The Skinny Confidential Him & Her Podcast - Dr. Peter Attia Pt. 1 On Optimal Fitness Routines, Body Fat Management, Fasting, & How To Live Longer

Episode Date: August 28, 2023

#603: Peter Attia, MD, is the founder of Early Medical, a medical practice that appliesthe principles of Medicine 3.0 to patients with the goal of lengthening theirlifespan and simultaneously improving their healthspan. He is the host of TheDrive, one of the most popular podcasts covering the topics of health andmedicine. He is also the author of the #1 New York Times Bestseller, Outlive: TheScience and Art of Longevity. Today Peter joins the show for part one of a two part episode. In part one we discuss optimal fitness routines, body fat management, fasting, and how to live longer.    To connect with Peter Attia click HERE To connect with Lauryn Bosstick click HERE To connect with Michael Bosstick click HERE Read More on The Skinny Confidential HERE To subscribe to our YouTube Page click HERE For Detailed Show Notes visit TSCPODCAST.COM To Call the Him & Her Hotline call: 1-833-SKINNYS (754-6697) This episode is brought to you by The Skinny Confidential This episode is brought to you by JSHealth JSHealth Vitamins is a science-focused vitamin and wellness brand that provides targeted formulas to help you meet your personal health goals. Go to jshealthvitamins.com/skinny and use code SKINNY for 20% your order or first subscription. This episode is brought to you by the Clean Simple Eats Clean Simple Eats protein powder is non-GMO, gluten-free, 3rd party tested, always grass-fed and made with zero artificial ingredients. You can get 20% off your first order by using code SKINNY at checkout at cleansimpleeats.com . This episode is brought to you by Dr. Dennis Gross If you want to take your beauty routines to the next level with immediate and long-term benefits, go to ddgskin.com/skinny for up to 25% off Lauryn's exclusive bundles and new lip products. This episode is brought to you by Westin Hotels At Westin hotels, there’s amenities and offerings aimed to help you move well, eat well, and sleep well, so you can keep your well-being close, while away. Find wellness on your next stay at Westin. This episode is brought to you by Ibotta Ibotta gives you cash back on hundreds of grocery items from produce to personal care to pantry goods, so you can make sure you’re beating inflation no matter what you’re purchasing. Download the Ibotta app now & use code SKINNY to receive $5. This episode is brought to you by Vegamour With Vegamour, you're able to have visibly thicker, fuller, shinier, longer hair, all without the harsh ingredients. Vegamour's products are 100% cruelty free and not formulated with any harsh chemicals. Visit vegamour.com/skinny and use code SKINNY at checkout to get 20% off your first order. Produced by Dear Media.

The following podcast is a Dear Media production. cream. Okay, so we launched a razor. It's silicone. It's pink. It's thick. You can replace the blades, which is amazing, especially because those blades can get really dirty and it's bad for your skin. So you want to be able to replace the blades on your facial razor. And we also launched a shaving cream and it was the first ever women's shaving cream. The one that we launched is super nourishing. It has shea butter and aloe vera, but there were a couple pain points. We wanted to fix the size so you can now travel with it. There's no artificial colors in it. The glide is amazing. I have been testing this forever. I'm so excited it's finally here. Shea butter, cocoa butter, olive oil, all in this incredible shaving cream. It makes the glide of

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A very smart cookie. And now Lauren Everts and Michael Bostic are bringing you along for the ride. Get ready for some major realness. Welcome to the skinny confidential, him and her. There are some people who don't enjoy exercise. I enjoy it. I feel so strongly that everybody exercise that I think we just have to find a way to make sure it becomes Natural and and sometimes for people who are not coming at it from a place of doing it The goal is to do just enough to simultaneously accomplish the following Make sure they don't get hurt and make sure they start to see some positive benefit that gets them a little bit hooked. I know that for my wife, who never wanted to lift a weight, about three years ago when she finally started doing it, the thing that got her most excited was that she could see her deltoids.

To have that little pop of a deltoid, she was like, I love this. Welcome back, everybody. Welcome back to the Skinny Confidential, him and her show. Today, we have a phenomenal guest on this podcast, on this show, and that is Peter Attia. Lauren and I have been trying to get Peter on this show for a couple of years now. And recently, I read his book, Outlive, The Science and Art of Longevity and was blown away. This episode had to be a two-parter. We were recording when we started this about two and a half hours and we just felt, okay, we got to break this out. We get into so many different subjects around longevity and weight loss and health and muscle building and hormones and supplementation and just so many incredible things. And we knew this couldn't just be a

single hour episode. So we made it a two-parter. This is part one of that two-parter. The second one will be live this Thursday. Be sure to check it out. For those of you that are unfamiliar with Peter Attia, he's the founder of Early Medical, a medical practice that applies the principles of Medicine 3.0 to patients with the goal of lengthening their lifespan and simultaneously improving their healthspan. He works with some of the world's biggest and greatest performers across all spectrums, athletics, entrepreneurship, podcasters, all sorts of different people. And we just could not be more excited to do this interview with Peter. We covered so much ground, like I said. He's also

the author of, like I said, the number one New York Times bestseller, Outlive, which is a phenomenal book all around the science and art of longevity. With that, Peter Attia, welcome to the Skinny Confidential Him and Her Show, part one. welcome to the Skinny Confidential Him and Her Show, part one. This is the Skinny Confidential Him and Her. Peter Attia, I feel like we've been trying to lock you down for a while now. Huge fan of your work, both of us. Cannot believe we were just catching up offline that you go to Alce in San Diego. Brad, why didn't you tell us this? We would have been posted up there, but so great to have you on the show.

Yeah. Thank you so much for having me. And I knew about you guys long before you knew about me because Lauren's parents would brag about you guys constantly over my elk pozole, just for folks who don't know what we're talking about. San Diego, nice place to live. Not so great on the food department. It's actually a food desert basically, but it does have this awesome restaurant in Solana Beach that my wife and I would frequent at least once a week, which happened to be your parents' restaurant. That is the best plug, especially with the book that you just wrote. My dad is probably so excited and just for anyone who's listening he gets the elk pozole but he gets it double no no quadruple so they make them they make the elk

pozole as a dish but then they make like a shareable bowl that's to feed four people and i get that as my own i'm literally doing that every single time i go i might have a margarita with it is that okay i think so okay I'll do really light sugar. Yeah. So we were talking, Ben, I was saying, you know, many of our audience may know you, but I also think many may not. It's a new introduction for you to this demo. And there's so many directions we could take this.

When you describe yourself and what you do now, high level, because you do so many things, what's the quick bullet point of exactly kind of how you work and what you do depends on the audience so if i'm at a party i weasel out of this as much as possible i'm a shepherd is usually what i say and usually enough people don't know enough about shepherds to ask good questions to prove that i'm lying and i can get away with it and that's the end of the discussion. Race car driver. I got away with that last week. I was out at dinner. The waitress asked me what I did. Formula three driver. She was so sweet because she said, are you ever going to drive formula one? I said, no, I'm never going to be good enough. And she was like, you got to believe in yourself. You can do it. I mean, she was so kind, but if I get boxed into a corner and I have to talk about

what I do, um, I will begrudgingly acknowledge that I am in the business of trying to figure out how to live longer and live better. So when you, I mean, there's so many things when you go to this, one of the things in your book, you talk about the difference between lifespan and healthspan. And I think that's a great place to start, the distinction between those two things. Because what Lauren and I try to do and the information we try to gather on this show, talking to people like yourself, is we're trying to not necessarily live till we're a thousand years old, but to just feel good every day that we're alive. And I think that might be a decent place to start. Yes. And I would say there's a caveat to that, which I'll come back to, but you're correct. So lifespan and healthspan are important concepts because the word longevity, most people make synonymous with lifespan. So longevity is living

longer. But that's not really true, at least not the way I define it. It's also a function of the quality of life. I think the quality of life tends to matter more the older you get. So I think when you're young, I'd put us all, certainly you guys in that category. I don't know. I'm certainly into middle age well now, but for someone like you, who's very young, it's easy to say, look, all that matters is how good i feel today and how well i function today and i would just push on that and say true but if you can set yourself up to really function well in your 80s you'll do things now that might be even more demanding but will pay dividends later and so really kind of my model is focus on healthspan at the end of life because that's the hardest thing to get right. And then everything else will flow from

it. You'll get the lifespan, you'll get the healthspan today, but that's the ultimate goal. It's kind of like delayed gratification. Totally. So what are some pillars of your sort of mission? Well, it depends. I have so many pillars in my life. Like my whole world comes down to pillars, right? So I have like the pillars of how we intervene, right? So nutrition is kind of a pillar of, of this, uh, you know, exercise is a pillar of this. Sleep is a pillar, emotional health, you know, medications are all pillars. So that's one way

that I think about it. I don't know if that's, that's the direction you want to go in. Yes. Let's go in that direction. Let's start with someone who maybe comes to you that feels like shit. Maybe they're 30 pounds overweight. They're working their ass off. They're probably going to bed at 11 p.m. at night. They're eating protein, but it's not great. Where do you start with a person like that? If someone's listening, where can they start?

So it's important to understand there's only a subset of people I take care of. So I take care of people who have bought into my thesis. And that's not a huge sliver of the population. So it's very important. So customer selection matters. So I'm interested in people who buy the idea that if I manipulate those five things that I just said, I have an opportunity to live a longer life and at a higher quality physically, emotionally, and cognitively. If they buy into

that argument, and I clearly do, my life is centered around that argument, then they'll have the patience to go really deep on how to manipulate all those things. If however, someone comes to me and says, I have to lose 30 pounds and I have to have a six pack and I have to look good in a bathing suit in six months, I will always say to them, there are better people out there than me. That is, I'm not saying that's not a worthy goal. It might be, it's just not something I'm good at. And therefore I will, I will sort of always shift them in that direction. So with that said, taking the example of your, of your, your, your person, I would, I always start by just learning as much as I can about an individual, right?

So what can I learn about them biochemically? What can I learn about them? Meaning looking at their blood work. What can I learn by looking at something like a DEXA scan to understand how much muscle mass they have, how much fat they have and where that fat lies. Cause some fat is harmful, really harmful. And some is just aesthetically a nuisance. You want to know the difference. I would want to understand in detail how they're training, how they're eating, how they're sleeping, how they're managing stress. And I think only with that information, could I begin to start to at least come up with the diagnosis

of what are the relative strengths at which they need to pull on each of those levers we talked about. Just based on what you were saying, clearly nutrition, exercise, and sleep are going to be big components. You mentioned two different kinds of fats, bad and good. Well, it's more nuanced than that. It's subcutaneous fat is the fat most of us think about, right? If I lift my shirt up and you pinch a little fat on my belly, that's subcutaneous fat.

It's fat that is stored in part of the body, believe it or not, where we were designed to store fat. And I think this is hard for people to understand, but you have to take an evolutionary lens to appreciate it. The ability to store fat is a very good thing. If we didn't have that capacity, if we, if we all had conditions called lipodystrophies, which are, is a medical term for people who can't store fat, our species wouldn't be here. So this, this would be, there'd be a bunch of amoeba doing this podcast right now and it wouldn't be very good because they wouldn't have brains the same as ours. So only because we could store fat, could we as a species, you know, directionally like 250,000 to 500,000 years ago, kind of really start to showcase our capacity as the superior species on this earth. And the reason for that is our brains are so energy demanding. So all of us are sitting in this room right now. Our brains are consuming 25% of our total calories. Wow. I didn't know that. Think about that for a second. So if you eat

3000 calories a day, what is that? 750 of those calories are just going to your brain. The thing weighs 2% of your body weight and consumes 25% of your energy. And that's why we have the brain that we do. That's why we are sitting here doing a podcast and not rummaging around in the dirt, but that comes at a very high cost. And the cost is we can never be without energy and that's why our bodies evolved to store energy and we really only store it in the form of fat you can only store about a day's worth of glucose and we don't store protein so up until like i don't know a couple hundred years ago this capacity to store fat was amazing it's really only in the modern world where food is so abundant that the need to carry enough energy to survive for two weeks without food was no longer

a liability. And now most of us have the opposite problem, which is restoring too much energy. But to go back to your question, only when the fat leaves these subcutaneous areas and goes into other areas, and the big ones are into the muscle itself. So if you look at a, you know, you look at it, ever see like a Wagyu steak, how it's like fat is marbling inside the muscle? Sure. Well, we do that too. And that's really problematic. That's what leads to insulin resistance, which I'm sure we'll talk about. If the fat starts to surround the organs in your body, if the fat builds up inside your liver, inside your pancreas, around your heart, now the fat is very problematic. It starts to release inflammatory cytokines. That's the type of fat that actually leads to heart disease, cancer, Alzheimer's disease, all these things.

And what are the main reasons the fat would start to go into those areas? Yeah. Awesome question. It basically is a genetic issue. So everybody has a different capacity for how much fat they store. So I'll give you one very obvious genetic difference is Asian to Caucasian. So specifically Asian to Northern European descent, you probably notice, or maybe you've heard the term skinny fat, right? Sure. That you will see that used to describe Asian populations where they don't really, you know, an Asian person who's metabolically unhealthy doesn't necessarily get fat. They'll just get type two diabetes, but on the outside, they'll actually look normal. And the reason is they just don't genetically have the capacity to store as much excess energy. So they'll very quickly go from energy appropriate to energy abundance, but you won't see it. Whereas people of Northern European ancestry can get a lot fatter first and believe it or not, initially stay reasonably healthy metabolically as they do. So the analogy I use in my book is a bathtub. Different people have different size bathtubs. So a really big bathtub is a person who could get really, really fat, meaning lots of water could get into that bathtub and not cause trouble until

at some point it overflows and then water leaks on the floor and that's problematic. Yeah. I remember reading in your book, you wrote about this, where it's not necessarily someone, if you look at someone aesthetically and they're big, that doesn't mean they're necessarily unhealthy compared to somebody who's not. And it comes down to this issue. Is there a reason why people of Asian descent based on genetics have more of that issue than Caucasian? I can speculate, but it would be nothing more than speculation.

I would assume that it might have to do with the fact that people of Northern European descent, there would have been another advantage to accumulating excess fat for, for example, for warmth and maybe people of Asian descent, it would not have been an evolutionary advantage to create such insulation. So in other words, maybe there was another advantage beyond the energetic one. Maybe there was a, a, an insulation one as well. So for you, and this is a question we asked when you were coming on, we asked the audience, like, hey, what questions do you have? And a lot of it centered around what to measure, how to measure, what to look at, what not to look at. And I think based on what you're talking about here, it's so important because Lauren and I both have different genetic makeups. I actually am a

quarter Japanese, which is why I was wondering. God damn it though. I mean, God. But it's important, I think what you're saying, to know these different kinds of markers because how you would potentially work with me is different than how you would potentially work with Lauren, even if we had the same goal. Well, yes, but I would also argue I wouldn't need to know your genetics

to make that distinction. I think in the end, it's measuring what's actually in front of you. So sometimes it's helpful to know that, but like if you were adopted and let's just say you didn't do a genet, like, let's say you didn't know that from a, you know, family history standpoint,

and you didn't do a genetic test, which could reveal that through ancestry, we would still be doing the same test on both of you, for example, we would still do a DEXA scan and that DEXA scan spits out four really important pieces of information that everybody should know about themselves. So the first is your bone density. So everybody should know this. And interestingly, people your age and my age, even I'm 50, a lot of people don't really think much about bone density at

this age. It doesn't really start to become a problem until people have fractures. And falling becomes an enormous source of mortality and morbidity as people age. But if you recognize a person in their 30s and 40s with below average bone density, at least for their age, that's a red flag and that has to be corrected. We can talk about how you would do that. Second piece of information I want to know from that test is total body fat. And again, I think that might be the least important of the four, but it still factors into the picture of where do you rank in terms of being on this kind of overnourished versus undernourished pathway,

which is the way I sort of describe it. And do they take total body fat as just a comparison against the muscle? The way total body fat is calculated is, so a DEXA scan can only distinguish between three types of tissue, fat, bone, and all else. And the majority of all else or lean tissue, i.e. not fat, not bone, is muscle, but it's also organs and stuff like that. So body fat is total amount of fat divided by total mass. Okay. And that's, so it's pretty accurate measurement, but then they can measure something called visceral adipose tissue or VAT, VAT. And that's something we care a lot about.

And that's the amount of fat around the organs. And so we really care a lot about that. So if a person is at the 50th percentile for body fat for their age and sex, so trying to think what that would be. So, you know, that would be like a 40, like someone my age at the 50th percentile is probably 22, 23% body fat. So they're not super lean, but they're, you know, they look normal. Right. But if their visceral adipose tissue was only at the 10th percentile, I would say from a body weight, body fat perspective, you're just fine. Because you're just storing healthy. Yeah. And by all means, again, I don't want to minimize the person's goals. If they say,

yeah, but like, dude, I want to be ripped. Well, yeah, then you need to be less than 50% body. I mean, less than 23% body fat if you want to be ripped. But you're just not as concerned with that reading. I'm not as concerned with your health. This isn't impacting the length and quality of your life, unless you tell me that the quality of your life is dependent on your abs. What are some things you are concerned about? When you see someone's labs with all these different people that you have coming to you, what makes you say, hold up?

On the DEXA scan, the three things that get me phosphorylated, which is just a fancy word of saying wound up, is bone mineral density problems, high VAT, and then the fourth thing we look at is muscle mass specifically. So we look at metrics of muscle mass and we look at two, and these are a little complicated to explain technically, but conceptually they're not. We just want to know how much muscle you have normalized to your height. And there's two ways to do that. The first is a metric called ALMI, Appendicular Lean Mass Index. So think about appendicular appendices, arms and legs.

You take the total amount of muscle on the arms and legs in kilograms, divide by height and meters squared. So you get a number that's might be as low as five, which would be really, really low and might be as high as 10 or 11. That would be really high. That gives you a sense of what the range is, but we put these on a chart and it will spit it out. So I wouldn't expect you and you to be the same because you have different heights. You're male, you're female. You're probably about the same age, but all those things factor in what I care about is percentile. How do you stack up? And so I just looked at a new patient who's not starting yet. It's a patient who's going to be coming on.

I just got this person's DEXA scan today. The ALMI is below the fifth percentile for this individual. So body fat is low. VAT is low. I don't remember what the bone density was, but I think it was average. But the fact that muscle mass is below the fifth percentile is a four alarm fire in my brain. So is that somebody that's either under eating or under nourished or maybe not working out enough? Yeah, it's all of the above. So not eating enough, not training enough. And let's be clear, genes play a role here. This is a person who just is of diminutive stature and has, this is a person who would

never probably ever be able to amount to having an ALMI at the 95th percentile. But this is a person who could get to the 30th or 40th percentile over five years. So when you see that, and in your book, you mentioned this like for horsemen of death, which is, tell me if I'm wrong here, heart disease, cancer, neurodegenerative disease, and type two diabetes are related metabolic. Yeah, all the metabolic diseases. So when you see that reading, what of those are you concerned that that leads to? So I, one thing I haven't seen in this patient yet, cause they haven't started yet.

And this is the first piece of data I have. I haven't seen other this patient yet, because they haven't started yet, and this is the first piece of data I have, I haven't seen other markers of their metabolic health. And I haven't seen their family history, and I haven't seen any of their chemistry. So I don't know yet. But what I do know is people with lower muscle mass have higher all-cause mortality across the board. On every one of those kind of functions.

Anything that can kill you, which is those things plus falling, plus kidney disease, everything that can kill you when your muscle mass is that low. So to put this another way, if you look at a study, and I think I cited this study in the book, if you took a bunch of roughly 70 year olds and you broke them down into quadrants of like how much muscle mass they

had by this metric, this ALMI, and you compare the top 25% to the bottom 25% and you follow them for 15 years. So 70 years old and on the people in the top 25%, 80% of them are going to be alive in 15 years. Interesting. In the bottom, half of them will be. It's a big difference in mortality. Okay.

So maybe staying on the muscle theme, I was going to talk about it later, but Lauren and I, we weightlift rather frequently. She just started, what is it, two years ago now for the first time ever. And I read in your book that, and tell me if I'm wrong here, that you are now maybe considering this kind of exercise maybe more important than diet and nutrition, muscle building. Would you agree with that? Or is it just all part of one component?

So if you asked me this question 10 years ago, of all those levers, which one's the most important? I would have probably said nutrition. But I think today that if I look at the data more objectively, I think that having a high VO2 max, so having really high cardio respiratory fitness and having high strength and muscle mass is more strongly associated with a longer life than anything else, including having a really good diet. And by the way, this is not just me saying I speculate on this.

The data are really clear if you look at the hazard ratios associated with the absence of those things. Does that make sense? So in other words, the easiest way to look at this is to say, what is the risk of having type 2 diabetes, which you could argue is the most extreme form of metabolic dysfunction associated with, you know, being the most overweight or all these other things. You could look at the hazard ratio of obesity. So you look at the hazard ratio, meaning the risk of increase in the risk of death from all of the things that go wrong when nutrition is off the

rails and compare that to the hazard ratio for death when you have low muscle mass, low strength, and or low VO2 max. And by the way, just for giggles, compare that to the hazard ratio of smoking and compare that to the hazard ratio of high blood pressure and all these other things. And those numbers are really clear. So for example, you take a person who smokes and someone who doesn't smoke. Cigarettes. Yep.

So same in all ways. And we're just going to march. We're going to look forward and predict their death. The smoker in any given year has a 40% higher chance of dying from all causes. Okay. What about type 2 diabetes? It's about the same. Maybe a little bit higher.

Take a person with type 2 diabetes, compare them to an age, sex matched, everything matched, compare on the way, same thing. It's about 1.4 to 1.5, which means 40% to 50% greater chance of death. So those are big numbers. Now look at it with low muscle mass and low strength. So you take someone with high muscle mass and strength, low muscle mass and strength, but otherwise they're the same. The difference is 150%. Holy shit. Wow.

Now do it for very high cardiorespiratory fitness and very low cardiorespiratory fitness. So top 25% to bottom 25%, it's 175% difference. 175% difference, not 75%. So on the scheme of the percentages, that is the bigger thing is the cardiovascular fitness. The cardio, respiratory fitness, the strength and muscle mass are so much more important simply on the basis of these types of observations, which is when you compare good and bad on those fronts, the gap is three times larger than when you do it on the nutrition front.

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forever. I wear it when I meditate for daily red light therapy. It's so easy to use on your face. Okay. But they just came out with a new device and this device targets the lips. So he totally recommended this. It's this new Lipwear Pro. Basically what it does is boost collagen, not only for preventative anti-aging, but also for immediate plumping. They launched this device with a lip treatment too. And the lip treatment's perfect immediate plumping. They launched this device with a lip treatment too. And the lip treatment's perfect for plumping. So if you're looking for something to do in between lip filler treatments, or you just like don't want to get lip filler, this is an incredible alternative. So I've been using it and it's like incredible what it does to your lips. He then pairs it with this amazing product that he created,

and it's called Derm Infusion's Plump and Repair Lip Treatment. I had the opportunity to test this out for a long time. Boy, oh boy, does it work. It plumps the shit out of your lips. This is so great to take your beauty routine to the next level. You'll get immediate and long-term benefits. Go to ddg.skin slash skinny, or click the link in the description to shop my exclusive bundles featuring the new lip products and some of my other all-time favorites for up to 25% off. Can you go into detail about cardio? Like what should we be doing? How many days a week specifically? Great question. So again, depends on the goal. So if you said to me, so my wife's a marathon runner. So she loves marathons, despite the fact that I've tried to get her to stop. She won't do it. Why stop?

I mean, I just think, look, she has nothing left to prove she's run amazing marathons she's run really fast marathons and i think deep down there's a part of me that's like worried like at some point she's just going to sustain an injury that is going to come back to bite her later on down the line just because it's so hard on the body yeah it's just like again it's like i always say like just run 10ks instead like you could be very competitive at 10k why does it have to be the marathon but that's also me that's not cool of me like i should just shut up and let her do her thing but you guys should always just shut up yeah yes dear yeah so but it's coming from a place of love admit it right you guys it is coming from a place i was saying though i don't know if i have a trophy wife right now because i showed her that salad video just posted i basically get a kale leaf and that's about it that big ass salad you

just got i was like lauren where's my big ass salad yes i'm not a I basically get a kale leaf and that's about it. I got a big ass salad you just got. I was like, Lauren, where's my big ass salad? I'm not a trophy. I get a piece of cabbage. That's it. Why fall of fame right there? So if you said to me, I want to do what Jill is doing. The answer is different than if you say, I just want to be really fit and live a long life.

So what we call sport specificity starts to matter. And in the case of my wife, it's a hell of a lot of running. But if you're my patient and you're saying, okay, I want the most efficient path to get there and I'm willing to do whatever, I'd say it's probably about four hours a week is probably that sweet spot. And what does that workout look like? Yeah. So be about 80 of that would be low intensity like a zone two zone two okay which we can if we can talk about zone two i can explain that in more detail and then about 20 of that would be higher intensity specifically geared towards vo2 max

training which means you are training in what I call intervals of hell. So like, are those be like hill sprints or assault bike workouts? It could be anything you want provided. It's about three to eight minutes of hard work followed by about three to eight minutes of recovery. And I think four is, we usually have our patients do four on four offs.

That's the sweet spot. So you'll do whether you could pick your choice, right? So it could be a stairmaster, assault bike, treadmill. I like my favorite by far is just riding a bike on a hill. And you're, is it like, and when you're, so when you're doing this in your body, like should you be like hands on knees, like trying to recover after that?

His hands can't be on his knees when he's riding a bicycle. No, no, he means in between. Just like in between, like, are you, are you so gassed? I'm in a lot of pain after. Yeah you're like but but because because you have to do many of them i'm not the most gassed okay so i'm like a zone like three four it's a four five it's a four five it's a four five yeah yeah yeah but if you want to get really technical and this is a good question because a lot of people who haven't done this type of training don't know how to pace themselves for this a four minute all out is really unpleasant but you shouldn't feel awful until the third minute does that make sense yeah

you should be able to just like so if i'm running up a hill i could be able to and then the last part of it is like this yeah so so when i do them there is the best hill i ever trained on it was in rancho santa fe where we used to live and i I haven't found a hill in Austin that's as good. But this one in Rancho Santa Fe was perfect because it was a 6% grade for 1.6 miles. I wonder what you're talking about. And it never went up or down. Like it was just perfect. And I remember distinctly because I knew every tree and leaf and thing.

Like you just knew exactly what was going on. The first minute feels totally fine. At minute two, I'm like, this sucks. At minute three, I'm in so much pain. And at minute four, I'm, I have to concentrate to make sure I don't make a stupid mistake on the bike. And then you have four minutes to recover and that might get my heart rate down to 100. And then you do it again and it goes through the same process you do that four times yeah maybe five or six wow okay so it's so you're that's like once a week okay like so there's like a 30 40 minute workout call it an hour with your warm-up and yeah okay and the rest of that on the zone two tell me if i'm wrong i've heard that zone two should be

enough of an exertion where you're, you get your heart rate elevated, but not where you can also either breathe through your nose or carry a conversation. So a couple of things to say on that for some people, like my sinuses are relatively straightforward. My septum is straight. I can breathe through my nose in zone two, but I don't think that's a great litmus test because I think there are enough people who have septum pathology that makes it. I think the talk test is the better test. Okay.

I always tell people, if you're on your bike doing a zone two workout in the gym and your wife comes up to you and asks you complicated enough questions that you can't just grunt the answers. So it's not just, you know, are you cool if Susie comes over for dinner? If it's like, hey, my parents want to do this and we need to do this. And you actually have to answer in full sentences. If you can't answer her in full sentences, you're going too hard. If you can, and it's actually not unpleasant, if it's actually easy to talk in full sentences, you're not going hard enough. If you're on the treadmill, treadmill, what, what is the incline and the speed?

If you had to tell us specifically. Well, it varies by your fitness. I can tell you what it is for me, but I don't know what it is for you. What is it for you? It would change depending on for. Yeah. For me, I like to treadmill at 3.5 to 3.6 miles per hour and 15 degrees incline. Holy shit. That will put me at that level.

15 degrees incline? Yeah. Wow. But then, so, okay. So that is the majority though of the cardio for the week is you're doing that for, call it three hours. That's right. So call it like, I do four hour sessions like that. Okay.

That's not too bad when you think about it. So you do four hours of your treadmill and then you also do your app. I do them mostly on a bike. The only time I do treadmill is when we're traveling and they don't have a, but I do all my zone two on a bike pretty much. And you like that just because it's easier on the body or? I mean, honestly, I think, I don't have a great reason other than I used to be a cyclist.

You wouldn't know it to look at my obese body today. When you're a wheel, you like cars and wheels. So it feels like more fun. But I think, yeah, cycling just is, it feels very natural to me. And I do spend a lot of other time walking outside. So I kind of feel like I get a good leg workout rucking, which is another pastime of mine.

Now that you guys, we all live in Austin, you're going to, the rite of passage with my friends is rucking with me in the heat. What is rucking, which is another pastime of mine. Now that you guys, we all live in Austin, you're going to write a passage with my friends as rucking with me in the heat. What is rucking? Our trainer that we work with, you just did a clip, I can't remember with who, and we were talking about the weighted vest versus the ruck pack. Yeah, yeah.

And we were talking about what was better. Yeah, I think the rucksack is significantly better. What is a rucksack? It's like a backpack with weights. It's just a backpack with heavy weight in it. Yeah. I think the rucksack is significantly better. What is a rucksack? It's like a backpack with weight. It's just a backpack with heavy weight in it. Yeah. I want a ruck. It's awesome.

Huh. You know, Lance Armstrong came out for a ruck with me yesterday because he's moving back to Austin. And so I brought him out. And I always do it as trial by fire. You just go middle of the day. So 4 p.m. Oh, God.

And I just threw 50 pounds on his back, 50 pounds on my back. And we just went out for an hour. You didn't, you're walking. Yeah. But it's a zone. So it's a heavy zone too. Yeah. It's funny. He asked me the same question.

He's like, like what zone of cardio are we going to be in? And I was like, honestly, it's a, it's, it's somewhere between one and five, depending on what we do. It's almost never a zone too, by the way. So like when you're on the flats and going downhill it's zone one sure we're talking like it's nothing when you're going uphill and when we were running on the track it's like zone five okay so in that so in that routine so in that i'll come back and answer your question because you asked about weight investor rucksack and i have a strong point of

view okay because he was he had a strong point of view too and i think it was he was probably the opposite of mine yeah but it was some kids with backtracks and issues but okay so if you're doing that amount of cardio per week and then implementing weight lifting for building muscle are you how what does that look like are you doing you personally strength training yeah is that like i do four days a week okay four days a week and i do two days upper body, two days lower body. Okay. How do you.

This is like really like getting in the details. But I love to know this. From on seven days a week. What's your schedule? Like tell us. On Monday I do this. On Tuesday I do this. Yeah.

So I do. I do lower body Monday, Friday in the gym. Upper body Wednesday, Sunday. Okay. I ride zone two Tuesday, Thursday, Wednesday, Sunday. I ride zone two, Tuesday, Thursday, Saturday, Sunday. I VO two max Saturday and I rock at least three days a week. So this week it's Monday, Wednesday, Friday, but normally it's Tuesday, Thursday, Sunday. So Saturday is your day where you got to find God and you got to, you know, you're going

to go and go all out on the cardio. Yep. So each day has something. Yeah. So Saturday is the hardest cardio day because you're doing that zone two followed by a VO2 max. Fridays tend to be very hard days. It's like kind of my deadlift day.

So that's like another go to the well. And let's be clear, like I'm an old man now and I don't believe in hurting myself. So I'm also very quick to back off. If I'm not feeling great, like there's not handing out medals at the end of the day for who hurt themselves. Why do you like rucking better than the weighted vest? Because as the weight gets significantly higher, which by definition it is, by the time you're rucking, you're really kind of working up to a third of your body weight. The ability of the rucksack to, because they have a belt on them and you cinch that belt on the hip bone. And what that does is it takes the weight and puts it on your hip and not on your shoulder. And the weighted vest

doesn't have that. Yeah. The weighted vest kind of just digs in. So the backpack theory really doesn't make sense. Well, I understand, I understand where I think your friend is going, where he's probably saying is a backpack puts you into spinal extension. Yes. And he's saying,

presumably, I don't want to put words in somebody's mouth. He's probably saying, well, kids spend enough time in spinal extension. They don't need any more. Yes. I would say adults spend too much time in spinal extension. They don't need any more. Yes, I would say adults spend too much time in spinal flexion.

We're sitting down too much, right? When you're in front of your computer, you're in flexion. You're hunched forward. So it's actually kind of nice to be opened up this way. But above all else, what it really comes down to is I put that hip belt on so tight, and it digs into my hips that I can almost take the shoulder straps off. You know, rucksacks also come with these little things that allow you to clip across your chest. I never use them. Like I don't. I'm going to blame you after this episode because he's going to go buy everything that you say. We're going to get all these Amazon packages.

It's going to be so annoying. He's, I can already see in his eyes, he's getting a rucksack. Well, I'm going to go look for a hill too. Yeah. you can come i have three of them first so if you want to come and sample first because there's there's different sizes and i have different sizes to it okay so for people that may not have direct access to you which is most people listening obviously and they're thinking about putting together just a you know an optimal fitness routine for themselves. We've covered that four days a week. Well, by the way, I'm also acknowledging I do more than most of my patients. Sure, sure. And the way I do this with my patients is different.

I go to them and I ask them the first question, which is, Michael, how much time are you willing to put into exercise in a week? Just tell me what that number looks like. So balance it with time with your wife, time with your kids, time with work, time with whatever you do. And tell me what that number is. And they'll come back with a number. And it's always less than my number.

I would say I'm willing to put in as much work as I need to put in to get to the next level. I don't think I would give you a number. Does anyone ever say like, just you tell me what I should put in? I mean, I love your answer. I would continue to work with you on figuring that out and then better define what the goals are

and say, okay. So yeah, what I would do is say, look, your VO2 max is here. It's at the 40th percentile. I would like it to be at the 95th percentile in two years. This is what I think it will take to get there. That's a good,

to maybe let you sort of show the goal or me tell you the goal and then you work backwards to get there. Yeah. Most people, and I love that because then like, then we can, we can go through that and it's a trade off. Most people usually come into it with like,

all right, I'm exercising three hours a week now. I'm willing to go up to six, but that's all I'm willing to do. That surprises me and I'll tell you why. It seems to me that you work with so many high performers. I would think that the answer would be whatever it takes. Yeah, it's funny you say that. We were talking about this on a team call recently and because i was sort of griping about

it to be honest with you i was having a little bit of a cry baby moment where i was bitching and i was like why don't these people want to do more and one of the people on my team sort of smacked me into shape and said hey you forgetting something peter like our patients are very high performing people they want in general well like, like they're CEOs, they're this, they're that. Like in every dimension of their life, they're really high performing. So they're kind of looking for minimum effective dose of everything. That's not universally true by the way, but that's like, I guess it was a good way to help me kind of maybe have a little bit of empathy for where someone's coming from. And by the way, if someone says I'm willing to do six hours a week, that's awesome. We can do anything with six hours a week.

What's the best? Okay. So now it depends on what are you coming in with? So if you're coming in balanced and balanced can be good or bad, meaning when I do my full evaluation on you, both from a cardio and strength perspective, you're roughly the same, either equally bad, equally okay, equally good, then I will use that time equally. Meaning I would have three hours on strength and stability training and three hours on cardio training. And of that three hours on cardio, I would have 80% of that being low intensity zone two, 20% of that being high intensity VO2 max. But for example, let's say you came in, which is not uncommon. I have people that come in who are amazing runners, like super, super fit.

They don't have an ounce of muscle on them. I mean, they're just- And probably vice versa with weightlifters and not having cardio. And then you get guys that come in that are really, really strong and they walk up a flight of stairs and they're out of breath. So when you get people who are extreme, I don't take their time 50 50. Now I have to really change the programming to offset their deficits. I remember we were doing this show one time and it was, I forget what topic it was on

something about like supplementation health. And we gave this kind of like laundry risk of the things that we, doing this show one time and it was, I forget what topic it was on, something about like supplementation health. And we gave this kind of like laundry list of the things that we, at least at the time, were doing. And one of the feedbacks was like, oh, this is unattainable. You can't do it. And I got it. And I said, well, listen to me to kind of lie and say whatever. But like all these guests come and say, I just have lemon water and wake up with the

sunlight. And I'm like, well, I want to tell people all of the information and then they can take that and decide what works for themselves, which is why I ask you these, you know, routines. And again, like some people may not want to do it, but I think if they can get three or four days of strength training and three or four days of this type of cardio, like that's not a bad prescription, right? It's just many people maybe won't. Yeah. I just, I always, I mean, patients always ask me this, by the way, every patient asks me, or almost every patient, Peter, what do you do? And I always preface it by, I'm happy to tell you what I do, but please don't let an aversion to what I'm doing be an impediment to your progress.

Like here's what I do, but I'm also a person who enjoys this a lot. There are some people who don't enjoy exercise. Sure. And I enjoy it. Like I really, I would exercise if it was bad for me. That's unfortunately a true statement, right? Like if you told me all this exercise will shorten your life by five years, I'd be like, well, so be it. And it's, it's worth it for the quality of life. So I feel so strongly that everybody exercise that I think we just have to find a way to make sure it becomes natural. And sometimes for people who are not coming at it from a place of doing it, the goal is to do just enough to simultaneously accomplish the following, make sure they don't get hurt

and make sure they start to see some positive benefit that gets them a little bit hooked. And for some people that's aesthetic. I mean, it sounds, I mean, my wife will be so pissed that I say this, but hopefully none of her friends are listening. And so I won't get back to her. But I know that for my wife who never wanted to lift a weight because she's just been a runner her whole life, about three years ago when she finally started doing it, the thing that got her most excited was that she could see her deltoids. I get that. Having that little, because she's a petite little thing, right? But to have that little pop of a deltoid, she was like, I love this. I will tell you the main reason I like lifting

weights, and I just got into weightlifting two years ago, and it's changed my body composition, and I love it so much, is I feel more confident after lifting weights. And I recognized that the other day and I can't explain. Confident in activities of daily living, like going to the grocery store. My posture feels more confident. I'm a confident person since I was born. I think I came out. But weightlifting just gives you this confidence. It's an energy. I can't explain it, what it is. But it takes your confidence up in the best way. And it is true. I would do it if it wasn't good for you.

It feels good. Well, I imagine when I was a young man and I discovered, you know, like in my room, just like watching Rocky movies, doing push-ups and sit-ups and pull-ups, like you start to see those results as a kid. You're like, oh, this confidence. Like, you know, now you're discovering this as a woman older than I was when I started. And I imagine it's that same kind of feeling. It's like, oh, I can actually change my body and do different things. And then you become more stable and you become more,

there's just so many things that come along with building muscle. Weightlifting you love. I love it. And I think it's important for everybody. It's important if you're young, it's important if you're old, it's important if you're a man, it's important if you're a woman. You have the joke I always say, my team gets sick of it. So there've been somewhere estimates of between 100 and 110 billion people have lived, right? If you go back 250,000 years to the beginning of Homo sapiens, there've been a little over a hundred billion of us. I'm willing to bet everything that not once in the history of those hundred billion people

has someone at the end of their life said, oh God, I just wish I had less muscle. Sure. Wow. You simply can't have too much muscle and too much strength as you age. I am someone who travels a lot and I'm constantly trying to be healthy when I travel, but it is a struggle. But leave it to the Westin Hotels to fix this issue. Okay, you guys, first of all, they have over 200 destinations around the world and they're committed to all things wellness. So what they've done is they've made travel an opportunity to actually

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that's $5 just for trying Ibotta and getting that cash back when you're shopping already. Enjoy. I have been on a journey when it comes to my hair, but I feel like my ponytail is 10 times thicker and it's a medley of a lot of things. I'm eating a lot of meat. I'm supplementing. I'm microneedling and I'm also taking my scalp health seriously. And how I'm doing that is I'm using a really great hair serum with a lot of scalp massage. And the hair serum that I have been using for visibly thicker, fuller, shinier, longer hair is by Vegamour. I will just like habit stack it into my routine at night. After I've done my skincare, I'll grab my scalp massager and then I'll use my Vegamour Grow Hair Serum. And what I do is I put it onto my scalp and then

I massage the scalp massager in. I think what people don't realize that I've learned through interviewing a lot of celebrity stylists is that your hair starts from your scalp. So if you're not taking care of your scalp, your hair pays the price. So add a little scalp massage to your routine with an amazing hair serum like Vegamore's Grow. I'm always on the lookout for products that take my hair to the next level, and I am telling you, this one works. Give your hair the power of the little pink bottle with Vegamore. For a limited time, the Skinny Confidential listeners get 20% off their first order. You're going to go to

vegamore.com slash skinny and use code skinny at checkout. That's V-E-G-A-M-O-U-R.com slash skinny. Code skinny to save 20% off your first order. V-E-G-A-M-O-U-R.com slash skinny. Code skinny. We had somebody on the show right before you came in and we were talking about even like facial muscle and as you age and that depleting and you lose if you're and you lose it like how that affects the aging process and how you look different and facial fat too sure it's such an interesting thing like i i actually think this is i i'm sure there's a really good explanation for why we lose facial fat but

i mean i'm sure you guys aren't old enough yet but once you get to be my age you'll start to notice you get bags under your eyes and people say oh oh, it's just because you're tired. No, it's actually because you're depleting fat under the eye. And so you lose a bit of the puffiness here. And that's what kind of creates that shadow. That's very true. And you know what else? Girls are getting fat taken out of their face right now.

They're getting their buckles removed right here. And a lot of people are. Wait, I didn't know this. Tell me about this. What the heck are you talking about so they want this look that looks like sort of like a model like yeah a lot of people a lot of celebrities are getting their buckle fat removed and i've talked with a lot of different plastic surgeons and they say do not do it because it's going to make you age and when you do start to age it looks even worse even worse

even worse you're sunken in so you have to be careful of removing fat from your face. You're 100% right about shadows. People do wild things these days. That's just a world I know little about. Optimal diet. What are your pillars when it comes to diet? I would like to know your pillars personally, what you eat besides elk, and then what you think is a really well-balanced diet for the general population. So I'll caveat this by saying the following. Remember at the outset, I said there are like kind of five big things you can manipulate

to impact the length and quality of your life. Exercise, nutrition, sleep, mental health, drugs, hormones, supplements, all in one bucket. If I have a superpower, it's exercise. What do you think my kryptonite is? Nutrition. Yeah. So I struggle more with nutrition than all the others combined. It's not hard for me to be disciplined about my sleep and regimented.

Now that I've kind of got a trajectory and a plan around mental health, I actually really enjoy doing the work and doing, but there's something about nutrition that is just probably going to be a constant struggle for me for my entire life. I am so envious of these people who food is fuel and they never get tempted by eating crap. Never heard him. And since I've known him since he was 12, he's never had a craving. Yeah. So I'm not that guy. I have other weaknesses. Yeah. No, look, I mean, I think it all balances out in the end. So maybe I'll start with kind of the principles of good nutrition, and then

I can sort of explain to you how I try to navigate that system. We're trying to basically address a couple of things with nutrition, right? So the overall state of energy balance, specifically the amount of muscle mass and metabolic health. Those are really the big things that we're manipulating nutrition on. And when it comes to how do you manipulate nutrition, you're basically manipulating the total amount of energy. So how many calories are you eating? And what's the composition of those calories? Does it matter how much comes from protein, fat, carbohydrates? There's a fourth macronutrient which is alcohol doesn't get enough attention but it's important remember it has seven calories per gram kcals to be more specific i want to bucket alcohol too and like spend some time on that we should yeah because

because alcohol is almost as energy dense as fat so it's very important for the person who's trying to lose weight to be mindful of that. It's very difficult to lose weight when you're having a bottle of wine a day, because you're getting no nutritional value, but you're getting a staggering sum of calories. In my view, very little is actually known about nutrition, despite how it's represented. And that includes maybe even how I was representing it a dozen years ago, something to which I cringe at now was the absolute certainty with which I thought I understood nutrition, which I won't represent to now. If a person needs to be eating less, which truthfully is most of us, most of us don't need to

be eating more. We need to be either eating the same or eating less. You kind of have three ways to go about doing that. You can directly restrict the number of calories you're eating. You can, that's called calorie restriction or CR. You can start to restrict macronutrients. So that's what most diets are doing. They're kind of carbs or cut the sugar. That's right.

Yeah. I'm not eating sugar. I'm not eating carbs. I'm not eating fat. I not eating carbs i'm not eating fat i'm not i'm vegan i'm paleo like all of those are basically forms of dietary restriction and if you restrict enough you will indirectly start to restrict the total amount and you'll accomplish your goal of course you have to be careful right like if you go on the no lettuce diet probably not going to lose weight because that's not restrictive enough from an energy perspective. And then you have time

restriction or what people call intermittent fasting, where you just say, look, I'm going to not eat during a large enough period of time during the day. And if you make that window big enough, you'll eventually lose weight. How do you feel about intermittent fasting? Because I know that you have thoughts on it. Yeah, I think there are some people for whom it works, but I get worried about it when people who are under-muscled do it. We watched that doc you did with Chris Hemsworth, by the way, that I thought was phenomenal. It was really cool. That whole thing was cool. And I was watching that extended period of fasting that you guys did.

Yeah. We just did four days of no eating. Which is like, that's wild. Or at least for someone who's never done it. Well, it was wild for him. I mean, for me, I'd done that all the time. For Chris, it was tough because he'd never, I think, I don't think Chris had ever gone eight hours without eating.

And then on top of that, he had to do all of these insane physical challenges while we were fasting. Yeah, when he was spearfishing at the end of it. It was crazy. Is that when he went in the freezing cold? Did he do that fasting? That was the next episode. Same documentary.

No, I know it's the same documentary. I'm saying, did he fast while he went in that freezing cold lake? No. No, no, no, no. Okay. But he did some training for the cold while we were still fasting. Got it. I bet he was not a happy camper.

Chris is a trooper. You know what was cool about that is he put the work in on that documentary. He didn't phone it in. I mean, it's so funny you say that because we were talking about this, oh, I don't know, God, maybe like a month ago, we were talking about something unrelated. And I was like, like hey do you remember how this thing was pitched this would be done in two months was how it was pitched right yeah it was like two years later oh she's broken ankle like all of this shit i will say after that because

he did that other thor movie he was yoked up in that way so when he did that and a guy like that who's got a lot of muscle totally reasonable once in a while okay where i worry about it is you've got that patient who's at the 10th percentile for muscle mass at the 70th percentile for fat so they're they're they're overnourished, but they're under-muscled. So they do need to restrict calories, but they can't lose muscle along the way. Intermittent fasting is not a great strategy for that person. They need caloric restriction or dietary restriction. Is there a difference for fasting between men and women? I've heard over the years that maybe it's not as great for women as it is for men. But again, that's... I've certainly heard that as well. I don't think the data necessarily represent that. I mean, I think what the data, at least not the data that I've seen, I think what the data make pretty clear

is there's no magical benefit of time-restricted feeding in terms of the impact on body weight beyond the caloric deficit. But the problem is on average, people lose more muscle because they're restricting protein more. So what if there's a woman that does have muscle, would you say to go to intermittent fasting or would that still be sort of last on your list? No, I mean, I guess it depends how big a fasting window she's talking about and whether she's willing to maybe have a protein shake outside of the fasting window. So if you could just get a little bit of protein in, let's just say she says, okay, fine. I'm only going to eat between two and eight, right? So that's a pretty tight window of six hours, I would say, look, if you could have a protein shake at nine

in the morning and then have a protein lunch at two and then a protein dinner at eight, I would say that would be worthwhile. And just make sure that that protein shake that you're having in the morning is very otherwise low in calories. Because you could still get like 35 grams of protein with virtually no fat or carbs. So do you like intermittent fasting more for disease prevention than for, I guess, weight loss? No, I think there's no specific benefit that it has with respect to disease prevention beyond the effect it has on energy balance. The reason that I did it for many years and the reason I still think it's a viable thing that people should consider as part of the toolkit is frankly, it's the easiest. Like I just think it's so easy. It's so efficacious. If you just say like, I just think at the end of the day, we're very binary creatures. It's much easier to not do something at all or to do it than to do it part way.

That's true, I think, for most people. Maybe not everybody. But if you just say, look, the only rules of engagement are don't start eating till two o'clock and wrap it up by seven, that's easier than don't eat carbs or just eat less total food. Sure. I i i think yeah it's not overwhelming how much protein do you like people to get if is it different for men and women it's different based on how much muscle mass you have are you trying to go up the muscle curve or just you know are you just trying to preserve what you have or increase how old are you so the older

you are the more you need because of something called anaerobic resistance, basically. So, or anabolic resistance rather, meaning the older you get, the harder it is for you to turn amino acids into muscle. And then of course, training volume. So the answer is somewhere between 0.7 and one gram per pound of body weight. Are you a carnivore diet fan i mean look i've never done it i have lots of friends who have who swear up and down by it i rogan's all excited about it now again and he just say he's doing it again to me and he's better than ever might be joe does it a couple times a year actually no the last time i saw joe was just before he went on vacation he was on it and

feeling amazing better than he had in a month so yeah he might still be on it jordan peterson and obviously like he's jordan's been on it for a very long time and jordan's on the most restrictive version of it i've ever heard of i mean jordan and again i don't know you know it's like salt and meat and it's not just me it has to be beef. He can't even eat other kinds of meat. The short answer is it hasn't been studied. I'd love to see it studied, but there's really two issues at hand. Is it a viable weight loss strategy? Clearly, there are so many people that have done it and lost a staggering amount of weight, but undeniably, it's a viable source of weight loss. But you could also argue, so too would any diet that consists of one food.

Right. I'm pretty sure the all-potato diet would be just as efficacious for weight loss. So the more important question is, what are the long-term health consequences of it if an individual decides they want to be on this diet indefinitely? On the other side of that, for vegans, the vegan diet, how do you feel about that route? Well, again, it depends. I was

just having a discussion today with our team, which was, look, when we have patients that come in and say they're vegan, my first question is, let's understand why. If you're vegan because you don't like meat, like you've never liked meat, you hate the consistency of it, you can't stand the thought of killing animals. I'm like, I think that's a good reason to be vegan, onward and upward. Let's come up with ways to work around that. If you tell me you're vegan because you think eating animal products can't be healthy, then I think we should educate you because that's patently false. There are lots of ways to eat animal products and be very healthy. Just like we wouldn't say all food is unhealthy, it's really a function of the food. and there are lots of ways to eat animal products and be very healthy. And just like, you know, we wouldn't say all food is unhealthy. It's really a function of the food. Well, similarly,

you can eat animals that are healthy. You can eat animals that are not healthy. You can eat plants that are healthy and plants that are unhealthy. So it's just really understanding kind of like what's a person's objective and then helping them achieve that. What did you eat for breakfast today? Well, it depends what you define as breakfast. But when I woke up pre-workout, all I had was coffee. Okay. No milk. Oh, no, no. I had some cream in the coffee. Okay.

And then post-in-workout, on the bike, I had water, just water. And that's where my zone two. And then, oh, there's one other type of workout I do that I forgot to describe. Two days a week, I do something called DNS, dynamic neuromuscular stabilization. These are stability workouts. So then I had my DNS after. And after that, I had six pieces of venison jerky. Six pieces of venison jerky. The reason is each piece is 10 grams. So I was getting like, or nine grams.

So I got 54 grams of protein. Is this a brand or is this at the farmer's market? It is a brand. It's called Maui Nui Venison. And by full disclosure, I'm an investor in the company. Michael's going to be buying it. Yep, there we go. He'll be our biggest customer.

Oh my God, he's going to be walking around eating jerky. My kids, everything. Yeah, Maui Nui Venison is awesome. And by the way, this is really cool. Like this is a food product that has probably got more vegans eating meat than anything I've ever seen. Because again, if you're a vegan who's opposed to eating animal products because of the way animals are treated, they very much come to see like, wow, this is the most humane operation in the United States. So it's, it's, it's a type of animal called axis deer, which are not native species in the United States, but they were brought to Hawaii in the 1950s for hunting. And then they proliferated like crazy because they have no natural predator. They then created such a problem.

They were destroying so much land. They were basically everything from the grass to the cows down to the coral is being eradicated because of these animals. There's too many of them. There's too many of them. And they have the Bengal tiger is their only predator and there aren't any Bengal tigers in Hawaii. So the Hawaiian government was basically left with no choice but to eradicate them from helicopters with machine guns. The same thing with like boars out here, huh? Yeah. And this friend of mine came along and said, no, no, no, we've got a better idea.

First of all, it's the most delicious animal ever. And it's perfectly natural. It just eats grass all day long. And we can harvest them in this insanely humane way at night using night vision. So they have snipers that basically harvest them at night from great distances. So the animals are under zero stress at the time of their death. So they're sleeping and they don't even know what happened. They're not sleeping because they're nocturnal. They're walking around and within an instant,

they're gone. Oh, I didn't know they were nocturnal. Wow. Yeah. So the jerky is incredible and I've become totally obsessed with it and it's my mainstay of snacks. Coming to this podcast, is that what you've had you said 10 or 7 pieces six pieces so about 50 grams of protein and so that would have been at 10 o'clock okay then i did a bunch of work and then just before coming here i had a bowl of greek yogurt with like i don't know how to describe it but like it's uh sort sort of a, it's a granola, but it's like more of a nuts type of granola. Okay. Your diet doesn't sound bad to me.

No, but I mean, I'm eating okay today so far. No, I don't eat that bad. It's just, I mean, where I struggle is if my kids make brownies, my wife can eat a brownie. I'll go two days resisting them and then I'll eat the rest of the tray. No, I'll do. my kids make brownies. Yeah. My wife can eat a brownie. I'll go two days resisting them and then I'll eat the rest of the tray. No, I'll do, so I'll do stuff like that. Like the other day

when you had the cookies out and I went, I had like two of them and then I looked, I'm like this, if this stays in this house, I will, like I threw them away.

Oh, you're the one that threw those cookies away. Yes, I told you because I know that if they stayed there, nobody was going to eat them. She's got the discipline. I will do stuff like that. I'll eat the cookies. Yeah. So it's like like i had a so my wife and i were rucking the other day by the way husband wife rock awesome husband sounds so

interesting my husband my wife said you said rocking yeah okay okay with an r okay got it so so so we were out there rucking yesterday, or not yesterday, two days ago, and I really laid it out. I was like, I need your help. Like, our pantry

is getting out of control. There is so much crap in that pantry that is so tempting to me. And I just was like, we can't do this anymore. Like, it's not fair to the kids

that they should be exposed to junk food just because they want it. We can't have it for them. And it's not fair to me because I have no willpower. So it's like everybody's losing when we have Pringles. The number one skinny tip I've realized is to not have it in sight. The problem is when you have cookies in sight and brownies, that's why for me, I just try to eliminate it all from my house. And then I'll have my huge chocolate bars like a piece

at night so i can get something you can't have it inside people come over and are severely disappointed in our bag of flaming hot cheetos in my pantry every single time i walk in or a mcdonald's happy meal i'm gonna want it no this is what and this is where my wife and i had a little bit of a tiff on the ruck was i said look i preach this to my patients. The answer is default food environment. Default food environment. You only want to exert willpower in very brief spikes, which is when you're shopping. That's when you resist the urge to buy the crap. And you never go shopping hungry and you never go down the middle aisles. Or you just postmate it and you have it all delivered to your house so you don't even have

to look. Even better. But then the goal is all delivered to your house so you don't even have to look. Even better. But then the goal is set up the environment such that you don't have to exert willpower when you're in your home. Yeah. When you are hungry, when you are tired, when you are weak. Is that ever a lot of pressure to be who you are and have written this book and to have all these high performer clients and then you feel like you have to be doing certain things because you're the doctor. I don't because I think I'm very transparent about my shortcomings and I'm very open about my struggles and I never represent myself to be, you know, the master and the guy, like I'm, you know, so yeah, I think if I, if I were representing myself in that regard, it would be horrible.

It would be like, you'd feel like you couldn't, you know, let your hair hang down, so to speak. But no, I don't feel that pressure at all. I just feel like, hey, I'm frustrated because I shouldn't be eating any Pringles. And yet every time I have, every time there are Pringles in our pantry, I go in and get a handful of them. Hey guys, thanks for listening to this episode. Be sure to tune in this week on Thursday on audio and Friday on video to part two of this episode with Peter Attia.

Again, most of our episodes typically around the hour, hour 15, hour and a half range. This one spanned two and a half hours. So we wanted to make it a two-parter to make sure that we didn't fatigue everyone and that we made sure that we got all the information in this well over two and a half hour conversation with Peter. So be sure to tune in to part two later this week.