Matt and Shane's Secret Podcast - Ep 534 - Outlive (feat. Peter Attia)

Episode Date: December 5, 2024

Support the D.A.W.G.Z. @ patreon.com/MSsecretpod Read Peter's Book  'Outlive: The Science and Art of Longevity' and Listen to The Drive Podcast @ https://peterattiamd.com/ Go See Matt Live @ mattmccusker.com/dates Go See Shane Live @ shanemgillis.com yo0o00o. Bonus ep for you guys. Surprise. Matt hit the podiums w/ Dr. Peter Attia. Check out his book 'Outlive: The Science and Art of Longevity' and listen to his pod The Drive Podcast. Also say a prayer for Matt's A1Cs (he just got diagnosed with pre-diabetes). Please enjoy. God Bless. 

Dr. Peter Tia dude. Thank you for coming. Thank you for doing this Thank you for doing this. I'm really I'm really pumped. I read your book. So I'm kind of oh, thank you so much I kind of like what you're about. Thanks for having me. Thanks for doing the podcast And I guess I'll give you an introduction and correct me if anything if I'm wrong You were a medical doctor and you did cancer surgery, right? General surgery with a focus on cancer the certain with the focus on. And then you just kind of, I liked your origin story a lot. And so from what I remember in your book, you did this big swim like rate.

It was like a marathon swim or something. And how far did you swim? It was about 21 miles. That's insane. So you did a 21 mile swim. And then if I remember correctly, you were eating a cheeseburger in celebration. And your wife kind of-

That was a slightly longer swim. But yes, yes. Now I know the story you're talking about. Okay. That I, that honestly, dude, that made me laugh so hard that you did like a, what I think that was like 25 miles or something. 25 mile swim. You go out to have a cheeseburger and I believe a Coca-Cola. Yeah. And your wife more or less was like, you're fat. Yeah, dude, that's the best. And then you, it launched you and then you just got the ultimate revenge and started like a super successful business. How do you feel about that?

She was very sweet. She said, she didn't say you're fat. She goes, you need to work on being less, not thin. That's worse, though. I'd rather someone be like, you fat ass, and be like, you need to be less, not thin. But you just swam 25 miles. Yeah, wow. That's wonderful, though. That is good, though, to have a woman to push you to those heights. Because then that's is that really like the

genesis of you kind of branching out into like I had actually already left medicine at that point. I had been out of medicine for three years. I was working at that time. How was I doing? I was working at an energy company, I think, or maybe I was in finance or something. But I was like, I had nothing to do with medicine. But that was right around the time my daughter was born as well. And so I think that was kind of the one-two punch. It was sort of my daughter's born.

And then I'm realizing actually like I'm not that healthy. Even though I exercise a lot, I'm actually not that healthy. And those two things were what kind of got me to be pretty obsessed with just trying to figure out how to Not die prematurely the kids do that. I have a two and a four year old and that really kind of I Actually thought you'll find this interesting. I thought it was healthy I did all I was doing the you know all these apps like I did the one where you like mail your poop and all That stuff and I did that that came back like dude. You're like six years younger biologically I was like, this is awesome. Did I had the fucking the order thing? I had that going on Telling me I'm seven years younger than my age and then I took a blood panel dude. I'm like pre-diabetic

Fuck man. It was like I thought I was like killing it and I got it back and it was like I Literally just found out two days ago. So this timing couldn't be more perfect But it was a 1c. Yeah, it, A1C I think it was? My A1C is like 5.7, which was like, but I did eat two bites of a pancake before my blood work, which I'm not supposed to do. Shouldn't impact the A1C though. Damn it dude, I was fucking hoping that was the answer.

Yeah, so that is kind of crazy. And again, I'm not the definition of fitness, but I'm not like, I wouldn't have thought I had almost type two diabetes. Well, it takes a while. No one wakes up diabetic, but also most people don't recognize that it's a 10 year journey for most people. Really?

To get there, yeah. So what, I have like four more years of pre-diabetes? I mean, I think that's impossible to predict for any one person, but we definitely know that disease is so much more complicated than people, I think, historically have thought of it. People have historically said, well, I mean, type 2 diabetes is your pancreas can't make enough insulin, you can't get enough glucose out of your blood into the muscles, and eventually

we just cut off some arbitrary number. We just say once you reach a certain level of blood glucose, then you have type 2 diabetes. But to me, that's just not a great way to think about it. I think of it as a continuum and a spectrum. And pre-diabetes is a step along the way, but we also know that the lower your blood sugar, the better. So 5.7 is better than 5.8 is better than 5.9. But even though we would call you, quote unquote, normal at 5.6, I would argue 5 is much better

than 5.6. Gotcha. I see what you're saying Yeah, yeah It was like for real joke and I was like dancing in the end zone on my wife because she's she is her biological Age and I'm not rubbing it in but it was like whatever and I was like I'm five years older than her So I was like her peer biologically and I was laughing. You know, I was these biologic clocks things are such such a scam You know, I was these biological clocks things are such a such a scam. I know. I love it. I love it. I love it. It's brilliant marketing. It is brilliant. I woke up one day and I went like I lost half a year of my biological age.

I was like, what the fuck did I do? I like went into a panic. But yeah, so the that was like a real revelation for me. I was like, holy shit, man, because my dad has type two diabetes. And I was like, yeah, that's on him. He eats ice cream all the time. I'm healthy. And I like got my blood work. And I was like, son of a's on him. He eats ice cream all the time I'm healthy and I like got my blood work and I was like son of a bitch by the way I'm just breaking this right now. I know this is breaking news. This is breaking news. This is this is like so timely I have free and I was actually it is very timely and I have been leveraging it emotionally in my household, which is nice

Anytime my wife bothers me. I'm like dude. I have pre-diabetes this cortisol is gonna mess up my insulin so I I got a text message literally on the way over here from a buddy who just got a vasectomy yesterday and We had recommended the urologist to him Who was gonna do it? So he goes look I just want to tell you man Literally the best experience ever the guy was incredible so funny You know, he's got me draped like over the table So like, you know, he's like there's a drape, I'm laying on my back. Like a C-section?

They don't let you see? Yeah, it's like you're sterile. They want to keep you sterile, right? Gotcha. And the guy walks in the room, first time, he hasn't seen me, he doesn't see my face, he just sees my shlong, and he goes, oh, I remember you.

But it was just all jokes, and so he says, today, he goes, look, honestly, zero pain at all, but don't tell my wife I am gonna milk this is 10 out of 10 pain or another week so important Yeah, yeah, so you also the vasectomy you can't ejaculate for like what seven days or something That's a good question. I don't know how many days. I don't know how many days. I don't like seven my friend did it Yeah, you had to hold off. Yeah seven whole days, and he said he went a little prematurely and said he had a little bit of pain So that's not good. But yeah, dude, so that's that was kind of crazy man Cuz I again I've been doing all the the services because I haven't I haven't like been to a doctor forever

Cuz I'm like, you know, I go to it and this is I think was cool in your book You have like was it health care 2.0 versus like three. What was the latest? Yeah medicine 2.0 versus medicine 3.0 Yeah, so 3.0 is kind of where you're at. That's kind of more cutting-edge Medicine 2.0 versus medicine 3.0, yeah. So 3.0 is kind of where you're at. That's kind of more cutting edge. 2.0 is like, what, a step up from medieval humors and? Yeah, but still important. I mean, we still want medicine 2.0.

Medicine 2.0 will take care of a problem when it shows up. Gotcha. And if you're in a car accident, you break your leg, you get pneumonia, you want someone who knows how to deal with those problems. But it's a very different system from, hey, how do I take a guy whose hemoglobin A1c is 5.5, who no one, everyone thinks is just perfect,

but I think he's on the path to actually being diabetic in 10 years, and why would I wait till he's staring down the door when I could just make the changes now? Yeah, and that was kind of my beef with doctors. I would go there, and they're like nice, I don't my beef with doctors. I would go there and they're like nice, I don't have anything against them, but I go there and they're just kind of like, yeah, cholesterol's good, and I'm like,

this is all we're worried about? Like this is, and then they lowered the window to like blood pressure. The one day I went in there and they're like, oh by the way, high blood pressure's lower now. I'm like, oh okay. I didn't have a blood pressure problem, but it's like, I just feel like you go there

and it's like, you're like a car. You go in and they check like two things like yeah, you're good But so I really liked your book how you're like you want to check for more things and try to increase the health span Not just the lifespan which I like cuz a lot of people are very unhealthy I thought I was a poster child for health dude. I'm one of the suffering Americans Just I need Michelle Obama to come get make me lunch dude. I'm fucking So what are you working on right now? Has anything changed from the book? And again, correct me if I'm wrong,

but the summary was like the four horsemen, that's the things that the four leading causes of death, and they are what, heart disease? Cancer. Cancer. Neurodegenerative diseases and dementing diseases like Alzheimer's disease and metabolic disease. That's me, that's diabetes, right? And they overlap.

So when you have type two diabetes, your risk of those other diseases goes up by 50%. So that one sort of feeds into the other. And also if you have cardiovascular disease, your risk of dementia goes way up. So. Oh really? Oh yeah.

Damn, that sucks. And you know what's weird too? Because I don't want to turn this into like a personal doctor visit, but like I For real had like crazy brain fog like I couldn't I was like messing up recalling words and a lot of my my mom's side had Like dementia stuff when they got older so I started being like damn

I might be like getting like early dementia and as soon as I Learned about the high a1c and I don't know if that's like high enough to cause brain fog I was like forget it forgot the word croissant I was like trying to think of that word. Couldn't think of that, but I, as soon as I got off all the carbs, and now I'm like basically doing like keto, my brain just like came right back to life. It's pretty nuts. Yeah, I mean, I don't know that that's related to the A1C per se, but fluctuating levels of blood glucose are, make it just a little more difficult. And some people are more sensitive to it than others. Some people, you know, they can eat all the carbs in the world and it doesn't seem to phase them.

And a lot of people are like, no, the moment I go to slower carbs or just no carbs at all, or just more complex carbs, my energy levels normalize and so too does my attention. Yeah, dude, that happened for me. And I also don't, I don't, you have to eat as much. Like I was eating so much, man. It would be like four cups of rice.

I was just pigging out. And then as soon as I stopped eating that much carbs, I eat like two meals a day and they're pretty like sparse. Tell me about these pictures here. Oh, thank you, man. This, I just figured it was funny because it's just kind of like a, just an ample naked lady sitting at a picnic. So I like sawed I literally picked the pictures very quickly

I this one I just wanted very intense imagery. Yeah, and so this is kind of like, you know, this is pleasant It's a little complicated. You have what do you think's going on here? Why is she naked and who are these guys? These guys are up to no good for sure They I think these guys it looks like they just got happened upon and someone's going what the hell you doing with that Ample naked lady in the park and this guy's like he's like fully dressed. Yeah Who's the girl in the background? So to answer your first question? This is a Cloth male naked female. It's a fetish That's going on and I think she's kind of like next I think they're like get over here

Strip down so we can have a kid pick take this calls a serious uproar back in the day when he this guy painted this It was a problem. I Bled I mean I see why they were like if you had someone pose this lady had to have been a prostitute No, like that's totally scandalous. Yeah, what year approximately was this? I wish I knew I don't know if I had a guess I would say like maybe Late 1800s I had a guess I could be wrong and that guy I don't know. If I had a guess, I would say like maybe late 1800s. I had a guess. I could be wrong. And that guy, I don't know what that guy's hats all about over there, but yeah, I mean it's sort of, I don't want to profile him, but, but I have thoughts.

True. It is a hat. I don't recognize that hat and I do have my own suspicions as well. But yeah, I don't know. I don't know if he's like, I don't know what's going on. He seems kind of distracted. I think he's being caught's like I don't know what's going on. He seems kind of distracted I think he's being caught she's just kind of getting caught. There's just a lady in a pond Maybe just kind of floating around. Oh, that's interesting. So yes, I see that now I thought she was picking up apples, but maybe she's washing her hands Well in the pond, you know one could only guess why but the Yeah, so that's that was cool. I thought that was a fun one. This is very intense

I like this and then I just you know toss a little crucifixion up there I thought that was a fun one. This is very intense, I like this. And then I just toss a little crucifixion up there. Yeah, it's the rainbow crucifixion. I don't know my biblical history well enough to, I would embarrass myself if I asked dumb questions, but is there a rainbow after the crucifixion? I would hope so.

God was rising back to heaven two days before, so I'd hope there was a rainbow. No, I thought it was three days after this. Three days, my bad, my bad, three days. So the, yeah, so that foreshadowed maybe the resurrection. Could be, yeah, could be. But I honestly don't know, I don't have any real knowledge or knowledge.

Can you imagine how brutal the world was when we crucified people? I think about it all the time. How lucky are we to live in this candy ass world of softness? Dude, I try to tell it to people, and I have people tell me. I'm so grateful.

It's insane, because I try to tell people, I'm like, dude, it was way different, and other people are like, it wasn't that different. Like those guys were thieves, right? Yeah. Like today, you wouldn't even go to jail. Yeah, they would kill you.

In most cities. Yeah, they would kill you. And then you get crucified? Yeah, and also the procession was a pretty nasty part of it, part of it Just get walked through the streets spit upon rocks thrown at you. I just I can't fathom do the social anxiety And by the way, that's only two thousand years ago, which in the arc of human history is Yesterday nothing that's nothing. That's what I try to tell people man. There's a lot of people are like everything's always been the same It's just different variations on the same themes. And I'm like, dude, it's gotten so much different from 2,000 years ago, it can still get so much different.

Think about 500 years ago, right? Think about, if you could be you, or you could be the king of England 500 years ago, with like, you know, it sounds great until you get like a dental abscess, and you realize there's no AC, there's no heat, the food sucks. Like, I don't think you're gonna be the king of England

500 years ago. I think you- Food still sucks in England. Now. Yeah, that's a good point, because you could- It's probably pre-fish and chips. Yeah, that would fucking, that would actually suck. I never thought about being like the king

of another country. But it would be pretty terrible. There was a king in some medieval time, like longer ago than that, but they thought alcohol was like health stuff back in the day. It was like the spirit of it. It kind of was, because water was so contaminated, right? So you basically had two broad cultures

that emerged from either the fermentation of water and alcohol to get rid of the bacteria, or tea. You had sort of the rise of alcohol, of water, right? And alcohol to make, to get rid of the bacteria, or tea. Right, you have sort of the rise of the sort of tea culture where you boiled water. But yeah, the idea that you were just gonna go and drink water was like, I mean, the fact that we're sitting here drinking this is incredible. It's pretty tight actually.

But yeah, they had a king, they were like, they rubbed him down in like brandy maybe. And then they were like, all right, we're gonna like rub this all over his body and like a Candle got too close and just burnt the guy alive and all the high priests or whatever had to be like you must have been fucking evil Yeah, it's fucked up. No one no one put two and two together. They didn't understand exothermic chemical reactions Damn dude, so so let me ask you this. What is your The gist of your book is basically, and again, correct me if I'm wrong, but the gist was basically like we can pre-screen better

and we can kind of promote wellness rather than waiting till somebody has like a horrible, often irreversible disease and like try to fix it through kind of like nuking the gist. Yeah, and part of it is like, you know, what gets measured gets managed. And so medicine 2.0 measures lifespan as the ultimate outcome, which is, that's been productive. That measures lifespan as the ultimate outcome.

Which is, that's been productive. That's a good thing to measure. I'm not suggesting we shouldn't care about lifespan because 150 years ago lifespan was 40 years. Today it's 80. That's insane. We doubled lifespan. And that's all due to Medicine 2.0. Basically figuring out how to not kill women when they gave birth to children, how to keep babies alive when they were born, how to fight infections, how to wash our hands, like that, and a little bit of stuff around trauma

and critical care, like you doubled human lifespan. But we're not managing healthspan. And so part of the argument is, okay, we've done pretty well on lifespan, we could do better, but we really have to manage healthspan. And so if we think about things that make up health span, it's sort of like, how much muscle mass do you have?

How strong are you? How much endurance do you have? How much flexibility and balance do you have? How quick is your cognitive performance? How happy are you? How are your relationships? How much joy do you have in your life? These things are softer and squishier.

Some of them are pretty easy to measure, like VO2 max and muscle mass and strength. Some of them are harder to measure, like cognitive performance. But if you don't measure something, there's no chance you're gonna manage to it. And I would just argue we have to slightly tilt in the direction of doing more on that front. Yeah, it'd also be cooler to go to the doctor

and have them hit the treadmill, let's check your VO2 max. Yeah, let me see how long you can dead hang for let me see your grip strength I'd be so much better than sitting there and just being like basically getting molested and leaving That's that's all you do you go there and they're like, alright, we're gonna what's what is the coffee? Why do they do that? Why do they call hold your it's funny? I thought you were gonna ask me to do it to you earlier when you said this is not An appointment. I literally thought you're gonna whip your junk out and check. I'm just going just for the A, dude. You got to do the butt.

It's they're checking for a hernia. Is that what it is? Yeah. Yeah. Well, why is that like the top of the pops and there's so much other things to check? It's like we're not going to do all this other stuff that would be useful. We're just not going to look at a bunch of things. But I do want to stick my finger in the inguinal canal. That's what I'm saying. Yeah. And I'm going to make you cough.

I'm glad they do that. But it's like, why did that get picked as opposed to all of this other stuff you're talking about? Do you think it has something to do with just institutional repressed homosexuality throughout the entire culture? And that was like the one thing. I don't know.

But I will say this. I can't tell you how many rectal exams I've done. And then I realized, I mean, technically, a good urologist will tell you that their finger is good enough to truly feel a prostate cancer that would otherwise not be picked up on a PSA or some other test. And I'll take them at their word. But I think for the rest of us who don't do 20 a day,

yeah, I just I don't think my finger is good enough. Don't say that. I mean, I don't think my finger's good enough, you know? Don't say that. I mean, I'll work harder, but. Yeah, that's crazy. So they're saying they can just feel, like it just. They've said like, look, man, you know, there's always that one case that slips through the crack where the guy has a normal PSA, no pun intended.

Yeah, she's. So they can't tell, yeah. But they're like, yep, if you feel a certain type of super hard nodule on the prostate, that would be suspicious. tell. Yeah. But they're like, yep, if you feel a certain type of super hard nodule on the prostate, that would be suspicious. Damn. Yeah, that is, I do, I think they really could if doctors would embrace that.

It'd be so much more fun. You go, you kind of run on the treadmill, dead hang. They could talk to you a little bit about, it just seems so kind of sterile. Plank. Yeah, there's like a bunch of basic tests everybody should be able to, we should be able to see the people do.

I completely agree. Yeah. So I did really like your book for that reason hopefully that kind of stuff takes so what is so if that's the scope of the book where do you stand now is anything change in that time or is anything that's like latest and greatest that's kind of like blowing your mind right now I think my thinking is always evolving I would say if I were writing that book today I would actually kind of add a fifth horseman which is anything that pertains to a weakened immune system so I'm just that book today. I would actually kind of add a fifth horseman, which is anything that pertains to a weakened

immune system. So I'm just getting over a cold because I have three kids and two of them are young. So basically I'm always in the face of like some virus, right? So twice a year I always get some stupid cold and it's no big deal. You know, it starts in my throat, blah, blah, blah. It gets into my lungs. I hack up a bunch of junk, and then I'm fine. But anyone who's been around older folks

realizes that that's the kind of thing that can tip them over the edge when they're 80 years old. A really bad infection, a flu, COVID, things that 50-year-olds laugh at can become deadly. And so from a research perspective, this is something I'm super interested in, is how do we regenerate the immune system? So, you know, I'm in my 50s,

my immune system's also in its 50s. Would it be amazing if when I'm in my 80s, I could still have an immune system that's maybe like in my 50s or 40s? The effect that that would have against, you know, mitigating the risk of fatal pneumonia's, infections, and even cancers is huge, because the immune system

is the first line of defense against cancer. Oh really? Yep. Didn't they use to use like fevers for that too? They would induce fevers to try to kill certain types of cancer? Yeah, and it wasn't very successful because it's so non-specific. Oh, okay. Yeah.

Cancer is, the only way for the immune system to eradicate cancer is it has to, you have to get the very, very, very specific T cell that recognizes exactly that cancer and you have to figure out a way to make enough of them that it wins that war. And that rarely happens spontaneously. I mean, the cases are documented in the literature,

they're so rare, but we now have drugs that can make that happen in about 10% of cases, which is huge. Yeah, that's pretty crazy. So how would you, how would, what's your research yielded? How do you think you can bolster the immune system or like? I mean, it depends. I don't know how technical the audience wants to get into this stuff.

But so stop me when this has become unbearable. So the, you know, we have DNAable. For sure. So we have DNA. Okay. Okay, so everyone's heard of DNA. DNA is the code that tells every cell how to make a protein. So what tells DNA to turn on and off are something called methylation, little carbons that stick on the backbone,

or something called the epigenome. So DNA is regulated through this methylation pattern. And as we age, that changes. Gotcha. So we can look at a T cell, which is the type of cell that fights a cancer or an infection, and we can say, that's what an old one looks like, that's what a new one looks like.

Even though the DNA is the same, the epigenome above the genome, this methylation pattern looks different. And so the question is, what if we took the methylation pattern of an old T cell and made it look like a young T cell? Would it revert into a young T cell? So to me, that's certainly top two or three

most interesting questions in aging research today. That's pretty cool. That makes sense, because it's like the DNA, you're born with it, and then the epa layer, that's like the kind of like pattern that's affected through the environment. That's what regulates it, exactly. Yeah, and then so if you can kind of get into that.

And then so you could, and it was stressed too, because I noticed that was a big thing in your book. So and you can stress yourself to the point where your epigenome will just start being like, fuck this. Everything in the environment can affect that. So it's affected just naturally through aging. So the passage of time affects it. But so does anything in the environment.

So whether you exercise, whether you smoke, whether you have diabetes or not, all of those things, good sleep, bad sleep, high stress, low stress, anything can tweak that in the right or wrong direction. Damn, okay. That's pretty cool. So you're saying get in there.

But the gravitational pull of age is huge and that's the one I'm most interested in is like, how would you, because even the healthiest 80 year old has nowhere near the immune system of an unhealthy 30 year old. Yeah, yeah and we also, we saw that. Everyone was hoping against hope that Mike Tyson would just knock out Jake Paul,

and that was kind of like a bitter moment for a lot of people. Yeah, he can't, like, age. Age is not. Yeah, just can't do it. Yeah, as father time is undefeated, as everybody said. Yeah, even with the TRT, what are your thoughts on that? In terms of what age to kind of smash the glass

and just go full upgrade. I don't know that there's an age I would do it. I mean, I think the things that I would, I had a long talk with a patient yesterday about this exact question and he's pretty young. He's like 36, does not have kids, but wants to have kids. So that's a huge consideration. So in his situation, I would say like TRT is not a good idea.

I suggested that he bank sperm. And if he wants to go down that rabbit hole, and by the way, I don't think he needs to, because I don't think his levels are like kind of 50th percentile. He's not terribly symptomatic. I would kind of eke out a bit more time, but I would rely on hormones that are going to ramp up his body's production of testosterone, as opposed to just giving him testosterone, which will shut off his body's production of testosterone as opposed to just giving him testosterone

which will shut off his body's supply. Forever? No, and it also, it's not something that happens overnight. Like, he'd have to be on testosterone for a while before he would shut down his own production. Yeah, so what are your thoughts on that, on like that whole thing, especially for 30 year olds, do you think it's like good to kind of have that

or do you think it like should be kind of a long road? I think you gotta, you know, take every case individually. But if a 30 year old has, has, has testosterone that is so low that it's impacting him, I think you have to start by asking why. Right. Like how bad is his sleep? How bad is his stress? How bad is every other factor going on? I mean, when I finished, God, when I was, you know, leaving my residency, my testosterone was 227, I think, which is insanely low.

That's, you know, that's only two and a half times higher than a woman. What? Yeah. Is that why doctor's hands are so soft every time you shake them? Yeah. No, that's for the rectal soft every time you shake them? That's for the rectal exam so you just don't that's true. That's true. You wouldn't want my dad know the

And but the reason is pretty clear right because I was sleeping 28 to 30 hours a week damn right so you know horrible sleep deprivation is gonna make it really difficult to make Appropriate levels of testosterone and that makes it harder for you to sleep too when your testosterone gets lower? I think probably a little bit, but the causality is much more in the opposite direction, meaning the horrible sleep is destroying the production of testosterone and growth hormone.

But of course at the time it never occurred to me to do anything about it. And once I was in a job where I could actually sleep each night, lo and behold, my testosterone kind of normalized. It peaked up. Yeah. What do you think that's a good thing

for people to actually look at? I always get the feeling that if you even go into one of those places, they're gonna hard sell you and you'll be on the tee before you know it. I think you should not go to... I'm trying to think of the right analogy. If you walk into a store that only sells hammers, everything's a nail. Yeah. Right. So I think if you walk into a tea shop and all they do is male hormone optimization, I would

say buyer beware. Even if they internally have the best of intentions, I just don't think they can get out of their own way. I also think you should be very wary of going to a place for any sort of therapy where they're selling you the therapy. If my whole shtick is I'm here to, you know, give you the best hormones or supplements or whatever, and oh, by the way, on your way out, we'll sell them to you,

it's just such a conflict of interest. Yeah, yeah. So. So what do you think about the, like, even like the internet companies that are like, like I did one, I don't know if it's nice to like name it or not, but like the ones that like you mail, like stool sample, blood, saliva, and they're're like here's precision supplements for you and you alone

How do you think they're like how much of that is kind of generic and you think some of those companies are really dialed in? They're like I don't doubt that there are ways to kind of sort of optimize supplements around biomarkers I Just I'm not sure that it's as precise as people want to believe. I certainly don't think that, I actually think you can do a lot of supplement optimization off really basic blood work. I don't think, certainly, you know, a stool sample is not necessary because most probiotics

can't even provide the bacteria you need to impact it. I mean, your diet has a far greater role. Your fiber content has a far greater role on your gut biome and things that you'd be measuring in stool. And obviously, saliva, blood, urine can measure things that are relevant and interesting. There aren't that many things that I think are worth taking. Like I think, yeah, if you're low in vitamin D and you're not getting enough sunlight, that makes sense. But that's a pretty simple blood test. If your homocysteine is elevated,

yeah, you probably should take some methylated B vitamins. And if you drop it by more than five or six points, you're probably doing a lot. If your omega levels are low, fish oil probably helps if you're not willing to eat three servings of fish a week. But the true basics of this are really simple. And then there's other supplements that probably make sense for most people,

and you don't even need to test for them. Anybody who's active could probably justify taking creatine. And there's no blood test that's gonna tell you whether or not you need it. We just know that to fill and saturate total body stores, you're gonna need three to five grams per day. Really? That was surprising.

That was something I heard in college years ago when I'd lift weights. Creatine was almost like, you just like a serious kind of bodybuilder supplement. Now everything I read is like, no, everyone needs a ton of creatine. Yeah, again, it's just, if you're playing the game of optimizing,

you're gonna get a benefit, probably about a 10% boost in performance for super short intensity, i.e. the creatine phosphate energy system, so kind of like high bursts of 10-second work, and then anaerobic stuff. It's not going to improve much aerobically. And you'll also get a little hypertrophy benefit,

because the muscles will get bigger when they bring more water in. That makes sense. Yeah, if and you'll also get a little hypertrophy benefit because the muscles will get bigger. Would they bring more water? It makes sense. Yeah. Like my kids are like seven feet away and they're not listening. I could just fucking run at them. Easy. Easy. Just hulk them down. Yeah, that's and that's my thing with fitness. A lot of people and I'm sure you I don't know if you've heard this. You're kind of I'm sure you're like listenership is very health oriented, But a lot of people get very like, I don't know, like very kind of scoffed, they kind of scoff a lot

of this stuff where they're like, who gives a shit? And it's like, and I feel bad because like I do get it. If you're like in a job you hate, you're just totally crushed down by like your life circumstance. Having somebody be like, dude, eat a banana and do jumping jacks, you're gonna be like, dude, fuck you. I don't want to think about this.

But it also will make your life better. Like I always like, whenever I eat a banana and do jumping jacks. You're going to be like, dude, fuck you. I don't want to think about this. But it also will make your life better. I always like, whenever I lose sight of that, whenever I get too into my own stuff where I'm like, this isn't going well, I don't have time. If I just take like an hour, even a half an hour, and just run as fast as I can, I feel amazing. And I always say that's a nice dimension you can add to your life where everyone's like,

I want to get better at my job, blah, blah, blah. It's like just adding that like time yourself running a hundred meters and then try to get a better time next week. It just adds, like it gives you something you're kind of making progress in. And it also, you feel great as a result. Yeah, I think this is where kind of social media really distorts reality.

And the example you give is a great one, right? So if your health sucks and you're trying to figure out where you're going to find an extra two hours a week to do some form of self-care, the last thing you need is some idiot influencer telling you to spend more time in the sauna and cold plunging. I can promise you that is not the first, second,

third, fourth, or fifth best use of your time if you only have two hours a week. How would you break it down then? If you've only got, so, you know, I would start with, let's do the absolute basics of blocking and tackling. So first thing I wanna know is, are you getting at least seven hours of sleep a night? Because if you're not getting

at least seven hours of sleep a night, it's gonna be very difficult for you to do anything at your best. So, I don't want to interrupt you. My question with that is, say you are tracking your sleep and you only get like 43 hours of deep sleep every night, even though you go to bed at like a proper time. Does that matter as much of like REM versus deep sleep?

I'd assume you mean 43 minutes. 43 minutes, I wish. It's fucking 43 hours. I only get 43 hours of deep sleep a year. I'm doing the math quickly. I don't know. If a person says, I feel really well, and there are these, I link to them in the book, there

are a whole bunch of surveys you can get for free that just have you do like, these are validated surveys that kind of go through daytime drowsiness and stuff like that. If you're in bed seven to seven and a half hours a night, ideally eight, and your little sleep tracker says you're sleeping seven, but you're not happy with your stages, I wouldn't put a lot of stock into that

unless you feel that there is a problem. But if you're like, no, I feel fine, and I fill out all the two surveys and they said I'm doing fine, ignore the data. And stop wearing the tracker. I know, I'm gonna stop. Just done with the tracker. So. I was checking every day, I'm doing fine, ignore the data. That makes sense. And stop wearing the tracker. I know, I gotta stop. Just done with the tracker. So.

I was checking every day, I'm like 43 fucking minutes. Yeah, yeah, like it just creates more anxiety. It's just red, I see red numbers and I'm like fuck. I haven't used one of those in a longer time than I can remember. Yeah, yeah. So. So just do the base sleep.

So then the next bucket I wanna know is what's your physical activity level? So let's say this is a person who's got none. They're doing none. And they say, look, I've only got two extra hours, I'm putting that entire two hours into exercise. So I'm gonna say, we're gonna do four 30-minute workouts a week.

And again, I'd have to know more about the person, but it could easily end up being, we're gonna do two cardio sessions a week, we're gonna do two strength sessions a week, we're gonna do two strength sessions a week. One of those cardio sessions per week is gonna be kind of aerobic base training where you're going at the same intensity the whole time, it's not that high, you can still sort of almost carry out a conversation, it's a little hard to talk, but you could. And then the other cardio session I would do, say three days off of that,

would be more interval, kind of like what you were describing. So let's get on a, if you're at a gym and they have one of those air bikes, do something there, be on a treadmill, be outside, it doesn't really matter. This person will get so much benefit from two hours a week of exercise that it almost doesn't matter what they do. And then the other two days a week,

I'd have them do two 30-minute whole body workouts at a gym, where they never stop moving. So if you're doing it at home, it might be push-ups, pull-ups, wall sits, something like that. If you're at the luxury of being at a gym, you might just rotate machine to machine to machine and never stop. And that would just bring huge dividends.

And then the last thing I'd do is in addition to that is just do a quick audit of their diet. Yeah. Are you overweight? Are you adequate weight? Are you underweight? That determines whether you need to eat more or less. And then are you getting enough protein?

And honestly, I wouldn't make it much more detailed than that. And so look, with just a little bit of that insight, you've made better use of two hours a week You've got them to stop worrying about their sleep. You've maybe changed three little things in their diet I promise you that person in three months is gonna feel Significantly better and then maybe by the way at that point They're like, you know what? I wouldn't mind doing three hours a week of this exercise thing because I'm feeling kind of good and you know

I kind of want to dial the diet in a little bit more because I'm feeling kind of good. And you know what? I kind of want to dial the diet in a little bit more. But again, the problem is too many people are consuming information that says, oh my God, you need to be on this supplement, you need to be on this supplement, you need to be doing 30 minutes of this type of sauna

and 20 minutes of this type of cold plunge. And people are like, shut up. Yeah, I can't do that. Yeah. I mean, and to be clear, I love sauna and I love cold plunge. But it is like the 20th thing on my list of 21 things that is a part of my routine. Yeah, that makes sense, man. That's actually cool to hear because it is like a solution is pretty basic and simple. And that's the thing that gets me bummed out when like, you know, I do think we live and I could just be wrong,

but I feel like we live in a pretty nihilistic kind of age, and it's like, it does suck when that spreads. It's like a physical nihilism, like what the fuck's the point of even, it's like, dude, you'll feel so much better. If I don't work out, I get depressed. It's like A to B, easily. If I don't do it for like two weeks, I'm just like depressed and sad.

And it's like, if you don't do it, it's just, yeah, you feel terrible. And I always like to try to, you know, like just get up and move your fucking body, man. There's so much better than this. We were meant to move. We were and meant to be outside. That might be the other thing I would add is figure out a way to do something

outdoors, like whether it's a quick walk or incorporate some of that exercise outdoors. You know what I started doing? Skateboarding. In my ripe old age of 38, I just took it. I just took it back. I've been doing it when I was little and I just started it. And it's weird. That's a that's a real eye-opener When you take it an activity you did in childhood effortlessly and like let me try this again at 38 Dude, I swear I burnt nine hundred something calories

I skateboarded for an hour and 20 minutes and I was I was dying awesome cardio wise I was I was just doing like a little pump track where you kind of just like ride up on a wall Yeah, I thought I was gonna die. I used to do this all day when I was younger. Now I'm like it's like a real eye opener to be like, all right, where am I at? Because I do feel like especially I guess men and maybe women do it to a men specifically over index like I'm good and it's like try something that you did when you're younger and you're like holy shit. I'm going to my heart rate was like one seven

the whole time skateboarding and I wasn't even I was barely pushing. I just had to like balance myself on this track. It was amazing though. I agree with you. It's like find something to do and just kind of, I don't know. I feel like, I do feel like we get too tunnel visioned into like the career stuff. And it's like, we need to.

You need to do that to survive. But it's like the sacrifice of hours of time, like the quote unquote rest time, into like physical activity, just pay dividends and all the other things you're trying to do anyway. I always sound like a broken record, but I'm like dude, it's so important man.

It really is. Yeah, skateboarding's awesome. We should go one time. Do you skate? Nope, I do not at all. Have you ever? Nope, and it's funny. I mean, growing up, I was certainly of that age

when a lot of kids were skateboarding, I don't know why, it just never appealed to me. Yeah. I was sort of busy in my own little world. My daughter did for a little bit. She's 16 now, but she did probably like, when she was 12, 10, 11, 12, she was pretty into it. The coolest thing I've picked up recently,

though it's not a physical activity, but I'm freaking obsessed with it, is chess. Really? Holy cow. How are you? Pretty good? No I'm horrible. I mean I'm just learning. But I love it. Yeah. I can't stop playing. Yeah. I just can't stop. Who are you playing against? I'm just playing my boys. Really? Literally just the three of us. Phone chess or physical chess? No, on the board. That's good. Writing down every move, studying our moves after. Really? Like nerding out, watching YouTube videos.

I'm obsessed with this guy, Magnus Carlsen, who's the best chess player in the world. I've heard of him actually, yeah. Dude, I can't stop watching chess porn. Really? Can't stop. That's awesome. Can't stop. You know how YouTube figures out what you're about?

Yes. Like my videographer for our podcast, he comes, he pulls me aside like three weeks ago. He goes, are you getting into chess? I'm like, how do you know? He goes, because like I'm managing our YouTube channel and like it only populates just it's just like pushing chess stuff all day. That's awesome. I can't stop. It is good for you at night. Like watching chess videos. Really? Oh, it's awful. I'm like, it's nine thirty. I should go to bed. What's the open? What's your opening move? What do you go with? Oh, I'm typically like E for, you know, but I like to I like to castle really early. So I'm going to try to castle within about three or within four or five moves. If I if I'm doing a king side castle. Really? Yeah, I like the first move, the horse just over your pawns. You're like, what's up?

Yeah, it's called there's a name for it. I feel like English or something. But I like the horse. I just fucking bang. Here's my motherfucking horse. Like what's up? Yeah, it's called there's a name for it Here's my motherfucking horse Yeah, no the night's cool because again he can he can he can he can hop over people you move in that fucked up L-shaped pattern But yeah, I love chess too. That is fun. I I just say yes. I don't have anyone to play with that's the thing It's like I don't and I don't it's it's how long is a chess game take One of my boys is super aggressive, so the games are quick,

because he just comes out swinging. Does he really? No, he swings. I like that. He goes for the fences. Does he? And then the other one is so conservative and so thoughtful, that the games take like so long.

And I got us a little timer too, so I'm like, buddy, you have two hours to make the first 40 moves or you're disqualified. That's good. Yeah, yeah, yeah. That's good. Yeah. You got to think on your feet. And the younger one, the one who's super aggressive is so competitive. Like if any one in our family ever makes it and becomes like great, it's him. Because you can't like hit the fire is insane.

Really? When he loses, he tears up his sheets. And I'm like, buddy, you my hand, and we had a good game He's like He's just losing his mind, but he lost a game of chess. It's war. Yeah It's war is it true that the possibilities of the chessboard are kind of infinite. They are truly infinite. That's crazy It's a computationally infinite problem Damn or as close to I mean I shouldn't say infinite right in that AI can Yeah, but but it's from a from a practical perspective, I shouldn't say infinite, right? In that AI can, but it's, from a practical perspective,

I think it's infinite. Damn, that's awesome. That is cool. I'm gonna try it, my kids are too young for that. Me and my daughter did a, like one of those. Your oldest is six? Four. Oh, four, okay.

Four, six could be, six is doable. Six is totally doable. I did chess, we did one of those big ones, we were on vacation and we did one of those, you know those like huge outdoor chess boards at the big pieces Yeah, we did it and I tried with my four-year-old and by the end of it It was like the mommy and daddy were Queen and King were mommy and daddy and the pawns are all of our babies And I was like, all right, man

Well, yeah, that is amazing I once made the mistake of in a game like Oh yeah, man, that is amazing. I once made the mistake of, in a game, like one of my older one, the one who's more conservative, like he had a rook knight bishop in the back that hadn't moved. And it was like 25 moves in. And I'm like, buddy, those guys over there are standing there like they got their thumbs up their butts.

And now those two boys cannot stop saying that. They just walk around every, any time someone's not moving, why do you have your thumb up your butt? And my wife's like, why do you say this stuff to them? Like, you can't say anything, like they're just gonna say whatever you say. It's weird, it's weird, because my four year old is like language police in our house.

She like will learn that something's bad and then she's just like horrified of the idea of saying it. And she's like if we if she hears us saying anything like we even say the word hate. I don't know if we didn't. This wasn't a rule for us. But I hate that. So like don't say that. She like polices our language. And we say like that. We said my wife said freaking the other day. She's like mom, that's a bad word. It's bad. Like no, it's not. And she's like and I was like I was arguing. My wife's like now just just give her that one. She's like it's it's pretty nuts. But yeah, that's not. And she's like, and I was like, I was arguing. My wife's like, no, just give her that one. She's like, it's pretty nuts. But yeah, that is true.

They do parrot everything. You really do got to watch what you say. Because you can say whatever you want around them for the longest time. And eventually, you're like, oh, shit. You can talk shit on my neighbors. You can hear this. You can hear this right now.

Our youngest one, when he was, this is the super aggressive one, so it's not surprising. And then he was like, three. We get a call from the preschool, and they're like, yeah, you gotta come and get him. My wife's like, what's going on? They're like, he said the F word. Whoa.

My wife's like, oh, I'll be right there. But I was a misunderstanding. They made you get him for that? Yeah, I'm like, this is a misunderstanding. And my wife's like, first of all, the kid is obsessed with rhyming. So he almost assuredly was like, truck, truck, fuck, this is a misunderstanding. And my wife's like, first of all, the kid is obsessed with rhyming. So he almost assuredly was like, truck, truck, fuck, or something like that.

And the woman is like, nope, nope. He's actually the first kid we've ever heard use it properly. Oh no. They're like, what was the situation? And they're like, well, he was in circle time. And we were telling all the kids they had to be quiet and he wasn't being quiet.

And we're like, hey, if you're not quiet, you're gonna have to get up and be quiet and he wasn't being quiet and we're like hey If you're not quiet, you're gonna have to get up and leave and he wouldn't be quiet So we got up and made him leave and he stood up apparently and just goes fuck it That's a coincidence I don't I think you learned that from his mom Yeah, my daughter nailed a she dropped something one time when she was really little and she was like, shit. I was like, damn it. That's right. That's on me. Yeah. So that made you what are you like? It was like a one day suspension. Yeah, it was like he's on probation.

Now we ended up finding another preschool form that he did grade in. That's cool. Yeah. That's saying to like be like you got to come get this kid Yeah, although that could spread like wildfire Yeah, I guess I can see it from the point as well. No, that's lame That's crazy to be like he must leave right now But I think they got to let that kind of stuff go that is that is tricky though man Cuz it's mostly that age it's like kids hit other kids and like, you know, some people are like this is this is like Yeah, it's like but you know, I treated like the dog park. It's like kids hit other kids and like, you know, some people are like, this is, this is like, it's like, I don't know.

I treated it like the dog park. It's like, they'll figure it out, man. If it's really bad, you can. There's gotta be enough discomfort in the situation for the kids to evolve. Yeah, exactly what I'm saying. Yeah, cause it's like, dude, you gotta let, they're gonna do that, man.

It's like, you know, me and my cousin got separated and we were in kindergarten together. And then we went to the same school the next year and they were like, AM class, BM class, they can BM class, they can't be with each other at all. But I thought that turned out all right. So before you get out here, we're coming up on, where are we at right now Josh? I don't want to keep you too long. Huh? Perfect. The one thing that I feel like was in the book a lot, you talked about how, and again always correct me if I'm wrong because I always have stuff in my head, stress was something you was really on the back burner that you kind of put to kind of like the forefront of your thinking

from like the day to day and the health perspective. How, where do you kind of stand on that and like what's like, do you have any, do you have any thoughts on that at all? When I think about like what is the, what is the thing that's going to kill me fastest? I think it's undoubtedly stress. I just think it's, you know, I think it's the most insidious killer in a way, because it's the hardest thing to measure directly. You can sort of measure some of its indirect actions, like on blood pressure and blood sugar,

which both go in the wrong direction when stress is high. But I think there's even components of it that just, even when blood sugar and blood pressure are normal, I still think it's just doing something to your brain, probably, and to your heart. And again, I don't think anybody would feel good living in a zero-stress environment. So it's mostly just about kind of managing

how one responds to it. And I think it goes beyond just stress. I think it's sort of like just overall satisfaction in life and contentment and enjoying your relationships with people. I interviewed this guy on my podcast, Bill Perkins, who wrote this incredible book. It's one of my favorite books. It's called Die With Zero. And he writes about how you have basically,

like you have time, you have money, and you have experiences. Sorry, he starts about through health. So health, time, and money. And you're not optimizing for the most of any one of those. You're optimizing for the net of fulfillment. So too many people miss that, right? They're just like working, working really, really hard to get as much money as possible

or as much fame as possible, or they're like maniacally focused on their health. That's the only thing to think about. Right. Or they're just trying to live as long as possible or make as much time for certain things. But it's kind of like how you put all those things together to optimize their own fulfillment. So in this book, he writes about this idea of people aren't doing the equation correctly.

They're deferring too many experiences when they're young to do when they're old, but then they don't realize when they're old, their health is actually not. They're not actually able to do it when they have all the money in the world. They can't go and take the incredible vacation. Or if they can, their kids aren't with them

or their kids aren't young. So I think it's just kind of reframed a lot in my mind and made me realize that when our kids are young and we are incredibly healthy, that should be the time that we invest more in fulfillment and experiences as a family, which has just been a completely different mindset for me from where I was most of my life.

Yeah, just going kind of like full blast to make as much money as possible. Sleep when I'm dead. Yeah, just going kind of like full blast. Yeah, yeah, yeah. Make as much money as possible. Sleep when I'm dead. Yeah, that's the big one. Sorry about that bug, dude. That bug won't leave you alone. It hasn't even come over to me at all. I mean, I must stink.

Yeah, that is kind of a cool thing too, man. Because it's also something you don't really learn. Like, nobody really tells you how to manage your stress. You kind of mostly, from what I gather, you kind of just like watch your parents deal with stress and you're like, all right, and you just kind of like take those patterns and just apply them to your life. And it's like it really does like, I don't what I've been trying to do recently is like just take one day out of the week. Usually it's Sunday because like we're all

off everyone's hanging out. And I just try to focus on like being as calm and at ease. That's like top priority of my day. Usually it's like, I gotta get this done, I gotta get this done, and on one day a week, I'll be like, I'm only focused today. My number one goal is to try to stay in a state of ease and contentment. If I get out of it, before I'm like,

I just try to zero in on that. That's been kind of like, for me, that's been a bit of a revelation to be like, oh, I can move through multiple days without completely spinning myself the fuck out. And it's been, I don't know, it's been like a bit of a revelation to be like, oh, I can move through like multiple days without completely spinning myself the fuck out. And you know, it's been, I don't know, it's been kind of nice. And what do you think spins you out?

Is it just busy, it's too much? Yeah, it's too much. Or is it a particular thing? Yeah, I mean, it could be anything. My kid's not listening, kind of spins me out if I'm like trying to get up the steps and it takes 40 minutes and I'm kind of like, all right, let's go.

It could be anything, it could be be like overwhelmed like just like situations at work I got to deal with that are just completely overwhelming stuff in the house You know, it's just like lack of sleep our kids are still so little that our sleep gets fucked up But yeah, it is. It's that it's usually like relational stress or Just like work stuff. Those are two the two main things I could that kind of like can really spin me out And I would argue that most work stress is relational as well So I I kind of agree. I think relationships are both the best part of life and the most stressful part of life Yeah, I agree. So that's been kind of that's been my that's what's going on here

By the way a lot of relational stress in that That is true, but yeah that uh, that is that's kind of thing man It's like well This is my whole point is like you do have some say and how much a thing can like like you can everything in Florida Things come out of nowhere and you're like you get caught in it, but it's learning how to be like All right, something got me. It's like laser tag like my things beeping I can kind of walk myself through this without like going on like a Godzilla path. You know what I mean? Yeah, it's like I don't know if that's been pretty helpful for me

Before I get caught that's that's my ultimate fate She's like babe. I'm having a naked victim with a She's right there and the coming out of the water just hawking me It's not what it looks like yeah, that is the number one man. It's like dude It's uh, you know like managing stress keep yourself physically fit cuz you can't like otherwise like what the fuck are we doing man? It's like you know it's like unless you I mean some people are just surviving which is which is kind of that sucks But I don't know I feel like you can even I feel like people there's other countries where people are just surviving They still do cool stuff. You're like big ornate jugs of water, and they carried around they like dancing stuff

I don't know it's kind of sick I'm just. They like dancing stuff. I don't know. It's kind of sick. I'm trying to make people happy. I don't know how to do it. Well, dude, I mean, is there anything else that's kicking in your mind? I don't think so. Well, I think you did it. Thank you for coming and doing this. I apologize for the strange format. But how do you feel about

standing in? I think it's hilarious. I think it is. This is the first standing podcast I've ever done. It's not bad. How do you feel about it? Honestly, you can hurt my feelings. Honestly, I think I have better posture than I normally do. So I'm saying when you're sitting on a podcast, you kind of slouching forward.

Standing keeps you on your feet. It keeps the mind sharper. Like, I feel like we're doing a political debate the way they're angled at each other. You know what I mean? Like, I feel like I need a moderator to ask me a question That's the only thing that it would have been a little better if it was moderated moderate was moderated. That's a good guy more heated That's true. Yeah, that is true. I got a work on being I would run a teleprompter next time if you wouldn't tell a prompter

I want to tell a prompter their moderator their Right more for sure. Yeah, I mean we could bring some heat. Yeah, it brings. Yeah, you want the heat. I have some burning hot questions. I didn't ask him about a lawsuit. So I was like, I can't ever you can't talk about lawsuits. No one can ever talk about them. I know the lawyers say no. Yeah, you why? Yeah, what's the point? Bring awareness. Yeah, I did. I actually I was researching just, you know, you when you have someone on I saw your

embroiled in a lawsuit and I said, hell yeah You know, when you have someone on, I saw you're embroiled in a lawsuit and I said, hell yeah, dude, that's what's up. So we won't have the lawyers won't like that. That is bullshit. You can't talk. I mean, dude, don't do it. Why the fuck's the problem? It's anyway.

Well, dude, thank you. Is there anything you want to plug? Is there any the book? Obviously, read the book, dude, read the book, listen, thank you. Is there anything you want to plug? Is there any book? Obviously, read the book, dude. Read the book. Listen to the podcast. Peter, thank you so much. Thanks for having me.