Special Episode: Ways to Improve Your Health, Performance, Endurance and Resilience

Living a Life in Full is a conversation you always wanted to have with that person who gave an amazing TED Talk or the author of one of your favorite books, or that inspirational Olympian you always wanted to know more about. It's graduate level conversations with those making a difference in the world and in the lives of others. This show brings you new ideas and approaches so that you can live a life in full. I'm your host, Dr. Chris Stout and I hope you enjoy this episode. This episode of Living a Life in Full is brought to you by ATI Physical Therapy. If you need physical therapy, choose ati. ATI offers exceptional care, trusted expertise and remarkable outcomes customized to your needs. ATI has over 800 clinics coast to coast in 25 states. We want to start feeling better fast. ATI can help address chronic pain or recovery from an injury or surgery expertly, quickly and conveniently. ATI's first program uses a performance based methodology to safely return injured workers to their workplace. FIRST is designed to increase strength, endurance and cardiovascular functioning. ATI's sports medicine provides athletic training services to help athletes get back in the game. ATI has hundreds of professional collegiate, high school, middle school and club relationships nationwide. ATI also offers a variety of specialty services including home health, hand therapy and women's health. To Learn more about ATI's advances in evidence based practice, clinical outcomes and their innovative new smartphone app, please visit atipt. Hi everyone. Welcome to another episode of Living a Life in Full. I'm your host, Dr. Chris Stout. Today's episode in the start of a new year and a new season is a bit of a departure. I don't have a specific in studio gist, but I'm going to be reviewing a piece that I wrote as a LinkedIn influencer a while back based upon people's requests to kind of get this out there and get this on the show. So it's going to be a little bit of me somewhat ad libbing to prepared notes and it's going to be a little bit of an experiment, so hopefully it goes well. The topic, as you can tell by the title, is taking a look at performance enhancing kinds of things from a health span perspective. We're not going to be a little bit of biohacking, but nothing illicit, no doping or anything like that, but really kind of covering the landscape around these kinds of issues. Some of it bleeds over into longevity. That really isn't my focus. It was more so health and performance improvement. So here we go. I'm certainly no poster boy for being a great athlete, but I'm pretty satisfied with where I'm at today and what I've been able to do, especially considering from where I started. I think this actually gives me some credibility to speak more so to the proverbial every man or woman. To some degree, I was not blessed with uber jeans or predestined to anything close to being fit or no, perhaps just the opposite. I had some orthopedic issues as a boy and I didn't really run somewhat of a rate limiting factor in most sports or even play. When combined with a killer sweet tooth, the result was a BMI of 33 by age 12. Ugh. And then puberty hit. It wasn't like a shift in hormone titration caused a biological metamorphosis. No, it was more like the desire to not spend my high school career warming the bench and never being kissed. This was the first time I really began to pay attention to what I ate and how I exercised. I started looking at macronutrients and calories. I became a vegetarian, which wasn't very common then and it's pretty rare for those living on a beef farm. Also, I think it was really a secondary function of my attempt at adolescent rebellion as my dad was the one raising those heifers. At age 13 I got my first pair of Nikes and I started to run the results. I lost 64 pounds in three months. Granted, this may have been a bit of a borderline of an eating disorder, but things normalized as I got older. Nevertheless, I remained active and a vegetarian. In the last two years I've been experimenting with a vegan diet while I try hard not to be an ugly vegan when I go out to fancy pants restaurants for work, I will have a conspiratorial chat with all of the wait staff and share with them my desire to avoid the bone broth infused head cheese appetizer followed by a bone in 12 ounces porterhouse steak. In a recent situation similar to this, one of my dinner mates, all of whom were new acquaintances, overheard of my vegan proclivity and asked what my reasons were for going exclusively plant based. He and his wife were sincerely interested and curious, perhaps considering some tweaks to their diets as well. I discussed my rationale and some data. Another person also showed interest. That was really nice and I quickly realized that I could not do justice to somewhat of a complex set of answers just over dinner. So I put together this as a piece for LinkedIn and then also now for this podcast. First of all, I am no pro what I am sharing next will not help you make an Olympic team, but anyway, this is my every person's guide to a better health span. What follows is an examination of what's available, what to look out for, and what I'm tinkering with. I hope you will find it of use and there's no laboratory required. So let's start off with talking about the word hacking. And hacking I use the word in the title herein is not as clickbait and not as a cheaty shortcut, but rather as a smart solution or ways to more efficiently make the gains you may be looking for. For example, I theorized that going vegan would be a hack for me to run further ultra distances by having less inflammation and thus a quicker recovery, and for me this has seemed to work More Caveats and Disclaimers the Half Life of Facts Just about everything you read will have something to contradict it, even in peer reviewed non fake scientific journals. Often my smart and athletic son has opined to me, why can't there just be a routine to follow that works? This was in response to researching sub 3 hour marathon time, training schedules, workouts and diets. And he's right. The humorous but true introduction to medical school students that 50% of what we teach you over the next five years will be wrong or inaccurate. Sadly, we don't know which 50% is quite true. Samuel Arbsman, a Harvard mathematician, coined the term half life of facts in reference to the predictability of scientific papers. Findings to become obsolete, we think we know changes over time, once accepted as true, will be shown to be plain wrong, as most scientific theories of the past have been disproven. It is arguable that much of today's orthodoxy will also turn out in due course to be flawed. In medical science, this can be pretty quick. By some estimates, a 45 year half life Mathematics does a better job, as most proofs stay proofs, so do keep in mind the dynamic nature of scientific understanding. Better studies, new findings, more precise measures, black swans and whatnot will all conspire to shake up the former orthodoxy. But also there's bad science and biased science. Fortunately, there are ways to counteract such without having to go to graduate school in biochemistry. Thanks to Tim Ferriss and Bill Goldacre. And if a study sponsored by the dairy industry touts the values of lactose, well, just keep who in mind? Who's paying for that study? My personal favorite site in Switzerland of nutrition and supplementation is examine.com I'll put all these links in the show notes too. They are a group of medical doctors, scientific researchers, professors and pharmacists. They keep up on the literature so the rest of us don't have to, and they explain how they have come to the conclusions and consensus on a number of nagging topics like Is saturated fat bad for me? Do I need to eat six times a day to keep my metabolism high? How important is sleep? What should I eat for weight loss? Is high fructose corn syrup worse than sugar? Are eggs healthy? Is diet soda bad for you? Is my slow metabolism stalling my weight loss? How much protein do I need every day? So take a look. Those are studies that they've actually done personal genomics 23 and you final disclaimer advice is tricky business. Most of it may not work for you, not because it's incorrect, but because it may be incorrect for you. Please note, everything may be different for everybody and while we share a lot in common, we do not share the same biology, biome, motivation, genetics, drives, proclivities, strengths, weaknesses, needs, problems, risk factors, protective factors, goals, fears, experiences, situations, traumas, victories. You get the picture. So bottom line, measure what you want, measure what matters and experiment. I saw a guy when I was running my first marathon who was smoking a cigar as he was running the marathon. I don't think I'll be puffing a Cuban in my next workout, so repeat after me. We are all very different. If 23andMe had a baby with examine.com then Dr. Rhonda Patrick would deliver. Found my fitness Dr. Patrick is amazingly brilliant. She scours the literature for relevant and properly done studies similar to the folks at Examine. But what's really cool is that you can upload your 23andMe data and she will share what studies are relevant to your specific genomic data. I did use Rhonda's genetic tool and I've also used Promethease. Both are a five dollar bargain. Promethease runs your genomic data against a Whopper database called SNpedia. It's a wiki for human genetics with more than 57,000 published gene polymorphisms. Using it provides information about your propensity for and against certain diseases. It uses the data on specific single nucleotide polymorphisms or SNPs. SNPs within your genome. Its comprehensiveness is both a blessing and a curse in that the findings are overwhelming to review and, as is, like many genetic findings, puzzlingly contradictory. I found Rhonda's genetic tool to be much smaller but more useful. Indeed, she notes, the report represents the genes I think are most interesting with regard to my focus, which is maintenance of health span in some cases. Some polymorphisms may have more obvious lifestyle intervention implications. In other cases it might just be because a gene's variation that interests me and I want to tell you about it. In all cases, however, they are picked by me and reflect my personal exploration of this growing field. In this sense, it's a living report that might be well worth rerunning periodically to see my latest revisions and possible corrections Close quote Thank you Rhonda and that's exactly what I've done when I've gotten updates on this, I just rerun them and see kind of what's what. They are very large data files. I have to keep them in Dropbox. But if you geek out on that sort of thing, then you'll very much enjoy it like I do. So listening to this, you may say, why do I care? You may think I really don't care if I'm prone to wet earwax, which is one of the things that 23andMe will tell you or not. Or I really do not know what possible disease it is that's going to take me out in a quarter century from now. And I get that. What I think is actionably helpful is the ability to personalize your nutrition. This is the brave new world of nutrigenomics or the interaction of your genes with how you metabolize what you eat. Dr. Patrick is the shiz on this topic. Some S&Ps are associated with folate metabolism or vitamin B12 absorption or other biological processing of other vitamins and nutrients. For example, if you have a variation in the FUT2 gene, you may have increased or decreased absorption of vitamin B12. If absorption is the problem, then you'd learn that the literature has found that taking your vitamin B12 from under your tongue instead of swallowing it will do the trick and you will absorb it properly. Some folks with the MTHFR variant do not properly process B vitamin supplements and need to take B vitamins in active forms like 5 methyltetrahydrofolate, methylchylambium, and a variety of other things that I can't pronounce along with the methylation pathway intermediates. And I've got links for all this too in the show notes. I think just knowing this information is incredibly meaningful to our health and fitness. So thank you again Rhonda. So here's my current experiments diet. As I noted earlier, it's I'm not trying to be an ugly vegan when going out with colleagues. So you may have guessed I'm dabbling with being in plant based and you'd be correct. Again, it's not for everyone. I'm not an evangelist, but I am a fan. I enjoy Dr. Michael Greger's work and his book how not to Die and here's a great Google talk that I'll put in the show notes as well too. As a primer, I also like his daily dozen which is 1 berries 1 serving 2 beans 3 servings 3 fruits 3 servings 4. Cruciferous veggies 1 serving 5. Greens 2 servings 6 veggies 2 servings 7. Flaxseeds 1 serving 8 nuts 1 serving 9 whole grains 3 servings 10 beverages 5 servings 11. Exercise 1 serving and 12 spices 1 serving I love that he has beverages and exercise in there too. I think that's terrific for a very informed daily dozen and a lot of folks again, from Tim Ferriss to Donald Lehman, who's a professor emeritus of nutrition at University of Illinois, recommended consuming at least 30 grams of protein for breakfast. I like it timing wise when it comes post workout or recovery when I really need it. But get it, you know, really however you wish. Being plant based makes my choices, things like legumes, greens, nuts, seeds and more. So on the weekends when I have more time and rice, pea or hemp protein shake weekdays on my drive to work. Some people prefer to have their boost of protein before their workouts when they first get up. Tim Ferriss is a fan of doing it within the first hour and that he speculates that that might help with weight loss as well. And I'll also put in I keep a kind of geeked out page on Pinterest called Gone Vegan with a lot of vegan resources, so we'll put a link in the show notes for that as well too. This will probably be the most show note heavy episode ever. While obesity is a major concern in the United States and many other developed countries due to the additional problems it begets, orthopedic issues, bad knees and joints, cancers, diabetes, hypertension, cardiac and pulmonary issues, etc. There's a growing awareness of people looking more seriously at what they eat, looking for hidden sugars, for example High fructose corn syrup, and it's a nice little thing that tends to hang out in ketchup, for example, and simply not wanting to eat bad things. There's a lot of documentaries that we'll put links into, such as Forks Over Knives, Knives, cowspiracy, Fed Up, Hungry for Change, Food incorporated fat, sick and nearly dead and vegucated that all provide concerning perspectives on what we eat and how it affects our health, our performance and our longevity. Podcasts such as Rich Rolls and websites such as Thrive Forward all act to further educate and provide tools to consider. This growing awareness is especially critical in medicine and healthcare vis a vis the recently published findings the Journal of the American Medical association that nearly 60% of Americans, the highest ever, are taking prescription drugs. I've not done a deep dive honestly into paleo or raw or ketosis, so I can't really be much help there. But I would recommend Tim Ferriss book the Four Hour Body, which really is a great unbiased perspective on almost anything and everything that's legitimate in the realm of eating, performance and health. I have to let you know there's also a controversial pushback to all plant based vegetarian diets in a book that I read called the Plant Paradox, it sounds the alarm on lectins. Full disclosure, I'm not convinced, honestly, especially in the context of my own testing and in working to better understand the process of hormetic dietary phytochemical thomerisis, which I'm sure I've misspelled that and butchered it somewhere. So please check out my website or the Gone Vegan Pinterest website for updates on what I'm able to learn. I've also reached out to Rich Roll and Rhonda Patrick and Michael Greger about this to see what they have to say, so I'll keep you updated on that as well too. Supplements this can be a tricky area. Ideally all of your micronutrients and minerals should be made available via your diet, but that can be difficult with limited time access and many other real world bothers and athletes. Needs can vary depending upon level, age, season, if they're in their sport or not. In general, vegans may want to supplement with vitamin B12 and proper levels of vitamin D and K can be tricky according to doctors Greger and Patrick. So do keep in mind Dr. Patrick's helpful points vis a vis nutrigenomics and consider getting your DNA looked at to see if your genetics are monkeying around with your ability to metabolize what it is you eat. Microbiome I have come close to being evangelistic about the role of gut health and well being as of late. I personally like inulin, a prebiotic that's actually sweet and can be sprinkled on or mixed in just about anything you'd like a little bit sweeter. In pill form, I supplement with a capsule of a strain of 1 billion Lactobacillus sporinges vegan, sourced of course three times a day. I will spare you all the details, but let's say I've noticed a number of benefits on more dietary aspects of boosting your microbiome. Kris Carr has a nice piece on three ways to boost your digestion improve gut health, which I'll have you a link for, and dietary options to help out. Such can be especially important if you have a history of antibiotic use that could have knocked out your GI's Flora workouts I am a big fan of Tony Horton and I spent many a morning with him doing P90X and P90X3 and variations thereof. I stretch and also do abs every morning and then I lift dumbbells and body weight on Mondays, Wednesdays and Fridays. I mix up routines about every quarter as well as weight and reps and speed of eccentric motion. I run shorter distances on Tuesdays and Thursdays and longer on Saturdays, ideally on trails. I'm a fan of Chris McDougal and his born to Run book and after having adopted more of a forefoot midfoot foot strike, I vastly improved my running and decreased my impact related injury issues. Sundays are kettlebell days and I find them to be a nice combination of dynamic movement and weight. I'll also sometimes sprinkle in when the weather's good. Decent bicycle workout as well. I need to add more yoga, but I do like on It's Unbreakable, which is a great little downloadable book on extended stretching and and joint flexation and also trying to get into splits a la Pavel if you know who that is. I'll put a link in and I try to do some of that each evening. It's good to stretch metaphorically and physically get outside of your comfort zone. At work I try to go for a two minute walk every hour. I try to sit no more than 20 minutes at a time and I do yoga squats if people aren't looking. All of the above are tweak tweaked when I'm traveling or training for a climb or a hike or a race or a goofy thing like I did last year. The Hundred ton challenge. Which one lifts £200,000 in a day? Or running with bulls or wall climbing or mud dashes and adventure races, Those kinds of things. Everything else gets kind of tweaked around those, but workout styles and preferences differ too. I know my wife loves being in an organized class at the Y, my daughter loves running and training with others and my son is Mr. Solo except when on a team with his coach and mates. Others like a personal trainer or a virtual trainer or an app or a virtual community. The point is, do what you can keep doing and enjoy and get the benefit from physically and psychologically Hit the Cold showers this is tough in Chicago January after having run in negative 10 degrees Fahrenheit weather. But science says that cold water exposure can help your body's immune, lymphatic, circulatory, digestive systems as well as help with the in the weight loss department, presumably because it seems to boost your metabolism. I find once I complete my shampooing and cleaning phase, I then dial back the temp to Frosty. I find it helpful to do some wim hof like breathing. If you don't know who he is, check the links in the notes and I warn my wife however, first because that can sound a little funky coming out of the shower and some of my best fitness tips. I also have a specific Pinterest page called really Fit that I'll link up for you Mindfulness Meditation and Gratitude I'm not a touchy feely kind of guy, but I do find it helpful while doing my daily stretching and yoga to purposely think of what I'm grateful for and to prayerfully focus on the needs of my family and friends. I do keep a bullet journal and I have a section on gratitude there as well. I've tried both Calm and Headspace, which are apps to try to get more easily into the meditation aspects of my life and integrate that in a little bit better. Personally, my preference is calm, but it's really up to your tastes and what you like. So here's what's next in my experimenting Time restricted eating A type of diet agnostic manner of eating to support weight loss, lean muscle and enhanced longevity and perhaps a number of other promising healthspan benefits has to do with the time in which one eats and does not eat. Certainly fasting is gaining greater popularity and scientific scrutiny and as is always warned, please don't do any of these things without medical supervision. However, restricted eating or intermittent fasting protocols are not as drastic and seem to hold promise as well. There's a whole world of work being done out there in the area of ketosis. Sort of a cousin of fasting, and if you're interested in that, I've got a good source for you in the notes. Tim Ferriss does a five day fast two to three times a year. There are a number of different types of protocol. Kate Morin has done a great job of doing a deep dive on each of the following and this is where I've pulled this information from. So take a look at the original sources from these summaries. Be safe. Vet whatever you're considering with your healthcare provider. First, of course the 168 protocol. This is also known as Lean Gains which was started by Martin Birkin, if I'm pronouncing that correctly. Basically one does not consume calories for 16 hours and one can eat during the other eight. Some suggest 14 hours of fasting. For women, it's fairly easy to fit into most lifestyles and folks can either tweak their further tweak based goals on weight loss and fitness gains with meal and workout timing. Another one's called Eat Stop Eat. This was founded by Brad Pillion and simply is based on fasting for 24 hours once or twice a week. Additional approaches Feel free to also check out the Warrior Diet by Ori Hofmekler which is basically eat one meal a day in the evening or night through to our biological origins. John Romanello and Dan Gough developed a combo of the above and call it Fat Loss forever and incorporates one weekly cheat day and then a 36 hour fast. Next then is a divided seven day cycle made up of different fasting approaches Heat Stress There's a growing peer reviewed literature in support of heat stress's benefit to longevity and athletic performance as delivered via sauna use. Here's a great resource in the show notes as to that one really needs to have a physician's clearance before experimenting with heat as it seems that longer duration at high temperatures is the secret sauce in its effectiveness. But there are obviously risks. More so for some folks depending upon your health and your age. So be safe and smart about that. I promised at the beginning we weren't really going to talk about doping, but here's a bizarre exception. Poop doping. I really can't help myself, but I have to make mention of this. If you want unofficial endorsement of something that may seem dicey, look at what some athletes are doing to get an edge. There is an Athlete Microbiome project that is investigating the saliva and poo from a cohort of highly fit professional cyclists to make an attempt to understand how their microbiomes may differ from those of the general population. The goal is to characterize the species present, the genes they carry, and how gene expression is modulated in athletes who push their bodies to the limit. Close quote Sleep is the new Black okay for anyone who's been living under a rock and not seen the following super ubiquitous and common sense advice as to a good night's sleep. Get a super dark room, have it be a cool temperature, have it be quiet or maybe white noise if you prefer that. Have a comfortable bed, comfortable pillows, comfortable sheets, keep out the blue screens, no alcohol for a couple hours prior or even longer proper hydration, have a calm state of mind and perhaps something to read that's in print. I also just have recently started experimenting with a chilipad and just a few days into it so far I'm a big fan. And again, Tim Ferriss has a great 61 page document about self experimentation which provides an overview of some findings including actionable sleep examples from Seth Roberts. So we'll put that in the notes as well too. So let's organize. Quants unite. One cannot biohack unless you measure. This can be a stopwatch plus a mile marker and a notebook. Pretty basic stuff or much, much more. You can geek out on this Kevin Kelly co founded with Gary Wolfe the Quantified Self As Tim Ferriss put it, this is the perfect home for all self experimenters. The resources section alone is worth a trip to the this site, which provides the most comprehensive list of data tracking tools and services on the web. As a scientist, a big data fan, and a biohacker, I'm also curious about the single subject research. Mark Drangsholt has said single subject research is generally not even thought of as a science. I know. How can you generalize big data? That's the ticket, right? Well, here's Mark's parable. Imagine an Earth like plan planet in a distant galaxy populated by intelligent creatures with a physiology similar to our own. Like us, the aliens have discovered the scientific method and they even use familiar experimental tools for health research such as case crossover studies and placebo controls. However, the aliens rarely aggregate data from many individuals. In fact, such aggregation is frowned upon. After all, why ruin accurate individual data by mashing it into a synthetic construction like a population? Now you're guaranteed to be wrong about everybody. And there's even a peer reviewed journal out for such quantified self folks called n of 1 the Journal of the Quantified Self. So be sure to check that out. 80:20 to jumpstart things so final tip of the hat to I'm a big fanboy of Dr. Rhonda Patrick and her work. Here are the biggest bangs for the buck to have a healthy fit lifestyle. Number one Eliminate refined sugar from your diet to the greatest extent possible, practice time restricted eating, and eat generally in accordance with your circadian rhythm. 3. Do everything in your power to maximize vegetable intake, possibly using a micronutrient smoothie method as a way to jumpstart the habit. 4 Enlist your physician and helping you monitor your vitamin D blood status and then attempting to titrate your dose to an above 30 ng per ML range, possibly trying to land between 50 or pardon me, 40 and 60. And number five try to get some meaningful vigorous cardiovascular exercise at least 30 minutes a few times a week. And finally, get bright blue light during the day as early as possible. Avoid the same blue light as much as you can in the evenings. So the point is really to experiment. Tim Ferriss is one of the best examples of being a human guinea pig. Decades earlier Buckminster Fuller referred to himself as Guinea Pig Bee. One of my favorite writers, AJ Jacobs is wonderfully and most publicly self experimented and in his documented Guinea Pig Diaries My Life as an Experiment and Drop Dead one man's humble quest for for bodily perfection. So thank you AJ my transparent friend. Finally, just keep in mind we're complex being biologically and psychologically in managing our lives we begin at a point in time and we have some options and choices. I simply am recommending that we all experiment, that we try things out and on for size. Keep what works, discard what doesn't, tweak, iterate, experiment, rinse and repeat. Our bodies and our psyches change over time and situations, so we'll always need to monitor and course correct as need be. Thanks for listening to this episode and do check out our show notes because we've got a lot of resources there as well. And best to you with your experimenting. Take care. Living a Life in Full is a production of Stout Media, a subsidiary of Gordian Knot, LLC. Assistant producer Gracie Wong Music Dan O' Brien executive producer and host Dr. Chris Stout to learn more, stop by our website A lifeinfull for show notes and please recommend us to your friends and subscribe on your favorite platform. And as for the obligatory disclaimer, this podcast is for general information uses only and does not constitute the practice of psychology, medicine, nutrition or other professional health care services, including the giving of medical or psychological advice. No doctor patient relationship is formed. Lastly, and perhaps most importantly, I take conflicts of interest seriously. For all of my disclosures as well as show notes, please see livingalifeinfull.org podcast and my LinkedIn profile. Well, thanks and until next time.