DO THIS DAILY To Increase Lifespan & REVERSE AGING! | Mark Hyman & Frank Lipman

I mean my genetic profile is terrible, but whether I get Alzheimer's and heart disease and all these diseases of aging is determined by how I live my life.

What do you think the biggest factor is when it comes to aging that controls our aging process?

The things that I've changed now in the last couple of years have been one, I eat less and I do that mainly by fasting a lot. I mainly do time restricted eating, which in a way forces me to eat less. I have two meals a day instead of three meals a day. So I eat less, I rarely pay attention to my sleep, like more attention than ever, which I think is important. Sorry, just to go back to what I eat. The big change, the other big change I made in my diet, as well as eating less and time restricted eating, I eat a little bit less animal protein, which we can talk about, which I think is important. But as we get to my age, also sarcopenia, losing muscle mass becomes important. So as much as you need to decrease animal protein, you need to be careful about decreasing protein too much because you don't want to lose muscle mass, which is a big issue with what people suffer with as they get older. There's all this fine tuning that needs to be done and it's not you got to do X, Y, and Z. You got to alter it according to your needs and how you coping with the aging process. Then the last thing I think is you got to be able to have a sense of humor. You got to be able to laugh about it. I just can't do some of the things I used to do and it is what it is. It's not you can't fight it. You've got to do the best you can, but you have to have a sense of humor about it. Otherwise, that's not a good thing if you can't laugh about it.

Yeah, if we take life too seriously, it definitely creates age. And it's interesting when you look at the studies on aging, the defining characteristics of a lot of centenarians, people who are to be 100 years old, is their resilience, is their ability to bounce back from life's punches. We all get knocked to our knees by loss, by divorce, by illness, by this, by that. The difference is how do we respond to those challenges? And are we resilient or do we end up going into a downward spiral of depression and despair and dysfunction? And to me, that's a really interesting thing. It's your mindset. It's your belief. It's your sense of optimism. Optimists live longer even if they're wrong.

Absolutely. Yeah, it's 100% correct. That concept, as I said earlier, it's about mixing this ancient wisdom with modern science. One of the first things I got taught by my Chinese medicine teacher, Ephram Kongdell and Harriet Beinfield, was health is about resilience. How do you build someone's resilience? It's not about how well you are, but how well you respond to the knocks in life, to diseases, etc. They always stress this concept of resilience. I agree 100% with you. It is about being more resilient, healthy, aging well is about being resilient. You may not be, you know, I can't run, for instance, I don't jog anymore because I got a gammy knee, but I walk and I cycle, so you adapt.

Yeah.

You know, and that's with everything in life, and I think your attitude is important too.

So food is a big deal in terms of health and in terms of aging. So what is the biggest mistake people make in terms of food when they eat if they want to live a long, healthy life?

Dr. Well, I think people eat too much, especially as you get older. I think people eat too frequently. I think there's more and more studies showing that time-restricted eating or fasting, whatever you want to call it, has very positive effects on our metabolism. There was a study that just came out, said it doesn't help you lose weight. That's maybe the case, but I think—and I've been monitoring this lately in our practice, we're doing more longevity stuff—we've been monitoring markers, biomarkers for health and aging with people who are doing, whether it's time-restricted eating or doing fasting, mimicking diets or fasting, whatever. weight they're fasting.

But.

We'Ve been finding that their metabolic markers change positively, which is very interesting. Now most people do lose a bit of weight, but for the most part, time restricted eating or only eating in certain periods of fasting definitely has a positive effect on aging. So I think eating less is important. Low carbohydrate diet. You came up with this brilliant term called the Pegan diet, which I think is absolutely brilliant. Thank you for that.

Well, Frank, for people listening, the way I came up with that was I was on a panel with Frank, and another doctor was a vegan cardiologist. Frank was more focused on paleo at the time, and they were arguing and fighting. I was in the middle like a ping-pong ball back and forth. If you're a Paleo and you're vegan, then I must be vegan. I sort of laughed as a joke, but then I realized it really made a lot of sense because they have far more in common with each other than the traditional American diet. The only difference is where you get your protein, which is animals or beans and grains. That's it. Everything else is the same.

Exactly. I think if you want to look at a diet that was probably the best, it would be some type of vegan diet. I'm not against animal protein, but as you get older, I think you need to eat a little bit less animal protein. Probably, I mean, this is what the research is showing, that the amino acid composition of animal proteins, in particular meat, is such that it inhibits one of the, or stimulates one of these biomarkers that you, you know, these nutrient sensors or longevity genes. that you don't want to stimulate as you get older. When you're young, when you're up to 40 or so and you want to get stronger and build muscle, then eating animal protein is good. But as you get older, it may be a problem.

Hasn't this research shown that actually as you get older that you need more protein to improve your muscle synthesis, which is really the thing that makes us age faster? We've talked about it before, but sarcopenia, this loss of muscle, results in a whole series of consequences, including inflammation and pre-diabetes. and abnormal cholesterol and all kinds of issues that lower hormones, increase cortisol and decrease testosterone. So losing muscle is a very dangerous thing as you get older and it's really why people end up in nursing homes. So how do we actually have enough but not too much? Because it seems like we need more as we get older.

Right. So this is probably the most complicated issue as we get older. How much? Because I agree 100%. I do think we need to increase animal protein, but as you get older, you actually need to increase protein. So how do you increase plant proteins if possible without increasing too much carbohydrates? Because you want to still keep your carbohydrates down. So the way I get around it, I actually use, I have a protein shake and I use pea protein and I put collagen in.

Yeah.

Because collagen actually has the Amino acid profile doesn't have as much leucine and methionine, so it's less of a problem than, you know, I won't have as much steak. It's not that I don't have steak. Tonight we're having steak. It's not that I don't have animal protein, but I have cut it back a bit and maybe I eat a little bit more fish and a little bit, I have collagen a lot of the time. I have collagen almost every day. So, I think that is a fine balance and it's not, there's no simple answer here and I don't, I think it's a big problem not having enough protein as one gets older. But it also seems to be a problem of eating too much animal protein as we get older.

For sure.

That's fine.

And what's enough? We have these giant steaks and big hunks of meat, and what we really need is about 30 grams to stimulate muscle synthesis, which is about the size of your palm. Now, if you're Shaquille O'Neal, it's a bigger piece. If you're five years old, it's a smaller piece, right? So you can use your own body as a measure of how much protein protein you need. But I think that's a very simple.

Right, and that's why your Pegan diet, I think, is brilliant. I love that. Thank you. I think that sums it up.

Yeah, exactly. And actually, it's funny you mentioned the Pegan diet because I created something called the Pegan Shake, which is essentially pea protein, pumpkin seed protein, and collagen, grass-fed collagen protein.

So it's exactly what you're talking about. Right, and that's what I do. I think that's a way of getting.

Around it, to be quite honest. So that's great.

That's brilliant. Yeah, fantastic.

Let's talk about this idea of time-restricted eating because there are many ways to quote fast. There's what we call intermittent fasting, which is maybe not eating for a whole day or three days or a week sometimes. There's time-restricted eating, which is only eating with a certain time window. There's fasting/mimicking diets, which are eating less calories for a number of days to stimulate the same pathways. There's ketogenic diets. They all do a very similar thing. So what is the biology of how this works? We know that these things do work, looking at animal studies, human studies in terms of improving metabolism and the longevity biomarkers. But what are we seeing in how these methods actually work and what is the most effective? What should people be doing? in order to take advantage of this new science.

Right. So what they're doing, I mean, the way I explain to patients is, which I think is, I mean, they're doing a number of things, but it's triggering your body's own self-cleansing mechanisms. After you haven't been eating for a certain amount of time, 14, probably more 16 hours, your body's self-cleansing mechanisms kick in, which is very important with the aging process because one of the the factors in aging is your body once it goes back to functional medicine, the functioning of these systems don't work as well. So the fasting actually starts putting that autophagy system into play. So I think that's probably one of the most important aspects. It also will improve mitochondrial function. which also decreases as we get older. So the consequences of fasting or what happens in your body are often the opposite of what happens as you get older. So that's why I think it's so important. Which way of fasting is best is the way that you'll do. I mean whatever works easiest for a person is what I encourage. And I think the easiest one for most people is to eat dinner earlier and eat breakfast later. which is what I do and what I recommend. Now, if people want to do a day of just water fasting or three days or even more, that's great. That's a little bit more complicated and most people won't do that, but if you can do that, that's fine. There's also this fasting mimicking diet where you do five days a month of very low calories and no animal protein and low carbs. We've actually created some shakes or My health coach has some recipes for people. If they want to do it themselves, you can buy the ProLon shakes as well. You should bring out some shake. I mean, it's a no-brainer to bring out a five-day program of, because it works. I mean, we've done it on patients that actually there's no question you get the same results whether you do a fasting, mimicking diet for five days, or you do intermittent fasting. We're seeing positive results. across the board with biomarkers and different types of fasting. So I don't think there's one way. I think the way is to find the way that you will do and that works easiest for your lifestyle.

Dr. Yeah, you know, people say, Dr. Hyman, what do you eat for snacks? And I'm like, I don't. I think snacking is the worst invention. Snack foods are typically really unhealthy and they're a modern invention and we used to not have to be eating all the time. And that's the problem where you're eating all the time. And I think, you know, just to underscore what you said about these different approaches to time-restricted eating, intermittent fasting, fasting and refeeding diets is they activate a set of mechanisms in the body that improve blood sugar control, that get rid of belly fat, that increase muscle synthesis, that build your bone density, that increase testosterone, that increase brain function and cognitive function, that improve your stem cell function, that help your immune system. and they clean up all the debris in your cells. It's called autophagy, which is the same sort of self-cleaning mechanisms. There's mitophagy as well that comes from the same process. These are things that we actually can take advantage about without actually changing what we eat. Now, if you change what you eat, you get a double benefit. These are very powerful things that we should be paying attention to in the science. I think you just feel better. You feel more energetic rather than being.

Sluggish from eating food all the time. Right, no, and you nailed it, thank you. All those mechanisms are what actually start, their function decreases as we get older. It becomes harder to keep your blood sugar under control, the muscle synthesis, all brain cognition and brain function. Fasting is like a magic pill or eating less is a magic pill. To me, that's Yeah, probably the most important thing you can do.

It's true. You mentioned the meat thing. To me, the science is still controversial. I talked to my friend, Walter Longo, who's one of the leading longevity scientists, and he's from Italy, and he's the guy who developed the fasting mimicking diet. He's been on the podcast. He knew this woman, Emma Morano, who lived to be 117 years old. She was anemic when she was young lady, and her doctor told her to eat three eggs a day, which she did for 100 years, literally. And then when she was in her 90s, I think she was getting frail and weak, and her doctor told her to eat a pound of meat a day. And she did. And she lived from 90 to 117. So I wonder, you know, how true is this and if your other lifestyle factors are good, if you're eating animal protein and getting adequate muscle benefit from it as you age, Where is that fine line in terms of animal protein?

Well, I think this is the dilemma, not really a dilemma, but I think we all need to find what works for our bodies. But I think it also points out a factor that in Western medicine we always try and look for the one thing that works and everything works together. We have this complicated system and the mTOR issue may be one small part of it. So I think you've got to find that balance. I agree. I don't think, I mean, I know vegetarians who get cancer, you know, the idea of animal causing cancer. Vegetarians get cancer. Vegetarians don't do well. You've got to find out what works for you. And once again, I'm not trying to blow smoke up here, but the Pegan concept, the Pegan diet, I think, and finding your own type of Pegan diet, I think, is if we're looking for a solution, not that there's a solution, the Pegan diet in terms of... Thank you, Frank. Intermittent fasting, eating within that content of time-restricted eating, a Pegan diet is the way we all should be eating.

Yeah. And, you know, I think the other thing that is important, I've noticed for aging, is muscle. And, I think we have a neglected organ, which is our muscle that we don't pay much attention to. And, this condition that we get as we age, it's inexorable. If you don't do something to stop it aggressively, you will lose muscle. So, you could be the same weight at 65 than you are at 25, but your body be twice as fat. And, it literally looks like a ribeye marble steak as opposed to a filet mignon, which is what you want for your muscle with no fat rippling through it. That's all related to our diet in the lack of exercise. The two things I want you to talk about is the other side of the coin because protein you need and you want to get enough but not too much, but it's actually sugar and starch that drive this aging process. That combined with muscle strengthening and building as you get older seems to be some of the most important factors. Can you talk about those and how they relate to aging? Sure.

Well, sugar and starches are the devil. It's not even a debate. You've got to get as much of that out of your diet as possible. The protein is a harder one, how much protein you eat. I think as you get older, maybe decreasing animal protein, increasing plant protein, but still keeping those carbohydrates as low as possible. possible or the sugars and the starches. I think the muscle issue is interesting because I've been doing acupuncture for so long and I really got into the functioning of the muscles. It's not just about building muscle. You want those muscles to work efficiently. What I see a lot of, especially as we get older and we have injuries, certain muscle groups tighten up. When certain muscles tighten up and they don't fire, your body compensates and starts using other muscles. So let's say you have a tight hip or you have an ankle problem, your back muscles have to work more and then you start getting back pains and then maybe it goes up to your shoulder. So not only do you have to improve muscle mass or watch the loss of muscle as you get older, you've got to watch that functioning because as we get older, Yes. Muscles tighten and the fascia tightens that thin layer that surrounds the muscles. When you cut open a chicken and there's this fascia around the muscles, that surrounds all our muscles in our body. And that as an acupuncturist and paying a lot of attention to that for the last 30 years, I've seen becomes a problem, especially as we get older and as we injure ourselves, and especially as we get older and we injure ourselves, don't tend to recover as well. So it's really important when you do injure yourself to get some body work, to get some acupuncture, to get those muscles working efficiently again, and not just letting injuries sit there and not treat them. So I think it's not only building muscle mass and not losing or not losing muscle mass, but it's improving the muscle efficiency and that's keeping those muscles long and and lumbar and watching that the fascia doesn't tighten.

That's a really good point, Frank, because I've had back issues my whole life from back surgery when I was 30 and recently had another back surgery. And now I'm getting treated by this physical therapist who's going into the fascia and rewiring things and then giving me exercise to do that compensate for the inactive muscles, exactly what you were talking about. It's been only like three days of working with this person and I feel like a different human being. My body feels limber, lighter, opener. It's pretty amazing. So, I mean, not everybody can access that, but there's ways you can do it yourself with foam rollers and other things to really help. Okay, so let's talk about something that is— Dr. Justin: and in the book.

I talk about foam rolling. I think I just have to mention foam rolling because I think that is— A lot of people can't afford going to some bodywork who does deep tissue work, but foam rolling is sort of the closest you'll get to going to someone who can do that. I really can't stress this enough. Recovering from injuries, recuperating, don't let those muscles tighten because the way our body works is to compensate and tighten somewhere else or overuse another muscle. It's really important to have those muscles working efficiently. It's one area of functional medicine that we didn't really get into in functional medicine. We talked about most of the other organs, but we didn't really talk about the functioning of the musculoskeletal system. I think that is really important.

Well, it's definitely one of the nodes on the matrix, which is structural, but if we don't get into it enough, I agree. And actually, we're talking about building a whole course on structural modules, so I think that's very important. All right, let's talk about something that is a little abstract, but is really central to aging. and that is impacted by our diet, light, by exercise, by environmental toxins. And it's something called our mitochondria. And we've talked about that on the show a little bit before, but it's really important. So, what are mitochondria? Why are they so important in aging and disease? And how do we improve them? Because it seems to be the central feature of aging is the dysfunction and the loss of mitochondria. Right.

So the mitochondria are just the energy powerhouses in the cells and you have many in all our cells. And as we get older, their number decreases and their function decreases. So optimizing their function and trying to increase their number is one of the most important things you can do for aging. And interestingly enough, Most of the things we've been talking about improve mitochondrial function or increase the number. We'll mention a few others we haven't, but it's a low carbohydrate diet or fats are what the mitochondria thrive on. Fasting is particularly good for mitochondria. Exercise, in particularly high intensity interval training, is really good for its strength training as well. So sleep, a lot of the lifestyle changes, you know, to me the mitochondria are what we in Chinese medicine talk about chi. We talk about the energy and how do you boost chi. To me the mitochondria are the Western equivalent to chi. That's your body's energy. And all these changes we talk about actually work with the mitochondria. One of the things we haven't talked about and which actually are seems to work well or stimulate the mitochondria is this concept called homesis, which is...

I love that concept. What does that mean? What does that mean? I love that concept.

Homesis means sort of what doesn't kill you makes you stronger, basically.

Ah, that's perfect definition. That's the best definition I've ever heard.

That's a little bit of stress is actually good for the body. Chronic stress we know is a problem and creates all these problems and it will help, won't help you age well, but a little bit of stress, hormesis is good. And that's what fasting is. Fasting is physical hormesis. It's a stress, a little bit of mild stress on the body and your body's response to that and we talked about resilience, but your body's response to that will be is a positive response which stimulates all these factors that are good for aging. So we talk about fasting, we talk about a little bit of interval training where you push yourself a little bit more than usual. Going from hot to cold, so even just having an ice-cold shower after a hot shower. I love going from a sauna, I've become obsessed with my sauna. going from my sauna jumping into some freezing cold water. So, you know, temperature extremes are another way of stimulating homesis.

I love that. I love that. I love going from my steam or sauna right into an ice bath.

And that's good for aging. I mean, that's good. That's homesis. So anything that's a little bit of stress on the body is good. And actually, what's interesting, I remember years ago at Jeff Bland talking about this or someone at one of the functional medicine conferences with phytonutrients. A lot of the homesis is really good for plants. So plants develop more antioxidants and protective phytonutrients to protect themselves from whatever they have to deal with to survive. Spraying them with herbicides and that doesn't actually help them develop these phytonutrients to protect themselves, which actually end up being good for us too. The first time I heard about homesis was years and years ago at one of the functional medicine conferences where someone, I think it was Jeff, who talked about the importance of homesis on plants and developing phytonutrients that would then benefit us.

Yeah, it's really important to understand this idea because when you look at, for example, organic versus conventional plants or even wild plants even versus organic plants, the wild plants have way more by hundreds to thousands of times more antioxidant potential, phytonutrient compound, and they also taste better. What's interesting is that flavor goes along with phytonutrients. So, the flavor profile of a food is directly related to the nutrient density. and to the phytochemical content. If you go to a garden, which I did the other day to a friend of mine's garden, and you pick a really ripe tomato that's just ripened on the vine, you stick it in your mouth, and it's an explosion of taste and flavor and phytochemicals that is so different than these cardboard store-bought tomatoes that don't taste like anything. That's really the power of the little stresses. I think the strength training, the HIIT interval training, the fasting, the phytochemicals. These are all ways to actually improve this. I want to get into some tweaks that you have in your book that are really, really great. But before I want to talk about this idea called our epigenome and how that plays a role in our cells age and how we deteriorate. So what is an epigenome? What is its relevance to aging? How do we deal with it? What can we do to help fix it? Right.

So this is, you know, once again, one of the basic concepts that's come out of Well, that hasn't come out of functional medicine, but what functional medicine treats. Most of our genes we can change, or we can manipulate in a way, or upregulate or downregulate. So, for instance, I actually just did a whole genetic test. I've got terrible genes. I knew I had terrible genes. I have the genes, I have the APOE, I have the gene for Alzheimer's, I have heart disease genes. genetic profile is terrible. But whether I get Alzheimer's and heart disease and all these diseases of aging is determined by how I live my life. These lifestyle factors, how I sleep, how I think, how kind I am to other people, how optimistic I am, what I eat, how I move my body, all are going to affect most of those other genes or the genes that we can affect to or upregulate or downregulate to affect our aging. So aging is probably less than 20% genetic. I mean, there's obviously a genetic component where you can't change those genes. I've got those genes. Oh, no, I don't know about those genes, but I've got enough genes that I know that I can change. Just because I have the APOE4 gene, just because I have some of these heart genes, doesn't mean I'm going to get it. Yeah, I'm probably losing it a little bit.

You seem all right. You seem all right, Frank. You're doing okay.

My heart may not be as good, but that sort of makes me want to just be more careful because you can change how you age. You can change the progression of these diseases. I think it just all comes back down to these lifestyle changes that we all have to make. Sleeping is one of those things that I think is really, really important. And we don't talk enough about it, although more and more people are starting to realize the importance of sleep. But how you move, how you sleep, how you think, how you eat, when you eat, all these factors affect this epigenome, these malleable genes that actually can be upregulated or downregulated and affect how well we feel. and how we age.

I think that's really an important point, Frank, because you mentioned you have these predisposing genes, but they're not predestined.

Exactly.

They're not predestined to get these conditions. And what most people don't realize is that 80 to 90% of our chronic disease issues are not driven by genetics. They're driven by what we call the exposome, what our genes are exposed to and how those genes are expressed. And so if you're exposed to environmental toxins, if your microbiome is not healthy, if your diet's crappy, if you're not exercising, if your mental set, your mindset is not optimistic and focused and positive, it literally can change the expression of your genes by all these factors. And that's the beautiful thing about functional medicine. It teaches you how to optimize the function and the expression of your genes to improve their functioning and also to reduce the ravages of aging. And I'm very optimistic about you, Frank, because I didn't realize you were 66. I thought you were like 56. I mean, I know you're kind of older than me, but you don't look it. So, something's working. And I think for two old dudes, we're doing all right. I'm 60 or 66. It's working. And I think that people don't understand that what we see often as aging in America is abnormal aging. It's not really how we need to age, that we can age vibrantly and healthfully, and be alert and focused and energetic even right up to the end. And I've seen this in many people. I met this guy who was 95 years old the other day. He had a girlfriend that was 20 years younger than him. She was a young spring chicken at 75. And he was just running around the room. And I'm like, what's up with you? How do you do this? He says, Whatever I did yesterday, I just do it today. If I played single sentence yesterday, I do it today. and I think he just kept living his life and not mentally succumb to the idea of aging. And I think you have to be more cautious, careful, you have to be more alert to what you need to take care of yourself. But I think we have so much potential to stop and even reverse the ravages of aging. And I noticed this to myself. Because of COVID I was locked at home like everybody else. I'm like, well, I'm not going to not exercise. got a Zoom trainer and I really never had done weights before because I was, you know, I was running around on the road. I was, I didn't, I don't like it. I don't like it. It hurts. It's uncomfortable. I'd rather go for a bike ride, you know, play tennis. And, and I got, I got serious about it. And within a very short time, I noticed my body started to change. I literally put on 10 pounds of muscle. My, my, it was like, I, I was an incredible transformation and it was just in a very short time. So I think we have the potential at any age to stop and even reverse these effects. and what I love about your book, Frank, is that you, you have very simple tweaks that have a profound impact on healthy aging. So talk about some of these tweaks, and I can sort of trigger you if you need to, but I just think it's really.

Yeah, I'm, I'm so, I mean.

I mean, you talk about things like physical intensity, cold showers. We talked about rolling out your fascia, magnesium, saunas, mushrooms, Sunshine, sleeping, sort of. Various kinds of simple tweaks or tricks. They're not really tricks, they're just science-based interventions that if we stack them have accumulative benefit.

Right. There's so many simple things we can do. I think actually just to get back to what you said, I'm also starting to do some weights now. I've always resisted weights too. I love riding my bike outside and doing yoga and stretching, but I've sort of always resisted weights. I'm starting to do a little bit of weight training now and I also find it actually quite helpful. So, I concur there. I think I'm going to start back to the fascia and watching injuries because what I've seen so often in so many people, because I see so many patients, many times people are exercising a lot and something happens, they injure themselves. and then they don't recover properly and then they stop exercising or they don't exercise as much. So, you know, I encourage everyone when you do hurt yourself, just take care of that injury. So it doesn't limit, it may change the way you exercise in future. Now, I can't run because of my knee, but I ride a bike. So, you know, you do want to continue exercising, but don't let that injury Just stick around or don't let it fester. You need to treat injuries. So if you can't get bodywork, a foam roller can be really helpful. I think getting outside early in the morning, getting some fresh air and some natural light first thing in the morning is a really good thing. I find it helps people sleep at night. In other words, getting your body into some type of rhythm I'm also obsessed with rhythm, you know, maybe because I saw when I first started doing medicine in South Africa, when I worked in the bush and there was no electricity and I saw how people lived with the rhythms and cycles of life. They got up when it was light, they went to bed when it was dark, they ate whatever was local and grown locally. And they didn't seem to have a lot of the chronic diseases I was seeing in the city. Trying to keep a rhythm is important. If you can try keep it with the seasons and with day and night, it's important. So if you go to bed, try to wake up early and get outside and try to go to bed at the same time every night. Try to create some type of regular schedule. I think that's really helpful. I'm boring now. Me and my wife go to bed pretty early. It's been great with a little grandchild because he goes to bed even earlier than us, probably the only person who does. But if you can get into some type of rhythm, going to bed at the same time, waking up at the same time in the morning and getting outside and getting some fresh air and some natural light, that's really helpful. I do think trying to incorporate some form of time-restricted eating is helpful for most people, especially as you get older than 50, it's a good idea. Keeping active during the day, so you don't have to go to the gym, you don't have to ride your bike, but get up and move around, move your body. You just want to move your body.

It's amazing how inactive we are. When you look at an average day, I've got a ring, it's called an Oura Ring, and it tells you how many hours of inactivity you you have and I'm like, holy crap, I've had eight hours of doing nothing and sitting on my doing podcasts or reading a book or working on my computer. And it just, you know, it's really important to move.

Right, and you know, I found that since COVID I've made that much more, you know, especially doing more virtual sessions with patients and not in the office, I'm actually getting up in between and going out, which is good. So I think that's important. And I think the little things we talk about, don't take yourself so seriously, have a sense of humor about aging, being optimistic, being kind to others and yourself. I think kindness, compassion, I think these are all really important factors in aging. And then finally, having a sense of purpose and some meaning. And that sense of purpose may be your job, it may be your family, Whatever it is, find something that's meaningful to you. It could be volunteering at a nonprofit. But I think getting involved in something that's important to you is really important. And then finally, find a tribe or a community that you relate to that supports you and that you can support. I think, yes, obviously eating, we talked about eating and sleeping and exercising. all important, but it's these non-tangible things that are important. And it's the little things we do on a daily basis, the ordinary things we do on a daily basis that have an extraordinary effect on our health and our aging. And that's these little things we're talking about, you know, having passion for life and having meaning and having a community. So, you know, don't just think it's all about diet and exercise and sleep, which is Really important.

It's a lot about what's going on up here.

Yeah, absolutely.

In your mind.

Yeah, these things are key and there's so much bad stuff going on. There's so much negative, it's so easy to get caught up in the negativity of today.

Well, you know, Frank, you were talking earlier, you just reminded me of this study I read in the Journal of the American Medical Association this year, which was very amazing, which showed that longevity was related to your sense of meaning and purpose. So even the science is showing that just being connected to something bigger than yourself is so, so important and having meaning and purpose is so key. So Frank, let's talk a little bit about supplements. Is there a role for supplements? Do they really work? There's all these longevity supplements out there. Is it a waste of money? Is it a good idea? Tell us, what's the deal on supplements?

Well, I think they work. I take a load of them. Yeah, I do think they work. I mean, look, I'm not going to... I think it's a bonus rather than essential because they tend to become expensive, but I do think supplements are helpful to optimize function. I really do. And, you know, I take the regular supplements that I will take with vitamin D, which I think is essential for everyone. I'll take my fish oils. But there are supplements which I think do affect the mitochondria and do affect the aging process. Am I sure about that? No, I'm not sure. But I'm not going to wait for the science to confirm, to make sure it's happening. I'm going to take it.

The thing is, when they're lower risk, they're low risk, there is a cost to it. But the benefit potential is there. and I think that there is good evidence that these things do affect some of the biology of aging.

Yeah, me too. I take N-acetyl coenzyme Q10. I take nicotinamide riboside, nucleotide ribosides, which is like the hot one.

NAD, right?

NAD, NAD, and NMR, everyone's pushing their supplements, but I actually do think I mean, I take it. It's hard to say if it's making a big difference because I'm doing all these other things too, but I take it. But, as we go older, it makes a big difference. I see people who are more nutritionally.

Deficient as they age, their diets aren't as good, their absorption is not good, and there's really good data that shows even a multivitamin in an older patient reduces the risk of disease and hospitalizations, infections, and a whole host of things. Particularly in the time of COVID we all need to upregulate our nutrient levels. So what about testing? Are there tests you can do in functional medicine that are different that help you determine longevity? What do you recommend?

Well, I don't know if they're different. I just do a few more biomarkers. We do like the Boston Heart or Cleveland Clinic has one, too. I mean, we do an advanced lipid panel. which I think can be helpful. And then we do, you know, we do insulin growth factor, we do interleukin 6, we do a couple of other inflammatory markers. But for the most part, we're doing most of the markers we've always done. We've added maybe a couple more. We're doing more, obviously hormones, measuring hormones. And then there's a wonderful genetic test that we've started doing, the 3x4 genetics, which I find by far the best genetic test started by a woman, actually a South African woman who is a functional medicine.

Oh, yeah.

What's her name again? But anyway, Yale. And I find that we've been finding, because it's the only genetic test that I've seen that actually sort of works in the functional medicine perspective and puts a lot of how these genes work together and what you can do to help these combination of genes. So it's actually a pretty helpful test that we've been doing as well. Then, you know, the other tests, you know, measuring your biologic clock and telomeres, I don't know about those tests. I mean, they've been promoted and, you know, we're starting to play around with it. I don't know how important that is. I think some people like to see these things, which is fine. But, you know, my philosophy hasn't changed from that perspective. It's more about making these lifestyle changes and whether you want to do this extensive testing is fine. My experience has been that these lifestyle, these factors we've been talking about have been changing people's markers. I mean, we've seen... Yeah, you can.

Measure the changes over time.

So you can, and people like that. If you want to actually do a test and then measure it three to six months later, you see the changes, which is actually, that's quite encouraging for people. From that perspective, I think it can be helpful. These things aren't necessary. The things that are necessary are the Pegan diet and then looking after your sleep and moving your body. And having meaning, all the things we talked about. Now, whether you want to measure all these factors can be helpful because it can help you fine tune things like the genetic test can say, okay, your liver function, you may need some more of these nutrients because the way you're processing hormones or toxins is not so good, or you have more propensity for inflammation or or your brain health may not be as good to take this. I do think the markers can be helpful in sort of taking it to the next level, but not essential.

Yeah, I think I agree. They're supplements, not replacements for everything else. So, you know, foundationally, all the things we talked about are really important. Lifestyle, diet, sleep, exercise, maybe a little supplements, but there's new things on the horizon that are for healthy aging that people are researching, talking about. Can you share some of the promising things that are ahead that you might be focused on? Sure.

As embarrassed I am to say, there's a drug called metformin, which is a popular, it's used in diabetes a lot, which seems to be showing positive effects for aging too, which go beyond just keeping your blood sugar down. It seems to be affecting this mTOR, one of these longevity genes or these nutrient sensors. seems to have some positive effect on aging. My concern with any drug, metformin included, is what are the side effects? Metformin seems to have a relatively low profile of side effects. It can affect absorption of some nutrients, B12 in particular, can reduce gas, also can affect your response to exercise. It's sort of relatively benign. That's one that I find interesting. There's a drug called Rapamycin, which I'm definitely not recommending yet, which some people are taking. Rapamycin shuts down mTOR. Yeah, mTOR. Those are the two drugs. Then some people are using peptides. I don't really know enough about peptides to recommend them. I find them quite intriguing and interesting. I just don't know enough about them yet. And I think there's so much research going on to there's going to be products coming out. But at this stage, it's really what we've been talking about. Metformin, especially if you tend to be pre-diabetic as you get older, is something interesting. I'm going to explore it a little bit further. I'm a little bit hesitant at the moment.

I'm cautious about it.

Berberine is the natural equivalent of metformin. I've been starting to take berberine now because that has similar effects to metformin. But that's as far as, you know, I don't do the crazy stuff, the biohacking. You know, the biohacking world has been very interesting because that's a very masculine approach to aging. But I think we've got some good stuff there. I mean, some of the biohacking guys, I think go a bit too far. I'm a little bit more on the sort of more gentle side of the pushing it.

Yeah, yeah. There's a lot of wild west out there. People should be cautious. People using stem cells, exosomes, stem cells is the other.

Exactly.

I think there are promising things that are not quite ready for prime time yet. I need to pick Metformin is, I believe that if you focus on the lifestyle and the dietary things, you can probably achieve most of the same benefits. And what I worry about is people say, oh, I'll take a statin and I can eat at McDonald's. It'll be fine for my cholesterol. That is just a bad idea. There's so much research on longevity and there's been so much research on healthy aging lately far more than even 10, 15 years ago. It's just astounding. So the goal really isn't necessarily to live as long as possible, although I want to live a long time. I'm going for another 60 years. The real goal is to live well, to be vibrant, energetic. My definition of health is basically being able to wake up in the morning and do whatever you want. If you want to go for a horseback ride, you want to climb a mountain, you want to sit and read a book in a rocking chair, whatever it is that makes you happy, that's what healthy aging is. How do we get there, Frank? How do we do this?

Well, as you said, I agree 100%. It's about getting up every day and enjoying your life and doing what you want to do and being able to do Being able to do what you want to do without struggling.

And.

The whole concept of functional medicine or optimizing function or optimizing the human condition is really how you age well. I think there are little tweaks you make. So you're 60, I'm 66 and we've been doing certain things for many years. And as you get to a certain age, as you get into your 60s, I think you need a tweak. a little bit more to actually affect these longevity genes or these nutrient sensors or whatever you want to call them, which actually affect your aging and help you just increase this health span as you're talking about or optimize your health span as you increase your lifespan. And what I find interesting, and I've always found this with functional medicine, is a lot of this ancient wisdom is there. It's how do we tap into this ancient wisdom And now, as well as you pointed out, there's more and more research. So it's how do we use this modern research and tap into this ancient wisdom and combine the two? And that's how you age well.

That's right. And it is pretty simple. I think to emphasize what you just said, there's a difference between your health span and your lifespan. Your lifespan is how many years are alive. your health span is how many years of your life are healthy. So you could live to be 90 and your health span could be 60, meaning you start to go downhill and you become decrepit and end up in a nursing home for 20 years. That is not the way we want to live. You basically want to live fully until the day you die and then drop dead of nothing. I think that's what I'm looking forward to.

Yeah, exactly. And that's, you know, I think, that was the impetus of the book, especially, you know, I now have a grandchild and I want to, you know, enjoy my grandchild growing up and be healthy and vibrant and be able to play. And that was sort of the impetus of, you know, what else can I do? I mean, yes, you know, I eat well, I exercise, I meditate, you know, you know, sleep is very important. So I started getting into the research and what are these little tweaks that I can do as I get older? And, and so that was why I wrote the book. Because in a way, it's a selfish journey. I wanted to see if it would help me. And then, as I do with my books, I try to make it simple for people. Because I think a lot of this research is very complicated. When you talk about the mTOR and the AMPK and a lot of these complicated concepts, my modus operandi is always, how do I make it simple? for people to understand so they can take these nuggets and make changes in their lives. They don't have to understand what mTOR is, although we can talk about it. They don't have to understand that you have these longevity genes that may be affected by certain, you know, of what you do. People just want to know what to do and how to do it.

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What I realized is actually I do. I have a much more important goal than I've ever thought of before because those other goals were quite arbitrary. Like how fast can you ride 40 kilometers on your bike or can you swim to Catalina Island? Those are interesting but quite arbitrary. But a much more interesting goal to me is how could I be the most kick-ass 100 year old to make sure that when my kids are in their 60s and their kids are in their 30s and their kids' kids are the age of my kids today, what is the life that I imagine living. And I mapped out 18 things that I need to be able to do physically to feel fulfilled.

Wow. Yeah.

Very, very specifically. Okay. I need to be able to carry four bags of groceries up a flight of stairs. Pardon me? Four bags of groceries up four flights of stairs. All at the same time. Yeah. Carry four.

Because I could do that today.

And I love the fact that I don't have to take an elevator to walk up to my apartment. Okay. Like I like that. I need to be able to get.

Up off the floor. Which you have to do in New York, by the way. Like we have no elevator in our building, so you have to walk up the stairs with your groceries and your luggage.

Yeah.

I need to be able to get up off the floor using a single point of support. And why do I realize that? Because I realize my boys who are two and five, we play on the floor a lot. We're playing with stuff and I have to come to their world. They're not going to come sit at the table and play with me. I have to get on their floor and play with their toys there, and I love doing that. But you have to be able to get up after doing that. And I mean, how many hundred year olds do you see that can actually stand up on their own with a single point of support?

Or even get up out of a chair.

That's right. I have to be able to put-.

Which, by the way, is why most people end up in a nursing home.

It's not because of a disease, because they can't get up out of a chair anymore. Yeah, this is true. This is what I call, well, there's a whole larger discussion, but I'll give you a few more. So I have to be able to put a 30 pound bag in an overhead compartment of an airplane. In other words, I want to be able to like, travel through an airport and actually put my stuff away. And I travel a lot, and I noticed how many people can't actually put their bag up or take their bag down, and I just don't want to be that guy. And not because they're short. No, no, no. It's just like there's something wrong, their shoulder, their back, something like that, their neck. I want to be able to pull myself out of a swimming pool without stairs. So you got to be able to lift yourself up. So anyway, I've got 18 of these things, and look, they're subject to change. I'm sure I'm going to think of other things. But they basically come down to a level of physical exertion that I want to be able to have. And by the way, there's a lot of things I'm not going to be able to do when I'm 100 that I can do now. Before we started this, I was showing you some pictures of places in Hawaii where we're hunting, and some of the terrain is the most complicated terrain in the history of the world. I mean, will I be able to hunt like that when I'm 100? Probably not. And I'm willing to accept certain things, but these 18 things became my bottom line. I want these things. And now, even though I'm only 46, that gives me 54 years to train to do that. And each of these things then projects back into milestones. So if you want to be able to do those things I just described when you're 100, you do what's called backcasting. Well, what do you need to be able to do when you're 90? And then what do you need to be able to do when you're 70 and 60 and 50? So right now I'm very fixated on what the 50 year old version needs to be able to do to make sure I hit those 18 things when I'm 100. And so that becomes the centenarian Olympics, is this event that I'm training for. I now do have an event in life, and it requires a totally different way of training. And it's totally foreign to me. Well, it's a much, much greater emphasis on stability, which gets virtually no attention. So mobility is the big buzzword. Everybody wants to talk about mobility this, mobility that, flexibility, balance. All of those things matter, and they're all a subset of stability. But stability is the thing that most of us have lost generally by the time we're five. So if you look, I'm lucky. I have a two year old, so I get this beautiful firsthand view of what amazing movement is meant to look like. And when you look at the things that they can do, you realize that every inch of them is connected. So when they're moving their arm, when they are doing something on the floor, when they're rolling, when they're turning, everything is connected. They are transferring force across their body through the muscles and not the joints. and then something happens. I mean, there are a lot of things that happen that I won't get into just for the sake of time, but one of the biggest insults is we start doing this. Sitting down. Yeah, once we start sitting, we lose our connection to our pelvic floor. And it's this cylinder that sits within our body from our diaphragm to our pelvic floor and around all of the muscles that line this tank. As we lose that connection, all of a sudden we start to lose the ability to connect what's happening here to what's happening here. and what's happening here to what's happening here. And all of these chronic injuries start to crop up. So both on a personal level, I've experienced, I mean, what I can only describe as the most remarkable transformations in terms of my own physical health, you know, without relying on surgery to fix injuries that I've- Like what? What do you do to- oh, I mean, I have torn labrums in both shoulders that at one point left me completely unable to do even one pushup. My elbow was in such debilitating pain that I could barely, I mean, I could still function, but I was basically in pain 24/7. And of course, to learn that that was coming from the inability I had to stabilize my scapula. So anytime I was doing anything that was pulling or pulling up or carrying anything, it was transmitting force all to this joint as opposed to these huge muscles we have here that were designed to transmit that force. You know, pain up, you know, I.

Figured out a different way of training.

I figured out a totally different way of training. Yeah. And so, and so, you know, now.

We'Re actually bringing this to our patients.

Is it like Pilates or strength training? It's, you know, I would take a.

Broader step back and say, I don't.

Do you know who Bruce Lee is? Remember Bruce Lee? Yeah. Yeah. So, so, the karate guy.

Yeah.

Yeah. So, so one of the things about Bruce Lee that I just always idolized was this system that he created called Jeet Kune Do. So, Jeet Kune Do, the way of no way or the way of the intercepting fist was this martial art that he created where he took something to the tune of 30 different martial arts. And he, in his own words, extracted what was useful from each of them and discarded what was useless. So to create sort of this unbiased view of what he was trying to optimize for, which was self-defense. And so this approach that we're taking is the same one, which is you take little pieces of yoga, Pilates, lots of pieces out of something called dynamic neuromuscular stabilization, all sorts of different training programs. And we're sort of building a protocol around how does one regain stability in the core, in the hips, in the scapula, in the neck, all of these areas. And so through that, then you learn how to transmit force correctly. And now you do the strength training, you do these other types of training that are necessary. So basically the four pillars of preparing for the centenarian Olympics is the stability piece, the strength piece, the aerobic piece, which is the mitochondrial efficiency piece, and then the anaerobic piece. So, lots of things that are missing from that. This threshold training is not a part of it.

Because I actually think — you- like.

Going super fast — interval training? Interval, yes. But so basically where I think most people are training incorrectly for longevity is you have super high intensity interval training like a Tabata, something like that, and then you have this sort of what we call zone two aerobic base training. A lot of people are spending too much time right in the middle. and they're, so they're not getting enough of the benefits here or here. And, you know, I think that, I think there's a lot of emerging data. James O'Keefe, I'm sure you know Jim's work, cardiologist, you know, looking at sort of athletes heart stuff, you know, higher, you know, we were seeing athletes that are seven to ten times more likely to get atrial fibrillation.

Yeah.

And, and again, I think that's largely the result of spending too much time at that sort of sub-threshold area, which is, again, that's important if you're trying to win a race. I'm not saying that that type of training shouldn't be done, but you have to be clear on your objective. And if your objective is to win a race, then you have to train at that zone. But if your objective is to do.

All these things that I have on my list of 18, which is more.

Functional life, physical fitness. Right. Physical fitness is incredibly efficient mitochondria, incredibly fit aerobic base, with the capacity to take very hard short-term bursts.

Amazing. Okay, so back to the other aspects of the centenarian. So it's not just the physical part, it's all the- Right, so the physical.

Piece is one part of it. Then so we talk about sort of physical or exoskeleton demise, and then there's a cognitive piece, and then there's an emotional piece. And so I think the three parts of health span than our physical, cognitive and emotional. But doesn't the physical also depend on nutrition? Oh, yes, yes, yes. Remember, these are the objectives. So, I'm talking about the outcomes, right? So, you have, I sort of think of the five tactics that we have, right? The nutritional piece, the exercise piece, the sleep piece, the distress management piece, the drugs and supplements. Those are your tools to affect change. But ultimately, what we're trying to do is enhance longevity, that means delaying death by delaying the onset of chronic disease and then enhancing health span by enhancing that exoskeleton, cognition, emotional health.

So one is not getting the bad stuff that's going to kill you and the other stuff is how do you supercharge your system to function optimally?

Yeah, because it's- and they're kind of related, but- They are, but they do require very- each of those four axes require very deliberate attention. the not dying part requires attention. And basically, you're gonna die, if you're a non-smoker in the developed world, you're very likely to die from atherosclerosis, cancer, or an accident. Those are, and again, you can dive into what those accidents look like. This is where you see an intersection with the physical centenarian Olympics piece, right? Is what's the leading cause of death overall? It's accidental death. But when you leave that to people who are in their ninth decade or eighth decade, it becomes accidental falls. So a fall becomes a more likely cause of demise when you get older. And as you sort of alluded to earlier, it's not always that you just fall and die. It's usually that you fall and you break your hip and the broken hip results in immobility that very quickly begins to spiral your quality of life and you end up in the nursing home and all these other things. So it's fighting all of these, you're sort of fighting all these fronts, which is why I think one should be paying attention to every possible tool they have to make this change.

So in terms of the food part of healthy aging and getting to 100, you talk about a lot of different techniques, whether it's intermittent fasting, calorie restriction, fasting itself, ketogenic diets, all of which seem to do really amazing things. which are all similar, whether it's boosting your own stem cells, helping your mitochondria work better, clean them up, increase your antioxidant levels, reduce inflammation, boost your hormones that need to be boosted, reduce the ones that need to be reduced. It's pretty amazing when you start to look at these mechanisms. How do you parse what's the right approach for the long term? And you earlier mentioned that you fast. So, you do a ramp up to fast with keto, and then you fast for a while.

A week and then come off it with a keto diet for a week. So it's like KFK, we call it KFK sandwich. So a week of keto, a week of KFC. Yeah, I miss me some KFC. So yeah, a week of keto, a week of fasting, a week of keto. I do that quarterly. And so again, I think with nutrition, I like to take a big step back and say, what are we talking about here? So I sort of start at one side and I say, there's this thing called the Standard American Diet and I think we can all agree, no matter what your dietary bent is, we can all agree the Standard American Diet is not a good diet. I don't think we need much more evidence of the futility of that. So then the question becomes, how would you escape the gravitational pull of this thing? And in my practice, I think there are two ways, there are two techniques to get people out of that pull. One of them is dietary restriction. And dietary restriction is anytime you restrict some element of the diet. So, it's taking away carbohydrates. Yes, taking away some part of the what. So, you're not really restricting the when and you're not restricting the how much, but you're restricting the what. So, this has the largest number of things in its bucket, right? So, this is a low-carb diet, a low-fat diet, a Mediterranean diet, a paleo diet, a vegetarian diet, vegan, there's, you know, you need scientific notation to count the number of things that fit in that bucket. And they all get termed diet, which I sort of, sort of don't find typically appealing. The second major way to get people to escape the gravitational pull of the standard American diet is time restricted feeding, where you don't restrict explicitly what they eat or how much they eat. You just restrict when they eat and you begin to compress that window of feeding. and those two things are not necessarily done in isolation. You can then start to combine those things and say, well, because we're going to see any form of dietary restriction, almost without exception, is an improvement over the standard American diet, which is why I sort of get a kick about these warring feuds that exist in these camps. My paleo diet is better than your vegan diet and blah, blah, blah. The answer is they're both infinitely better than what you were doing before. And by the way, they both be infinitely idiotic, right? So the paleo brownie and the vegan cookie are equally bad. Of course. But you can take the best of both worlds. You can take sort of the best of dietary restriction and combine it with time-restricted feeding and then you get an even more potent tool. And then you move from there into intermittent fasting, where you take these periods, in my opinion, sort of three days is the minimum effective dose, Five days is probably the sweet spot. Seven days is also with benefit and totally doable. And you either fast in a complete way, which is my preference personally, to just water only for those periods of time, or in a hypocaloric way, like the Prolon fast. That's right. So, Prolon is one example of that. It's something called a fast mimicking diet, I think is their trademark name, for a hypocaloric five-day fast. And obviously there's an infinite number of permutations and combinations to how you would go about doing intermittent fasting. And again, usually by the time a patient's been with us for about a year, we are really pushing them into that world where they're going to be spending some time doing that. Not all year long, but for periods of time.

Well, by definition, not all year long.

Of course, yeah, it's intermittent by the nature of its name.

But intermittent fasting you can do do every day?

Well, no, I refer to that as time-restricted feeding. And that's why I really like to be strict about the terminology. So, time-restricted feeding isn't really a fast. It's just not eating for certain periods of time. We reserve the term intermittent fasting for fasts of three days or longer. Or if not outright fasts, hugely reduced caloric intake.

So, do you think people should do.

Time-Restricted eating every day? I don't know. This is tough, Mark, because I think One of the challenges, remember how I said if I could be czar for a day I would change dinner time? Yeah, like I haven't eaten yet today. Okay, what time is it?

It's like almost seven o'clock.

So I know we gotta go. And so this will be my only meal today. But the problem is, so I'm gonna eat a little more than I normally would because it's, you know, it's the only thing I've eaten today. And I know that that's actually not great for my circadian rhythm. It's actually, I'm gonna pay a little bit of a price when I sleep tonight because let's say I eat dinner at seven tonight. tonight and I'm going to eat more than I normally would. And, let's say I go to bed at 10, I just know that my body works best if I've got a much bigger gap between when I eat, especially a large meal and when I sleep. So, no, I don't think everybody should do this every day. And, in fact, I like to mix it up quite a little bit. And, I actually, I really love to mix it up and reverse it and sort of do all of my eating early in the day, especially when I'm in New York because I don't have my kids here and my family's not here so I don't have this pressure to, like, Having dinner with your family is a really important thing.

The problem is in America, most of breakfast is dessert.

Well, yeah, but I mean, we can work through that, right? I mean, I'm confident that a committed individual can have a good breakfast. But the bigger issue is the social one, right? Like so much of our lives revolve around dinners and that. But I think time-restricted feeding very likely has benefits. I think it's a bit soon to tout the magnitude of them because so much of that research has been done in mice. or other animals, and especially in mice. And as you know, the metabolism of a mouse is so different from ours. So the benefits that you see by giving a mouse a 16-hour fast are unbelievable. But that's not the same as you or I going 16 hours without food. That's probably closer to you or I going two to three days without food. Yeah.

So for you, what does your day look like? How do you construct all the things you've learned about these five pillars of health and longevity. How do they integrate into your daily life? You're a busy guy. You have practices on two coasts. You have a family. You're sleeping around. You're doing podcasts.

How does it work for you?

You know, I was just talking about this with my assistant this morning because I was sort of. Or maybe it was yesterday, and I sort of said, you know, I haven't meditated in a few days, and I really feel the difference. Like I'm. really, really snippy and grouchy and just generally kind of a jerk. And she's like, you know, she's like, look, Peter, you just need to be more disciplined about this. You're so disciplined about, like, you never miss a workout. You're really disciplined about, you know, all these things you do. You're very disciplined about your archery. You know, you're up there practicing twice a day, every day when you're home and blah, blah, blah. And she's like, you know, we need to get back to a routine that in the past, which is we used to put your meditations on the calendar and it was you treated it like you treated an appointment. And I was like, you know, you're right. I've been, you know, I've been a little bit out of my routine, which is so for me, the right day is I wake up and I meditate before I do a single other thing, before I make a coffee, before certainly before I look at email or anything like that. And, you know, over the past few days, I think I was just, you know, something came up and so There's a little bit of an issue going on in my life and it sort of pulled me out of my routine a bit. But in many ways, I think the bottom line is these are all things that whether it's exercise, nutrition, meditation, sleep, you have to prioritize them.

Yeah.

And people don't want to do these things. And one of the exercises I do with patients is I sit down and we look at the 168 hours in a week and look at where they're allocating time. And I say, look, I could say you run a hedge fund or something. I say, your whole job is capital allocation. You're an asset allocator. You take money and your job is to decide where to put it into which companies to generate the right profile of return, liquidity, volatility, etc. So you are an asset allocator. Well, I said, well, everybody's an asset allocator when it comes to an even more precious commodity than money, which is time. And this is one where we're all the same. We all get 168 hours in a week and you got to figure out how you're going to spend them. And I'm really committed to saying eight hours of those every single night are going to be for sleep. And that means I really want to get my seven and a half hours a night total at least of eight hours in bed. And that's a sacrifice. Because there's a lot of times when I'd like to stay up and watch a movie or screw around on Twitter or whatever. You can pick a hundred things that you could do, but I'm really committed to allocating that time. And then you sort of go through this and say, well, for example, using food, How much time do people really allocate to thinking about food choices? Because you have to be kind of deliberate about it. It requires, for me at least, surrounding myself with good food choices because I actually really struggle with food. If left to my own devices, Mark, I could just eat nonstop junk food all day, every day. And so the reason I don't is not because I have some great discipline. It's because I surround myself with good food choices. It's like the worst thing I can possibly eat in a moment of weakness is like a piece of dark chocolate.

You don't have it in the house. I don't have Ben and Jerry's Chunky Monkey in my freezer because if it.

Was there and I had a long day and I was tired, I would eat it. Me too. And I think it's okay. I think people need to start accepting the fact that it's okay to say that we are humans and we're not perfect. And to me, this is why I love sort of behavioral economics and the work of Richard Thaler and others is you change the default environment. And that's where you want to put your bandwidth. That's where you want to put your energy is change your environment. Change your environment so that you don't have to constantly rely on willpower.

To.

Eat a certain way or to do a certain thing.

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In those studies, it's pretty clear that men who go to the salon a few times a week, have less cardiovascular disease risk and heart attacks. Now, there's one caveat which they actually admit in one of the papers, is that people who are sick or in hospital don't go to the sauna as often.