Ep 534 - Outlive (feat. Peter Attia)

Speaker 1 Wow, wow, Wes.

Speaker 2 Dr. Peter Attia, dude, thank you for coming.
Thank you for doing this.

Speaker 2 Thank you for doing this.

Speaker 2 I'm really pumped. I read your book, so I'm kind of familiar with you.
Oh, thank you so much.

Speaker 2 I kind of like what you're about. Thanks for having me.
Thanks for doing the podcast.

Speaker 2 And I guess I'll give you an introduction and correct me if I'm wrong. You were a medical doctor and you did cancer surgery, right?

Speaker 1 A general surgery with a focus on cancer.

Speaker 2 With the focus on cancer. And then you just kind of...
I liked your origin story a lot.

Speaker 2 And so, from what I remember in in your book, you did this big swim, like rate. It was like a marathon swim or something.
And how far did you swim?

Speaker 1 It was about 21 miles.

Speaker 2 That's insane. So, you did a 21-mile swim, and then if I remember correctly, you were eating a cheeseburger in celebration.

Speaker 1 And your wife, that was your wife,

Speaker 1 that was a slightly longer swim, but yes, yes, now I know the story you're talking about.

Speaker 2 Okay, yeah, that I, that honestly, dude, that made me laugh so hard that you did like a what?

Speaker 1 I think that was like 25 miles or something.

Speaker 2 25-mile swim. You go out to have a cheeseburger, and I believe a Coca-Cola.

Speaker 1 Yeah.

Speaker 2 And your wife more or less was like, you're fat.

Speaker 1 Yeah. Dude, that's the best.

Speaker 2 And then you, it launched you. And then you just got the ultimate revenge and started like a super successful business.

Speaker 1 How do you feel? She was very sweet. She said,

Speaker 1 she just, she didn't say you're fat. She goes, you need to work on being less, not thin.

Speaker 1 That's worse, though.

Speaker 2 I'd rather someone be like, you fat ass and be like, you need to be less, not thin. But you just swam 25 miles.

Speaker 1 Yeah.

Speaker 2 That's wonderful, though. That is good, though, to have a woman to push you to those heights.
Because then, that's is that really like the genesis of you kind of branching out into like

Speaker 1 I had actually already left medicine at that point. I had been out of medicine for three years.
I was working at that time,

Speaker 1 God, what was I doing? I was working at an energy company, I think, or maybe I was in finance or something. I was, but I was like, I had nothing to do with medicine.

Speaker 1 Um, but that was right around the time my daughter was born as well. And so, I think that was kind of the one-two punch.
It was sort of my daughter's born. Um,

Speaker 1 and then I'm realizing actually, like, I'm not that healthy. Even though I exercise a lot, I'm actually not that healthy.

Speaker 1 And that, those, those two things were what kind of got me to be pretty obsessed with just trying to figure out how to not die prematurely.

Speaker 2 The kids do that. I have a two and a four-year-old, and that really kind of I actually thought you'll find this interesting.
I thought I was healthy.

Speaker 2 I did all, I was doing the, you know, all these apps. Like, I did the one where you like mail your poop and all that stuff.
And I did that.

Speaker 2 It came back, like, dude, you're like six years younger biologically. I was like, this is awesome.

Speaker 2 I had the fucking aura thing.

Speaker 2 i had that going on telling me i'm seven years younger than my age and then i took a blood panel dude i'm like pre-diabetic yeah exactly i was like what the man it was like i i thought i was like killing it and i got it back and it was like

Speaker 2 i literally just found out two days ago so this this timing couldn't be more perfect my a what is it a1c i think it was my a1c is like 5.7 which was like but i did eat uh two bites of a pancake before my blood work which i'm not sure

Speaker 2 shouldn't impact the a1c damn it dude i was fucking hoping that was the answer yeah that's so that is kind of crazy because you and again i don't you know I'm not the definition of fitness, but I'm not like, I wouldn't thought I had almost type two diabetes.

Speaker 1 Well, it takes a while. Like, you don't, no one wakes up diabetic, but also most people don't kind of don't recognize that it's a 10-year journey for most people.
Really? You get there, yeah.

Speaker 2 So what? I have like four, like four more years of pre-diabetes?

Speaker 1 I mean, I think that's impossible to predict for any one person, but

Speaker 1 we definitely know that disease is so much more complicated than people, I think, historically have thought of it.

Speaker 1 People have historically said, well, I mean, type 2 diabetes is your pancreas can't make enough insulin, you can't get enough glucose out of your blood, into the muscles, and eventually we just cut off some arbitrary number.

Speaker 1 We just say, once you reach a certain level of blood glucose, then you have type 2 diabetes. But, you know, to me, that's just not a great way to think about it.

Speaker 1 I think of it as a continuum and a spectrum. And pre-diabetes is a step along the way, but we also know that the lower your blood sugar, the better.
So 5.7 is better than 5.8 is better than 5.9.

Speaker 1 But even though we would call you quote unquote normal at 5.6, I would argue five is much better than 5.6.

Speaker 2 Gotcha. I see what you're saying.
Yeah, it was like for real a joke because I was like dancing in the end zone on my wife because she's, she is her biological age.

Speaker 2 And I'm not rubbing it in, but it was like, whatever. And I was like, I'm five years older than her.
So I was like her peer biologically. And I was laughing, you know, I was.

Speaker 1 These biologic clocks things are such a, such a scam. It is incredible.
Dude, finding it. No, I love it.
I love it. I find it.
It's brilliant marketing.

Speaker 2 it's brilliant marketing i woke up one day and i went like i lost half a year of my biological age i was like what the did i do i'm i like start went into a panic but yeah so the uh that was like a real revelation for me i was like holy man because my dad has type 2 diabetes and i was like yeah that's on him he eats ice cream all the time i'm healthy and i like got my blood working i was like son of a bitch by the way i'm just breaking this right now i know i don't this is breaking news this is breaking news this is this is like so timely i have pre and i was actually it is very timely and i i have been leveraging it emotionally in my household which is nice.

Speaker 2 Anytime my wife bothers me, I'm like, dude, I have pre-diabetes. This cortisol is going to mess up my insulin.

Speaker 1 I got a text message literally on the way over here from a buddy who just got a vasectomy yesterday. And we had recommended the urologist to him

Speaker 1 who was going to do it. So he goes, look, I just want to tell you, man, literally the best experience ever.
The guy was incredible. So funny.

Speaker 1 You know, he's got me draped like over the table. So like, you know, he's like, there's a drape, like I'm laying on my back.

Speaker 2 Like a C-section? They do like it. They don't let you see.
Yeah, yeah.

Speaker 1 It's It's like, you're sterile. They want to keep you sterile, right? Gotcha.
And the guy walks in the room first time. He hasn't seen me.
He doesn't see my face.

Speaker 1 He just sees my, my, my schlong and he goes, oh, I remember you. But he was like, but it was just all jokes.

Speaker 1 And he's, so he says today he goes, you know, look, honestly, zero pain at all, but don't tell my wife I am going to milk this is 10 out of 10 pain for another week.

Speaker 2 So important. Yeah, yeah, yeah.
So also the vasectomy, you can't ejaculate for like, what? Seven days or something?

Speaker 1 That's a good question. I don't know how many days I'm going to be.
I swear to God. I don't know how many days.
I don't know.

Speaker 2 It's like seven. My friend did it.

Speaker 1 He had to hold off, yeah.

Speaker 2 Seven whole days, and he said he went a little prematurely and said he had a little bit of pain.

Speaker 2 So that's not good. But yeah, dude, so that's that was kind of crazy, man.
Because, again, I've been doing all the services because I haven't been to a doctor in forever.

Speaker 2 Cause I'm like, you know, I go to it, and this is what I think was cool in your book. You have like, was it healthcare 2.0 versus like 3.0? What was the latest?

Speaker 1 Yeah, medicine 2.0 versus medicine 3.0. Yeah.

Speaker 2 So 3.0 is kind of where you're at. That's kind of more cutting edge.
2.0 is like, what, a step up from like medieval humors?

Speaker 1 Yeah, but still important. I mean, we still want medicine 2.0.
Medicine 2.0 will take care of a problem when it shows up.

Speaker 1 And if you, you know, if you, if you're in a car accident, you break your leg, you get pneumonia,

Speaker 1 you want someone who knows how to deal with those problems.

Speaker 1 But it's a very different system from,

Speaker 1 hey, how do I take a guy whose hemoglobin A1C is 5.5, who no one, everyone thinks is just perfect, but I think he's on the path to actually, you know, being diabetic in 10 years.

Speaker 1 And why would I wait till he's staring down the door when I could just make the changes now?

Speaker 2 Yeah, and that was kind of my beef with doctors.

Speaker 1 I would go there, and they're like, nice.

Speaker 2 I don't have anything against them, but I go there and they're just kind of like, yeah, cholesterol is good.

Speaker 1 And I'm like, this is all we're worried about.

Speaker 2 Like, this is like, and then they lowered the window to like blood pressure. One day I went in there and they're like, oh, by the way, high blood pressure is lower now.

Speaker 1 And I'm like, okay.

Speaker 2 I didn't have a blood pressure problem, but it's like, I just feel like you go there and it's like, you're like a car. You go in and they check like two things.
You're like, yeah, you're good.

Speaker 2 But so I really liked your book, how you're like, you want to check for more things and try to increase the health span, not just the lifespan.

Speaker 2 Because a lot of people are very unhealthy. I thought I was a poster child for health, dude.
I'm one of the suffering Americans. Just, I need Michelle Obama to come get, make me lunch, dude.

Speaker 1 I'm fucking fucked up right now.

Speaker 2 So, what are you working on right now? Because the book, has anything changed from the book? And again, correct me if I'm wrong, but the summary was like the four horsemen.

Speaker 2 That's the things that are the four leading causes of death. And they are what? Heart disease?

Speaker 1 Cancer. Cancer.
Neurodegenerative diseases and dementing diseases like Alzheimer's disease and metabolic disease.

Speaker 2 That's me. That's diabetes, right?

Speaker 1 And they overlap. So when you have type 2 diabetes, your risk of those other diseases goes up by 50%.

Speaker 1 So one sort of feeds into the other. And also, if you have cardiovascular disease, your risk of dementia goes way up.

Speaker 1 Oh, really? Oh, yeah.

Speaker 2 Damn, that sucks. Yeah.

Speaker 1 And you know what's weird too?

Speaker 2 Because I don't want to turn this into like a personal doctor visit, but like I, for real, had like crazy brain fog. Like, I couldn't, I was like messing up, recalling words.

Speaker 2 And a lot of my mom's side had

Speaker 2 like dementia stuff when they got older. So I started being like, damn, I might be like getting like early dementia.

Speaker 2 And as soon as I learned about the high A1C, and I don't know if that's like high enough to cause brain fog, like I was like, forget, I forgot the word croissant.

Speaker 2 I was like trying to think of that word, couldn't think of that. But I, as soon as I got off all the carbs, and now I'm like basically doing like keto, my brain just like came right back to life.

Speaker 2 It's pretty nuts.

Speaker 1 Yeah, I mean, I don't know that that's related to the A1c per se, but fluctuating levels of blood glucose are make it just a little more difficult and and some people are more sensitive to it than others some people

Speaker 1 you know they can eat all the carbs in the world and it doesn't seem to phase them and a lot of people are like no the moment i go to slower carbs or just no carbs at all or just more complex carbs my energy levels normalize and so too does my attention yeah dude that's that happened for me and i also don't uh i don't you have to eat as much like i was eating so much man it would be like four cups of rice i'd be I was just pigging out.

Speaker 2 Yeah. And then as soon as I stopped eating that much carbs, I eat like two meals a day, and they're pretty sparse.

Speaker 1 So tell me about these pictures here. What's

Speaker 2 Michigan's?

Speaker 2 This, I just figured it was funny because it's just kind of like a

Speaker 2 just an ample naked lady sitting at a picnic. So I like saw that.
I literally picked the pictures very quickly. This one, I just wanted very intense imagery.

Speaker 1 Yeah.

Speaker 2 And so this is kind of like, you know, this is pleasant. It's a little complicated.
You have.

Speaker 1 What do you think is going on here? Why is she naked? And who are these guys?

Speaker 2 These guys are up to no good for sure.

Speaker 2 I think these guys, it looks like they just got happened upon. And someone's going, what the hell are you doing with that ample naked lady in the park? And this guy's

Speaker 1 like fully dressed. Yeah.

Speaker 1 Who's the girl in the background?

Speaker 2 So to answer your first question, this is a clothed male, naked female. It's a fetish.

Speaker 2 That's going on. And I think she's kind of like next.
I think they're like, get over here.

Speaker 2 Stripped down so we can have a naked picnic. This caused a serious uproar back in the day when this guy painted this, it was a problem.

Speaker 1 I believe, I mean, I can see why.

Speaker 2 They were like, if you had someone pose, this lady had to have been a prostitute, and they're like, that's totally scandalous.

Speaker 1 Yeah, what year approximately was this?

Speaker 2 I wish I knew. I don't know.
If I had a guess, I would say, like, maybe the

Speaker 2 late 1800s, if I had a guess, but I could be wrong. And I don't know what that guy's hat's all about over there, but yeah, I mean, it's sort of.

Speaker 1 I don't want to profile him, but I have thoughts.

Speaker 1 True.

Speaker 2 It is a hat. I don't recognize that hat, and I do have my own suspicions as well.

Speaker 2 But yeah, I don't know. I don't know if he's like, I don't know what's going on.
He seems kind of distracted. I think he's being caught.
She's just kind of getting caught.

Speaker 2 There's just a lady in a pond, maybe, just kind of floating around.

Speaker 1 Oh, that's interesting. So I see that now.
I thought she was picking up apples, but maybe she's washing her hands

Speaker 1 in the pond.

Speaker 2 You know, one could only guess why.

Speaker 2 But yeah, so that was cool. I thought that was a fun one.
This is very intense. I like this.
And then I just, you know, toss a little crucifixion up there.

Speaker 1 Yeah, it's the rainbow crucifixion.

Speaker 1 I don't know my biblical history well enough to, I would embarrass myself if I asked dumb questions, but

Speaker 1 is there a rainbow after

Speaker 1 the crucifixion?

Speaker 1 I would hope so.

Speaker 2 You know, God was rising back to heaven two days before, so I'd hope that.

Speaker 1 No, I thought it was three days after that.

Speaker 2 Three days, my bad. Yeah, three days.

Speaker 1 Yeah, so that foreshadowed maybe the resurrection.

Speaker 2 Could be, yeah, it could be.

Speaker 2 But I honestly don't know. I don't have any real knowledge of it.

Speaker 1 Can you imagine how brutal the world was when we crucified people i think about it all the time

Speaker 1 how lucky are we to live in this candy ass world of softness dude i try to tell it to people and i have people tell me i'm so grateful it's insane because i try to tell people i'm like dude it was way different and other people like like those guys were thieves right yeah like that today you wouldn't even go to jail

Speaker 1 in most cities yeah they'll kill you yeah and then you get crucified yeah And it also,

Speaker 2 the procession was like a pretty nasty part of it. Just get walked through the streets, spit upon, rocks thrown at you.

Speaker 1 I just, I can't, I can't fathom.

Speaker 2 Dude, the social anxiety.

Speaker 1 And by the way, that's only 2,000 years ago, which in the arc of human history is yesterday. Nothing.
That's nothing.

Speaker 2 That's what I try to tell people, man, because there's a lot of people who are like, everything's always been the same. It's just different variations on the same themes.

Speaker 2 And I'm like, dude, it's gotten so much different from 2,000 years ago. It can still get so much different.

Speaker 1 Think about 500 years ago, right? Think about if you could be you

Speaker 1 or you could be the king of England 500 years ago with like, you know, now it sounds great until you get like a dental abscess and you realize there's no AC, there's no heat, the food sucks. Yeah.

Speaker 1 Like,

Speaker 1 I don't think you're going to be the king of England 500 years ago. I think you.

Speaker 2 Food still sucks in England.

Speaker 1 Now,

Speaker 2 yeah, that's a good point because you could.

Speaker 1 It's probably pre-fish and chips.

Speaker 2 Yeah, that would fucking, that would actually suck. I never thought about being like the king of another country.
But it would be pretty terrible. There was a king in

Speaker 2 some medieval time, like longer ago than that, but they thought alcohol was like health stuff back in the day. It was like the spirit.

Speaker 1 It kind of was because water was so contaminated, right? So you basically had two broad cultures that emerged from either the fermentation of alcohol, of water, right?

Speaker 1 And alcohol to make, to get rid of the bacteria, or tea, right? You have sort of the rise of the sort of tea culture where you boiled water.

Speaker 1 But yeah, the idea that you were just going to go and drink water was like,

Speaker 1 the fact that we're sitting here drinking this is incredible.

Speaker 2 It's pretty tight, actually. But yeah, they had a king.

Speaker 2 They rubbed him down in brandy, maybe.

Speaker 2 And then they were like, all right, we're going to rub this all over his body. And a candle got too close and just burnt the guy alive.

Speaker 2 And all the high priests or whatever had to be like, oh, you must have been fucking evil.

Speaker 1 Yeah. It's fucked up.

Speaker 1 No one put two and two together. They didn't understand exothermochemical reactions.

Speaker 2 Damn, dude. So.
So let me ask you this. What is your,

Speaker 1 the gist of your book is basically, and again, correct me if I'm wrong, but the gist was basically like we can pre-screen better and we can kind of promote wellness rather than waiting till somebody has like a horrible often irreversible disease and like try to fix it through kind of like nuking the yeah and and and part of it is like you know what gets measured gets managed and so medicine 2.0 measures lifespan as the ultimate outcome which is that's been productive that's that's a good thing to measure i don't i'm not suggesting we shouldn't care about lifespan because 150 years ago lifespan was 40 years today it's 80.

Speaker 1 that's insane we doubled lifespan. And that's all due to medicine 2.0.
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Speaker 1 Basically, figuring out how to not kill women when they gave birth to children, how to keep babies alive when they were born, how to fight infections, how to wash our hands, like that.

Speaker 1 And a little bit of stuff around trauma and critical care, like you doubled human lifespan. But we're not managing health span.

Speaker 1 And so part of the argument is, okay, we've done pretty well on lifespan. We could do better, but we really have to manage health span.

Speaker 1 And so if we think about things that make up health span, it's sort of like how much muscle mass do you have? How strong are you? How much endurance do you have?

Speaker 1 How much flexibility and balance do you have? How quick is your cognitive performance? You know, how happy are you? How are your relationships? How much joy do you have in your life?

Speaker 1 These things are softer and squishier. Some of them are pretty easy to measure, like VO2 max and muscle mass and strength.
Some of them are harder to measure, like cognitive performance.

Speaker 1 But if you don't measure something, there's no chance you're going to manage to it. And I would just argue we have to, we have to slightly tilt in the direction of doing more on that front.

Speaker 2 Yeah, it'd also be cooler to go to the doctor and have him like hit the treadmill. Let's check your VO2 max.

Speaker 1 Yeah, let me see how long you can dead hang for. Let me see your grip strength.

Speaker 2 That'd be so much better than sitting there and just being like basically getting molested and leaving.

Speaker 2 That's all you do. You go there and they're like, all right, we're going to, what's this coffee?

Speaker 1 Why do they do that? Why do they hold your. It's funny.
I thought you were going to ask me to do it to you earlier when you said this is not an appointment.

Speaker 1 I literally thought you were going to whip your junk out and and check.

Speaker 2 I'm just going just for the A, dude. You got to do the butt.

Speaker 1 They're checking for a hernia.

Speaker 2 Is that what it is? Yeah.

Speaker 1 Yeah.

Speaker 2 But why is that like the top of the pops? Yeah, there's so much other things to check. It's like, we're not going to do all this other stuff that'd be useful.

Speaker 1 I'm not going to look at a bunch of things, but I do want to stick my finger in the inguinal canal. That's what I'm saying.
Yeah. And I'm going to make you cough.

Speaker 2 I'm glad, you know, they do that, but it's like, why did that get picked as opposed to all of this other stuff you're talking about?

Speaker 2 Do you think it has something to do with like just like institutional, just repressed homosexuality throughout the entire culture? And that was like I don't know.

Speaker 1 But I will say this, like I can't tell you how many rectal exams I've done. And then I realized like,

Speaker 1 I mean, technically a good, a good urologist will tell you that their finger is good enough to truly feel a prostate cancer that would otherwise not be picked up on a PSA or some other test.

Speaker 1 And I'll take them at their word, but I think for the rest of us who don't do 20 a day, yeah, I just, I don't think my finger is good enough you know don't say that i mean i'll work harder but yeah that's crazy so they're saying they can just feel like it's just they've said like look man you know there's always that one case that slips through the crack where the guy has a normal psa no pun intended yeah she's

Speaker 2 so they can't tell yeah and but they're like yep if you feel a certain type of super hard nodule on the prostate that would be suspicious damn yeah yeah that is i i do i i think they really could if you know if doctors would embrace that it'd be so much more fun.

Speaker 2 You go, you kind of run on the treadmill, dead hang, you know, they can talk to you a little bit about, it just seems so kind of sterile.

Speaker 1 Plank. Yeah, there's like a bunch of basic tests everybody should be able to, we should be able to see the people do.
I completely agree.

Speaker 2 Yeah, I know, that's so I did really like your book for that reason. Hopefully that kind of stuff takes.
So what, what is, so if that's the scope of the book, where do you stand now?

Speaker 2 Has anything changed in that time? Is there anything that's like latest and greatest that's kind of like blowing your mind right now?

Speaker 1 I think my thinking is always evolving. I would say

Speaker 1 if I were writing that book today, I would actually kind of add a fifth horseman,

Speaker 1 which is anything that pertains to a weakened immune system.

Speaker 1 So I'm just getting over a cold because I have three kids and two of them are young. So basically I'm always in the, I'm always in the face of like some virus, right? Yeah.

Speaker 1 So twice a year, I always get some stupid cold and it's no big deal. You know, it starts in my throat, blah, blah, blah, it gets into my lungs.
I hack up a bunch of junk and then I'm fine.

Speaker 1 But you know, anyone who's been around older folks realizes that that's the kind of thing that can tip them over the edge when they're 80 years old.

Speaker 1 You know, a really bad infection, a flu, COVID, things that us, you know, 50 year olds laugh at can become deadly.

Speaker 1 And so

Speaker 1 from a research perspective, this is something I'm super interested in is how do we regenerate the immune system? So, you know, I'm in my 50s. My immune system is also in its 50s.

Speaker 1 Would it be amazing if when I'm in my 80s, I could still have an immune system that's maybe like in my 50s or 40s?

Speaker 1 The effect that that would have against, you know, mitigating the risk of fatal pneumonias, infections, and even cancers is huge because the immune system is the first line of defense against cancer.

Speaker 1 Oh, really? Yep.

Speaker 2 Didn't they used to use like fevers for that too? They would induce fevers to try to kill certain types of cancer.

Speaker 1 Yeah, and it wasn't very successful because it's so nonspecific. Oh, okay.
Yeah.

Speaker 1 Cancer is the only way for the immune system to eradicate cancer is it has to you have to get the very, very, very specific T cell that recognizes exactly that cancer, and you have to figure out a way to make enough of them that it, you know, wins that war.

Speaker 1 And that rarely happens spontaneously. I mean, the cases are

Speaker 1 documented in the literature. They're so rare.
But we now have drugs that can make that happen in about 10% of cases. That's pretty huge.
Yeah, that's pretty crazy.

Speaker 2 So, how, how would you, how would you, what does your research yield it? How do you think you can bolster the immune system?

Speaker 1 Or like, I mean, it depends how, I don't know how technical the audience wants to get into this stuff, but

Speaker 1 so stop me when this has become unbearable. For sure.
So the, you know, we have DNA. Okay.
Okay. So everyone's heard of DNA.
DNA is the code that tells every cell how to make a protein. So

Speaker 1 what tells DNA to turn on and off are

Speaker 1 something called methylations, little carbons that stick on the backbone or something called the epigenome. So DNA is regulated through this methylation pattern.
And as we age, that changes. Gotcha.

Speaker 1 So we can look at a T cell, which is the type of cell that fights a cancer or an infection, and we can say, that's what an old one looks like. That's what a new one looks like.

Speaker 1 Even though the DNA is the same, the epigenome above the genome, this methylation pattern looks different.

Speaker 1 And so the question is, what if we took the methylation pattern of an old T cell and made it look like a young T cell? Would it revert into a young T cell? So to me, that's that's

Speaker 1 certainly top two or three most interesting questions in aging research today.

Speaker 2 That's pretty cool. And that makes sense because it's like the DNA, you're born with it, and then the EPA layer, that's like the kind of like pattern that's affected through the environment.

Speaker 1 That's what regulates it, exactly.

Speaker 2 Yeah. And then, so if you can kind of get into that, and then so you could, and it was stress too, because I noticed that was a big thing in your book.

Speaker 2 So, and you can stress yourself to the point where your epigenome will just start being like

Speaker 1 everything in the environment can affect that. So it's affected just naturally through aging.
So the passage of time affects it, but so does anything in the environment.

Speaker 1 So whether you exercise, whether you smoke, whether you have diabetes or not, all of those things, good sleep, bad sleep, high stress, low stress, anything can tweak that in the right or wrong direction.

Speaker 1 Damn, okay. That's pretty cool.

Speaker 1 But the gravitational pull of age is huge. And that's the one I'm most interested in is like, how would you.

Speaker 1 Because even the healthiest 80-year-old has nowhere near the immune system of an unhealthy 30-year-old.

Speaker 2 Yeah. Yeah.
And we also, we saw that. Everyone was hoping against hope that Mike Tyson would just knock out Jake Paul.
And that was kind of like a bitter moment for a lot of people.

Speaker 1 Yeah. He could be like

Speaker 1 age is not. He just can't do it.
Yeah. Father Time is undefeated, as everybody said.
Yeah.

Speaker 2 Even with the, even with like the TRT, what are your thoughts on that? Like in terms of like, you know, what age to kind of smash the glass and just go

Speaker 1 full upgrade? I don't know that there's an age I would do it.

Speaker 1 I mean, I think the things that I would, you know, I had a long talk with a patient yesterday about this exact question, and he's pretty young. He's like 36,

Speaker 1 does not have kids, but wants to have kids. So that's a huge consideration.
So in his situation, I would say like TRT is not a good idea.

Speaker 1 I suggested that he bank sperm. And if he wants to go down that rabbit hole, And by the way, I don't think he needs to because I don't think his level, his levels are like kind of 50th percentile.

Speaker 1 He's not terribly symptomatic.

Speaker 1 I would kind of eke out a bit more time, but I would rely on hormones that are going to ramp up his body's production of testosterone as opposed to just giving him testosterone, which will shut off his body's supply.

Speaker 1 Forever?

Speaker 1 No.

Speaker 1 And it also, it's not something that happens overnight. Like, you know, he'd have to be on testosterone for a while before he would shut down his own production.

Speaker 2 Yeah. So, what are your thoughts on that? On that whole thing, especially for 30-year-olds, do you think it's good to kind of have that, or do you think it should be kind of a long road?

Speaker 1 I think you got to, I think you got to, you know, take every case individually, but if a 30-year-old

Speaker 1 has testosterone that is so low that it's impacting him, I think you have to start by asking why. Right.
Like, how bad is his sleep? How bad is his stress? How bad is every other factor going on?

Speaker 1 I mean, when I finished,

Speaker 1 God, when I was,

Speaker 1 you know, leaving my residency, my testosterone was 227, I think, which is insanely low. That's, you know, that's only two and a half times higher than a woman.
What? Yeah.

Speaker 2 Is that why doctors' hands are so soft every time they shake them?

Speaker 1 No, that's for the rectal exam. So you just don't need to.

Speaker 2 That's true. That's true.
You wouldn't want to be my dad's.

Speaker 1 But the reason is pretty clear, right? Because I was sleeping 28 to 30 hours a week. Damn.
Right.

Speaker 1 So, you know, horrible sleep deprivation is going to make it really difficult to make appropriate levels of testosterone.

Speaker 2 And that makes it harder for you to sleep, too, when your testosterone gets lower?

Speaker 1 I think probably a little bit, but the causality is much more in the the opposite direction, meaning the horrible sleep is destroying

Speaker 1 the production of testosterone and growth hormone.

Speaker 1 So, but of course, at the time, it never occurred to me to do anything about it.

Speaker 1 And once I, you know, was in a job where I could actually sleep each night,

Speaker 1 lo and behold, my testosterone kind of normalized.

Speaker 2 It peaked up. Yeah.
Well, do you think that's a good thing for people to actually look at?

Speaker 2 I always get the feeling that if you even go into one of those places, they're going to hard sell you and you'll be on the T like before you know it.

Speaker 1 I think you should not go to,

Speaker 1 I'm trying to think of the right analogy.

Speaker 1 If you walk into a store that only sells hammers, everything's a nail. Yeah.
Right. So

Speaker 1 I think if you walk into a tea shop and all they do is male hormone optimization, I would say buyer beware. Yeah.

Speaker 1 Because they, even if they internally have the best of intentions, like I just don't think they can get out of their own way.

Speaker 1 I also think you should be very wary of

Speaker 1 going to a place for

Speaker 1 any sort of therapy where they're selling you the therapy.

Speaker 1 If my whole shtick is I'm here to, you know, give you the best hormones or supplements or whatever. And oh, by the way, on your way out, we'll sell them to you.
It's just such a conflict of interest.

Speaker 1 Yeah, yeah. So

Speaker 2 what do you think about the, like, even like the internet companies that are like, like I did one, I don't know if it's nice to like name it or not, but like the ones that like you mail like stool sample blood saliva and they're like here's precision supplements for you and you alone how do you think they're like how much of that is kind of generic and do you think some of those companies are really dialed in or like

Speaker 1 um I don't doubt that there are ways to kind of sort of optimize supplements around biomarkers um

Speaker 1 I just I'm not sure that it's as precise as people want to believe. I certainly don't think that

Speaker 1 I actually think you can do a lot of supplement optimization off really basic blood work. Like, I don't think

Speaker 1 certainly, you know, a stool sample is not necessary because most probiotics can't even provide the bacteria you need to impact it. I mean, your diet has a far greater role.

Speaker 1 Your fiber content has a far greater role on your gut biome and things that you'd be measuring in stool.

Speaker 1 And obviously, saliva, blood, urine can measure things that are relevant and interesting.

Speaker 1 There aren't that many things that I think are worth taking. Like, I I think, yeah, if you're low in vitamin D and you're not getting enough sunlight, that makes sense.

Speaker 1 But that's a pretty simple blood test. If your homocysteine is elevated,

Speaker 1 yeah, you probably should take some methylated B vitamins. And if you drop it by more than five or six points, you're probably doing a lot.

Speaker 1 If your omega levels are low, fish oil probably helps if you're not willing to eat three servings of fish a week.

Speaker 1 But the true basics of this are really simple. And then there's other supplements that probably make sense for most people.
And you don't even need to test for them.

Speaker 1 Like anybody who's active could could probably justify taking creatine. Yeah.

Speaker 1 And there's no blood test that's going to tell you whether or not you need it. We just know that, you know, to fill and saturate total body storage, you're going to need three to five grams per day.

Speaker 2 So, you know, really, that's, yeah, that's, that was surprising. That was like something I heard like in college, like, you know, years ago when I'd lift weights.

Speaker 2 It was like creatine was almost like viewed as like a serious kind of like bodybuilder supplement. Now everything I read is like, no, everyone needs a ton of creatine.

Speaker 1 Yeah. I mean, again, it's just, if you're playing the game of optimizing, you're going to to get a benefit, probably about a 10% boost in performance for

Speaker 1 intensity and

Speaker 1 like super short intensity, i.e. the creatine phosphate energy system.
So kind of like high bursts of, you know, 10-second work and then anaerobic stuff. It's not going to improve much aerobically.

Speaker 1 Yeah. But and you'll also get a little hypertrophy benefit because the muscles will get bigger when they bring more water in.
That makes sense.

Speaker 2 Yeah. If like my kids are like seven feet away and they're not listening, I could just fucking run at them.

Speaker 1 Easy. What the fuck are you doing?

Speaker 1 easy

Speaker 2 just hook them down yeah that that's and that's my thing with fitness a lot of people and I'm sure I mean I don't know if you've heard this you're you're kind of uh I'm sure your like listenership is very health oriented but a lot of people get very like I don't know like very kind of scoffed they kind of scoff a lot of this stuff where they're like who gives a shit and it's like and I feel bad because like I do get it if you're like in a job you hate and you're just totally crushed down by like your life circumstance having somebody be like dude eat a banana and do jumping jacks you're gonna be like dude fuck you i don't want to think about this.

Speaker 1 But it also will make your life better.

Speaker 2 Like, I always like, whenever I lose sight of that, whenever I get too into my own, like, just stuff where I'm like, this isn't going well. I don't have time.

Speaker 2 If I just take like an hour, any, even a half an hour, and just like run as fast as I can, it's like, I feel fuck, like, amazing. Yeah.

Speaker 2 And I always say that's like a nice dimension you can add to your life where it's like, everyone's like, you know, like, I want to get better in my job.

Speaker 2 It's like just adding that, like, time yourself running 100 meters and then try to get a better time next week. It is like, it gives you something you're kind of making progress in.

Speaker 2 And it also, you feel like great as a result.

Speaker 1 Yeah, I think this is where kind of social media really distorts reality. And the example you give is a great one, right? So if you're, if your

Speaker 1 health sucks and you, you know, you're trying to figure out where you're going to find an extra two hours a week to do some form of self-care, the last thing you need is some idiot influencer telling you to spend more time in the sauna and cold plunging.

Speaker 1 Like, I can promise you that is not the first, second, third, fourth, or fifth best use of your time if you only have two hours a week.

Speaker 2 How would you break it down then?

Speaker 1 If you've only got, so, you know, I would start with what's the, let's do the absolute basics of blocking and tackling.

Speaker 1 So first thing I want to know is, are you getting at least seven hours of sleep a night?

Speaker 1 Because if you're not getting at least seven hours of sleep a night, it's going to be very difficult for you to do anything. at your best.

Speaker 2 So let me,

Speaker 2 I don't want to interrupt you.

Speaker 2 My question with that is, say like, you know, say you are tracking your sleep and you only get like 43 hours of deep sleep every night, even though you go to bed at like a proper time.

Speaker 2 Does that matter as much of like REM versus deep sleep or like

Speaker 1 assuming 43 minutes, but 43 minutes? Yeah, I wish it's fucking 43 hours. I only get 43 hours of deep sleep a year.
I'm doing the math quickly. Oh, God.

Speaker 1 I don't know. If you feel, if a person says, I feel really well, and there are these, I link to them in the book.

Speaker 1 There are a whole bunch of surveys you can get for free that just have you do like, you know, these are validated surveys that kind of go through daytime drowsiness and stuff like that.

Speaker 1 If you're in bed seven to seven and a half hours a night, ideally eight, and you're, you know, your little sleep tracker says you're sleeping seven, but you're not happy with your stages, I wouldn't put a lot of stock into that unless you feel that there is a problem.

Speaker 1 Got you. But if you're like, no, I feel fine, and I fill out all the two surveys and they said I'm doing fine, ignore the data.

Speaker 2 That makes sense. And stop worrying the tracker.

Speaker 1 I know. I got to stop.
I'm done with the tracker.

Speaker 2 I was checking every day.

Speaker 1 I'm like, 43 fucking minutes. Yeah, like it just creates more anxiety.
It's just red.

Speaker 2 I see red numbers.

Speaker 1 I haven't used, I haven't used one of those in a longer time than I can remember. Yeah, yeah.
So

Speaker 1 just do the next bucket. Yeah.
So then the next bucket I want to know is what are, you know, what's your physical activity level? So let's say this is a person who's got none.

Speaker 1 They're doing none. And they say, look, I've only got two extra hours.
I'm putting that entire two hours into exercise. So I'm going to say, we're going to do four 30-minute workouts a week.

Speaker 1 And, you know, again, I'd have to know more about the person, but it could easily end up being we're going to do two cardio sessions a week. We're going to do two strength sessions a week.

Speaker 1 One of those cardio sessions per week is going to be kind of aerobic base training where you're going at the same intensity the whole time. It's not that high.

Speaker 1 You can still sort of almost carry out a conversation. It's a little hard to talk, but you could.

Speaker 1 And then the other cardio session I would do, say three days off of that, would be more interval, kind of like what you were describing.

Speaker 1 So let's get on a, you know, if you, if you're at a gym and they have one of those like, you know, um, air bikes, do something there, be on a treadmill, be outside. It doesn't really matter.

Speaker 1 Like the goal, like this person will get so much benefit from two hours a week of exercise that it almost doesn't matter what they do. And then the other two days a week, I'd have them do

Speaker 1 two 30-minute whole body workouts at a gym where they never stop moving. Okay.
So if you're doing it at home, it might be push-ups, pull-ups,

Speaker 1 wall sits, something like that. If you're at the luxury of being at a gym, you might just rotate machine to machine to machine and never stop.

Speaker 1 And that would, I mean, that would just bring huge huge dividends. And then the last thing I'd do is, in addition to that, is just do a quick audit of their diet.
Yeah. You know, are you overweight?

Speaker 1 Are you adequate weight? Are you underweight? That determines whether you need to eat more or less. And then are you getting enough protein?

Speaker 1 And honestly, like, I wouldn't make it much more detailed than that. And so, look, with, with just a little bit of that insight, you've made better use of two hours a week.

Speaker 1 You've got them to stop worrying about their sleep. You've maybe changed three little things in their diet.
I promise you, that person in three months is going to feel significantly better.

Speaker 1 And then, maybe, by the way, at that point, they're like, you know what? I wouldn't mind doing three hours a week of this exercise thing because I'm feeling kind of good. And you know what?

Speaker 1 I kind of want to dial the diet in a little bit more.

Speaker 1 But again, the problem is too many people are consuming information that says, oh my God, you need to be on this supplement. You need to be on this supplement.

Speaker 1 You need to be doing 30 minutes of this type of sauna and 20 minutes of this type of cold plunge. And people are like,

Speaker 1 shut up. Yeah,

Speaker 1 like, I can't do that. Yeah.

Speaker 1 I mean, and to be clear, I love Sana and I love Cold Plunge, but it is like the 20th thing on my list of 21 things that is a part of my routine.

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Yeah, that makes sense, man. That's actually cool to hear because it is like the solution is pretty basic and simple.

Speaker 2 And that's the thing that gets me bummed out when like, you know, because I do think we live, and I could just be wrong, but I feel like we live in a pretty nihilistic kind of age.

Speaker 2 And it's like, it does suck when that spreads. It's like a physical nihilism.
What the fuck's the point of even where? It's like, dude, you'll feel so much better.

Speaker 2 If I don't work out, I get depressed. It's like A to B easily.
If I don't do it for like two weeks, I'm just like depressed and sad.

Speaker 2 And it's like, if you don't do it, it's just, yeah, you feel terrible. And I always, I always like to try to, you know, like, just get up and move your fucking body, man.
There's so much sense.

Speaker 2 There's so much better.

Speaker 1 We were meant to move.

Speaker 2 We were. And meant to be outside.

Speaker 1 That might be the other thing I would add:

Speaker 1 figure out a way to do something outdoors, like whether it's a quick walk or incorporate some of that exercise outdoors.

Speaker 2 You know what I started doing? Skateboarding. At my ripe old age of 38.
Oh, just took it out. I just took it back.
I've been doing it when I was little and I just started it.

Speaker 2 And it's weird doing that. That's a real eye-opener when you take an activity activity you did in childhood effortlessly.
You're like, let me try this again at 38.

Speaker 2 Dude, I, I swear I burnt 900-something calories. I skateboarded for an hour and 20 minutes and I was, I was dying.

Speaker 1 That's awesome.

Speaker 2 Cardio-wise, I was, I was just doing like a little pump track where you kind of just like ride up on a wall. Dude, I thought I was going to die.
I used to do this all day when I was younger.

Speaker 2 Now I'm like, it's like a real eye-opener to be like, all right, where am I at? Because I do feel like, especially,

Speaker 2 I guess men and maybe women do it too, but men specifically over-index. Like, I'm good.

Speaker 2 And it's like, try something that you did when you were younger and you're like holy shit i'm gonna pay my heart rate was at like 170 the whole time just skateboarding and i wasn't even i was barely pushing i just had to like balance myself on this track it was it was amazing though i i agree with you it's like find something you know to do and just kind of i don't know i feel like uh

Speaker 2 i do feel like we get too tunnel visioned into like the career stuff and it's like we need to you need to do that to survive but it's like the the sacrifice of hours of time like the quote unquote rest time into like physical activity just pay dividends and all the other things you're trying to do anyway.

Speaker 2 But yeah, I always sound like a broken record, but I'm like, dude, it's so important, man.

Speaker 1 It really is.

Speaker 2 So, yeah, skateboarding is awesome. We should go one time.

Speaker 1 Do you skate? Nope, I do not at all. Have you ever? Nope.
And it's funny. I mean, growing up, I was certainly of that age when a lot of kids were skateboarding.

Speaker 1 I don't know why it just never appealed to me. Yeah.

Speaker 1 I was sort of busy in my own little world.

Speaker 1 My daughter did for a little bit. She's 16 now, but she did probably like when she was 12, 10, 11, 12, she was pretty into it.

Speaker 1 The coolest thing I've picked up recently, though, it's not a physical activity, but it's, I'm freaking obsessed with it, is chess. Really? Holy cow.

Speaker 2 How do you, how are you? Pretty good?

Speaker 1 No, I'm horrible. I mean,

Speaker 1 but I love it. Like, I can't stop playing.
I just can't stop. Who are you playing against? I'm just playing my boys.
Really? Literally, just the three of us.

Speaker 1 Phone chess or physical chess on the board. That's good.
Writing down every move, studying our moves after. Really? Like, nerding out, watching YouTube videos.

Speaker 1 I'm obsessed with this guy, Magnus Carlson, who's the best chess player in the world. Actually, dude,

Speaker 1 I can't stop watching chess porn. Really? Can't stop.
That's awesome. Can't stop.
You know how YouTube figures out what you're about?

Speaker 1 Like my videographer for our podcast, he comes, he pulls me aside like three weeks ago. He goes,

Speaker 1 Are you getting into chess? I'm like, how do you know? He goes, because like I'm managing our YouTube channel and like it only populates just, it's just like pushing chess stuff all day.

Speaker 1 That's awesome. Yeah, dude.
I can't stop. It is good for your brain.
I stay up at night like watching chess videos. Do you really? Oh, it's awful.
I'm like, it's 9.30. I should go to bed.

Speaker 2 What's the open, what's your opening move?

Speaker 1 What do you go with? Oh, I'm typically like E4, you know, but I like to, I like to castle really early.

Speaker 1 So I'm going to try to castle within about three or within four or five moves if I, if I'm doing a kingside castle. Really? Yeah.

Speaker 2 I like the first move, the horse, just over your pawns and be like, what's up? Yeah. It's called, there's a name for it.
I forget what it's called.

Speaker 1 It's like English or something, but I like the horse. I fucking bang.

Speaker 2 Here's my motherfucking horse. Yeah.

Speaker 1 No, the knight's cool because, again,

Speaker 1 he can hop over people. He moves in that fucked up L-shaped pattern.

Speaker 2 But yeah, I love chess too. That is fun.
I just say, yeah, I don't have anyone to play it with. That's the thing.
It's like, I don't, and I don't, it's, it's, how long does a chess game take?

Speaker 1 One of my boys is super aggressive, so the games are quick because he just comes out swinging. Does he really? Oh, he swings.
I like that. He goes for the fences.

Speaker 1 And then the other one is so conservative and so thoughtful that the games take like like so long.

Speaker 1 And I got us a little timer, too. So I'm like, buddy.
That's nice. Yeah.
Two hours to make the first 40 moves or you're disqualified. That's good.
Yeah, yeah, yeah. That's good.

Speaker 2 Yeah. You got to think on your feet.

Speaker 1 And the younger one, the one who's super aggressive, is so competitive. Like if anyone in our family ever makes it and becomes like

Speaker 1 great, it's him. Because you can't like the fire is insane.
Really? When he loses, he tears up his sheets. And I'm like, buddy, you shake my hand and we had a good game.
He's like,

Speaker 1 he's just losing his mind that he lost a game of chess.

Speaker 2 It's war. Yeah.
It's war. Is it true that the possibilities of the chessboard are kind of infinite?

Speaker 1 They are truly infinite. That's crazy.
It's a computationally infinite problem.

Speaker 1 Damn. Or as close to, I mean, I shouldn't say infinite, right? In that AI can.

Speaker 1 Yeah. But, but it's from a from a practical perspective, I think it's infinite.
Damn. That's awesome.
That is cool. How old are I?

Speaker 2 I'm going to try it. My kids are too young for that.
Me and my daughter did a like one of the.

Speaker 1 Your oldest is six? Four. Oh, four.

Speaker 2 Okay. Four.
Six could be. Six is doable.
Four.

Speaker 1 It's totally doable.

Speaker 2 I did chess. We did one of those big ones.
We're on vacation. We did one of those, like, you know, those like huge outdoor chess boards with the big pieces.

Speaker 1 Yeah.

Speaker 2 We did it, and I tried with my four-year-old. And by the end of it, it was like the mommy and daddy were queen and king were mommy and daddy and the pawns are all of our babies.

Speaker 2 And I was like, all right, man.

Speaker 1 It all sucks.

Speaker 2 But yeah, man, that is amazing.

Speaker 1 I once made the mistake of, in a game, like

Speaker 1 my older one, the one who's more conservative, like he had, you know, he had a rook knight bishop in the back that hadn't moved. And it was like 25 moves in.

Speaker 1 And I'm like, buddy, those guys over there are standing there like they got their thumbs up their butts. And now those two boys cannot stop saying that.

Speaker 1 They just walk around every anytime someone's not moving. Why do you have your thumb up your butt? And my wife's like, why do you say this stuff to them? Like, you can't say anything like that.

Speaker 1 They're just going to say whatever you say.

Speaker 2 It's weird. It's weird because my four-year-old is like language police in our house.
She will learn that something's bad and then she's just horrified of the idea of saying it.

Speaker 2 And she's like, if we, if she hears us saying anything like, like, we even say the word hate, I don't know. We didn't, this wasn't a rule for us.

Speaker 1 Like, oh, I hate that.

Speaker 2 She'll be like, don't say that. She like polices our language.
And if we say, like, that, we said, my wife said freaking the other day. She's like, mom, it's a bad word.

Speaker 1 It's a bad word.

Speaker 2 Like, no, it's not. And she's like, and I was like, I was arguing.
My wife's like, no, just give her that one.

Speaker 2 She's like, it's pretty nuts. But yeah, that is true.
They do parrot everything.

Speaker 2 You really do got to watch what you say because you can say whatever you want around them for the longest time. And eventually you're like, oh, shit, you can talk shit on my neighbors.

Speaker 2 You can hear this.

Speaker 1 You can hear this right now.

Speaker 1 Our youngest one, when he was, this is the super aggressive one. So it's not surprising.
I think when he was like three,

Speaker 1 we got a call from the preschool and they're like, yeah, you got to come and get him. My wife's like, what's going on? They're like, he said the F word.
Whoa. My wife's like, oh,

Speaker 1 I'll be right there. But I made you get him for that? Yeah.
I'm like, this is a misunderstanding. And my wife's like, first of all, the kid is obsessed with rhyming.

Speaker 1 So he almost assuredly was like, truck, truck, fuck, or something like that. And the woman is like, nope, nope.
He's actually the first kid we've ever heard use it properly. Oh, no.

Speaker 1 They're like, what was the situation? And they're like, well, he was in circle time and

Speaker 1 we were telling all the kids they had to be quiet. And he wasn't being quiet.
And we're like, hey, if you're not quiet, you're going to have to get up and leave. And he wouldn't be quiet.

Speaker 1 So we got up and made him leave. And he stood up, apparently, and just goes, fuck it.

Speaker 1 And then walked and got out of the corner.

Speaker 2 Like, that's a coincidence.

Speaker 1 Yeah. I'm like, I don't, I think he learned that from his mom.

Speaker 2 Yeah, my daughter nailed a, she dropped something one time when she was really little and she was like, shit.

Speaker 1 I was like, oh, damn it. That's, I was right on the money.
That's on me. Yeah, I was right on the money.

Speaker 2 So they made you, what are you? Like, it was like a one-day suspension?

Speaker 1 Yeah. It was like, he's on probation now.
I mean, it was like

Speaker 1 we ended up finding another preschool for him that he did great in.

Speaker 2 Oh, that's cool. Yeah, that's insane to like be like, you got to come get this kid.
Yeah.

Speaker 1 Although that could spread like wildfire amongst other people.

Speaker 1 Yeah, I guess I can see it from the point as well.

Speaker 2 No, that's lame. That's crazy to be like, he must leave right now.
But I think they got to let that kind of stuff go. That is tricky, though, man, because especially that age, it's like.

Speaker 2 Kids hit other kids and like, you know, some people are like, this is, this is like, you can't, it's like, but I don't know. I treat it like the dog park.
It's like, he'll figure it out, man.

Speaker 1 If it's really bad, there's got to be enough discomfort in the situation for the kids to evolve.

Speaker 2 Yeah, exactly what I'm saying. Yeah, because it's like, dude, you got to let they're going to do that, man.

Speaker 2 It's like, you know, me and my cousin got separated, and we were in kindergarten together, and then we went to the same school the next year, and they were like, AM class, BM class.

Speaker 1 They can't be with each other at all. But I thought it turned out all right.
That turned out all right.

Speaker 2 So before you get out of here, we are coming up on,

Speaker 2 where are we at right now, Josh? I don't want to keep you too long.

Speaker 1 Huh?

Speaker 2 Perfect.

Speaker 2 The one thing that I feel like was in the book a lot, you talked about how, and again, always correct me if I'm wrong because I always have stuff in my head.

Speaker 2 Stress was something you was really on the back burner that you kind of put to kind of like the forefront of your thinking from like a day-to-day and a health perspective.

Speaker 2 How, where do you kind of stand on that? And like, what's like, do you have any, do you have any thoughts on that at all?

Speaker 1 When I think about like

Speaker 1 what is the, what is the thing that's going to kill me fastest, I think it's undoubtedly stress.

Speaker 1 I just think

Speaker 1 it's, you know, I think it's the most insidious killer in a way because it's the hardest thing to measure directly.

Speaker 1 You can sort of measure some of its indirect actions, like on blood pressure and blood sugar, which both go in the wrong direction when stress is high.

Speaker 1 But I think there's even components of it that just

Speaker 1 even when blood sugar and blood pressure are normal, I still think it's just doing something to your brain, probably and to your heart.

Speaker 1 And again, I don't think anybody would feel good living in a zero stress environment. So it's mostly just about kind of managing how one responds to it.
And I think it goes beyond just stress.

Speaker 1 I think it's sort of like just

Speaker 1 overall

Speaker 1 like satisfaction in life and contentment and, you know, enjoying your relationships with people. You know, I interviewed this guy on my podcast,

Speaker 1 Bill Perkins, who wrote this incredible book. It's one of my favorite books.
It's called Die with Zero. And he writes about how you have basically

Speaker 1 like, you know, you have time, you have money, and you have experiences. And

Speaker 1 sorry, he talks about through health. So health, time, and money.
Okay. And you're not optimizing for the most of any one of those.
You're optimizing for the net of fulfillment. Okay.

Speaker 1 So too many people miss that, right?

Speaker 1 They're just like working, working really, really hard to get as much money as possible or as much fame as possible, or they're like maniacally focused on their health.

Speaker 1 That's the only thing they think about. Or they're just trying to, you know, live as long as possible or make as much time for certain things.

Speaker 1 But it's kind of like how you put all those things together to optimize their own fulfillment. So in this book, he writes about this idea of like people aren't doing the equation correctly.

Speaker 1 They're deferring too many experiences when they're young to do when they're old, but then they don't realize when they're old, their health is actually not, they're not actually able to do it when they have all the money in the world.

Speaker 1 Yeah. They can't go and take the incredible vacation.
Or if they can, their kids aren't with them or their kids aren't young.

Speaker 1 So I think it's just kind of reframed a lot in my mind and made me realize that, you know, when our kids are young and we are incredibly healthy, that should be the time that we invest more in fulfillment and experiences as a family,

Speaker 1 which has just been a, you know, a completely different mindset for me from where I was most of my life. Yeah.

Speaker 2 Just going kind of like full blast, make as much money as possible.

Speaker 1 Sleep when I'm dead. Yeah.

Speaker 2 Yeah. That's a big one.
Sorry about that bug, dude. That bug won't leave you alone.
It hasn't even come over to me at all.

Speaker 1 I mean, I must stink.

Speaker 2 Yeah, that is, that is kind of a cool thing, too, man.

Speaker 2 Cause you don't really, it's also something you don't really learn. Like, nobody really tells you how to manage your stress.

Speaker 2 You kind of mostly, from what I gather, you kind of just like watch your parents deal with stress and you're like, all right.

Speaker 2 And you just kind of like take those patterns and just apply them to your life. And it's like, it really does.
Like,

Speaker 2 what I've been trying to do recently is like just take one day out of the week. Usually it's Sunday because we're all off.
Everyone's hanging out. And I just try to focus on like.

Speaker 2 being as calm and at ease. That's like top priority of my day.
Usually it's like, I got to get this done. I got to get this done.
And on one day a week, I'll be like, I'm only focused today.

Speaker 2 My number one goal is to try to like stay in a state of like ease and kind of contentment. If I get out of it, I'll like before I'm like, you know, like, well, I just try to zero in on that.

Speaker 2 That's been kind of like, for me, that's been like a bit of a revelation to be like, oh, I can move through like multiple days without completely spinning myself the fuck out.

Speaker 2 And, you know, it's been, I don't know, it's been kind of nice.

Speaker 1 And what do you think spins you out? Is it just

Speaker 1 busy? It's too much?

Speaker 1 Yeah, it's

Speaker 1 a particular thing.

Speaker 2 Yeah, I mean, it could be anything. Maybe my kids not listening kind of spins me out if I'm like trying to get up the steps and it takes 40 minutes and I'm kind of like, all right, let's go.

Speaker 2 It could be anything. It could be like overwhelm, like just like situations at work I got to deal with that are just completely overwhelming.

Speaker 2 Stuff in the house, you know, it's just like lack of sleep. Because our kids are still so little that our sleep gets fucked up.

Speaker 2 But yeah, it is. It's usually like relational stress.

Speaker 2 or just like work stuff. Those are the two main things that kind of like can really spin me out.

Speaker 1 And I would argue that most work stress is relational as well. So I, yeah, I kind of agree.
I think relationships are both the best part of life and the most stressful part of life. Yeah, I agree.

Speaker 2 So that's been kind of, that's been my that's what's going on here, by the way.

Speaker 1 A lot of relational stress in that

Speaker 1 I can tell you right now.

Speaker 2 That is true.

Speaker 1 But yeah, that

Speaker 2 that is, that's kind of the thing, man. It's like, well, this is my whole point is like, you do have some say in how much a thing can like, like you can, it could, everything can floor you.

Speaker 2 Things come out of nowhere and you're like, you get caught in it. But it's learning how to be like,

Speaker 2 all right, something got me it's like laser tag like my thing's beeping i can kind of walk myself through this without like going on like a gozilla path you know what i mean yeah it's like i don't know that's been pretty helpful for me before i get caught that's that's my ultimate fate she's like babe babe i'm having a naked picnic with a prostitute

Speaker 2 she's right there and they're coming out of the water just hawking me

Speaker 2 it's not what it looks like but yeah that is that is the number one man it's like dude it's uh you know like managing stress keeping yourself physically fit because you can't, like, otherwise, like, what the fuck are we doing, man?

Speaker 2 It's like, you know, it's like, unless you're, I mean, some people are just surviving, which is, which is kind of, that sucks, but I don't know.

Speaker 1 I feel like you can even, I feel like people, there's other countries where people are just surviving, but they still do cool stuff.

Speaker 2 They have like big, ornate jugs of water, and they carry it around. They like dance and stuff.
I don't know.

Speaker 1 It's kind of sick.

Speaker 1 I'm just trying to make people happy. I don't know how to do it.

Speaker 2 Well, dude, I mean, is there anything else that's kicking in your mind?

Speaker 1 I don't think so.

Speaker 2 Well, I think you did it. Thank you for coming and doing this.
I apologize for the strange format, but how do you feel about standing in podcast?

Speaker 1 I think it's hilarious. I think it is.
This is the first standing podcast I've ever done. Bro, it's not bad.

Speaker 2 How do you feel about it, honestly? You can hurt my feelings if you feel like it.

Speaker 1 Honestly, I think I have better posture than I normally do. That's what I'm saying.

Speaker 2 When you're sitting on a podcast,

Speaker 2 you're kind of like slouching forward. Standing keeps you on your feet.
It keeps the mind sharper.

Speaker 1 Like, I feel like we're doing a political debate the way they're angled at each other, too. You know what I mean?

Speaker 1 I feel like I need a moderator to ask me a a question. That's the only thing that it would have been a little better if it was moderated.
Moderate. The discussion was moderated.
That's a good idea.

Speaker 1 I'm more heated.

Speaker 2 That's true. That is true.

Speaker 1 I want to work on being I wouldn't mind a teleprompter next time if you wouldn't mind.

Speaker 2 Teleprompter is though.

Speaker 1 So I want a teleprompter there, moderator there. Right.
A little more.

Speaker 2 For sure. Yeah.
I mean, we could bring some heat.

Speaker 1 We could bring some heat to them. If you wanted the heat, I have some burning hot questions.

Speaker 2 I didn't ask them.

Speaker 1 They're about a lawsuit, so I was like, I don't know.

Speaker 2 Why can't everyone, you can't talk about lawsuits. No one can ever talk about them.

Speaker 1 I know the lawyers say no. Yeah, why? What's the point?

Speaker 2 Bring awareness.

Speaker 1 Bring awareness.

Speaker 2 Yeah, I did. I actually, I was researching.
Just, you know, when you have someone on on the scene, I saw you're embroiled in a lawsuit, and I said, hell yeah, dude. That's what's up.

Speaker 1 So, but we won't. The lawyers won't like that.

Speaker 2 That is bullshit. You can't talk.
I mean, dude, don't do it.

Speaker 1 That is like, why? What the fuck's the problem?

Speaker 1 I don't know, whatever. Anyway.

Speaker 2 Well, dude, thank you.

Speaker 2 Dude, is there anything you want to plug? Is there any book? Obviously, read the book, dude.

Speaker 1 Read the book, listen to the podcast.

Speaker 2 Peter T. Thank you so much.
Thanks for having me.

Speaker 1 The man.