The Startling Science Behind Modern Health Crises | Simon Hill DSH #720

literally working till the day they die.

Yes, and that's a really critical point.

We don't want people to be frail and old,

unable to navigate their environment or do the things they enjoy for 20 or 30 years at the end of their life.

So it's not just about extending life, it really is about compressing the number of years where you are suffering from chronic disease.

Right.

All right guys, we made it happen.

Had some address issues, but he's here.

Simon Hill.

Thanks for coming, man.

Sean, finally, thank you so much.

Health topics are one of my favorite things to discuss, so this will be fun.

Yeah, I've seen the list that you've sent through some topics that we're going to cover, and I'm excited.

Yeah.

Some controversial stuff.

Absolutely.

So how did you get started on this journey?

Was it a specific moment that triggered it?

Yeah, when I was a kid, I was constantly surrounded by science.

My dad's a professor of physiology.

So there was always printed studies all over the house and in the car.

And I didn't really understand what those studies said but I understood the the role of science and the importance of science to my dad you know he taught me that this is a way where we can be curious about the world and help understand the world better

and growing up I because of that and and kind of seeing my dad's love for science I felt like I would pursue some sort of career in science.

When I was 15,

I was spending a day, there's an area outside of Melbourne called the Yarra Valley.

It's a wine region.

And my dad and I would often drive out there on the weekends together and just spend some time.

We were driving back home and he started to get chest pain.

And long story short, we went back home.

It was just he and I.

He ended up having a severe heart attack.

Was taken by helicopter actually, because we were quite remote to the nearest hospital.

And I followed in an ambulance by road.

There wasn't room for me in the helicopter.

So that was like quite a traumatic experience for a 15-year-old.

Absolutely.

And,

you know, not knowing like what was the outcome of this going to be.

And it wasn't like my dad was obese or unwell.

He was not diagnosed with any type of chronic disease.

So this was really out of left field.

And it was a very long wait, or what felt like a long wait.

And the cardiologist came out and told us that they had fortunately saved his life, but he'd had a severe heart attack.

He would be on medications likely for the remainder of his life.

Wow.

And

my brother and I would need to keep a very close eye on this as cardiovascular disease runs in families.

And I really didn't think too much of it beyond that conversation.

I was 15, right?

Sort of went back just to living life as I did.

And just in the back of my mind, I always thought,

you know, based on that conversation, perhaps we have a genetic predisposition or vulnerability.

And that's going to be something that I have to deal with when I am my dad's age.

And he was only 41.

That's young.

That's young.

So, you know, as I graduated, I did an undergraduate in science, became more and more interested in the role of lifestyle and how we can kind of attenuate or reduce our risk of these chronic diseases that are really crippling our communities in Western society.

was inspired to go back and do a master's in nutrition science and really so I could get the skills to read the research because it really is like another language.

and so as a kind of outsider to that field of science even though I had an undergraduate science degree when I was trying to make sense of the nutrition literature I was finding it very difficult I was confused because you'd read something in a magazine and then you'd speak to someone in the locker room I played football and they'd have a very conflicting view jump online see people were fighting how do you make sense of that I wanted to develop those skills so I could attempt to do that myself.

Yeah.

What a story.

Yeah.

I mean, obese people having heart attacks, that makes sense to me.

The ones that scare me are like skinny people like your dad.

What do you think is causing that if it's not obesity?

Well, obesity is the predominant risk factor that is driving cardiovascular disease, type 2 diabetes, non-alcoholic fatty liver disease, significantly raising risk of neurodegenerative diseases like dementia.

But

it is possible to be metabolically unhealthy, but from the outside, appear to be a normal body weight.

And a lot of this comes down to genes and where you store fat.

So

it's also true and possible that you can look at someone who is two people

who are both obese to the eye, but one of them is of much higher risk of developing cardiovascular disease and type 2 diabetes.

Why is that?

Well, there is differences between us in terms of where we store fat.

So fat distribution matters a lot.

And

long story short, there's three main compartments where you can store fat.

Subcutaneous, which is like just underneath the skin.

And then there's visceral and ectopic, which is sort of in and around the organs,

like your liver and your pancreas.

And

some people who are, let's say, genetically blessed, have what's called a higher personal fat threshold.

They can gain weight and store more fat subcutaneously in that compartment without it spilling over into the visceral and ectopic fat compartments, which are really the deleterious, dangerous ones.

That's where fat is very toxic and inflammatory.

So those people can gain a lot of weight and not suffer much consequence.

Now,

on the flip side, you can have someone who has a very, very low subcutaneous fat storage capability, and they're the person that from the outside doesn't look that overweight.

And they're walking around the streets and have no idea that even though they tend to to look healthy from the outside, there's a lot of fat being stored in the pancreas and in the liver.

And they can go on and develop type 2 diabetes.

One in six people with type 2 diabetes are of normal BMI.

Wow.

And that's important, right?

Because I just got my first MRI last week.

Yeah, so you can do things like MRI or DEXA scans and start to sort of get get ahead of the curve and look at your fat distribution and use that as a way of kind of understanding, you know, to what extent would you like to or be motivated to make lifestyle changes?

Absolutely.

And I thought I was super healthy.

I'm, you know, 185 pounds, pretty lean, have a six pack and stuff, eat healthy.

But my scan came back really bad.

I had a lot of visceral fat all over my organs and heart.

So I think it's more than just diet, you know.

Yeah, there's other parts of our lifestyle can also influence that

fat

distribution kind of equation.

So it can be genes, which I mentioned, can determine where you store fat and which compartment.

But we also know things like sleep deprivation, right?

There are studies showing when you deprive someone of sleep, not only the next day are they more likely to eat hyper-palatable foods and excess calories, but they're also, they have

this preference to store the excess energy in those visceral compartments.

Wow.

So, you know, you're right.

It's not just genetics and the food we eat.

There's more going on that can influence where we're storing fat.

That's scary because a lot of students are sleep deprived.

Yeah.

And alcohol is another big one.

So alcohol is a big one that will increase fat, particularly in the liver, especially if you're in a calorie surplus, if you're eating more calories than you're expending.

And then when it does come to nutrition, independent of calories.

So calories are certainly the worst thing when it comes to storing fat in these, you know, storing fat where we don't want it.

Let's just say that.

That's what is metabolically damaging.

Calories is the most important thing when it comes to nutrition.

But behind that is certain dietary constituents, parts of our diet, independent of calories that can affect fat storage in organs.

And the biggest one is the type of fat you're actually eating.

So saturated fats, and there are metabolic studies, randomized controlled trials in humans showing this, even when you're not in a calorie surplus,

saturated fats will increase hepatic or liver fat compared to polyunsaturated fats.

So when I say saturated fats, I'm really talking to things like palm oil, coconut oil, butter, ghee, fat that's in red meat, if it's a fatty cut of red meat.

And when I say polyunsaturated fats, which would be

of preference if we're thinking about visceral fat, would be like fatty fish, nuts, and seeds.

Oh, wow.

That makes sense because I eat a lot of canned fish.

No,

as in fatty fish are rich in the polyunsaturated fat.

So if anything, they should be a good thing when it comes to

liver health.

So if you have excess fat in your liver, it's probably not from

my heart.

I got it on the abs and someone's on the heart too.

Yeah.

I was really scared, honestly.

Need to make some changes, man.

Because I'm 27, so to have that visceral fat, people don't really get MRIs in their 20s.

Like, that's not really common.

No, and I'd be interested to know, know, outside of the MRI results, what's happening with certain blood biomarkers.

Like,

usually, if someone has excess fat in the liver, and especially if it's in the liver and the pancreas, you see changes to important biomarkers, like fasting blood glucose, triglycerides, HbA1c, they tend to be elevated.

And that's when we know, like, when you're looking at not only the results of a scan, but you see see those changes in blood biochemistry.

That's when

you know we really start to see more of a full picture that this person has some type of metabolic dysfunction.

Got it.

And what's your take on carbohydrates?

Because the person that gave my scan told me to pretty much cut them out completely.

Yeah, I mean carbohydrates stems everything from a jelly bean to a black bean.

So it's hard to throw all carbohydrate containing foods in the same bucket because

you and I, I'm sure, would agree that a jelly bean will have a different effect on your health outcomes long term and physiology compared to a black bean right right one of those they both contain carbohydrates but one of those also contains a lot of phytonutrients different types of fiber polyphenols so the food matrix is different and so sometimes we can get so reductionist and say hey there's 30 grams of carbs in black beans and 30 grams of carbs in jelly beans that's going to have the same effect on your body.

But the food matrix is very different.

So

not all carbohydrates are kind of created equal.

And carbohydrate containing foods like whole grains and fruits and vegetables

and legumes are associated with good long-term health outcomes and lower risk of metabolic disease.

So for someone like you, if your goal is to reduce your risk of metabolic disease, I certainly wouldn't be saying, hey, you have to go keto or super low carb.

You recommend carnivore.

But

I probably wouldn't recommend carnivore.

I would say to you, the type of carbohydrates that you eat matters.

And when you're getting carbohydrates from hyper-palatable ultra-processed foods, it's not that the sugar molecule is inherently bad, right?

The sugar molecule in an ultra-processed food is the same as a sugar

molecule in fruit.

But the food matrix, the overall package is completely different.

And when you're eating those ultra processed foods that are low in water, low in fiber, low in protein, calorie dense, hyper palatable, what happens?

You don't reach the same level of satiety for the same number of calories.

So you end up over consuming.

And that's that's the real problem with ultra-processed foods for most people is A, they end up eating excess calories.

And B, as a result of filling up on those foods, think about all the foods that they didn't consume

that have a very healthy effect on physiology.

Makes sense.

So there's kind of a displacement factor as well.

Yeah, how common would you say overeating right now is?

Well, it's massively common.

I think by 2030, one in two adults in this country will be obese.

Jeez.

Less than 7% of adults in this country are what you would define as metabolically healthy.

Oh my gosh.

Yeah.

So, you know, to

we're in a huge health crisis.

And

it's not like we're staring down the barrel of a health crisis.

The gun has been shot and

people are, you know, we're not down and out, but

people are

critically wounded, I guess, is how you'd put it.

And so we have to work out

how do we resolve this?

What are the problems?

What's causing the obesity epidemic?

And what can you do at a public health level?

What can you do at an individual level?

And is this a US problem or is this in Australia?

Is this in other countries?

It's a Western culture problem.

And as Western culture starts to

sort of creep into Eastern communities, you're seeing those communities change and start to take on these

same levels or same incidence of these non-communicable cardiometabolic diseases.

We have an environment where we have a mismatch between our genetics and our environment.

And the environment that we live in largely sets us up to fail.

We have a set of genes that

have evolved over

hundreds of thousands, millions of years in an environment where food was scarce.

So it makes sense that we're really good at consuming extra calories and storing fat.

That benefited our ancestors.

Today, in an environment where there is really not no famine for most people,

and thankfully levels of hunger and

undernutrition or malnutrition are decreasing year on year, but overnutrition is becoming a problem because we have those genes, we're surrounded by this hyper-palatable food environment,

and we can't really rely on willpower.

If you look to the communities that live to 100 or have a high number of centenarians, I personally don't think those people were born with more willpower than us.

They just live in a different environment.

And the environment's conducive to better health.

So

a way that I try and explain this to people is

if you think about a maze versus a labyrinth.

So a maze is

something that we were designed to sort of get people lost.

Makes it hard for you to find your way through it.

Whereas a labyrinth is very much a path that is created.

There's only one way to walk.

It's a mindfulness type practice.

It's designed for you to succeed.

And in these

communities, often some of them are described as blue zones.

You may have heard of that.

They live in an environment that's more akin to a labyrinth, where the healthy choice is also the easiest and the normal choice.

Whereas we live in a maze.

And so short of rapid changes to the food environment, just the environment in general that we live in, I think the only way out of this is for people to be more intentional with how they're living in this environment.

So, okay, despite the environment that you're living in, can you still be healthy?

Yes, you can, but it's going to take more intention or intentionality.

You have to be more deliberate than someone that lives in a blue zone.

And the impressive thing with these blue zones is not only are they living to 100, but their health span, they're literally working till the day they die.

Yes, and that's a really critical point.

We don't want people to be frail and old,

unable to navigate their environment or do the things they enjoy for 20 or 30 years at the end of their life.

So it's not just about extending life, it really is about compressing the number of years where you are suffering from chronic disease.

And so that's, you know, that's mostly what I kind of focus on.

Yeah.

I want to help people avoid premature chronic disease.

Yeah, I look at my grandparents and yeah, those last five, ten years were tough.

And that's something I definitely don't want.

Yeah, tell me about it.

My grandma

is still alive now.

She's 96.

Wow.

It's very good innings.

But the last, I'm going to say 12 to 15 years, she's had...

pretty severe dementia.

Dang.

Which,

you know, I,

if I'm being being completely honest, I don't know that I would say her quality of life is that great.

Wow.

You know, she's in a home.

It's tough on her family.

Financially.

You know, she doesn't remember any of her family.

Yeah, so there's financial burden.

It's very sad.

Yeah, and now there's new studies about dementia and Alzheimer's, how it might be type 3 diabetes, right?

Right, so there seems to be...

at least for some types of dementia,

a vascular component.

And we know that people who have insulin resistance or type 2 diabetes are at significantly higher risk of developing dementia.

I think it's doubling of the risk if you have type 2 diabetes.

So certainly getting people metabolically healthy, which means we want to get fat from being stored, get it out of these places where it shouldn't be stored.

And we also need sleletal muscle because metabolic health is not just about getting fat out of organs.

It's also about having skeletal muscle working in an efficient, healthy manner, which comes down to healthy mitochondria in your muscle fibers, which is largely achieved through exercise.

Got it.

So the other thing that we're not doing a lot of is moving.

Yeah.

I think that's why I had the visceral fat, because I was not active.

My lifestyle was very sedentary.

I was only walking 3,400 steps a day.

Yeah, and now skeletal muscle, I think a nice way to think about it is like a sponge.

So when you eat a meal, inevitably you will have a rise in blood glucose after that.

And that's normal physiology.

I know there's been a lot made of blood glucose spikes and flattening the curve.

I don't think we need to flatten it.

It is normal for your blood glucose to go up.

What is not normal is if it goes up and stays up two hours post-meal, it should be coming back down.

And people with pre-diabetes and type 2 diabetes, if they're not medicated, When they have a meal, their blood glucose will go up and it will stay up.

Wow.

But a really nice kind of hack or

thing that people can do to help manage their blood glucose is actually moving their body.

So if you eat a meal and then you just sit down, your blood glucose response will be dramatically different to if you eat a meal and then move your body, even if it's just for 10 minutes.

Particularly if you can do some type of whole body exercise.

Interesting.

So if you can get muscles working from top to bottom, then you will help bring that blood glucose rise back down to a normal level in a in a shorter amount of time.

Wow.

So taking walks after a meal is probably really beneficial then.

Yeah, and there's quite a few studies now looking at people at work and getting them to, when they have their lunch, a lot of people are eating their lunch sitting down at their computer.

Right.

If you can, and particularly if you are in management and this is something that you can encourage your staff to do, get people moving, even if it is just a 10, 15 minute walk straight afterwards.

Yeah.

And that's going to really benefit not only their long-term health, but it's going to benefit their energy energy levels in that afternoon which hopefully has an effect an influence on

their productivity yeah that's great advice so talking about the living proof challenge what exactly is that

so i've written a book that i published in 2021 i've done like 320 podcasts i think at this point and my whole my whole shtick is

i want to get the domain specific experts on like i i'm aware of what my limitations are even in the nutrition sphere like i'm relatively young.

So it's impossible to kind of know everything.

So I want to sit down with these domain-specific experts that have often worked in a specific area of science that influences our health for like 30 years.

And I just ask the questions that I'm curious about.

And then over time, hopefully I'm sort of evolving my own thinking, but bringing the listener along for that journey.

The issue is a lot of these conversations are like two or three hours long.

So like you can imagine how many people email me and

Simon, just tell me what to do.

Absolutely.

So the Living Proof Challenge is kind of my answer to that.

I was like, how can I synthesize all of this information back to the maze, help people be more deliberate, more intentional?

So the challenge is basically a distillation of all of that information and will be really objective.

So what are the things we can measure?

that really predict our health span.

I call those the 10 truths.

What are the science-based interventions or protocols that can improve those?

Let's put those into the challenge and help people build habits around those over a 12-week period.

And then at the end, let's retest.

So let's go back and retest those 10 truths.

And hopefully people, what people can see, even if they are moderately adherent to it, they will see great improvements in certain biomarkers that maybe were not optimal at the outset that's great yeah i think measuring your biomarkers are is very important because people just kind of take all these supplements without knowing where they're at

yeah

it's it's hard to optimize

something that you don't measure

at least being very specific so when you when you measure this and the 10 truths are really a window into four key systems so of the body so the musculoskeletal system cardiorespiratory

metabolic health, and psychological well-being.

When you measure the 10 truths, you can, it's like it's a window into these systems.

You can look underneath the hood and see which areas of your health you need to focus most on.

Right.

Because there's probably a bunch of things that you're already doing that are amazing.

And rather than investing more time into those, you can say, okay, here's actually some of my weak points.

No different to if you or I were like,

let's go to the gym and develop a program.

You know, we probably at at the outset would say,

what's our weaknesses here?

Or what are our goals?

And someone might say, you know what,

my upper body strength's really good,

but my quads or my glutes are really weak.

And so that program will be built around strengthening those weaknesses.

So we can do the same thing if we measure things at the outset before we start an intervention.

And one of the critical things in terms of me distilling that down to 10 key predictors of health in the 10 truths was that there are so many things that we can measure.

There's a huge laundry list, right?

So much.

But not all of those are validated.

You know, data is good to the extent that you can act on it, but we could go out and measure a lot of things.

And if the data is not validated and there's not interventions that can improve them, what are we doing?

We're just overloading people with information.

So I wanted to get these

predictors that are not only validated, but are accessible so most people can just go down and speak to their doctor or get these functional tests done pretty easily and affordably

but also that there is the evidence that you can actually improve it got it so when you say validated what does that mean validated means that it's reliable so that it reliably predicts let's say cardiovascular disease imagine that

we were measuring one of the markers is APO B

okay and it is a reliable predictor of your risk of cardiovascular disease.

But imagine that that marker, you know, there was a lot of daily fluctuations, it was influenced heavily by sleep or exercise or stress,

then it might not have much predictive power in terms of your long-term risk of cardiovascular disease.

And it's a marker that has been replicated in many studies over time,

in different types of studies.

So we have like genetic studies, observational, randomized controlled trials.

So when I say it's validated,

there's also a wide body of literature that supports its use as a predictor of health span.

Is there any direct studies at high testosterone levels increase your health span?

I don't think there is any evidence that I've seen and someone can correct me if I haven't seen it and

send it to me via email, but I wouldn't say high, but I would say that low testosterone can correlate with higher mortality, so premature death.

Once you get into sort of 300 to

it's called 1,100

total testosterone, I don't think there's much difference in terms of association with longevity.

And I did an episode on testosterone.

Actually, I had my testosterone measured, and I think it was like 500 or 600.

And then I did some interventions and got it up to 800.

Nice.

But in even in this conversation and speaking to people

a lot of people you won't you won't feel significantly different subjectively you won't experience any differences moving from say four five hundred up to eight hundred.

Some people might, but many people won't.

And so there is no evidence that if you're in the lower sort of part of normal that you need to do TRT or anything like that unless if you're at the lower end and you have subjective symptoms like low libido low energy so it comes down to both the measurement and your subjective experience got it got it hope that's good no that's good to know because I was similar I was at 520 and I thought that was considered low so no so sub 300 would be cause for concern and let's let's dig deeper

but if you're at 500 and your libido is good and your energy is good then there's no indication there that you need to do like testosterone replacement therapy or things like that and i think a lot of of people are jumping the gun, particularly young males on TRT.

Not that it is a bad thing.

It can be used responsibly.

It's that you need to understand

the risks and what it does to the body, particularly from a fertility reproduction point of view

for a young male if they're wanting to have kids.

Because there are things that you can do kind of as alternatives to it that will increase your testosterone and not affect your fertility so much.

Or there are things that you can do side by side with it to maintain sperm production throughout it.

And

by doing that, you know, down the, let's say, five years down the track, you want to have children.

Yeah.

That is hopefully an easier process for you.

Did you see the new microplastic thing?

It was found in every male's testicles.

Yeah, I saw that.

That's scary.

It is scary.

I haven't read that study.

I saw that, and it reminded me of a study that came out about three months ago, New England Journal of Medicine, looking at the plaque in the coronary arteries and they also found significant microplastics.

Oh my gosh.

So it's in the air too.

Yeah, microplastics are kind of showing up in multiple organs.

That's scary.

That could be through circulation going through

the coronary arteries.

I had a heart surgeon on.

He said he saw it in a heart while performing surgery.

I mean, I don't really know how to combat this one.

Yeah, it doesn't really surprise me given how dramatically our environment has changed.

I'm not sure there's a lot that we can do, but I'm certainly,

I think it's an area of research that we need to continue exploring.

And another big one that doesn't get a lot of air time is particulate matter, so pollution.

And we know that these kind of very small particles found in air that is polluted significantly raises risk of cardiovascular disease as well.

So air quality does seem to be particularly important.

That's interesting.

So if you live in like Manhattan, that's something to keep an eye on.

Yeah, and there's, can you do a lot outside other than maybe wear some masks?

I mean, how far?

How far do we go?

Yeah.

You can probably, you know, you can, most people are probably willing to explore things like controlling the air inside their home.

I'll do that, yeah.

Yeah.

And you can do that with certain machines.

I'm not affiliated with any of them.

And

having plants inside is probably a good thing, too.

Yeah.

Yeah.

I'll do the indoor ones.

Brian Johnson has the outdoor ones, though, in the backyard.

I think that's pretty interesting.

What do you think of Brian Johnson?

I've had dinner with Brian Johnson, actually.

Really?

I want to hear how that went.

It was a fun experience.

Nice.

It was about 10 of us, and it was a

philosophical kind of exploration of

longevity and how far you would go.

And are you prepared to give up everything and be controlled by an algorithm if that guarantees optimal spiritual, physical, mental health?

And we deliberated on that as a group.

Interesting.

And where were you on that spectrum?

I kind of ebbed and flowed, but the sticky point for me where I think I actually agree with Brian is that

immediately there's this visceral response to letting go and allowing an algorithm to control everything where you think, hang on, I fought hard for autonomy.

Like I really value freedom.

And it feels like it's encroaching on that.

But then when you

kind of replay the theoretical situation that he was putting out there.

And I don't think you'll mind me speaking about this.

Sorry, Brian, if you're listening.

You know, he worded it in a way where the algorithm will guarantee your most optimal physical, spiritual, mental health.

And

so while the visceral reaction is, hey, if I give up my autonomy, I'm not going to be as happy as, you know, emotionally, he's guaranteeing that in the hypothetical.

So I think I landed on siding with him that I probably would give it up.

I don't think it's going to happen.

Interesting.

I don't think that'll happen.

But it was kind of, it was interesting to see the responses from people on the table.

It was pretty split.

Yeah, well, you look at the lifestyle, sleep at the same time, wake up at the same time, you know, you're almost living like a robot.

Yeah, so from the outside, that seems very boring and would seem to really affect life satisfaction.

But he, in his hypothetical, he's suggesting it doesn't.

So

don't, again, I don't think that will happen.

I think so much of

the joy we get from our lives does come down to autonomy.

Absolutely.

Simon, it's been fun.

Where can people find your books and get some coaching from you?

Theproof.com is kind of the hub where you can get links to everything: podcast, the book, blogs, all the things, socials.

Perfect.

We'll link below.

Thanks for coming on.

Thanks, Sean.

Appreciate it.

Thanks for watching, guys.

See you tomorrow.

Thank you.