WHOOP Podcast - Why Australians Live 7 Years Longer Than Americans with Dr. Adrian Cois

Episode Date: April 23, 2025

On this month's installment of our Longevity Series, WHOOP Global Head of Human Performance, Principal Scientist, Dr. Kristen Holmes, sits down with Dr. Adrian Cois. Dr. Cois is an Australian-born Emergency Physician and Assistant Professor of Emergency Medicine, currently practicing in Portland, Oregon. Dr. Cois has an extensive background as a strength and conditioning coach, working with 5 professional Australian sports teams before completing his medical residency at Oregon Health and Science University. Dr. Cois joins the WHOOP podcast to discuss his TedX presentation on the cultural comparison of healthcare in Australia versus the United States and how this impacts longevity. Dr. Holmes and Dr. Cois discuss:(00:25) Dr. Cois’s background in Medicine(01:47) Reframing Trauma in Emergency Care(05:26) Frontline Healthcare Workers' Challenges with Personal Health and Wellness (07:46) Cultural Differences between the US and Australia(10:28) Importance of Implementing Preventative Medicine (18:27) Areas for Improvement in the US Healthcare System(21:17) Best Methods to Motivate Individuals to Take Control of Their Health(25:29) The Existing Health Culture in Australia (30:04) Light Behavior and The Benefits of Time Spent Outside. (31:30) Lessons Americans Can Learn From Australians(33:58) Implementing Health Culture(35:12) The Relationship Between Sleep Quality and Shift Work (41:27) How Americans Can Improve Their Health (41:54) Habit Changes For Your Health Follow Dr. Adrian Cois:InstagramLinkedInSupport the showFollow WHOOP: www.whoop.com Trial WHOOP for Free Instagram TikTok YouTube X Facebook LinkedIn Follow Will Ahmed: Instagram X LinkedIn Follow Kristen Holmes: Instagram LinkedIn Follow Emily Capodilupo: LinkedIn

We love American culture. We do a lot of the similar things. And I talked about some stats looking at obesity and diabetes and smoking rates. And there's really not that much difference between us. But we live seven years longer. Both men and women live longer on average. Australian women live a little longer than the Australian men. And same in the US.

But really, the gap is very similar. Hopefully we can start to recover that. Dr. Cois, welcome. Thanks so much for having me. Thanks for coming. I'm super excited. for this conversation today. You have a really interesting background as a professor of emergency medicine, emergency room physician. How did you get interested in longevity? Well, it's a massive

question. I unfortunately get to see a lot of folks in the emergency department who come in on the worst day of their life. Some of them are unfortunately dying. Some of them are having complications of chronic diseases, which are going to cause them not only mortality and death, but morbidity. So their life will never be the same. I'll never be able to, like, exercise as much as they used to, or do simple things like get up off the floor, off the chair at home, you know, in a safe way. So, and I think some of the things that kept sort of coming back to me is that a lot of these folks are living with diseases that are preventable. It's very well known that vast majority

of cardiovascular disease is preventable. I'm starting to see people who come in who are younger and younger and just makes me passionate about wanting to try and head that off so that I don't have to see them on the worst day of their life in the emergency department. Well, that's noble work for sure. Just to talk a little bit about that experience, how long are you still practicing actively? Are you still in the... Yeah, yeah. That's my full-time job. That's your full-time job. Yeah, I'm there. How do you... One of my best friends is an acute care surgeon, and she is an incredibly strong human being, and I marvel at her ability to, you know, in a sense, compartmentalize or,

you know, maybe a better, healthier way of saying it is, you know, she has this incredible ability to reframe, you know, just all the trauma that she sees, you know, the worst imaginable stuff, which I know you you see every day as well. How do you, how do you think about that? How do you go home at night? It's a, it's a good question. Actually, I was just talking to a colleague about this the other day. I'm like, are we going to at some point in down the line just like wake up screaming in the middle of the night at home because of all the trauma that we've seen? What I will say about that is that we, I feel very fortunate because we get to work as a part of a high performance team. So, you know, and that team includes like myself as a physician, oftentimes I'm working with

another physician, and if I've got a really challenging case, I'll bring them in, and, you know, you get to work with a colleague as well to try and figure out what's going on. We have a team of nurses, we have emergency room techs, we have x-ray folks, we have, you know, radiologists that are off-site, we have cardiologists as well that we can call and get support. So, you know, you're not in there by yourself. You're there with a team, and although as a team, we deal with trauma. We talk about it pretty openly. I think we're kind of in a way a little bit.

We'll probably all have a little bit of a screw loose to want to do this work. But my take on it is that I have challenging cases. And when I do get a challenging case, it makes me want to do better and be better for the next time that I get a challenging case so that I can potentially help that person, even if I don't completely reverse what they've got going on, but just do better than I did the last time. And then, you know, I think certainly it helps me personally to, like, get through that trauma.

But it also, I think, helps the person that is going to come in in front of me. Yeah, how much mentoring goes on? Oh, a ton. Yeah, there's got to be, right? Yeah, yeah. I mean, I feel like when I'm, my role in the department is I see myself as, like, when I'm there, I'm a leader in the department. And that, you know, extends to, like, how are we moving patients through the department? Are we, like, can we move people to different areas so we can, you know, free up acute care beds?

Can we, like, think about, like, how many ambulances are coming in? So, you know, I feel like, as a leader in that role, I like to push that towards being a mentor for other people as well. You know, like, the other day we had a nurse who had just started, and this was her first nursing job in the emergency department. and it was the first resuscitation. We unfortunately didn't get the patient back and they died. And, you know, she was beside herself. You know, I think her role was maybe like the scribe or something like that, detailing what was going on.

And like just sort of exploring that with her was really interesting. For me, it was really interesting, even though she wasn't supporting me or no one was supporting me necessarily, helping to support other people was really helpful for me because it kind of like gives you a chance to like run through what happened and see you know again what you can do better the next time and then acknowledging what you did really well you know which comes down to the training that you have and you know how you can do things better i mean i love talking about teams because before i went into medicine i was a sports performance coach um and i worked with a lot

of teams and was a strengthening coach so like i love that team mentality and that doesn't all come down to one person you know like sure you may have like let in a goal or something like that but Like there were so many pieces before that that your team members could have made different actions and prevented that from happening. So I apply the same thing to the work I do in medicine. Oh, I love that. That's a whole other podcast in terms of talking about high performance in healthcare, you know, because I think that that is, I think they're starting to be more energy around this idea or more acknowledgement that, hey, why don't fraudulent healthcare clinicians get the same tools as professional athletes and elite military operators.

Like it's kind of crazy, right? When we think about the lack of education and training on on how to, you know, regulate the autonomic nervous system, for example, and how to regulate, you know, emotions and, you know, and how those entry points are actually through the physiology, you know, it's, yeah, in part, you know, our psychological framing and all of that, but just simple things on, you know, when and how to eat and, you know, just stuff that athletes get access to, you know,

it's, I feel really passionately, that frontline medicine should get access to the same tool. I will say on that point, I think that we are getting better. Yeah, agreed. But it's baby steps. You know, I think the biggest, the biggest piece is that we're acknowledging more and more that we have really hard jobs and that people rely on us, you know, the patients rely on us to be there and be ready to perform. So I think there has been like a big shift, I guess, that I noticed during my training in

particular where, and I'm practicing in a part of the country that is, like, values, you know, the wellness of it. What part of the country are you? I'm in northwest, so I'm in Portland, Oregon. We have, obviously, culture is something that takes a long time to change, but we're working hard to, like, acknowledge that people have lives outside of medicine and that we are trying our best to honor that people, you know, are not doctors or surgeons 24 hours a day, you know, and it's important to, you know, help people so that they can come to work ready and, you know,

not suffer the consequences of having overtaxing work, you know, when they leave work. So you just delivered a TED Talk, literally, just moments ago, and we're here in Woop HQ. Tell us a little bit about the subject of your talk and why you chose that. Yeah, good question. So I delivered a talk. It was titled Why Australians Live Seven Years Long. than America. It's very provocative.

Yeah, yeah. Well, you know, when you read about how to give a TED talk, they say start with something provocative. I know, I know. So I thought, why not? You know, I thought I'd just throw myself in the lines, Dan. But I guess when I first started residency training in the U.S., because I did obstetrics beforehand, so I worked for five years after my, you know, medical training, medic schooling

back in Australia. I've got to say, I haven't run into too many docs in America that are practicing in America that have taken my pathway because we have a really. functioning healthcare system in Australia and oftentimes like I'd have some of my mentors and teachers and while I was doing my emergency medicine training in America say why would you leave you know and of course I left for reasons that were not related to medicine I left for love my wife is American so we moved over here so the kids could be closer to grandparents so it got me thinking you know and I was sort of chatting with organizers about about this and you know why is it

that Australians who ostensibly are very similar to Americans. You know, we love the same things. We love sport. You know, we like, I grew up with Michael, when Michael Jordan, the Chicago Bulls were like the hottest ticket in culture, you know. So, and we did everything. Like kids would be walking around, like wearing basketball, NBA gear. And so we love American culture. And we do a lot of the similar things. And I talked about some stats looking at obesity and diabetes and, you know, smoking rates. And there's really not that much difference. between us, but we live seven years longer. No, no, I mean, so there are some, there are some differences, but they're minimal

by Harrison. Both men and women live longer on average. Australian women live a little longer than Australian men and same in the US, but really the gap is very similar. It's also, you might think is a little facetious because seven years is bigger before COVID, obviously, the difference was about four years. And COVID took a massive hit to life expectancy in Americans, which is super sad, and hopefully we can start to recover that. But, you know, I think that what I came down to is what's the difference? And it's the way that we, that we provide healthcare. And then there's a massive difference between the way we provide health care in Australia versus the way we provide health care in America. You can look at it in so many different ways,

you know, how, what's the accessibility for people to actually get in and receive preventive services? Can I ask you a question on that? So in the U.S., you know, you go in and, you're pre-diabetic, come back when you're a diabetic. You know, like, there's no prevention. So you just said the word prevention. Is it the case that in Australia they're actively trying to prevent? Because that would be the reason right there that the life expectancy is, you know, longer in Australia versus America because we don't really do preventative care.

To answer the question simply, yes. I think that that's, obviously this is a massive topic and it's very nuanced. Right. However, we have a very robust network of primary care providers back in Australia, general practitioners, we call them GPs. And in fact, a lot of doctors who go into training, they will spend their time in hospitals doing postgraduate training and they don't end up becoming specialists. They'll go down and become a GP and then going out in the community and working in a GP clinic.

So everyone who, you know, when you turn 40, you get a screening evaluation for all of those things, elevated blood pressure, diabetes, hyperclostrolemia, you know, say you get diagnosed with prediabetes or diabetes, then you can get put on a diabetes or chronic disease management plan, which is funded by the publicly available Medicare. And this is, it's been a little while since I've worked in that system, so I don't know exactly what they're doing right now, but at least back when I was working there, you know, that chronic management plan would include, you know, doctor's visits. It would include dietitian consultations. It would include a visit with exercise physiologists. So you're actually getting educated. Exactly. Exactly. And you start to understand

your glucose response. Like do you get like a CGM? Like, you know, it's a good that far. I mean, I don't think it's quite to that stage just yet. But, you know, once you have the evidence that can support that that's something that would be helpful, then sure, you know, there's lots of different mechanisms you can put in place to help people. But I think the bottom line is that you're not leaving people out in the cold where it's like, and the other day, I had a patient who I saw a 40-year-old guy came in because he had an absus on his leg because he's got diabetes.

Like he doesn't have pre-diabetes. He's got diabetes right now. And like normal range of blood sugar is like, you know, 70 to 100, let's say. His sugar was 440. Yeah. Yeah. When he came into the department and he would have been fasting for eight hours.

And I was like, hey, so 10. tell me about your diabetes and he's like oh well i have so he's fasting blood sugar was 440 was 440 yeah and he was just living living his life i just didn't even know that that was actually possible 100% see it all the time see it all the time he's 40 years old he's got three young kids you know so i was like tell me about your blood sugar and he's like well my doctor's been sort of telling me that i've got pre-diabetes and been threatened me with diabetes i'm like well so you have fasting fasting sugar of 440 you have diabetes and I was like so what do you like what's the plan like tell me about like when your next primary care appointment is when are you going to go see them to try and get

it's under control and he said well I just moved from out of state and my first appointment to establish care is in June of 2025 just can't get in and we're in what are we in October now of 24 so it's like nine months down the track he's waiting to establish care what are the complications that could ensue. I mean, he was there with an abscess, right? So you have a sugar-rich environment in all of his, that sugar is not just in his blood, it's in every tissue in his body.

So, you know, this is a thing. So he, not unlike other people that I see, get a sound bite from me. I interacted with this gentleman for 30, 40 minutes in the emergency environment, you know, and he was worried. He was scared, and he just needed help. So I talked to him. all about you know. So you treat the abscess, but you're not treating the root cause here.

I'm doing my best to, like, talk to him about dietary interventions and trying to figure out, like, what it is that, you know, is driving him to eat and all these sorts of things. You know, we find out, we find lots of different things. You know, we talk, we found out that he's a traveling guy, traveling salesman essentially. He like, he has like convenient food, convenience foods. Eating in the car on the plane and the like, those are the sorts of things that in order to make meaningful change, you need to have a regular sit down. with someone who can be there as a support person. And let's say, transplant that guy into Australia, my hope, and again, I'm not up to date

on like the waiting times for primary care providers and GPs in Australia, but the hope is that that person would be linked in, get a chronic disease management plan, they can have a meeting with a dietician because the doctor, GPs are amazing, like here and in Australia, they're amazing, they have so much knowledge on healthcare and how to prevent disease. But they're not to be all and end all. Like, as I said, this is a team game. You know, so you've got dietitians. You've got, you know, you've got your nutritionists. You've got your diabetes educators. You have your psychologists. You have your exercise physiologists who can come in and they can provide an additional pillar to help someone with their health care. How many full-blown

diabetics do you have in Australia? Do you know what the percentage is relative to the U.S.? Yeah, I was looking at that as well. So it depends, right? So you've got lots of different types diabetes, but basically you've got the double the amount of people who live with a diagnosis of some form of diabetes in the US compared to Australia. I guess maybe lifestyle, if we break it down to type one, type two, that's maybe a better lens into, I guess I'm just trying to get at this prevention piece. You know, would the gentleman who you saw in the emergency room with the abscess, would that have even happened in Australia? That's a good question. It's possible no. And the reason why is that when you move states here, it is very hard to reestablish care with

someone. Plus, there's like a mentality shift as well, right? So people know that when they come to see and interact with the healthcare system, it's going to cost some money, regardless of whether they have insurance or not. Even if you have the best insurance in the world, if you go to the emergency department, more than likely there's going to be some sort of a co-pay, especially if you're young, right, you haven't met your deductible for the year so therefore you're going to have to pay so people don't have that like they just don't have you know whatever it costs a couple of couple hundred hundred dollars to to get healthcare so people sometimes in america have an aversion to actually interacting with the health care system because they're worried about the cost whereas that piece is taken

away in australia because of medicare and the fact that we have a system that is single payer so people can attend if they don't have a primary doctor they can attend the emergency department they can get, you know, started on a journey to improve their health and then know that, yep, I actually, my instinct was correct, I need to have a GP here and I need to, you know, establish with someone so that I can, you know, have the care that I need ongoing. People even, like something that I talked about in my TED talk is something that boils my blood when I see people is that, like, for the first three months of every year, I'll get a very similar story where it's like, hey, I need a refill on this medication.

and oh why don't you go to your primary doctor well my employer changed my insurance company and my doctor is now not in network for that insurance company for someone like that gentleman I'm talking about he needs that totally and he needs the help and yet we're just like letting him swim out in the open by himself and then it's hard as well because I'm like okay well you don't you don't have a provider you're welcome to come back you're welcome to come back here and see us anytime you want but if he has a bill or he knows that he's going to have a bill how likely is going to want to come back just to have another conversation with me about, you know, oh, well, let's check it today. Is it 440 or is it 380? You know, it's just very challenging for

folks. And I think that if we want in this country to have better outcomes for a lot of that stuff, we do need to think about spending our money, not when disease risk is already accumulated, but spending it wisely before it presents. Yeah. And, you know, I think that's why we see a lot of these functional medicine clinics popping up, you know, in the U.S. and becoming really popular because they're getting at the root cause of things. We've got to level up in some ways, you know, modern health care does. Yeah. I think that we have a chance and we have a future. And I was with some of my Aussie buddies like about a month ago now. And he was like, oh man, what's it like living in the US? Like we have, you have the smartest people there. You know, you have all these

Ivy League universities and like there's just an assortment of incredibly smart people. That must be amazing to be around. And it's true. Like we have some incredible people. We have incredible innovators. But I think everyone's at risk of like falling into this like track and just like doing what they do. And not thinking to ask questions of like, well, is the status quo exactly what we want. And I think that this is the double edge sort of somewhere like America is that yes, you can get into those entrenched sort of values and systems, but you also innovation is valued. And we can do a lot. And, you know, to that end, where I talked about, I guess I had a call to action in my TED Talk,

and part of that was that people can support things like direct primary care, where it's essentially a stripped-back version of, you know, the current primary care that we have whereby docs are sick of having to do pre-approvals and dealing with insurance companies. So they basically take themselves and a nurse, and they do everything. They take the blood, they, you know, book people in for the next appointments, and they can spend 40, 45 minutes with a patient. And that is so much more rewarding for the provider and for the patient, and it allows the provider to provide healthcare that's less expensive and is what the person wants and needs. So that's not the be on and all for solving healthcare, but it's a step, you know, in the right direction.

And I think the more that people sort of explore this and, you know, why it costs so much to provide health care in the U.S., the more they can support things like this that sort of strip away those unnecessary entities that are contributing to the cost. What's up, folks, if you are enjoying this podcast or if you care about health, performance, fitness, you may really enjoy getting a whoop. That's right. You can check out WOOP at WOOP.com. It measures everything around sleep, recovery, strain, and you can now sign up for free for 30 days. So you'll literally get the high performance wearable in the mail for free. You get to try it for 30 days to see whether you want to be a member. And that is just at Woop.com.

Back to the guests. Do you've been kind of in the high performance space for a long time. So presumably you working with, you know, some motivated folks. What about, I mean, the folks who end up sick, you know, the guy with the abscess, for example, a lot of it is, I see kind of two problems or two tensions. One is the individual doesn't know how to apply their effort. So there's just a lack of education or understanding. If we put that aside for a second and say, okay, I know what I need to be doing, but I don't do it. How do you solve that for an individual? And I know that is a million dollar question, right? But, you know, you're with humans all the time, right? And I'm just curious, you know, your thoughts. because I, yeah, something might resonate with a listener, you know, and who's on a path to trying to make change. Yeah, for sure. I like to use smoking for this example, because believe it or not, people still smoke.

I know, it's crazy, right? It is. It blows on mind that people still smoke. I just talked to a pulmonologist, and he was saying that, yeah, smoking. I'm like, oh, people still smoke, but yeah, they do still smoke. So, I mean, it's 11%. So it's significantly less than it was, which is great. but the thing that I like to do when I'm talking to people, and don't forget, I have, like,

I have pressure to, like, move people through my department when they come to see me. So I have very little time to talk with them. But I think that also feeds into part of, like, the answer to your question is that having these repeat exposures to these ideas again and again and again is really, really important. And focusing on dollars, not cents. I think what so many people do is that they'll step over dollars and pick up cents. That's a line that I got from one of my countrymen by the name of Simon Hill. He's a podcast. I interviewed Simon on this. Yeah. Yeah. He's tremendous. So knowledgeable. Oh, it's amazing. But, you know, I think that, for example, smoking is a dollar that people can easily pick up, you know, whereas like getting optimal sleep

might be, you know, an example of a cent that they shouldn't try to pick up until they, you know, pick up the dollar. So, you know, asking a simple question like, hey, what do you like about smoking? And oftentimes they say, well, you know, I'm addicted to nicotine, so I like how it makes me feel. And when I don't have a cigarette, I don't like the way that I feel. Okay, well, did you know that there are products out of that that actually replace nicotine without exposing you to all the other risks and chemicals, tire, and things like that, that are in cigarettes and, you know, all the damage that the smoke does to your lungs? Or it might be something super simple which people don't probably realize like I really enjoy having a cigarette when I go out

on my front porch with my cup of coffee it's cold out I have my warm coffee and I smoke a cigarette you know so when you and then that that's something that's even harder to replace for them right then you flip it on them and say well what is it that you don't like about it what are some things that you know if you didn't have smoking your life you'd be able to do better and they'd be like well I'd be able to play with my grandkids more you know I get puffed out because when I, like, you know, I've been doing a pillow fight with the kids for, you know, two minutes or whatever. This whole, like, concept is called motivational interviewing, which, again, GPs, primary care providers are really, they get trained at doing it and they're really good at it.

When they have time, I have, like, no time. So it's really hard for me to do these things in the emergency department, but I still do it because I think it's really, really important. When I ran my sports performance business back home in Australia, my mentor then, he said, some people need to be exposed to the same thing six, seven times before they actually take action. So my take on it is that we continue to tell people what the dollars are and then continue to tell them how to pick them up. Because it might take that person six, seven, eight, nine times of hearing the same thing again before they actually, something clicks

in their mind and like, yep, I'm going to do that today. Sometimes, like, it's a little easier for me in the emergency environment because I can connect it with something really bad that's going on for them right now. So they have this like visceral memory of what it was that happened to them because of some lifestyle choices that they made that maybe were not optimal. Yeah, that's a really nice framework. So you spent a lot of time doing this like big comparative analysis. We spent some time to talk about diabetes. You know, what are some of the other behaviors that you see Australians maybe engaging in less, you know, if we were to look at the big dollars, right, that really move around our health. So like, you know, alcohol, smoking. What are some of the

behaviors that you see maybe Americans doing more of and Australians doing less of? And maybe there aren't any difference in there's something else. Maybe it does purely lie and just healthcare being more educational and preventative minded. Is there anything else at play that you see culturally? I think, well, I mean, you look at that. Yeah, I mean, that, Not to be facetious, that is a big part of it. You know, I think being able to be outdoors for basically the whole year around, that makes a massive difference. So, you know, events and social events that people engage in, you know,

fun runs and all those sorts of things, they happen all the way throughout the year. So that gives people like some goals to work towards. So, I mean, honestly, I didn't look into physical activity rates, but intuitively I would say that probably Australia is a little more physically active. I have a theory around that. You do? I do, yeah. Club sports. Yeah, for sure. You know, I think the club infrastructure in Australia, I played field hockey for the U.S. team, and we trained in Australia a ton. And Australian, your field hockey team is sensational. I play during Rick Charlesworth's reign. I don't know if you know him and Terry Walsh, who sent her for the Australian men's national team for, I think, three Olympics. He was one of our coaches for the U.S. team. Anyway, so love all things, Australian field hockey. They were so damn good. But one of the things that I observed when I was there is just, how, I think, established the club infrastructure is.

And it's basically like every district, I guess, you know, has their own club where they have field hockey and basketball and, you know, cricket and, you know, there's tons of sports. And everyone just descends in the area, belongs to the club, descends on it, and just play sports all day. Is that a right? A fair organization? There is. There's definitely a big culture.

That has to do something. We just don't have that. You know, adults stop playing sports after college, right? generally, you know, you might do a game of pickup basketball or something, but there's no kind of established infrastructure where adults can continue to play sports. I think it's a big piece of it. I think that there is certainly a piece to that. And I think adding to that is like the social aspect that you get from that. Yeah. Connection. Yeah, there's a lot of people who have been talking, especially today at TEDx, have been talking about, you know, the social connectivity

of, and how important that is in terms of, you know, remaining, you know, connected to people and how how that affects your lifespan. You know, I think, back to the weather piece, I think that there is this like huge percentage of the population. They go underground during winter and, you know, just it's. Yeah, and the behaviors that come with that are, you know, we're watching a lot of TV, you know, eating a lot of food. Yeah, it was not getting exposed to temperatures.

Totally, totally, you know. And then there's this, this whole concept of like food and the way that people eat and how we have a few cultural events, such as Thanksgiving, where we just gorge on massive amounts of calories, you know. And that's not to say we don't do that in Australia. There is certainly, you know, Christmas Day is kind of the equivalent. It's a Barbie, though. It's around the protein. And also around the seafood. Seafood's a big part of it as well, you know. So like just just thinking about like animal protein and the type of type of food that you eat,

there's those pieces. So there's, whilst there's a lot of similarities, there are some differences. I think that also when people do go off track for whatever reason, I lose their job, they, you know, are coming from another country, immigrating from another country. You know, as permanent residence, my wife was a permanent resident. She had, some was in the NICU for his delivery for four or five days. She had access to lactation consultant afterwards. She had a midwife come out to the home for the first couple days after delivery. As a permanent resident, she got access to all of that for free. So, you know, I think that there's this, this large safety net that I think protects us from the own bad habits that we have as Australians, you know,

you know, the proof is in the pudding. We, we, on average, men, women live longer than than Americans. So, you know, I think there's a, there's a big, there's something very profound to be said for how effective, you know, supporting people, particularly when they're vulnerable can be to help them live longer and happy lives. Do you observe light behavior in Australia being better perhaps than what we find here in the U.S.? You know, we spend about 93% of our time indoors, right? So we're not really connected to the primal thresholds of nature. And, you know, just kind of back to our point about Australia, Ozzy's kind of having the opportunity to be outside because it's so, you know, the temperature is so favorable. And do we have any

data around how much time Australians are spending inside versus Americans? So in terms of data, we have some of the highest rates of skin cancer anywhere in the world. So that to me says that we got light exposure. I remember playing over there and we have to, yeah, all this general stuff. So, you know, I think that from that perspective, like that in and of itself is a pretty telling statistic that we get plenty of light exposure. We obviously have to be smarter about when you do it and applying, you know, a decent sun cream and things like that. But, you know, I think that's a pretty telling, telling stat, which, you know, is that,

is that a part of, of that, a part of what helps us live longer and live with marginally lower rates of these, of these non-communable diseases? Maybe, maybe. Yeah. Yeah, I mean, vitamin D is really from the sun. It's so powerful, you know, on our immune function. And it's fun kind of putting the puzzle together here. what do you feel like, you know, Americans can learn to think about it really tactically, you know,

from a behavioral standpoint, you know, you've been inside the world of Strengthing conditioning for a really long time as a strength coach and are there things that we're missing here that would be really helpful for us to think more broadly about? Oh, man, that's a huge question. Yeah, I think that I think I've talked about it quite a lot, whereby this whole concept of dollars and cents, only because it just makes a lot of, It is a very poignant example, but we in the US, I think there's a massive push for people to try to find out what those one percenters are.

How many of the 330 million people actually need those one percenters? I think it's probably a lot less. I think that people need support to be able to do the simple things correctly. So not smoking, you know, how can we help that mom who is like, two or three jobs to get by who just goes to the local KFC because they have a meal for four for $12 available when how can we help her be able to access healthier options that are within a price range yeah you know so then that way we're getting a larger percentage of our population who are able to you know do those simple things really well so then

that way we can really, you know, use the innovators that we have in this country to, like, then switch mode to, like, really get down on the, on the one percenters and be able to help folks, you know, with those one percenters, which then is going to, really, will take us to a whole new level. Yeah. In terms of how we live our lives and how long we live. Yeah, because I, I suppose, you know, without the foundation layering that on top of a really cracky foundation is, is not going to really have a kind of effect. But then people who don't have those, people who don't have those foundation in place feel pressure to like reach for these other things that they're not that yeah they're going to help you know but if you're still smoking or you're still like having

like 80% of your calories come from highly processed hyper palatable foods what additional benefit are you going to actually give yourself when you've got this huge pillar you can put in place that's going to exponentially improve your health span what else do you see as the big pillars. Yes. I mean, like the big ones would be like diet, exercise, not smoking. You know, and I think on on those fronts, it kind of supports a fourth, which would be social connection and acknowledging culture that you have. And that can be culture that you have as an immigrant. That can be the culture that you have as, you know, an American family living in Boston. That can be the culture you have as, you know, a college athlete, you know. So,

how can you like exercise in a way that acknowledges your specific needs and your specific culture how can you eat in a way that acknowledges your you know culture as well as help improve your social connection with the people around you um you know and how can you undertake your lifestyle in a way that is meaningful to you um so yeah i think that like those probably four things i think are really important so what did i say i said diet That exercise, social connection. Connection, yeah. Three things, yeah.

I think those are the three things that I see people skipping over the most when they come to me in the emergency department. Wow. That's really interesting. I'm surprised you didn't say sleep. Oh, gosh, don't get me started on sleep. Okay. Well, I, you know, I wondered, you know, as an emergency care physician, are you, you know, do you work nights? I do a lot of my research is on shift workers.

Yeah. Yeah, we just wrapped up a really big study with Stanford Medical. I did a study with University of California, San Francisco, and Las Palmos. So lots of shiftwork data. And when I look at the physiology, we did one with acute care surgeons, too, dinner health, 270 in that sample. And the average age in that study was 43. Their resting physiology was that of a 60-year-old.

Wow. And, you know, when you look at, you know, the amount of nights on call, you know, we have a shortage of acute care surgeons here in the U.S. as you probably are very much aware. So the roster size for those folks is pretty small. So they do, they're doing a lot of on call. You know, they're going in a lot. And, you know, we see a basically a direct correlation between, you know, how many times folks go on call and the Maslick Burnout inventory scale. So, you know, we see MBI and, you know, number. of times on call kind of move in the same direction, unfortunately. So curious, your thoughts on

just shift work and sleep. Yeah, I mean, it takes years off of our life working as a shift worker. Yeah, I say it all the time to my wife. I'm like, hey, I need to work on my sleep hygiene because there is no way around me not being able to, I have to work overnight. Yeah. And I think the only way that I could optimize probably the best way to do, you know, switching back and forward between days and nights would be to just work all nights, you know, and switch my circadian rhythm completely. No question. Yes. But I don't want to do that because I've got an eight and a six-year-old and I want to like, I want to be around and like go to their sports and, you know, go and help and volunteer in their class and things like that. So, yeah, sleep is super important from that perspective. And

I'm like acutely aware of that. I think that it's not, and it's not just people in the medical field, right? There's people that are working in warehouses doing packing overnight. Like there's so many people out there that are working shift work, where they have to be switching back and forward. When you think about just the definition of a shift worker, you know, that we use in circadian science, I mean, it's basically if you're awake between the hours of 10 p.m. and 4 a.m. for 2 hours per week for 25 weeks of the year, you basically qualify as a card carrying shift worker. So I mean, that is, and you think about 10 p.m. and 4 am. That's like everyone, right? Like who's, there's a lot of folks, right? And you can qualify. There's a massive hole for those folks.

in terms of, like, you need to better understand how, like, this is going to affect your body. I hadn't heard that, like, resting physiology piece for these folks. That's crazy to me. I know. I know. So, you know, we have the benefit of being able to do an age-match cohort. And we have healthy user bias on the WOOP platform to be really clear. But basically what we did is, you know, we have our acute care surgeon population wearing WOOP for the entire duration of the study.

So we have two years of data on these folks. So we look at their resting physiology and then we do an age-match cohort. So a perfect match of those 270. perfect match, right? And we basically what we see is that their resting physiology looks like 60-year-olds on our platform. Yeah, blows my mind. Isn't that just wild? It kind of gives me a little bit of anxiety to think about right now. It's like one of those things where it's, it's, I have all these data, right? And it's, it's hard not to sound so ominous, but it really is a call. That's a call to action, too, you know, is like, how do we give folks like yourself more resources, you know? And, you know,

when I think about the global population and global, you know, just the health of our population, like I really think about this, you know, our interaction with light as being kind of so foundational to kind of health and longevity. And we're getting our light behavior wrong. A majority of folks are. And I don't know that folks are really aware of the significance of what's happening and how that might be a reason for some of these diseases and illnesses that folks find themselves with. Yeah. And I think the key here, though, is to talk about it and to, like, I guess, hopefully and try to get strategies.

For sure, yeah. You know, what this is actually how do you pay down the risk. People would be like, I don't even know that this is, that this is a risk for me. I know, I know. So, like, first, like, as a first step helping them understand that. And two is say, well, actually, you know what, this is something that you can do to try and help improve that. Exactly.

And we're trying to do a lot of that research, too, is, you know, when folks, when they exercise two times a week or three times a week, does that pay down the risk? And they have better resting physiology. You know, so we're looking at the data in all these directions. And there's no surprise, the more you exercise, the better off you are, right? You can mitigate some of the effects of being up during the night. You know, just even timing of when people eat as well, you know, just doing it during, you know, the daylight hours when, you know, at the end of your shift, before your shift, in the sense of getting a bulk of your calories in. Also, you know, seems to be a really helpful dietary strategy of shift workers. So there's things that we can do, you know? Yeah, for sure. And then I think being able to make that in an accessible way for people is super important because, you know, we talk about wellness and burnout and all of those sorts of things. And like these things contribute to it. You know, if you are like, you know what it's like work. Well, when you're working in a hospital, there's always donuts out. There is always like candy out. Like it's so easy to just walk past that drawer and like pull out some candy from there. And it's the same for all of these workplaces.

You know, you see people come in and they've got these 22-ounce, you know, specialty coffees that are late in with sugar and all of this sort of stuff. And it's just, and I get it because it's a convenience food, right? I'm driving to work and it's 11 o'clock at night, and that's the only thing that's open, so I'm just going to stop in there on my way to work. But, you know, helping people to better understand those things is really important and trying to help them. But you need people there that are able to help them, you know, and give them that information.

Yeah. What's the message that you want to get out into the world? Oh, my gosh. I think the goal is it's never too late. It's never too early to start. I love that. Yeah, it's never too early to start, and it's never too late to start. It doesn't matter.

Like, if you're 50 years old and you've been smoking for 20 years, you can stop today. and in seven years time you will have reversed much of the of the damage that you've had to your lungs and you can continue to go on and further reduce your risk by putting in multiple other you know practices like better dietary approaches maybe starting some medications to help manage all the other risk factors you have for cardiovascular disease but it's important that you start early and better understand you know what it is that you need to do people know what they need to do. Like, I can't tell you the amount of times where I will foreshadow to people that I'm going to get on my soapbox and talk to them about what, what interventions they can do

to improve their health. And they'll rattle off to me before I even start what they need to do, you know? So people know what they need to do. It's just that we need to make it, I don't know, almost make it cool to do that, you know, as a group, as a society, as we need to encourage people to make different choices that are going to be better for them. Because if, If we do, we have more people in our community that are healthier, then we're going to just have a better community and a better society because people are healthier, you know. I see that shift happening with alcohol. Yeah, for sure.

Do you see that too? Yeah, like culturally. I might be in just an echo chamber, but. I think there's probably, there's certainly, certainly are echo chambers. But I think, you know, you see all these, these companies coming out that are like non-alcoholic, you know, beer or whatever it is. Like, I see a lot of people that are making that choice now, you know. And I'm sure there's certain times in your life.

I certainly did partake myself where, you know, drinking alcohol is, you know, part of the culture that you have in that moment. But I think that there are shifts to move away from that. I'm positive about the, what are they, Gen Z is now? I'm positive about their group. I think that they're going to change a lot about the way we do things. Yeah, I completely agree. I mean, my son is kind of a good example.

Like, you know, he and his friends are all like wearing whoop. and it's like getting cool in their school to like be optimizing for sleep and recovery and like working out and kind of talking about the data and it's it's it's it's fun like really neat to witness you know that there is just this I guess acceptance too of just the data and the truth that kind of comes along with that you know and just being more objective I guess about the things that move around capacity and performance levels and yeah it's kind of a It's cool to see that shift. I think also we need more people that are able to communicate science to more people.

Yeah. You know, I think there's so many, you can rattle off all of the names of people that are doing really well in this space at the moment. But this is partly why I wanted to do TEDx is I wanted to be able to put together a 10-minute talk where I can get across the information that I want to get across in a meaningful way. Yeah. So I think that's a really important piece. that that needs to be added. We need to encourage people who are doing science in these areas and these, like, specialty areas to be able to be better communicators so that they can get

these messages across to people in a way that's meaningful to them. Yeah, I love that. It's a hard skill, you know, and especially when you're doing the research and writing manuscripts and going through the peer review process, you know, it's very time consuming. So scientists are doing science and, you know, it can be hard, you know, to... It's boring, too. It's not interesting. I've, I've written so many papers that have like never got accepted, you know, because they didn't like, they didn't have the right wording. They didn't like explain the methods in the way that, you know, the journal wants. But that's the way it goes, right? That's what makes peer review science rigorous because it can be reproducible. Yeah. But it's boring, you know, so being able to like take

folks who can, who do that research and then be able to like educate them or encourage them, empower them to, like, communicate it. What does no good if that research sitting on the shelf somewhere. You know, it's like if it's, you know, if it's going to help people, we need to get it out there, you know, so I do think there's energy around that too, you know, with folks like Dr. Huberman and, you know, like there's some really amazing scientists out there who are super effective at communicating science and putting in a very actionable term. So there's a lot of good templates, you know, that I think scientists can use, you know, to

to be like, all right, I need to figure this. I need to figure out how to do this, you know. Well, it's been really wonderful to talk to you. Thanks very much for having me. Is there any other final thoughts? You want to leave with our listeners? No, I'm just, I'm very excited to be here and I hope that in some small way, things that I've had to say today will spark some kind of, you know, energy in someone to make a change in the life that will, you know, help increase their health span. I love that. Thank you so much.

No worries. Thank you. If you enjoyed this episode of the Whoop podcast, please leave a rating or review. Check us out on social at Whoop at Will Ahmed. If you have a question to us answered on the podcast, email us, podcast to Whoop.com. Call us 508-4434349.52. If you think about joining Whoop, you can visit Whoop.com. Sign up for a free 30-day trial membership. New members can use the code Will, W-I-L-L, to get a $60 credit on Whoop accessories

when you enter the code at checkout. That's a wrap, folks. Thank you all for listening. catch you next week on the WOOP podcast. As always, stay healthy and stay in the green.