don't begin to do this until they're 50 but again, the analogy I would use here is comparable to that of investing for retirement. The longer you
wait, the less money, you're probably going to have at the end.
Springs to mind. This graph ice will be the day which had sent to my friends, which shows that the decline. I think it was in muscle mass from when you're 30. And it makes the point that there's this line which on this graph called disability. And it shows that people who didn't have enough muscle mass when they were 30 cross. The line of disability when they're 70 and those that did have more muscle mass at 30, don't don't get close to that line so that for me was shocking because it goes to show that what I do.
I was going to determine whether I'm
You know, boiled in terms of measures disabled, when I'm 70, or if I'm able the sooner, you
start the better, the drawback that young people have is, I mean, you've had a, you've had a great experience because you're your introspective about it and you've been able to observe it in somebody older, so you've been able to gather motivation without having to experience the decline
yourself.
So that's a, that's a wonderful position to be in for many people. That's not the case. They only begin to
realize the inevitability of the decline when it be sets them. But the way to think about this again, is another analogy is that of a glider. So gliders, eventually all have to come down, right? Our health span is basically a glider, but we have a lot of control about how long it stays in the air based on how high we can start it. So, if you think about, you know, would you rather take a glider off, a really high cliff or off a low Cliff? That's the
The decision we get to make and we sort of call that concept physiologic Headroom. So the example you gave is a great one, right? So, muscle mass muscle strength, provide, an enormous amount of physiologic Headroom as does cardiopulmonary Fitness. These are huge variables that make all the difference and everyone's coming down, but the fitter, you are the slower, the rate of Decline and therefore the longer it takes, before you cross below a threshold and that threshold.
Hold differs by different metrics, but once you're below that threshold, it's very difficult to engage in activities of enjoyment,
Pizza. You'll 51 Now 52 52. What do you wish someone had told you when you are 32. I'm 32 years old. What do you wish? Someone had screamed in your face and told you when you were
my age.
It wouldn't have been much about exercise. It would have been more about other aspects of life, for sure. Because for whatever reason, I've always gravitated towards exercise, that's always been a very high priority for me. So I think my advice to 32 year old Peter would be much more about relationships and emotional health,
but if I could go back and speak to 14 year old Peter,
He pee, he wouldn't have listened, but I would
have begged
him to go a little bit easier on his body and back off on certain things that probably have led to
injuries. I have today, that could have been prevented.
Can I ask what they said things? Uh,
sure. I think, I think I lifted far too. Heavy far too often and probably without enough coaching on technique and so, you know, I by the time I was 27, I had a devastating back injury but it's one of those things that happened without any incident which in which is often the case, by the way, for a back injury when you really blow out a disc in your back, it's
Not necessarily something you did in that moment. It's usually something that's been built up from the past. So this injury I had at the age of 27, really was the result of years of unnecessarily, heavy axial, loading loading, done, with probably insufficient technique, you know, or technique that was at times sloppy and under fatigue. Because I used to do a lot under fatigue, you know, I sort of believed in training under a lot of fatigue and I
I think that that's a mistake. I think that training under very heavy load, should not be done under great fatigue.
Interesting, we'll talk about that soon on that point of advice that you gave me their about emotional health, one of the things that's been very front of mind for me, at the moment is Men's Health. Hmm, specifically, men's emotional health because I read a report that came out in March called Lost Boys and it just details this pretty horrific picture of men's emotional health in the UK at the moment in particular but the trend holds around the world and it came
Came out in the start of March, has been in all the newspapers in the UK and it details, a couple of sort of headline stats, the reverse gender pay Gap, amongst young men. So women are now learning more, you know, the stats probably around soon for everybody. Yes, it was side and one in seven, young men are unemployed or out of work, all these sort of horrific stats and then compounds with things like suicide, suicidal, ideation etc, etc.
I was thinking about this this morning when I was listening to some your work, I thinking I wonder what Peter's perspective is on what it is to be a man. Actually, it does kind of dovetail into some of your work around testosterone and the decline in testosterone. And because one of the things I was thinking about is how testosterone plays a role in what it is to be a man. But if you look at the stats around testosterone, it appears to be declining. Yes. And I say this in part as well because testosterone causes a certain set of behaviors.
men, that
Define and shape. What a man is and what they want and how they show up. And even when I said earlier on protection, as one of the three things I cared about, that's probably in part because of the testosterone in me, this debate, around testosterone, this conversation around testosterone and its decline.
Is it declining? It is, it is. Why is it declining? And what in is this does it matter?
Well, I think the second question is easier to answer them. The first I do think it matters.
The
the why is probably multifactorial and the Y is just as important as the fact that it is. In other words, the fact that it's declining is both relevant for the fact that a very, very important hormone that has incredible benefit to men and women. By the way, is going
I'm down and we have to come up with an answer to that, right? Like so how do we address that do we address it medically where we replace that hormone exotic? Honestly, meaning we give you that hormone directly or do we try to fix the underlying problem. So if you want to do the ladder, you have to know what the underlying problem is now, at the population level, the best answer as to why testosterone levels are declining and unmistakably they are. So the data here are unambiguous, there's no debate on. This fact, the debate is around the why I
That the best answer probably has to do with two things. One is increase in body weight and fat body fat specifically in men and some combination of reduced quality of sleep and and and sort of disruption to sleep. So why are those two things relevant? So when you increase body fat, two things are happening. One is you're increasing.
Nation and you are reducing the amount of testosterone that gets to stay in the form of testosterone because part of the testosterone gets converted into estrogen. So, with body fat comes more of this process called aromatization or converting testosterone into estrogen. So if you think about what those two things are doing, if you have more inflammation, that reduces your ability to make testosterone and you have more capacity to turn the less testosterone, you make into a
In the net result of that is both of those things are reducing your total pool of testosterone. If you couple that with less, you know, lower quality sleep and I'm not talking about over the last 3 years, I'm comparing like now to say, 40 years ago and what are all the reasons that people might have poor quality of sleep. Now, I think there were many but obviously phones and social media and just the stimulation of the world. We live in probably plays a greater role in that sleep is when we make these hormones, right?
So so, so we make follicle stimulating hormone and luteinizing hormone at their maximum amount during sleep. And those are the hormones that are driving the production of testosterone. So what we've seen in many of our patients, when they have low testosterone because there's a test, you can do to see if their testosterone is low because their body can't make it or because their brain isn't receiving enough of a signal to make it. This is a very easy thing to determine medically.
Unfortunately, most people aren't subjected to that level of testing because they go to these testosterone shops on street corners that are just giving everybody testosterone. But if physician is curious enough to understand that you can give a patient a drug, or a hormone called HCG, HCG is luteinizing hormone which is one of the hormones made by the brain. So if you come in and you see a man who's got very low testosterone and you can understand why you give him luteinizing hormone,
if he still has low testosterone, you know, that he has, what's called primary hypogonadism, which means is testosterone is low, because his testes can't make testosterone conversely. If you give them an luteinizing hormone and all of a sudden, his testosterone goes up, he has secondary hypogonadism or I mean you could mix the primary secondary there. But really what it the terminology doesn't mean anything. What matters is? He can make testosterone but for some reason, his brain isn't giving his body the signal to do.
And that's That's a classic finding in a person who's under high stress and or not sleeping. Well. So that's a long-winded answer to your question, but I think that those are probably the greatest contributors to this. Now, people have talked a lot about what about microplastics, what about other environmental factors? What about other factors in nutrition Beyond? Just the ones that would contribute to excess body fat, the evidence there is less compelling.
But I don't think we should discount it but I think I think that that if those things are playing a role it is probably much smaller than what we
just talked about. I was thinking as you're speaking about sleep and testosterone about how I know. So the link that with bad diets how if I have not slept well I wake up and make worse food choices for sure and I was like is that like dopamine dysfunction like no, it's been probably more due to insulin signaling.
So
We know from
a really good experimental studies that when you sleep deprived people, they become insulin resistant. And the more insulin resistant, a person is the less they're able to access their stored energy. So higher insulin resistance means greater difficulty, accessing stored energy. So if you're if you wake up and your if you know you have successive days of poor sleep and
Are becoming somewhat insulin-resistant. You're going to want to eat more because you're not able to access your own natural stores of fat, which is where we want to go for energy. So if you look at one experiment that was done out of the University of Chicago, they they took healthy subjects, young young subjects and sleep-deprived them for somewhere between 10 and 14 days. So not a huge period of time and they only let them sleep four hours a night.
Which by the way, I know a lot of people who are doing that for years at a time in in that 10 to 14 day period of time, their insulin resistance was worsened by 50%. This is in other words, they, they do an experiment called the glycemic clamp where they inject them with glucose to see how effectively they can put glucose into their cells. Which is that's the that's the Hallmark of insulin. Sensitivity is how well you can put glucose into your muscles when it's infused in you and their capacity.
You to do, that was reduced by 50%, after such a short
intervention. So I think sleep,
restriction, and unhealthy sleep is a very underappreciated cause of metabolic health and weight gain. And then by extension, these other things we're talking about,
it seems to me to be the thing furthest Upstream in my life than kosis. This cascading effect to how I show up it. Mm, sort of cognitive performance. How will I can articulate myself? If I go to the gym, how hard my workout is, if I choose healthy options versus unhealthy options, so
So it feels like the band and mood in general. Yeah, yeah, I mean, look, I I've said this before and I'm
not the first to say this, so I'm paraphrasing others, but if you really stop to think about it sleep, doesn't make a lot of sense from an evolutionary perspective. Like if you go back in time, a few hundred thousand years. Why would we have spent a third of our life
unconscious? It didn't serve our
purpose. You can't mate, you can't hunt, and you can't defend
yourself.
So you have to believe that if we could have evolved out of it, we would have done it and we didn't. So that means that whatever it's doing, it must be really important. I mean core essential to our
existence while I will completely acknowledge the different. People have a different necessity or requirement for how much they sleep. I still think that many people underestimate how much
Need you know, you asked me to start, you said I'm what are the things that you want to do when you reach your marginal decade and I gave you my answer? What's your answer to that? Now that you're a father in have many different season of life?
Well, they're very similar to the types of things you're thinking about and I love how you've got specific examples. So I really like playing with my kids, right? So I can imagine that in my marginal decade I'll have grandkids that are the age of my kids. Yeah, right. And
And you know, maybe a bit older but as I'm even getting towards that marginal decade, okay? So playing sports is really, really fun. I really like playing especially because when I grew up like I played hockey because I grew up in Canada and then I immediately went into kind of boxing and martial arts, and those became my life. So, now playing sports, that I didn't play much. As a kid, is really fun, like, I'm really enjoying baseball. I'm really enjoying soccer. And, and so, when you
These things you
realize this is not an easy thing to do when you get old
like to sit in the, you know, to plate to sit in the goal and actually like stop a ball when a kid is blasting At You full stop. You have to be able to move around. So again, like I would love to be able to play soccer, throw a football, throw and hit a baseball as long as possible, you can get into movements that are much simpler, but if I can do all of those things, I'm in great shape. Now, of course,
Course to be able to do that. I also need to be able to do a lot of things that many people also can't do in their marginal decade, like, sit on the floor, get up off the floor, under their own power. You know, walk up ex number of flights of stairs, having the strength to do that, I like doing certain things. Like I like archery a lot. So it's, you know, I want to be able to pull a bow back, obviously not at the same poundage as the current both at, I pull back but I would still like to be able to pull a 50 pound bow, back in the final decade of my life.
And when you think about all those things,
You want to accomplish if we were then to sort of codify them into a bunch of exercises or areas of your health that you had to now, be thinking about that. I need to be thinking about what are the most important things. So I'm a 32 year old. What are the most important parts of my health that I should be thinking about if I want to achieve all the things that I said to you. My final
decade. No one in the final decade of their life ever said, I wish I had less strength and I wish I wish I had less endurance, so you cannot be too strong and you cannot
It be to fit the only time that one would throttle back on the pursuit of those is a, if doing so is coming at the expense of something else. Either with respect to your health or your life, and to if the pursuit of that at such, an extreme level produces risk of injury. Okay. So in other words, could I be stronger than I am
today? Yes,
I'll give you an example. We know that in resistance training,
In The Sweet Spot for Pure strength, is 125 reps.
When your goal is to maximize strength, you need to be pushing one, two, three, four, five reps. Once you start thinking about hypertrophy muscle size, we're starting to think about 7, 8 9, 10 11, 12 reps. Once we start thinking about muscular endurance, we start thinking about north of 15, right? Those are the general patterns of resistance training.
So if I want to build my muscles because I'm going for aesthetic goals, that I need to be aiming above five, wraps these be 10 or 12. Yeah. If I'm just purely thinking about
Strength, bigger
weights but lower wrap. That's exactly
right, okay, and then I felt muscular
endurance, which I'd be even higher reps, okay? Low white. Yep. Okay. So again we could go into much more detail around that but just to finish the point here, why do I not do much training at 1 to 5 reps? In fact, these days, I don't do any training at 1 to 5 reps
anymore.
Why? Because to train at 1 to 5 reps comes at a risk, especially for heavy compound movements. So like I'm, you know, I'm okay getting a little bit less of a strength benefit while still, of course, getting stronger but training at a higher rep load. So I'm typically, so I'm targeting 8 to 12 reps with one to two reps in reserve is
Sickly. How I'm doing my resistance training. That means every set I'm doing, I would expect to get to within about one rep of failure somewhere. So today, when I lifted, I don't think I did less than 7. I didn't do more than
12, and
the weight was always titrated, so that I was either failing, almost failing or one, rep away from failing, somewhere in there and I was adjusting the weight constantly on every exercise to get there with the exception of one exercise. I didn't push ups, was one of the things I did. Push-ups are kind of more on the muscle endurance.
You see, I'm doing more reps when I was doing push-ups but pretty much everything else was in that range. So again, I'm not fully maximizing strength anymore because the cost of it might be a little bit high in terms of injury risk. Similarly, I'm not strength training 24/7 because I need to make time to do my endurance training and other types of training.
How often do you train resistance training?
I've resistant strain three times a
week and how often do you train?
Generally and
the train, every day, every day. Yeah,
why because you know again the
the intensity of my training is not that high, at least three days a week. So the three resistance days are pretty hard, because I'm really only doing each body part once a week. So, when I'm doing it, I'm really, I'll spend that 90 minutes really, kind of hammering. Those body parts, three of those days are just Zone 2. So 3, 3 of my for cardio days are Zone 2 days.
As where I'm doing, you know, I'm on a bike and I am riding at a level of intensity that actually allows me to still talk some, you know, not talk like I am now but talking on a sort of a strained way. So for me, that's about a heart rate of 140 beats per minute
and that's just not that's just not
taking a huge toll on me like that. Those are almost like recovery days for me and then one day a week, I do.
I've really, really hard vo2max day and that's, that's a really hard day, that burns a lot of matches that's tomorrow. Not looking forward to this. Do you do cardio on your resistance training days as well? No, no I don't. So it's the seven-day, it's four days of cardio. Three days of resistance. Now, that's going to change in the summer. When I'm going to add three days of swimming and I will end up doing some swims on some resistance
days. So,
Before you do your resistance workout, you don't go in the step after 20 minutes or
cycle for 20 minutes or something. I don't, is there a particular reason why it wouldn't really serve a purpose. I so I know a lot of people do that. I know a lot of people will say, hey, I'm going to do a little bit of a warm up on this treadmill or the step Master before I lift. But I actually have a pretty strong point of view on how we should warm up to lift. And I don't think walking on the treadmill or running on the treadmill or being on the StairMaster on the bike is a great prep for the lift. I think it's better to warm up for a
F doing movements that prepare you to lift. So, for example, like if it's a leg day, so Monday's leg day, right? So what am I going to do? I'm going to start by doing a bunch of core stabilizing stuff. So I'm going to do a whole bunch of this Dynamic, neuromuscular stabilization stuff. So you get into basically these baby positions and you really learn to activate your core As you move around in a six-month position and stuff like that, I then do a whole bunch of like, you know, to 90 90 is or aschenbach.
Ox exercises where you're kind of on the ground in a position where you're really. I see, you know, you can start out doing it isometrically, but ultimately going through a slow eccentric and concentric phase of movement, that's kind of activating glutes. So I go through basically a whole DNS sequence, then I get into a dynamic movement prep. So then I get into a bunch of bouncing, a bunch of footwork, and then I start with really lightweight. So I'll go to a leg extension machine. And do very, very light leg.
It's very very light leg curls. Come back and do more jumping and moving and lunging and go back for it. So I'll spend 20 minutes doing a warm-up but the warm-up is geared for me to lift whereas if I had just sat on a bike and pedaled around, that doesn't actually replicate any of the movements I'm going to do. When I start loading
myself, I've got particularly concerned about injury. Yeah. Now that I'm 32 because when I was 30, 20, I could do almost anything. It seemed nothing would break, but I had a couple of injuries when doing like shoulder press.
Has and things like that. And one of my friends had a similar injury recently which took him out for three or four months where he did a shoulder press pulled something in his back or something as like neck. Yeah. And then he could like turn his head anymore in terms of injury.
If I wanted to get injured, am I right in thinking that the the thing that leads to injuries, basically, just walking straight in and trying to lift something heavy. Or is there things further Upstream that cause injury in the gym? Know? There's I mean, that's
one way to increase your risk of injury for sure. But but, yes, there are other ways that it can happen. And I think about it a lot. I mean, one of the injuries. I think a lot about our calf injuries. Achilles injuries sort of tendon injuries. This is, I think one of the things that becomes a real problem
Bloom for people as they age, you know, you often hear about people my age tearing and achilles. Yeah, it's a devastating injury now, again, it's not devastating in that. You won't recover from it, but boy, it's going to take you out of commission for six months. So a lot of these injuries happen because the individual still has strength, but they've, they've kind of lost some of the pliability in the tendon, because they've kind of lost some of the jumping. That's why I always start these workouts with low.
Low level of jumping and I'll progress to higher levels of jumping. But jumping is actually a very important part of training and it's one of the things that we take for granted but boy when your ability to jump is gone and jumping, by the way, can mean like just initiating a jump but it can also mean jumping off something and stopping yourself. Those are really important skills. And so like something like jumping rope is really important, right? Your feet are just kind of moving like that. They're acting as shock absorbers cash.
Laughs, and achilles have to constantly change in length. And that accommodation is a really important part of resilience. And I think that should, that should be an important part of everybody's warm up at a minimum, if not part of their
workout. One thing, I'd love you to do is to persuade people. Listening that muscle mass matters for longevity because
And also, if you can within that, that leg day matters
because we all avoid
leg, treating me and sometimes I need to be
told again. Why it
matters for me
dad. Well, I mean, I think look muscle mass is probably the second most highly correlated finding or third most to longevity after strength and cardiorespiratory Fitness
vo2max.
So why is that? So first of all, I think that muscle mass is both directly a proxy for strength. In general, the more muscle you have the stronger. You are we all know exceptions to that. We know wiry little people who are insanely strong and I have patients like that, they're just naturally, you know, thin people but when we put them through the testing,
protocols,
You know, their
remarkable in terms of their strengths and I tend to not worry about the fact that there's slight and build when I see that there's strong across the board, there is another benefit of muscle mass which is it's the place where you dispose of glucose. So from a metabolic perspective, the more muscle mass you have, the more glucose buffering capacity
you have. And what does that matter as I age? Because, you know, one of the
Hallmarks of Aging is a reduction in the capacity to
Metabolize and buffer glucose. And so as as glucose levels become less and less regulated, all sorts of bad things, happen, bad things. Happen to micro vessels in the body. So we if you think of the most extreme example of this is type 2 diabetes. So once a person has Type 2 diabetes, what are they at risk for there at the risk of reduced vision and ultimately blindness amputations of their digits, impotence right? The penis has tons of tiny blood vessels in it and the more that you know, like
Isolated proteins, accumulate there, the less they get blood flow and obviously damage to the small blood vessels of the brain as well. So all of these things are hugely problematic when glucose is disregulated. And again, the most important thing that you can do to regulate glucose, in addition to the obvious, which is eating in energy balance, not eating too much, is making sure you have large, insulin sensitive muscles, which means large muscles in the context of an individual who's sleeping.
Well and exercising and you're going to basically have a great place to put all of that glucose when you consume
it and it's not going to stay with me getting belly fat because my glucose is going to be stored in the muscles as opposed to somewhere else.
Or again, it all depends on the total energy balance, but yes, it's clearly going to make a difference, right? So one of the surest ways to reduce Your Capacity to store fat is to add more
muscle, okay? I did the grip strength test, then it twice now.
And
Meaning, you did want to be like grip meters or you did a hanging
test, the one of the great grip me. Okay. Actually, did it? Brian Johnson's house and then I but I also did it with Andy Galpin and people tell me it's a indicator of longevity, but I've never really understood. Why is it just testing my strength?
Yeah, grip strength of all the strength metrics. It's one of the most highly correlated with longevity. We actually prefer to do it like at N squared where your colleagues tested yesterday, we prefer to do it on a dead hang so we make them
NG from a bar and we just time how long they can hang. So that that's a really good metric of your grip strength because it's also normalized here. Wait, okay. So so we want to see that people can hang for at least 2 minutes on a bar. And so the question is why is that so highly correlated with longevity and it's what you said, it's it's its strength. And the reason for it is it's really hard to be strong anywhere in the upper body. If your grip is
weak.
Like if you think about being able to push specially, being able to pull, like all of the real metrics of upper body strength, require a strong grip. And if you have a strong grip, you have a strong hand. You have a strong forearm. You have a strong scapula that is connected to your rib cage. Like it goes up the whole chain and that's another reason why we like the dead hang as a way to test it because the dead hang is testing everything. It's testing your actual grip. It's testing your scapular stabilization, the stability of your show.
Older. It's basically testing that entire chain and then I also think there's a practical side of this, right? When you know it's very underappreciated what Frailty does to an aging individual and what sarcopenia loss of muscle mass does to an aging person. And and what it is about falling that is so devastating to an older person and the stronger, your grip, the easier. You're able to navigate a lot of those things,
right? It just seems Unthinkable that fooling is something I should be thinking about that.
32 in the future, like his wit because my mom is ridiculous. It seems ridiculous. Yeah, and yet it
is devastating. So once you reach the age of 65, which I think that far, I mean, you know, 65 year olds all day long that does. That's not a not a very old person. Yeah, once you reach the age of 65,
your
mortality from a fall that results in a broken hip or femur.
Is 15 to
30% fix. Just think that is such a
staggering number. So, you're over 65, you fall and that fall results in the break of a femur or
hip.
There's a 15 to 30 percent chance. You'll be dead within a
year. What kills me?
It could be something very acute, like you bet, you know, the fall, that's significant enough to do that, also bangs your head. It could be that you get a fat embolism, you get a blood clot. It could be that, you know, during the recovery process of this, you just never really get better. You never Thrive again, I think a more disturbing statistic is that of all the people who
survived
50% will never again regain the level of function they had before the
injury,
So they will require a cane for the rest of their life or something like that. Now, there are lots of things that account for that, Andy Galpin, who you mentioned, a moment ago talks a lot about this, but it's a lot of it comes down to foot explosiveness power. So the reason you're not really afraid of falling like when was the last time you were walking and you your foot caught something and used you slipped like yesterday I quite often. Yeah,
exactly. Why don't you fall? When that happens because I can quickly Ray just right, that's power.
So you have the power in your foot to readjust when you lose your step, you step off a curb not realizing it, it doesn't matter. You readjust it okay those are a very very specific muscle fiber. That is responsible for that it's called the type to be muscle fiber. That is the first fiber that atrophies when you age, in fact any you're already at your Peak it's all downhill from where you are now Hank. You so much. Yes, so I'm already 20 years past you and my power is a fraction of what it was 20 years ago now.
Now I fight like hell based on the exercises I do to try to make to try to keep it as high as possible. So the reason that these you know, people who were in their 70s are falling all the time is people think it's a balance thing, it's not just a balance thing, right? It's that they're undergoing. The same insult you and I undergo on a daily basis, but the difference is their probability of being able to catch it either through the explosiveness of their foot, where their lower leg, coupled, with maybe not being able to grab
Something is quickly and adjust its app, our deficit problem. So what
do I have to train now at 32 to ensure that specifically the example of hitting something and quickly being able to adjust? I'm able to do that when I'm 70,
I think jumping is a great way to do this, right? So, I mean, I use certain specialized pieces of equipment that actually have power built into it because power is different from strength, right? So strength is really, the ability to is just the ability to move a force independent of the speed at which you move
it Hower.
Is the maximum combination of force and speed. Okay, so if you on the, on the, on the x axis, if you were to put force and on the y axis, if you were to put Power, the curve is an inverted U. So as the
force
or the weight that you're moving goes up and you're trying to move it as fast as you can. You're getting more and more, and more and more power. But then, at some point, the weight gets so heavy that even as you continue to move it, it's going.
Slower and slower and slower as your power is going down. So there's a sweet spot there. So one of the things I do is there certain specialized pieces of equipment that allow you to train in that way. So I definitely rely on a lot of those but even if you don't have access to that machine jumping is a really important way to generate power. So if you're just doing a vertical jump, that's a that's
power. What about balance? I was at Brian Johnson's house and as he was cooking his garden at breakfast, or lunch, whatever, he was balancing on a half ball.
You've seen one of these things. Yeah, I don't think I asked him why he was bouncing on it, but I assumed it was to do with balance and the certain muscles in the leg.
There are lots of exercises that are great for balance, anything that produces instability is great because it's a for lack of a better term. I've heard it described as problem solving for your foot, okay, right? So, so if you think about being on any unstable surface, even if you're just walking on an unstable surface. So if you, if you were to look at a person's foot there,
R lower leg actually, as they're walking on a Surface that's constantly changing. So, like a gravel path or something like that, you're going to see. Like, if this were my lower leg, you would see the musculature of the lower leg constantly adjusting to it. And so, yeah, I'm I really enjoy things that force, that type of
training. Do you do flexibility stuff?
Yeah. So I'm actually naturally a pretty
lacks person. So I don't do
any stretching if that's what you're asking.
Skiing, but all of this sort of stability and dynamic stuff I do incorporates movement at and ranges.
So, I'll give
you an example of why. I think the notion of flexibility might be a little bit misunderstood if you ask a person to stand up and with their legs straight touch their toes. Most people would say, that's a great test of flexibility in the hamstring, right? And most people can't do that.
What they don't realize is
everybody's hamstrings are long enough to allow them to do
that. The reason they can't
do it is their central nervous system will not release them to do. It. Does that make
sense? Interesting. The central nervous system won't release them to do it. That's right. It
doesn't feel safe for them to do it now. How do I know this?
Because
if you take a person under general, anesthesia
You can put them into almost any
position possible. So if you took a person under general anesthesia laid them on the operating room table, you could lift their leg up to here.
When they're awake, you couldn't get it past here. When they wake up from surgery, will they have a torn hamstring not at all? They won't even know. They're leg was moved. The difference is when they're under general anesthesia their brain is not sending a signal to the leg that says
don't lift. So
why is the why is the leg? Why is the brain doing that to the individual? This is how I learned it on a personal level. So about six years ago, I had tweaked my back and just on a, you know,
no unnecessarily heavy set of deadlifts and just pushed it a little too far and I was kind of nursing this, this sort of, you know, just very, very tight ql. I was completely jammed up and I came in to do some training with a friend of mine, who's one of the guys that actually, he is really the guy that introduced me to this thing called, DNS Dynamic neuromuscular stabilization. And I mean, I was stiff as a board, I couldn't, you know, get past my knees bending forward, and I've been hurting for like three days. And we went through a series
He's of exercises
for
40 minutes, which included me laying on my back? With my legs, up him leaning on top of me. So, my feet are here on his chest and doing isometric pushes, while working on generating intra-abdominal pressure, and after and
yeah, maybe 40 minutes of
this type of exercises. I was Palms on the
floor.
How do I go from not being able to get to my knees to Palms on the floor in 40 minutes with three days of horrible back pain? The difference is, when I my back was hurting, it was my body was not going to let me go down, right? The body was saying, no way you're back. I'm
protecting you because you were, you are
not stable. You're not going to go any further and what we went through with this exercise in a series of
Exercises was basically, I mean, I'm over simplifying this and sort of anthropomorphizing it but letting my brain. No, it's okay. You're stable your stable, your stable. The back is safe. The back is safe. Let him go. And then I'm Palms on the floor. So I love testing this, sometimes I'll just wake up in the morning. Do five minutes of breathing exercises when I'm stiff as a board and just get into a position on the
floor. Why the breathing breathing
exercises? Because that's really how it's the. It's the breathing is how I
Of create this cylinder in my abdomen to sort of push the, you know, push the the floor of the cylinder down is the pelvic wall. The diaphragm is the cylinder the top, and then the the entire, you know, in entirety of my abdomen is the wall of the cylinder. And so I kind of go through these exercises every single day. Usually, on my back, actually, that's kind of like, part of my warmup and, and it's just a way to kind of ground myself around creating concentric pressure in the abdomen just to get
some tips from you around you'll strength.
Raiding regime. And how many exercises do you do? What does really curious? He's trained three days a week doing strength and resistance stuff.
Do you do like shoulders and back and as like a pet, like, you know,
Pas just exactly. So on Monday, Monday is, is pure lower body. Okay. And Wednesday is arms and shoulders and Friday is chest and back, okay? Super simple like nothing, nothing no rocket science. And Iowa, I mean, it's a little bit like an hour and a half of lifting play, plus maybe 20 minutes of the warm-up
stuff. So when the
Come back day. How many chest exercises are you doing 44? Okay. Yeah. And then for him back.
Yeah, okay. And I just I'm just super setting them and I'm gonna do maybe five sets of each so five working set. So there's a lot of warm up in there too. And also do some other stuff like some Med ball slams or things like that as well.
It's been the huge rise in people doing these high Roxas and sort of elite endurance events in such as really interesting that it's become so popular.
Euler even things like running clubs, I know. But yeah, the fact that people are more people doing marathons now than ever before. Why do you think this is happening? I don't know. I mean I think it's a very net
positive thing though. I mean II, do think that there's more and more people that are taking up things like rocking and running? And you know, Finding camaraderie in these things. The only thing I hope is that the people are doing it in a manner that sustainable and safe and allows them to do it indefinitely. So I, you know, I just I'm always hopeful that whatever thing that people are doing.
They're not injuring themselves because again, rule number one is don't get injured. So so you're you know, you're playing your plant. You want the gate, the name of the game is to play the game as long as possible.
In front of me, I have a bunch of different graphs and images and they some of them relate to a word you said, earlier on which is vo2max and this is something I've heard you talk about previously, but
For anyone that doesn't understand what VO2 max is or why it's important, can you explain what it is and why it's so critical to longevity and health span? I
think most people will be familiar with the idea that we are obligate anaerobes, which in English means we cannot survive without
oxygen. Okay? So why is that? So oxygen is absolutely essential to
catalyze the chemical reaction that
Turns food into
a currency for energy called
ATP.
So everybody's probably heard of ATP. ATP is the money, the currency of energy in our body. Anything that interrupts the production of ATP is fatal. It's an extreme example of that is cyanide. Everyone's heard of cyanide as a poison. If you take cyanide, you'll be dead within seconds because cyanide blocks, one of the Transporters in the
One of ATP. So this just gives you a sense of how critical it is to have an infinite and abundant supply of ATP oxygen is also essential for that. That's why without oxygen you can only survive for a couple of minutes longer than you can without cyanide but not much
longer. So how does it work? So we breathe in air and
that air goes into our lungs and that air goes through our lungs into these distal things called capillaries, where hemoglobin?
Is bringing the waste product called carbon dioxide back to the lungs. And there's a gradient of partial pressure between oxygen and carbon dioxide. Such that a switch takes place, the air that we breathe in delivers, some of its oxygen to the hemoglobin molecules, and the carbon dioxide diffuses off that into the air, and we breathe out
air, that is lower in
oxygen and higher in carbon dioxide than what we breathed in. So, if I go that was high oxygen.
Low carbon dioxide.
That was low oxygen, high carbon dioxide and that's this that's happening. Every second of every day that oxygen that hemoglobin molecule. That's carrying oxygen is carrying it to every cell in my body because every cell in my body needs oxygen
and
that cell in the body is taking the oxygen to run that chemical reaction to make ATP. And it's shuttling back carbon dioxide and it's just the most incredible thing in the world to imagine how frequently this is happening.
And the more you exercise, the more you consume oxygen. So oxygen consumption is a proxy for energy demand.
So we can measure this not to do.
So you have to put a mask on because I have to be able to
measure very precisely two things.
After build a measure, exactly, the flow
rate of air going in and out of your mouth. And I have to be able to measure very precisely the concentration of oxygen coming out.
If I know those two things
I can calculate how many liters per minute of oxygen. You are consuming
so,
you and I sitting here right now
are probably consuming
Less than half a liter a minute.
Call it 500 CC a minute of oxygen right now because you have to consume some to be alive. And look, I'm moving my arms around and you're nodding and taking notes.
So you know
if you're sleeping you might be consuming 300 mL of oxygen per minute.
That's that's the lowest level.
If you were to get up and we were to walk around here that number might go up to 800 milliliters per minute. If we were to walk a little more briskly, we might be at a
A liter per
minute of oxygen.
If I said, let's go in the parking lot and Jog. Well, we might get up to like, 1.5 liters per
minute. Pick up the pace a little bit, will get the two
liters per minute. If I start really, really running
us hard. We're going to get the three and a half,
four liters per minute. Well, at some point,
I am going to push you so hard that you will achieve your maximum level of
oxygen consumption and if I push you any harder and faster you won't
Extract more oxygen from the
air. You may go
faster, but you will do so through a process that does not involve the consumption of oxygen. You will do. Do so through an anaerobic, glycolytic pathway, but you will have achieved your maximum consumption of oxygen and that number has a very special name. It's called vo2max so vo2max measured in liters per minute is the maximum amount of oxygen. You can consume. And the only way you can measure that
Again is to have this
mask with very, very
fancy apparatus that measures both of those things. I said, and you have to be stressed hard. So we typically do this on a treadmill or on a bike. So your colleagues that came in to 10 squared yesterday, they did it on treadmills, they ran and they ran them and ran them. And they ran them until they couldn't go any faster. And then we measured. How many liters per minute of oxygen. They were consuming now,
Now that answers what VO2 max is. So the next question is
Does this matter? Well, the short answer is we don't have a single metric of humans that we can measure that better predicts how long they will live that how high their VO2 max is.
and,
It's not even close to be completely clear. So, if you compare somebody who is in the top 2% to someone, who is in the bottom 25%, for their age, the difference in mortality is 5X, five hundred percent, yes, 400%, technically. Because with Hazard ratios. You, you go to to a 2X Hazard, ratios, 100%, I guess, yeah. So let's look at you. So yes, I see. You've pulled this chart out which is one of my favorite charts, okay?
So you,
oh, by the way, there's one other thing, I should State we normalize this by. Wait. Okay. Okay, so we always divide that number of liters per minute by how many kilograms you are. So, the number is actually reported as ml per kilogram per minute. Okay, okay.
All right, so if we look at somebody who is your age, male 30 to 39, if their VO2 max is below, 35 milliliters per kilogram per minute. They are in the bottom 25%.
Conversely, if they are at 53 ml per kilogram per minute, they are in the top two and a half percent.
So to be clear, if you take a 35 year old man and one of them has a VO2 max of 53 and the other one has a vo2max of 35, there is a 400 percent difference in their all-cause. Mortality over the coming year,
wow? Okay. So all cause mortality anything killing them over the coming year. That's
right now. This becomes more and more profound as you age because the
All cause mortality ratio for a 35 year. Old is incredibly low. Yeah, it's like 1%. So that means you're comparing 1% to 4%, it's not that big a deal, but when you get up to my age, so I'm two decades older than you. So now the low bar, the bottom quartile is less than 29.
The high bar is more than 50.
Well, my relative mortality in the next decades, probably two to three percent. So now multiply that by 4, okay, when I get into my marginal decade, the low bar is 18.
The high bar is 36.
That's a 2X difference in vo2max a 4X difference in mortality is huge. When the all-cause mortality for an 85 year old is going to be
You know, the one year annual, you know, the one year mortality for that person is, you know, more than 10%. Yeah.
So
one of the things that we do
is we
sort of think through this, not just through the lens of mortality, which is what I just walked you through here. But also Health span, which is kind of what you were talking about earlier with the graph of strength and disability. So we have another figure that we show people that on the x-axis shows. A
Age. Yeah and on the y-axis, shows v02.
And it has a whole bunch of lines that come across that show various activities. You know, if you want to be able to run a six-minute mile, you have to vo to that's very high. If you want to be able to run an eight-minute mile, a 10-minute mile, if you want to be able to climb a flight of stairs without getting out of breath. Like it shows all of these different things and you see what the required VO2 is. I think in fact we might even have these graphs in here, yeah, right there.
So we put your dot on the graph, and we say, if you stay where you are, you're meeting right at that green curve, you're in for a great life, why? Because even when you're in your 80s, you're still going to be able to do all of those things.
So the results you're looking at here on Jack's results. Yep. Who runs the production here.
He came to your Center. Yep. Came to 10 squared in Austin. He did the task, I think he's on the treadmill for like an hour or something like that. And can you explain to me exactly what his results say, as it relates to what you were just describing. Yeah,
so he did both zone two and a VO2 max test. So Jack got on the treadmill and, you know, there's a protocol for how you warm somebody up. You really want them to be able to get to a maximum effort. You don't just put them on a treadmill and Crank It Up. You take, you take your time, getting them up there and
And he had an amazing result so his VO2 max was 4.1 liters per minute and he achieved that a heart rate of two hundred and four beats per minute, Which is higher than what was predicted for his age. If you normalize it by his weight, he was at 56.5 ml per kilogram per minute. So when you look at his age because he's in his
20s,
he was at about the
Indy seventh percentile for his age. Meaning his VO2 max was higher than 97% of people his age and so out of the gate that just tells us from a longevity standpoint. Our goal is to keep him there as long as possible. I mean, we're so ambitious with our patients and clients that we actually want them to be as as an aspiration to be two decades younger
at the top 2%.
So if you're 50
Do you want to be vo2max north of 53? And then the other thing we do is we check on something called heart rate recovery. So in 60 seconds post vo2max, how long does it take, how many beats does their heart rate come down in one minute? This is also a very powerful predictor of mortality because it's a huge indication of what's called parasympathetic sympathetic balance. So it's basically a question of how does the how how
Much is their autonomic nervous system in favor of sort of a stress response versus a recovery response. And so the gold standard here, we want to see people that can recover at least 30 beats in the first minute. He did pretty well. He recovered, 28 beats. You know, if you're really, really fit, you're going to be 40, 50 beats of recovery within the first one minute, it's incredible.
Then we
tested his lactate level.
Owls. And we ran him for what we called Zone 2, testing right. So Zone 2 is is aerobic base. This is where he should be spending 80 percent of his training. 80% of his cardio training time, should be in this Energy System. So it's hard enough that it's not just pure recovery but not so hard that it's you know, pushing energy systems that are higher. This is this is a pace. He should be able to hold for an hour and he should certainly feel like he's working but not feel it too much.
Technically, it's also a
place where he's pretty. He's got maximum fat oxidation. So we do this. Also in the same measure on a treadmill, this is a bit more of a complicated test because you're titrating between how he feels and what his blood lactate levels are. Maybe not to get too complicated In The Weeds on that. But we're simultaneously looking at the ratio of how much carbon dioxide he produces to how much oxygen. He consumes that tells us how much fat he is using.
Seeing in his own body and we look at that number and he maxed out at point seven, seven grams per minute, which is very good, one gram per minute of fat oxidation is exceptional. So Point 7677 is pretty darn good, his lactate hit about to mmol and he achieved this running at seven point three miles per hour. So again that's there's a lot to unpack in there but that gives us a pretty good sense of his level of fitness and for a guy in his
He's that's that's really good Fitness. He does a lot of running. Yes, yeah, yeah. And but even this test is about what we normally would separate these two tests on two separate days. Okay. So people you know, the people who come to 10 squared or not from Austin, they're from all over the place. So they come in for two days of testing and you got to sort of figure out a way to take a person who's not necessarily that fit and and allow them to do these tests so that it's kind of broken up over to a couple days. So they can mix it with the strength testing and all the other
stuff. And if you were advising
sizing Jack on how to improve some of these schools here. What would you say?
So the truth of the matter is, looking at his stuff here, I would say, I think you've got the endurance thing, really covered. In his case, there were other issues that were uncovered during his intake that were of more concern. And this is a matter of like, now what we think of his portfolio management, right? So when your VO2 max is in the top 2%, when you're fat oxidizing .7, you know, almost point eight grams per minute and he's got a heart rate of 165 to
ND, when he's in zone 2. I mean, this guy's cardio is dialed in
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With Fiverr. Freelances visit fiverr.com / diary today and use code D, OE, C for 10% off. Your first order, these are Jack's results. So I've invited Jacqueline because I feel like he might have some questions and you might have some questions, so you guys go ahead. All
right, well, first off Jack, thanks for being an awesome. Guinea pig yesterday you hit it out of the park as far as your cardio training. So tell me a little bit. Like, what are you? What are you doing for cardio? How often are you running? So I actually stripped it back. Quite a lot of
really started me.
Maybe,
maybe like two years ago, going really heavy on
running and that's all I did. And then I started getting a little bit injured. So now,
I've cut it back, but I'd say I do like one long run a week and that's like 20K outside of that don't really do much other cardio. Interesting. I know that the team talk to you about your left foot. Yes. And did they show you the pictures on the treadmill? It did. Yeah. Super interesting. Okay, interesting. I sprained my ankle really badly like six months ago. Yep. Said that could have been something.
I think it's very likely that the ankle sprain has not, has changed your gate, such that you probably are going to develop an injury over time with your running, if the if your pattern is not corrected. So you're overcompensating on the left and did I assume they assume you notice the difference in the height, of your shoulders and your head and everything while you were running. So even though the engine is working insanely, well, this test only measures the performance of your engine, your chassis, which is a subjective.
Of assessment to use the car analogy. Shows that the chassis is a bit weak. Okay, I'll give a bit of context and well, thought she was. So when I was running on the treadmill. Yep, I think it's Kyla. Yep. That he showed me a picture afterwards of me running and basically, my head was right in the middle when I went on my right size. Yep. But then, when I went on my left, my whole body was like a bit lopsided. Yep. So yeah. That's kind of what you're talking about. That's right. And again like the good news about running is each step is very light. Hmm.
But if you're running 20k, that's a lot of steps. So even something that's a light impact, but done thousands of times will produce a
problem, okay.
So let's shift from how? Well the engine is, which is exceptional at both ends, by the way, to be clear, your Peak engine output, which is vo2max was awesome and your engine efficiency, which was your Zone to your fat oxidation, exceptional, we do have this issue in the chassis that needs to be addressed or you're going to get a
repetitive strain injury. So then the next thing that the team did was just a very simple test called the dexa, scan, but we do a more comprehensive one. So we're looking at all the bone density, left hip, right hip, lumbar spine, and then total body fat total muscle mass and then visceral fat, which is fat around the organs. I think the most surprising aspect of the test was your bone density. So a dexa scan measures bone density. Very accurately
and
Both
sort of across the board in terms of your lumbar spine and your right hip in your left hip
you were in your, in your lumbar
spine, two standard deviations below the mean, for someone your age. So, that means basically, you're in the bottom, 10 percentile of bone density for a guy, your age, and for your hips, you're not much better both on the left and right hip, you're about one and a half to one point seven, standard deviations below the mean.
Mean,
so what does that mean? That
means that you're at, you already have something called osteoporosis. So when you're t score which in your case is almost the same as your Z score because of your age, but the z-score Compares you to someone your age, the t-score Compares you to someone 30 years old. So when your t-score is minus 1, you have osteopenia. And when it gets below, -2.5, you have osteoporosis, those are just technical definitions of bone density. The problem is, you are
Risk of bone fracture. Goes up really significantly now because of how young you are. It's not like I'm worried you're going to walk out of here and something's going to go wrong but the risk of you sustaining an injury and sport is not trivial, right? So if you were out skiing and Stephen was out skiing assuming, he had normal bone density and you guys both took a tumble. I would be infinitely, more worried about your bone density, and we have patients in our practice who do their young healthy people and they get these freakish fractures while skiing or playing sports.
And things like that and they have really low bone density. So once just something we want to address the bigger concern is that what's what what is the what is this story of this going to be when you're 60 and 65 and 70? And that's that's the one where we really want to mitigate it. So I know that the team talk to you about, making sure you follow up with an endocrinologist. You want to make sure that there's nothing here that is medically obvious to be treated such as vitamin D deficiency, anything that has to do with parathyroid hormone or calcium and things that are medically obvious to treat.
The
most important behavioral thing that a person can do with low bone density, Beyond correcting, all the nutritional deficiencies that can lead to it, is applying heavy load to the Bone. So bones are active pieces of tissue even though we don't think of them that way and they respond to deformation, so you have to put strain into a bone for it to respond and strengthen and it's counterintuitive.
That running is not amazing at doing that, it's not bad. So on, in general Runners have better bone density than sedentary people but not by much, Believe It or Not, swimmers and cyclists, Believe It or Not Tech tip actually have lower bone density on average, but resistance training with heavy weights, is, is actually kind of what is necessary grappling as well, by the way. So people who do Jiu Jitsu, strength, training, resistance training, those are, those are the ways that you're going to, you're going to increase this. So, I would say that,
Was the first finding that that that is important and worth
discussing, do you have any questions on the Concorde a couple? Well, I think my first one was
so I only actually started lifting weights like properly, maybe two years ago. So that's probably why you're seeing
that maybe I mean, I guess. Would you have asthma as a child or
anything? No, I know. When I, my mum said something about, like, when I
was born, I had low calcium. Something about low calcium Network saying my teeth but I don't know what that is exactly.
Well, if you had low, if it is something
It was impacting your calcium levels when you were little that would certainly be a potential risk for it. The our bones are mostly formed for males in the early 20s for girls, typically in the late teens. So anything that disrupted calcium metabolism? When you were young, could have played a role in this. For sure, the reason I asked if you had asthma is a lot of the times we see folks that, you know, had any medical condition that required corticosteroids prolonged. Use of corticosteroids would be another big risk factor. Of course, there's also
Jetix so, probably worth knowing if your parents themselves have low bone density, but but it sounds like there's something going on with calcium metabolism is is a kid that might have played a role. The reason it is really important to connect with an endocrinologist. Now is there are actual Medical Treatments that can increase bone density. In addition to all of the sort of the total optimization of the nutritional stuff, vitamin D, calcium levels, things of that nature, and of course, the training, the specific,
Is I'll do to increase that or is it just an all-around? Kind of? No. I mean, I think the the if you think about the long bones of the body, which are the ones that were basically measuring here, I mean, the short bones in the spine, but the femurs and hips anything that puts those things under deformation. So anything, from a farmer's carry to a step up to a box, squat. I mean, you know, it's whatever you can do, safely, that's loading. You and placing these bones in a manner that forces them to actually undergo deformation. The way, the way the, and the other thing,
I would also make sure of is that someone's checking your blood levels to look at things like testosterone and estrogen. So estrogen believe it or not, probably the most important hormone besides vitamin D in bone health. So you can think of a bone as something with a strain gauge in it. And as the bone is deformed, The Strain gauge sends a signal, a chemical signal to cells that build the bone. The chemical signal is estrogen. So the reason women are so susceptible to osteopenia
No, and osteoporosis is once they go through menopause, many of them lose their estrogen, if they're not placed on well, they all lose the restroom, but if they're not placed on hormone replacement therapy, they don't get it back and so they lose that chemical signal. So women, see a rapid drop off in bone density at menopause. Peter is this chrome accurate? Roughly
Yes, this would be accurate. So if this is broadly accurate, what is the game then? For someone like Jack, is it, is it building bone? Or is
it preventing the climb? Yeah. Okay. Eventing decline most of us reach our Peak bone mass in our 20s.
Okay. Yeah.
So so the name of the game is prevent it from getting any weaker. The good news is, by the way, I had a woman on my podcast named belynda Beck who studies osteoporosis. She's from Australia.
Leah. And she did this amazing study there called the lift more study, where she enrolled a bunch of women with osteoporosis who had never done any resistance training, and half of them were randomized to the usual activities, like, you know, yoga and things of that nature and then half of them were randomized, heavy resistance training and the women that did the heavy resistance training. Actually. First of all, on dexa, saw no change in bone density. Or saw very minor reduction in bone density compared to a significant reduction
In the women who were not resistance training. But more importantly, on, CT scans, the women who had done a resistance training. Actually showed an increase in cortical thickening of bone suggesting that it might even be that dexa is not by itself. Sufficient to fully assess bone health. It has bone density, but not necessarily bone health and her hypothesis is that these women might actually be getting stronger bones, even if the density is going down, just a little. But either way, even if density were sufficient, the fact that they're dead
Density went down so much less than the others was amazing. It's actually, you know, if you can find the video and link to it on YouTube Belinda, Beck's, lift more study. It's just an awesome video to watch. These
little old ladies walking around, picking up, you know, dead
lifting, their body weight and stuff like that. Is there
anything else you wanted to ask Jack? Who about your results or anything else? Me pressing questions? You don't, you have your nutrition would be a good one,
actually. Yeah. Calcium vitamin D protein, everything that's going to support muscle mass as well, because that's the other thing.
That we found here. So we looked at your body fat percentage again, in absolute terms, not that high, but for your age pretty high because you're because you're young. So you were at the 80th percentile for your age and your visceral fat was at the 50th percentile for your age, we like to see. So we don't really care that much about total body fat. We Care a lot more about visceral fat. So the fact that your visceral fat was at the 50th percentile, visceral fat is the fat that's around your organs. That's the more metabolically deranging damaging fat. We actually, we have a very
High standard. We want to see that below the 10th percentile. I'll hit pause on that for a second, but then to relay the next thing that we looked at was your muscle mass. So we looked at the total muscle mass in your arms and legs that's called your appendicular lean mass. And then we looked at the total fat free mass in your body and both of those puts you at about the 20th percentile. So the first question I'm asking when I'm looking at these results is, are you adequately muscled or under muscled? So, I really want to see some
The above the 50th percentile and muscle mass so, you're under muscled. The second thing I'm looking at is with the body fat percentage, where it is both. And the visceral fat is that to me, I call that over nourished now. I don't have blood test to see where you are metabolically but I want. Those are the, those are what I call my three questions. Are you metabolically healthy or not? I need a blood test to see it. I suspect you are though based on your Zone 2. So the fact that your fat oxidation was point seven, seven grams per minute very hard.
And you're fasting lactate was point five, which is also very good. So, my bet is, you are metabolically healthy. We have to do a bunch of blood tests to confirm that but I bet you would be, but you are over nourished, meaning, body fat is too high and visceral. Fat is too high and you were under muscled, your am I in your FMI or too low. So that immediately tells me like what do you need to be doing? You need to be eating more protein, fewer calories, more resistance training, you don't need to do.
Cardio think that's an oversimplification but like that's, that's your path
forward.
The last question I had around, I think
I've heard you speak about it before, but it's around like the potential of what your muscle mass can be. If you lift, as a
teenager versus, if you start lifting in
your 29.
So, if I start lifting it like 27, the potential is a lot less, right? Is that true? Or is that? I'm not sure. I think, I think genetics play a pretty big role in that and I think, in other words I think.
I think that your ceiling is probably more dictated by your genetics, then it is the age at which you started. I think if you took a you know someone who was just genetically wired to put on muscle and they don't start lifting until they're in their 20s they're still going to put on a ton of muscle. I mean like I've been lifting weights my whole life since I was 13 years old I'm never going to be like a monster. Like it's just not gonna happen, right? There's no chance I'm ever going to be on the stage of bodybuilding, you know, contest, okay. Yeah. That's
One thing I was like, oh, it's haunted me. Well, wanted me in the last two years. Yeah,
and now you but, but I don't get it. There's, you have to consider a bunch of variables as you're lifting, right? So, are you training at the right? Intensity? Are you training at the right frequency? Do you have the right selection of exercises is your Technique, correct? So lifting weights, it's not a uniform term, so you really have to dive into that, right? So to put on muscle, you probably need to be doing a minimum of 10, and I would say, aye.
Ideally closer to 20 sets per week per body group. The intensity has to be sufficient. So we were talking about that minimum to ideally one, rep and Reserve / working set. So if you're if you're just doing like three sets of ten, but you could have done three more reps if you really pushed. There was no training stimulus.
There was a question on that which is linked to one of my friends, but it's something I've had you say which is you said to me before that you struggled with gaining weight? Yes, A friend of mine.
It has said this to me for the last 10 years muscle. Yeah, he said, yes, he says like he even when he eats a lot, he has to like, she was like, he's forced feeding himself and it's like not natural and then when he goes to the gym, he hasn't seen the results. Whereas for me, I have never had the problem of like I can eat loads and then I go to the gym and work out and muscle comes on. So for those people that struggle with a eating enough calories, and then they go to the gym and they don't feel like they're able to gain muscle, you've experienced this before ever. You've experienced people that
add this to
sure it's actually much more common with women than men, but it's sort of focusing more on the protein as opposed to the total calories. I mean, you do need the calories, but it's probably breaking down the protein intake into smaller servings and that for many people just means they have to get shakes or things like that. Like they're not going to get it through Whole Foods. All the time. I don't need to drink shakes because I'm able to get protein through food enough, but that shouldn't be viewed as something you don't want to do, I mean,
I'm sure some of the most successful body builders in the world, just based on their protein requirements still have to resort to shakes. So, figuring out what it takes to get 1 gram of protein per pound of body weight, and making sure you get that even if it takes four servings a day is, as it should be the highest priority. And again, you don't need more calories at this point based on your visceral and body fat. We just need to make sure you're getting that gram of protein per pound of body weight and that you're doing there. You're getting the right training stimulus in the
gym.
I'm okay, thank you. Okay. Thank you for that pizza.
I didn't know we were going to be doing a little concert. Yeah, it's super fast even for me, even though they're not my results, I learned a ton about about that
and the question we don't necessarily need to go through all of the results here for your mind that. But how do you see women's results being different? Typically, as a relates to bone density, muscle mass. And those things I was wondering if even for the vo2max are expecting different results for women or well, we
score them on a different curve. So the the results
Going to be a little lower. And again, part of the reason is women have less muscle all things equal and muscle is the organ that is going to consume the most oxygen. I mean, outside of the brain. So so, you know, if you took a woman at 25 and a man at 25, there's a different threshold for what a, what the grade is on the curve. But I would say, the biggest difference we typically see is and not so much at the ages of these guys, because they're both so young and fit.
It. But as we, as we get into kind of older, folks, we definitely see more of an issue with muscle mass in women and bone density and
women. I was quite surprised with Jack when you talked about visceral fat. Yeah, there's two types of fact, I've come to London subcutaneous, which is, I think, is on the outside. Yep. And then visceral is around the organs, right?
So the body fat is mostly measuring his subcutaneous,
fat 0 on the outside. Yeah. Okay.
I've got a little bit of subcutaneous fat right now as we do all, how do I know if it's it if it's an issue or not? Unfortunately, it's very difficult to know. Without further investigation, I say this because I haven't been able to predict it looking at somebody, like I've seen people who have lots of subcutaneous fat but when you look at their liver and look at their visceral fat, they have virtually none and they tend to be quite metabolically healthy. So maybe aesthetically they
Got too much body fat. And there are lots of reasons why they might want. That might not want that. I'm sorry. Based on, you know, excess body weight that just in general is an impediment to movement or, you know, pain in their knees or joints, but it's not actually causing them harm physiologically and conversely. You know, if you look at Jack
like he's he actually looks things. Pretty
lean looking guy like nobody would look at Jack and say he's overweight, but he's got a little bit too much fat on the inside, and that
If not I mean hit I think his running and his Fitness is probably offsetting it metabolically, but there might be come a day when that's not the case.
So it, you know, this is something that I think just needs to be addressed. And again, people that are in their 20s can get away with a lot and it starts to become something, you don't get away with in your 40s. Is there a
genetic component to this? And also, what is caused
What usually causes it,
the body fat, the visceral fat is several fan. Yeah, there's definitely a genetic component to it, but the truth of the matter is what the cause of this is just fuel partitioning. It's just it's just where the body is, putting excess energy, right? So, so all of the fat we have in our body comes down to where does our body choose to store excess energy? Because that's that's the only way we store it, we can't store protein. So we can only store when we store protein technically in muscles, but we're basically storing carbohydrates and fat.
So you can store carbohydrates, preferably in the muscle and in the liver as glycogen but that's a very finite source. So most of where you're storing, those things is excess, glucose gets stored as fat and then in fat gets stored as fat.
So if theoretically Jack had a higher muscle mass, you have less visceral fat potentially.
Yeah, probably because first of all muscle is more metabolically active. So more metabolically, active tissue means higher energy expenditure which would all think
things equal mean, lower
fat that makes sense. And if there were a couple of things that I could do to reduce my visceral fat, we talked about exercise that we talk about diet intermittent fasting, do they, are you a fan of those kinds of things? There is
no evidence that intermittent fasting produces any benefits above the equivalent amount of caloric, restriction. So, you know what, whether you're eating in 8 hours or six hours or across 12 hours. If the same number of calories are consumed, it's essentially producing.
Same outcome, sleep stress. Absolutely dramatic.
When we talked about sleep already, right? If your sleep is not good, you are going to be insulin resistant, if you are insulin resistant, you are partitioning fuel in an unfavorable way, which in English means you are more likely to access glucose than access fat, even at low levels of intensity when you should be accessing fat. So if that's, that's why, by the way I thought he's probably still insulin sensitive based on how high is fat oxidation.
Station was.
Meaning when he was at 165 beats per minute on a treadmill, he was pulling out almost point eight grams per minute of fat. That's really good. That tells me. He fuel partitions. Well,
He knows how to access fat when he needs fat. So that's that's still working in his favor, but for many people once they're exercising that hard, they're fat oxidation Goes to Hell and all they're doing is accessing
glucose but there could be a link for in his case between sleep and visceral
fat. Yep. Especially if he travels with
you. Yeah. It's and then I'll call you mean Jack doesn't alcohol. But generally visceral fat
alcohol. Yeah, that's fine. I
want to talk to you about the song called point because that's all he Berman. Tweet the other day. Saying that
Now pretty well established that even moderate alcohol. Intake is bad for you, but I saw hated the day was someone else. You said to me, that they talked about the matter to Mediterranean diet. It's aliens. They seem to be fine Etc. And I wanted to kind of get your perspective on whether small amounts of alcohol intake are, okay, or not, cuz some people still think it's healthy to have moderate alcohol intake. It's better for the heart.
I think that is pretty abundantly, not true. So I don't think
I am aware of any real evidence and we've scrutinized the heck, out of this. We so the subscribers to our podcast, get these premium newsletters, every month where we do an ultra insane. Deep dive into a topic and alcohol was one of them. So this is like, you're getting A Treatise, write a 20-page research report on a topic. So for anybody who's interested in that, they should go and get the alcohol piece, but I'll link it below. Yeah, the tldr is that there is no compelling evidence whatsoever.
So ever that there is a health benefit that comes from ethanol consumption, the molecule of ethanol is not healthy at any dose and I believe that is unambiguously true. That said it does not appear to be linearly.
Toxic, meaning low low doses, probably sub
15 grams per day, 15 grams of ethanol would be what you would get in a
Standard drink standard. Drink not a generous drink. So, you know, whatever. Like 34 ounces of wine would be 15 grams of ethanol, 14 grams of ethanol. It appears that for most people, the toxicity of that amount of ethanol is very difficult to measure.
And
this is where you get into the area
of. For
some people. There might actually be enough of a pro-social benefit from that amount of ethanol if consumed.
And in an otherwise healthy environment, right? So if you talk about the individual who comes home and has a glass of wine while he's with his wife and they kind of unwind in the
backyard and talk about their day and things like that.
There might be benefits from doing that. That outweigh the very, very small amount of toxicity that came in that ethanol.
Once you reach about 30 grams of ethanol a day, I don't see. And I have not seen a shred of evidence that there is any amount of pro-social behavior that can offset the toxicity of that ethanol.
So, while I
would not go as far as the World Health Organization which has condemned ethanol as a carcinogen at every dose. I just don't see the data to make that case for every
dose.
I
tell my patients in a very measured nuanced way. Kind of what I just told you like, you know, I drink alcohol and I but I but I think about it. Every time I do like, is it worth it? Is it worth it? Is it worth it? Like, I'm not just drinking for the sake of drinking. I have this expression, don't drink on airplanes because the alcohol sucks. Like I'm not just drinking to numb myself, right? Like, if I'm gonna drink there's a reason it's going to be really freaking good
and that for me
Amounts to probably like four drinks a week, you've stolen my a planes. Now is thinking about electrolytes. There's been a huge Boom, the last couple of months. And yeah, if people consuming more and more electrolytes, everyone's like launching an electrolyte drink and consuming much more salt and sodium, what do you make of this? Are we electrolyte deficient?
Well, first of all, as a disclosure, I'm an investor in a company that sells electrolytes so Element e. So I'm an investor in that company, which I was want to disclose.
If like that, if it's pertinent, the short answer is, it depends. So why did I get interested in electrolytes? Well, I historically, never consumed, electrolytes when exercising, I was pretty much always consuming water and or water plus carbohydrate depending on the intensity and duration of the exercise. I also tend to have very low blood pressure and a couple of years ago, I had a really, really bad fall. When I woke up in the morning and I was jet-lagged. So I had just flown to Brazil. So obviously you get a little bit.
Dehydrated on a plane and then the first like you know, you get in whatever that night and then the next morning I woke up got out of bed and face-planted into a table. You can probably still see the scar on my forehead and I got back home and you know my doc measures my blood pressure, it's like 95 over 60 and he's like, yeah, you're just, you're really dehydrated man. Like we need to get a little more
and it's not like I don't eat
salt, I make zero effort to restrict
My diet. But
clearly I was just exercising too much. You know, I mean especially living in Texas. Like when I'm exercising Outdoors, I'm sweating like crazy. She was like you just gotta get more salt man. So I just went, I literally then did a super deep dive on hydration and realize that there's basically two ways to maximize hydration either. You consume water with a high enough, not just a high enough with the absolute correct concentration of glucose in it, and the correct concentration is between five and six percent.
That's 50 to 60 grams of glucose per liter of fluid will maximize water. Uptake through the sodium, water, transporter, or you consume. What's called osmotic, sodium in water. Those are your two options
with the with the
glucose one, being slightly better? And so I realized is look, I don't exercise long enough anymore to justify it and the only workout I do a week that is intense enough to justify it. Is that vo2max one where I'm actually am using glucose in water?
But for the rest of my workouts, I don't need it. I just need sodium in water and then I just went through every product on the market, like literally went to Amazon, click, click click, click click, click, click order. Every one of them and realize at the end of the day, it's a commodity product. Get the one that tastes the best, because that's the one you're going to have to suck down every day.
He's what's the most important thing we didn't talk about that? We should have talked about as it relates to your work, the science that you're obsessed with it. The moment and anything that might audience might and should need to know that we haven't
Yet
discussed.
Maybe just the idea that it's really tempting in, in the world. I live
in.
To want to find single sources of problems, right? So there's always a, there's always a boogeyman and I think, unfortunately, the entire landscape of Health, influencing and social media has has created a very unhelpful narrative around many of these things. And so,
You know, there's an effect called the dunning-kruger effect, which can be sort of, you know, put into a cartoon right where it shows it, you know, experience on the x-axis and confidence on the y-axis. So you've seen this graph, I'm sure where it starts out like it just skyrockets up to what's called the peak of stupidity. And then it kind of comes down into the valley of humility and then as you become more and more of an expert you gradually rise, right? So there's this idea of like the deeper, you go out from Shore, the further from Shore.
The deeper, the water gets and you and most of what you're what what I'm sure your audience is going to be exposed to because we all are, if we're on social media or whatever is like people preaching from the peak of Mount stupidity. And so I think maybe maybe the thing to be thinking about is, like, what are the signs of that, right? And it's usually people that are like, there's one thing that is the thing, right? Like, it's this additive in food, or it's this particular oil, or it's this sugar, or it's this that and it's like
Truth of the matter is, it isn't one thing, like it's really, really complicated. And it's hard to talk about things that are complicated. And we tend to just want to focus on one thing and I've been guilty of this myself. If I look at stuff, I was writing 15 years ago. I'm like
man, you really over simplified that too much like
you over indexed on that and you ignored this thing and and so I just think that, you know, try to try to identify people out there who were talking about things in a nuanced way.
And you're generally going to be closer to the direction of
reality. And how do you deal with as a podcast? Is because you must sit there. You know, so much about the subject matter and you must sit there and hear people say to you on your podcast things that you don't agree
with or on my podcast, it's easy. Because again the nature of my podcast is super inquisitive so it's just very easy to
to push back and sometimes I don't sometimes
I'll, you know, I was recently interviewing somebody and they made a comment and I just knew it was wrong but I I was like, you know,
I'll make an editorial comment later about this for the audience to understand that he's he's confusing cause and effect and I didn't push back and afterwards. I thought I probably should have I probably should have pushed back on what he said a little bit. But again on my podcast it's easy. I think the bigger issue is when people send me links to podcasts like what do you think of this? And I have to go through and like, explain why what this person said is
Completely wrong. I mean just completely unfounded in any scientific basis whatsoever but there are very compelling speaker and so I get it like I get why you know the that you would you know as my friend send that to me with concern. One of the things
we've introduced recently well in the last three or four months is just we put some, we have some independent scientific
Individuals who have a look at some of the things that are being said, just to cross-reference and provide context call, it kind of context, checking nice. Just because some of the bigger things or see, there's so many big as you were saying so many terms, like seed oils in this, in this. In this that I've started a bit of a nutrition war on the internet and so we just want to make sure that we provide more context to these things. So that a person at home who isn't going to take it upon themselves to apply that context will do the research has more more of a wide opinion but it's difficult because you say, oftentimes
Times. It's the best speaker, or the person with the most conviction that gets heard. You've managed to break through all of that and provided a tremendous amount of nuance and complexity to these subjects. But also to achieve the same focus and articulation and resonance and accessibility some of those individuals have achieved. I would highly recommend anybody who has not read this book to read this book because this is the book on this subject. And I say that I've interviewed many hundreds of people, but this is the book on this subject.
It's been a global phenomenon for all the reasons. I've described about it being so accessible, it's so nuanced but so easy for someone like me to understand even though I'm not a scientist and it's the book that I recommend to my friends to my family when they're trying to understand the subject matter of longevity in a world where there is just so much information and that's why this book did so well, and it continues to do so unbelievably. Well, but I'd also recommend everybody go check out your podcast which I love watching. And also if they want other resources from you, where do we send to people people?
Peter,
I think our website probably, Tsar Peter, a trmd. The website are probably direct people to all the different sort of places where we have unbelievable amounts of free information. So we have a newsletter that comes out every single week. It's free. It's really valuable people. You know, the open rate on that is through the roof because it's not junk. Like it's we're putting something in your inbox every single Sunday that you're going to want to read about the exact topics you're asking. So
I'm going to link. What about below soap? All of the links below for Peters work. If you if you have
Become obsessed. Like we all are here with Peters work and I really mean that we're all massive fans of yours. Jack was saying before you came. He said, I love Peter you saying this the other day I was thinking about week ago. And that's something that I think we all feel because of the impact you've had on our lives of demystified this information but bringing it to us in a way that so, so accessible. So smart, and so trustworthy. So Peter thank you for what you're doing because you're demystifying a very complicated world for all of us. And it's worlds that if demystified, we stand, a better chance of living a happier, healthier longer lives and there's probably nothing more important.
What makes life meaningful and fulfilling and me being able to walk up and down those stairs, and barley when I'm 75. So thank you, Peter. It's tremendous,
really, really tremendous and I appreciate you very, very
much Peter. I was so caught up in admiration, few, that I forgot that we have to ask you this question, which is the question left by the last guest, and that is, what would you do if you weren't afraid?
Mmm,
what was that face?
Oh,
Because I've been dealing with that for a long, I've been dealing with something for a for a couple of weeks that is is incredibly frightening, but I think I finally worked up the courage to do it, but I can't speak about it unfortunately. Oh really
at least not yet. I will
be able to one day. There will be a day when I will be able to tell this story and it will it will be one of the most important decisions I've ever made in my life.
Oh, I'm so curious and so intrigued and it's some I can tell by your reaction
Action that it's going to be profound for both you and all of us, I could tell by your reaction because I can tell that there's some, some of them have struggled there. So, yes, whatever it is best of luck and maybe we'll talk again in the future. Once you've been able to talk about it, I can't wait. Thank you, Peter. We launched his conversation cards and they sold out and we launched them again and they sold out again. We launched them again and they sold out again because people love playing these with colleagues at work with friends at home and also with family. And we've also got a big audience that use them as Journal prompts, every
Good time. A gas comes on a, diary of the CEO. They leave a question for the next guest in the diary. And I've sat here with some of the most incredible people in the world. And they've left all of these questions in the diary and I've ranked them from one to three in terms of the depth. One being a starter question and level 3. If you look on the back here, this is a level 3 becomes a much deeper question that builds even more connection. If you turn the cards over and you scan that QR code, you can see who answered the card.
And watch the video of them are answering it in real time. So if you would like to get your hands on some of these conversation cards, go to the diary.com, or look at the link in the description below. This is always blown my mind a little bit 53% of you. That listen to the show regularly. Haven't yet subscribed to this show. So could I ask you for a favor? But if you like the show and you're like, what we do here and you want to support us, the free, simple way that you can do, just, that is by hitting the Subscribe button and my commitment to you is if you do that then I'll do everything in my power. Me and my team to make sure that this show is better for you.
You every single week, we'll listen to your feedback will find the guest that you want me to speak to and will continue to do what we do. Thank you so much.
