63 Cups Of Coffee A Day & More: Five Simple Things You Can Do to Live a Longer, Healthier Life.

Hey, what's up? It's Ben Greenfield. Today's podcast discussion is pretty cool. We get into elephant poop, coffee, a mighty mouse that they engineered to live and exercise forever, basically, and a ton of other really interesting information. I interview a Harvard medical researcher in this episode of the Ben Greenfield Fitness Show.

For centuries, people have meditated and found subjectively that they're happier, feel, experience more bliss, they're more creative, they have better interpersonal relationships. Now the science is catching up. What else does it do? These are all subjective. What about objective things? Coffee protects against five cancers. Primary cancer of the liver, which is now the third leading cause of cancer mortality in the world, endometrial cancer, prostate cancer, colon cancer, and skin cancer, including the deadly melanoma.

He's an expert in human performance and nutrition, voted America's top personal trainer and one of the globe's most influential people in health and fitness. His show provides you with everything you need to optimize physical and mental performance. He is Ben Greenfield.

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Hey folks, it's Ben Greenfield. And I actually received plenty of puzzled comments and inquiries from you guys, the listeners, when a few episodes ago I mentioned that you could get a big number of surprising health and longevity and disease preventing benefits by drinking not one, not two, not three, but up to four to six cups of coffee a day. And what I said in that episode was actually based on a book that I recently read. And this is a book written by a Harvard medical researcher named Dr. Chopra. And the book is called the Big Five. And it goes in these five things you can do to live a longer, healthier life. And typically I don't learn a lot from books like this, but this one actually had quite a bit of interesting information about coffee and vitamin D and nuts and beyond and a ton of like, tests and trials and studies all over in it, which, which I always like. I like it when there's research to back stuff up. And anyways, Dr. Chopra says that if you practice the five things in this book that you can live a longer and healthier life without needing expensive supplements or fad diets or jazzy exercise programs or state of the art gym equipment. And since I'm all about natural living and anti aging and longevity, I decided that I had to get him on the show. So, like I mentioned Dr. Chopra is a professor of medicine. He teaches at Harvard Medical School. He has a ton of awards under his name. I'll put his comprehensive bio in the show notes. You can access the show notes over@BenGreenfieldFitness.com Big Five. That's BenGreenfieldFitness.com Big the number five. And today we're going to delve into coffee and beyond. So Dr. Chopra, welcome to the show. Man.

Ben, I'm delighted to be on your show. And I'm sipping my third cup of coffee as we speak.

I only had one cup of coffee, but my wife tells me that my one cup of coffee counts as three. I have a lucky, a lucky mug with a big tiger face on it that I won at a triathlon a few years ago and I believe it's probably close to about 18 ounces, maybe more. So it's a decent sized mug.

You're getting a good solid three cups. Yeah, yeah.

And I'm actually, I want to ask you about that in a second. Actually, there's a section in your book that you start with that I think is fascinating that I wanted to ask you about. But then I'm curious also what counts as a serving of coffee. So perhaps we can delve into that later. But early on in the book, you talk about a question that you ask an audience when you're giving a lecture on liver disorders. Can you go into that? Because I think it's pretty fascinating.

Yeah. So, you know, I'm privileged to give medical talks and non medical talks to about 30 to 40,000 clinicians and non clinicians each year throughout the country and also abroad. And my specialty is liver disease. So I give a lot of talks on different liver disorders. And then in the middle of the talk, I suddenly stop and I look at the audience and the audience could be 400 people in Anaheim, could be 6,000 clinicians. And I say, how many of you drink coffee? And you know, about 80, 90% of the hands go up. And I said how many of you drink more than two cups of coffee? And now it's about 60%. And I say how many of you drink more than four cups of coffee? And now they're like hundred nervous people slowly raising their hand and they say how many of you drink more than six cups but a dozen? And they're looking very sheepish. They're looking around, they're nervous. And then I say it's good for you. And then I'm going to show you all the research on the benefits of coffee. But Then the next slide I show is a beautiful portrait of the French philosopher Voltaire.

Yeah.

And he lived from 1694 to 1778. He died at the age of 83 years. And I said, who is this? And some of the people in the audience get it. And I say, how old was he when he died? Nobody gets it. So I click, it was 83 years. And then I say, guess how many cups of coffee a day he had? And people, because I'm asking, will say 10, 20. And the correct answer is 50 to 72 cups of coffee a day.

50 to 72 cups of coffee a day.

Coffee a day. And people. Then some people, how could you even do that? Yeah, they say, what size? I said, how does it matter if it's Half an inch? 72 adds up to a lot.

That's a crap ton of coffee.

That's a ton of coffee.

So I have to ask you, is there actual evidence of that? Who does this fact come from?

So this is. Yeah, this, you're right. I mean, how can we be sure about the veracity? But if you Google it, there are multiple sites where they refer to this.

Either way, he drank a ton of.

Coffee, so drank a tan. It turns out Jefferson, who also lived to 83, also drank a ton of coffee.

What is a serving of coffee considered in, like the research that people do.

On coffee, you know, usually six to eight ounces.

Okay, so, so really like my morning mug actually would be like three servings of coffee.

Technically, your morning cup. You're, you've already ahead of the curve.

Yeah, interesting. So, so besides Volterra, though, is there actual research to back up this claim that, that four to six plus cups of coffee could be beneficial? Because I know, you know, we, we like some people will say, oh, you look at the blue zones, a lot of them drink a lot of coffee or tannic substances like tea, therefore, that's what's making them live longer. But, but in terms of actual clinical research, has that actually been investigated?

Right, That's a very good question. And you know, if somebody listening to the show goes tomorrow or next week to see their primary care and they say, I heard this guy and he said, coffee is good for you. He or she, unless they know the entire literature, medical literature published and peer reviewed, everything in moderation, these studies come and go. That's the usual refrain. So for decades, we as a medical community were mystified. How come there were some people drinking a pint of whiskey a day or a liter of wine a day, and at the end of 20 years, only 20% of them, at most 25% became cirrhotic. What happened to the other people? And we said, aha, maybe it's genes. Maybe it's the enzyme called alcoholic dehydrogenase. Maybe it's different in these people. And then Art Klatsky from Kaiser Permanente published a study some years ago, looked at 120,000 patients. And if you drank that much whiskey or that much wine and had one cup of coffee a day, it lowered your risk of alcoholic cirrhosis by 20%. 2 cups by 40%, 3 cups by 60%, 4 cups by 80%. So dose dependent effect.

Holy cow. I don't remember if I saw that one in the book. Do you have that one in the book about coffee being protective from huge amounts of alcohol?

You know, I don't know. I hope it is, but if not, I can send you the risk.

That's crazy. Yeah, send me the link if you have that one. I'll put it in the show notes for people if they want to check it out.

I will look for it. Yeah. And then, you know, I attend on the liver transplant, the hepatology service at the Beth Israel Deaconess Medical Center. I did it for years, four weeks in the year. And I love to teach and I taught the house staff and the medical students and the fellows and the interns and residents that every patient admitted to our liver service ask them about tea and coffee. And I would go at 1 o' clock to make rounds, and sometimes round till 7, 8, 9. And we would have 20, 24 of the most sickest patients with liver disease in Boston and from elsewhere. And every time I sat down, they'd look at me and say, Dr. Chopra, we had five admissions, we have 22 people on our service. Nobody drinks coffee. All of these people with severe liver disease. And one day I go sit down for rounds and one of them looks at me, the resident presenting the case, and he says, we finally have a patient, Dr. Chopra, and he drinks coffee. And we asked him how many cups? And he told us four cups. We asked about the size. He pointed to a paper cup and we also asked him, is it regular or decaf? And he said, ha, if you want to drink the stuff, you might as well drink regular because you've told us that for cirrhosis, not for the other conditions, but for cirrhosis it should be regular coffee. So I said, you know, these are epidemiological studies. There's some mechanistic explanations, but I will take my own history. So we go for Rounds. We arrive at his bed. I sit down, I take a detailed history, and I turn to him and at the end I said, so tell me about tea and coffee. He says, doc, I don't drink tea. I love coffee. I said, what do you drink? He says, regular. How many cups? Four cups. I said, what size? He again points to a paper cup at his table. I asked one more question. I said, how long have you been drinking coffee? He turned to me and he says, since my liver transplant.

My God.

And the house staff fell over and he said, doc, I never liked coffee. I got my transplant and I crave for coffee. Should I stop it? I said, keep drinking. He was in for cellulitis, you know, not for any liver related problem. And because these people are immunosuppressed, we jump on it. We treat them with antibiotics, we do the blood cultures. So I have yet to come across a patient with end stage or severe cirrhosis of the liver who drank, you know, a lot of coffee.

Yeah. So. But there's more than, like, the liver protective properties. Like, let's talk about. There's one study on, like 50,000 guys who, if they drank six or more cups of coffee a day, that their prostate cancer went down by like 60% or their prostate cancer. Yeah, it's not like 60%.

Yeah, yeah. And it's the bad prostate cancer. It's the metastatic, not the one that's silent. And you die with, not die off. This is metastatic prostate cancer. And then there's a very recent study just came out, I think, earlier this week in the British Journal of Cancer, that if you eat nuts, that there is a 34% reduction in dying from prostate cancer.

Nuts.

Yeah. Coffee protects against five cancers. Primary cancer of the liver, that is cancer rising in the liver, which is now the third leading cause of cancer mortality in the world. Endometrial cancer, prostate cancer, colon cancer, and skin cancer, including the deadly melanoma. Then it protects against cirrhosis, type 2 diabetes, Parkinsonism, cognitive decline, which is dementia.

Right.

And then finally, a study came out in the New England Journal of Medicine, the premier medical journal in the world, about two and a half years ago. And it said, coffee drinkers, men and women, have lowered total and cause specific mortality. And I got about 103 emails that day saying, sanjeev, you've been telling us about coffee and its health benefits. Did you see this study in the New England Journal? You're vindicated. Amazing.

Yeah. I mean, the list of studies in the book is enormous. And I think folks should read the book to check it out. But one question I wanted to ask you that wasn't quite clear to me. Does it matter if it's caffeinated versus decaffeinated coffee?

So all the health benefits are seen with both caffeinated and decaffeinated, except cirrhosis of the liver. For some reason it has to be regular coffee. And we know it's not the caffeine. Something about the process of making it decaffeinated. Right, right. Because tea has no benefit. Tea has no benefit and Coca Cola has no benefit.

So you said that tea has no benefit and Coca Cola has no benefit, but that either caffeinated or decaffeinated coffee has benefit. And caffeinated coffee, especially for the liver.

Especially for the liver. And you know, it turns out it has 1000 constituents. Amongst them there's something called chlorogenic acid which is one of the richest antioxidants. There's something called caviol and cofestol. And you can take an animal in the lab and produce toxic liver injury, give it a horrific chemical producers. And now you repeat the experiment and you pre treat the animal with carveol or cofestol and it significantly abrogates the liver injury.

Now the method with which you make the coffee is important. With that, I don't use paper filters because it filters out a lot of that Kawai al and Kaphestol. I use a stainless steel aeropress or a French press or a stainless steel pour over because you can actually filter out a lot of those positive cholesterols and chlorogenic acids.

That makes perfect sense. Yeah.

Okay, so caffeinated versus decaffeinated doesn't matter unless you're really focusing on liver health.

Cirrhosis, liver disease.

I know some people are gonna ask this because there's people concerned about the effects of caffeine on the central nervous system, specifically blood pressure and heart rate. What does research say about what caffeine or multiple cups of coffee a day could do? Let's start with blood pressure. What are the issues with blood pressure?

Absolutely. A very good question. So, you know, one or two cups of regular coffee will increase your blood pressure by 2 or 3 millimeters of mercury and it can increase the heart rate. However, you know, the benefits so far exceed what we're talking about. You know, trivial effects on blood pressure and heart rate. There's a very common form of a heart arrhythmia called atrial fibrillation. And these people then tend to form clots in the heart. Clots can leave the heart, go into the brain, get strokes. So it can be a significant and serious condition. And for decades, cardiologists have been telling their patients, you know, avoid coffee, avoid caffeine. And now the studies have come out, and I, when they come out, I send them to all my cardiology colleagues at the Beth Israel Deaconess Medical center at Brigham Women's Hospital. And I said, did you see this study? And it says that there is no increase of atrial fibrillation with coffee or caffeine containing beverages.

In fact, that would be like a rapid, kind of like fluttering of the heart.

No, absolutely no increase. In fact, it may be protective against atrial fibrillation.

What about blood pressure?

So blood pressure can go up 2 or 3 millimeters. But if we do the other things we talk about in the book, like exercise and meditation, then you can forget this negative effect of coffee. Okay. And the other negative effect is there are people who have irritable bowel syndrome, diarrhea predominant. The coffee may cause them to have more diarrhea. If people have bad reflux, gastroesophageal reflux disease, heartburn, it's a very, very common condition. Both regular and decaf coffee can make it.

I have some clients who get that, and they drink cold brew instead to reduce the acidity of the coffee.

They drink cold brew coffee, and that seems to protect.

They don't get the heartburn when they drink cold brew versus conventional brewing methods. Yeah, it's lower in acidity. That's interesting. So only a slight increase in blood pressure and no effect in terms of deleterious, like fibrillation or atrial fibrillation in the heart. Okay, gotcha. What about for pregnant women? I think you have a section in your book that actually, I raised my eyebrow. It seemed interesting.

Yeah. So, you know, we used to advise our patients, you know, probably one cup of regular coffee is safe and don't drink more than that. And then the American College of Obstetrics and Gynecology a few years ago said there is no data to back that. And we think coffee in moderate consumption. And I really don't like that. When people use terms like that, they're totally nebulous and vague. What does moderate consumption mean? So I tell my patients, and I've talked to obstetricians at Harvard Medical School, and they say we tell our patients not to have more than two cups of regular coffee a day.

You mean pregnant patients?

I'm sorry, pregnant patients? Yeah.

So there's no risk for the baby in terms of like, caffeine crossing the barrier to the placenta and that affecting, like a grown infant?

No, no, no. Deleterious in terms of prematurity, stillbirth, caffeine withdrawal when the newborn is born. Not seen.

There's gonna be a lot of pregnant women listening in who are gonna be fist pumping. Now they can actually return to Starbucks. Interesting. So pregnant women can use caffeine and they haven't shown that up to two cups or two cups at least a day is not gonna have any issues in terms of birth defects or anything like that? Miscarriage, preterm birth.

Yeah, that is correct.

Gotcha. Gotcha. Now, speaking of women, do men and women respond differently to coffee? Like, is there a different dosage effect for men versus women?

I don't know the answer to that. But what has been discovered, and this is a study from the Harvard School of Public Health and also from Brigham and Women's Hospital, is that there are at least six genetic variants and they affect caffeine metabolism. They affect sort of the reward system we feel, from coffee. And that it's possible in the future that we could tell people, you know, for you, Jack, two cups is good. You don't need to drink more. And for you, Henry, you probably need to drink four cups of coffee a day.

Yeah. So this genetic testing, are you referring to the testing that shows whether you're a fast coffee coffee oxidizer versus absolute coffee oxidizer?

Right, Absolutely. And I've heard this speaker from the Brigham and Women's Hospital at a coffee symposium where I was speaking, and he followed me. And it's fascinating data, but I don't think we're there yet. I think our body tells us, you know, you've had enough coffee or you shouldn't drink coffee after 5pm I mean, I drink four cups of regular coffee a day, but if I go out for dinner and I'm at a restaurant and my companions are ordering double espresso, I'm either ordering decaf if I trust the waiter, or I'm just skipping it because I would be up till 4 in the morning. And the odd thing is.

So you would probably.

I don't think that's genetic because I could tolerate that 20 years ago, but now I can't.

Interesting. See, there's. There's a. I think there. There's some interesting research about fast coffee oxidizing versus slow. You know, I'm immersed in exercise research primarily, and there was a study, I believe it was a couple of weeks ago that showed that when it comes to the ergogenic effects of caffeine, which I actually want to ask you about later on. When it comes to the ergogenic effects of caffeine, like the sports performance enhancing effects of caffeine, fast coffee oxidizers who carry the genetic snip for being a fast coffee oxidizer, they actually display an increase in performance, decreased rating of perceived exertion and better overall athletic performance. Whereas the slow coffee oxidizers, they actually didn't experience the same ergogenic effect from caffeine. And so athletes who are, for example, loading with caffeine prior to competition, some of them may not even be getting any benefit from that from an ergogenic standpoint.

Yeah, I think this is a very ripe field for research because the heart rate could go up, you know, you could become a little unsteady, you could have a little bit of a tremor. What kind of sports are you taking part in? Is it archery? Is it playing tennis? Is it running the marathon? What is the timing of when you should drink that coffee? How does it compare to five hour energy, which is a six billion dollar drink now in the country? So I think all these questions need to be answered. But clearly some people drink coffee, you know, in between sets of tennis and during, while playing golf. I'm an avid golfer and get to the ninth hole at the Shack, I drink coffee and I feel that I have more energy on the back nine. And I have a friend who drinks Gatorade and then he uses a pull card and the 16th hole is up a hole, he's just like one over. He's a great golfer, Lefty, and he's like one over. And then 16, 17 and 18. He double boys. And I tell him, Paul, you're tired and you're going up the hill with a pull card and you lose your focus. And you can't do that in golf. You lose the energy. Yeah, gone.

I shoot, I shoot the bow. And I'm actually careful before my competitions with coffee. If I, if I do a cup of coffee, which I actually like in the morning for everything from like initiating a bowel movement to I just like the taste of a cup of coffee in the morning. But I'll use theanine sometimes, like a theanine supplement or coffee. There's one brand that I drink called Chimera that actually has theanine in it and I'll drink coffee with theanine because theanine kind of balances out some of the almost some of like the jitter effects you can get from coffee for something that's as fine motor skill requiring as, say, shooting the bow or. Or golfing.

I also, I also think that first cup of coffee is the most amazing cup of coffee in the morning.

And as.

And my. You know, I think logically, I've not had coffee now since 5pm and I meet at a Starbucks every morning with two other friends. We sit down at around 6:15, and we get our tall Americano or whatever drink we like, and then we solve the world's problems over 15 minutes just to come back the next day and find nothing had changed. And everyone who comes at the same time, about 12 years ago, they would all sort of nod and smile. And I said, listen, we should introduce ourselves. Now everyone knows everyone. We know the baristas. I travel to many, many countries. My only souvenir is to get a coffee mug. And I have a whole collection. And one time my wife was dropping me to Logan airport early in the morning, and she says, sanjeev, I'll get your drink. And she walks in with my mug. And the head barista, Barbara, looks and says, this is Sanjeev's mug. Are you his wife? And she said, yes. And she said, nelly, Whitney, come meet Sanjeev's wife. So I'm known by the mug on my face. Don't buy a collection of other coffee mugs.

I like it. Hey. Hey. One last question about women. Bioidentical hormone replacement therapy. Like, I've heard that hormone replacement drugs, like in postmenopausal women might affect their response to caffeine. Are you familiar with that at all?

Yeah, actually, not at all. Not at all.

Okay. Interesting. Yeah, I've just heard that I read somewhere about these hormone replacement drugs being something that might make a woman less responsive to caffeine. Okay, I have another question for you in the realm of coffee. And there are a couple other things you talk about in the book besides coffee that I don't want to delve into, but ergogenic effects. I think a lot of people are aware, like I mentioned, that coffee can increase sports performance by decreasing the rating of perceived exertion or by making you feel more alert and more energetic. But as far as the actual muscle fibers themselves or the signals to the muscles, not the nervous system, is there any effect, do you know, on the musculoskeletal system or on muscles?

It's all speculation. You know, it's all speculation. What is the caffeine doing? Does it stimulate the brain and the nervous system to do things differently? Is it signaling to us? If you've taken Coffee that, you know, you're not really fatigued. Keep going. Or is it actually recruiting extra units of muscle for very good athletic performance? I parenthetically give a talk called the Top Stories in Medicine in the Last Century. And then I predict what's going to happen in the next 50 years. And for that part, I sent an email to all my division of medicine colleagues, heads of the different divisions like endocrine and rheumatology and GI and cardiology and so on. And the chief of endocrine, Barbara Khan, a brilliant woman. She's won many awards. Brilliant scientists. Said, sanjeev, in the future, there'll be a pill that will simulate exercise and combat obesity and the metabolic syndrome. So I wrote back. I said, barbara, come on. I said, do you have any references? So she sent me three references and an editorial that she had written. And in one of the references, there's a mouse, and you can create a genetic mutation, and this mouse can pretty much exercise forever without getting tired. And it's called the Mighty Mouse.

The Mighty Mouse.

The Mighty Mouse.

That's right. I'll have to put research to this or link to this research on the show. Notes. This is fascinating. So they somehow knock out a gene in this mouse that allows it to just exercise and exercise.

Yeah.

Holy cow.

Isn't that amazing? And when I mentioned this to the clinicians in the audience, they cheer because most people don't like to exercise, or they find it very tedious and boring, and we have to make it fun for them. And one of the things we do, which I learned from a colleague working at Spalding Rehab, and it's based on some research, is that you turn to your patient and you say, okay, you don't like to exercise. Yeah, Doc, I just don't like to exercise. Well, what could you do in terms of exercise? I could walk. I could swim. All right, could you swim, you know, 30, 45 minutes, four days a week? Absolutely. So you take a prescription pad and you put his name, and then you put swimming. 45 minutes each time, four times a week. Number of refills, infinite. You sign it and you give it to the patient, and it turns out they're more likely to then do it.

Yeah. That's interesting that they need a prescription for it. I want to delve back into this mouse thing real quick. I can't leave that behind me. Ken, just skim over that. One. Genetically engineered Mighty mouse can run 6km without stopping. I'm looking at this headline, and it says that they cause these mice to overexpress the gene for this enzyme called phosphoenolpyruvate carboxykinase. Pepck. And it looks like it acts on skeletal muscle. On the skeletal muscle actin. Were you saying that there's some mechanism by which coffee may also upregulate that enzyme or were you just saying that? That we don't know.

Total speculation. Totally. We have no idea what coffee does to those enzymes or does it create any.

Oh, man, this is fascinating. I actually was not familiar with this study.

Yeah, I never heard of it till Barbara Khan mentioned it.

They say the mice are metabolically similar to Lance Armstrong biking up the Pyrenees. They utilize mainly fatty acids for energy and produce very little lactic acid. I've never seen this study. This is amazing. I wonder if they've done or if they're planning on doing follow up studies on how you could activate this enzyme, this PEPCK enzyme. Super interesting.

I bet they're doing it. I bet they're doing it and I bet they're going to. You need to now study it from mice into mammals. Yeah, that'll be the next.

I'll put that link in the notes for people I do know. By the way, there is one study that shows that caffeine affects what's called the self sustained firing of motor units, of human motor units. There was a study that they did with coffee versus a placebo and they found in men's muscles in their legs that coffee actually did increase motor unit recruitment. So there's something going on in terms of you actually being able to grab more muscle fibers, not just like a decreased rating of perceived exertion or not just an increase in blood flow or awakeness or alertness. It appears that and perhaps this is why high amounts of coffee, they're actually banned by the World Anti Doping association. If you have too much caffeine in your system, perhaps that's one of the effects. Interesting stuff.

Fascinating. Yeah.

In your book you talk about the world's most expensive coffee. Can you tell the audience about that?

Yeah. So there are these different kinds of coffee that, you know, sell for $70 a cup or sometimes even $160 a pound. There are these elephants that eat these arabica beans, but these elephants don't digest these beans. So after several days they pass through the elephant's GI tract, the digestive system, during which time they are fermenting and then they're finally excreted and collected and apparently they're sold at five star hotels for like $70 a cup.

Have you ever had it?

No. I'm afraid to have it. Wow.

So is that something.

I'm happy with my $2.30 tall Americano.

Is there something that's going on when they're actually eating these beans? An animal eats a bean and it goes through its digestive tract. Do you know if it alters the flavor somehow?

I don't know. I mean, it would be interesting to do a blind study. Right. But it would have to be placebo controlled, and you'd. You'd have to get informed consent that you're basically consuming something that came out in the poop of the elephant.

So it's called Black Ivory Coffee.

Yeah.

I wonder if you can order it online. I'm going to do a search and I'll link in the show notes if I can hunt down some Black Ivory Coffee online for folks to try. But that's. That's interesting that that makes me want to actually taste it and see what happens. I would imagine maybe there's some kind of like a fermentation or something that occurs in the digestive tract as the beans go through.

As the beans go through. Yeah.

Maybe it's. Maybe it's like a probiotic.

Yeah. The other question that that sometimes gets asked is, what about coffee enemas? And I have not seen any good research, but I know a lot of people, including some celebrities. I'm not going to name them who it is a daily ritual for them to use a puffy enema.

Well, it can, and this is just pure subjective experience. And I haven't talked to you about this at all before the show, but I do a coffee enema twice a month, and I retain it after a bowel movement in the morning, I'll do a coffee enema. I'll retain it for about 20 minutes while lying on my side. And what I've found is that since I started doing it about two years ago, I actually have an article about the whole procedure on my website. If anybody wants to go read it, I'll put it in the show notes.

I will read it.

I've found that. That my digestion has improved. And I've also found that my bowel movements are much more regular and not loose, but formed the correct way on the Bristol stool scale. And I think there's some stuff going on that medical research perhaps hasn't yet looked at. But all I can say is I feel like a million bucks when I do it.

Wow, that's great to hear. So, one possibility, and I think this is the hottest topic in medicine right now. It's Called microbiome. Right. The trillions of bacteria that live in our GI tract, and in aggregate, they weigh about three pounds. It's been called the second human genome, the inner bacterial rainforest. And it has implications in obesity, in diabetes, in arthritis and asthma, in encephalitis, potentially autism. How we are born, C section versus vaginal delivery. Whether we're born in rural Iowa or in New York City, whether we get antibiotics in the first six months of life or the first year or not, whether we take stuff like Nexium proton pump inhibitors to shut off acid secretion in the stomach, whether we travel a lot and experience jet lag, all these things affect the microbiome. So I'm wondering if the coffee enemas changes the microbiome in some way and it changes it to suit you so that you now have the good bacteria, more of them, and less of the bad bacteria. Probiotics is a $31.5 billion industry. And in the scientific literature, probiotics help with only a few things. Antibiotic associated diarrhea, a condition called pouchitis, which occurs in people with ulcerative colitis. And their surgeon creates a pouch and the pouch gets inflamed. Hepatic encephalopathy, which is a pretty serious condition. So people with bad cirrhosis can be comatose or be very confused. And there's a study from Chandigarh, India, published in Gastroenterology, saying that a particular probiotic given they had marked improvement. Marked improvement. I think what's going to happen in the future, in the next five to ten years of us have heard in many of the audience will have heard of precision medicine, personalized medicine. I think what will happen is we'll go get a simple stool test done. It will analyze our microbiome, and it will say, ben, for you, you should really take Phillips colon health and this. Other probiotics, Sanjeev, you should take, you know, probiotic VSL and probiotic this, and also have a cup of yogurt every day. I don't think we're that far away from that. Amazing.

Yeah, I've actually already sent all my skin microbiome, my mouth microbiome, and my gut microbiome over to the human gut project. And right now they're only analyzing stool, but, yeah, they're actually in the process of doing that. And then there's another company that I'm currently investigating, I'll talk about on a podcast at some point, but they're actually doing kits that they send to your house that do not just Blood and saliva and urine, but also stool, mouth, skin, microbiome. It's gonna be, I agree, the next frontier in terms of personalized medicine. I wanted to ask you a few other questions about things aside from coffee. In your book, for example, you have an entire section on vitamin D. That's number two. That's one of the things that you highly recommend for longevity in addition to doing four to six cups of coffee a day. And we've talked about vitamin D quite a bit on the show before, so I don't think we'll spend too much time on that one. But I did want to ask you, in terms of getting the most out of vitamin D supplementation or vitamin D exposure outside, what would be your one biggest tip for the audience when it comes to getting more vitamin D naturally?

Yeah, so my first biggest tip would be that we really don't know what our vitamin D3 level is until we get it tested.

Now, for someone who's out in the sun trying to get vitamin D, what would be the best way to actually expose the skin to vitamin D? Like, does it matter if it's your arms, your legs, your face? I mean, have they done any research on which parts of the body actually absorb most vitamin D?

Not to my knowledge. What I've heard is that the most skin that's exposed, and it's a beautiful day, cloudless day, and a good nice sun, then the more vitamin D your skin will make, and then the skin makes vitamin D1, it goes to the liver, it makes it into D2, and then it goes to the kidney and it makes it D3. And that's the one we want. And there are certain conditions which are rare, but there's a condition called hyperparathyroidism, another condition called sarcoidosis, which isn't that rare, and they have to be careful about taking supplemental vitamin D. Okay, interesting.

So as far as the amount of vitamin D that you can get from the sun without taking actual supplements, is there any research on the amount of vitamin D you can actually get from just pure sunlight on the skin?

Yeah, I think it depends again, on your. Where you are. Are you in a Scandinavian country? Are you at the equator? How tall are you? What is your skin surface? Are there clouds that day? But you can make a lot of vitamin D in one or two hours, you know, several thousand units.

Several thousand? Actually, you know what? I think your book somewhere. What'd you say? I think you said 25,000. 25,000 international units in about the time it takes your skin to turn Light pink.

Yeah.

So basically for a fair person.

Yeah, I mean, that's a lot. But of course you can't do that every day. Right? And you get skin cancer.

Well, yeah, if you burn, you'd get skin cancer. But obviously that's a little bit blown out of proportion in terms of the amount of people have vitamin D deficits versus the amount of people who are getting skin cancer from the sun. I think it's blown way out of proportion. By the way, for those of you listening in, I have found the elephant poop coffee and I've also found the weasel poop coffee. And I will put links to both of those in the show notes along with the coffee enema article. You can go to BenGreenfieldFitness.com Big5 to check those out. Okay, so we've got vitamin D. You also talk about nuts and you recommend them highly. But I've got kind of an eyebrow raised about that because I think some people will eat too many nuts and get too many omega 6 fatty acids and also will grab nuts from the bulk food section of the grocery store that have been roasted to high temperatures or are rancid or for example, have canola oil on them. Do you care about sourcing of the nuts or do these studies that in which you talk about nuts increasing longevity, do they differentiate between the type of the nut and how it's prepared?

A very good question. So, you know, nuts were considered food for the gods in ancient Rome and Greek times. And growing up and even in medical school and early in my career, everybody would say, be careful about nuts. There are lots of calories in nuts and, you know, not that healthy. I remember growing up in India, my grandparents always gave me almonds and said, this is good for you, this is good for your health. And they ate almonds every day. And they lived back then to the ripe old age of in the 90s. So then the research started emerging and it said if you eat nuts, you have a low risk of couple of cancers, coronary artery disease. One pistachio has only four calories. So if you have 25 of them and you eat them slowly, you'll consume 100 calories. A can of Coca Cola is 140. A slice of bread is about 100 calories. And then if you eat it before a major meal, let's say you're going to eat lunch at 1pm around 12:30, eat a few nuts, you'll actually feel satiated and you will probably consume less calories at lunch. The study in the New England Journal of Medicine again a couple of years ago, said people who eat nuts, and it included pine nuts, cashew nuts, almonds, walnuts, and also peanuts even. And I hate to tell this to patients, but I'm going to say it because it was in the paper. It said, even if they don't exercise and are overweight, live long.

Really, with no confounding variables like they didn't like. Are these food reporting questionnaires where they're looking at people who eat nuts but maybe are also eating other things, or were these actually looking at just like nut consumption versus no nut consumption?

Yeah, basically it is asking a survey, asking hundreds of questions. But the one thing that stood out is whether you eat nuts or you don't eat nuts. New England Journal of Medicine, you know, so I find that fascinating. It turns out that then people said, okay, peanuts, come on. We call that the lowly nut.

Yeah, it's not even nuts. It's a leg.

It's not even a nut. It's a legume. And so now a couple of articles have come out in the last two years. I think one came out in the British Medical Journal, where they specifically look at peanuts and they confer the same benefits and people live longer. So in terms of whether they should be roasted raw, you know, can you take peanuts and heat them and put some onions around? Commonly done in India, does that affect it? These studies don't address that.

Now, when it comes to peanuts, what about issues? And this is something. For example, there's a guy named the Bulletproof executive, Dave Asprey. He talks about how coffee can have mold and fungi and how how peanuts also can have mold and fungi issues and potentially cause allergenic reactions in people. Things along those lines. Do you have any thoughts on that in terms of sourcing or in terms of what they looked at in this research?

So the mold on these things is obvious, it's not subtle, and that you won't even notice it or it won't affect the taste.

What do you mean?

The fungus will be obvious.

So you can actually.

Yeah, you don't close your eyes and eat the peanuts. Right. You buy them. And if you open something and it looks funny and it's smelly or it's got a mold on it, you either go back to the grocery store or Whole Foods and say, what are you selling? Or you.

So it's like fish oil if you smell it and it smells rancid or it smells fishy.

Yeah.

Even if it's a good fish oil.

So, yeah. So there is A mold that grows on peanuts, and it's called aflatoxin, and it is one of the most potent. But it's not only peanuts, it's other food as well, especially in Africa. And it is one of the most potent hepatic carcinogens. So people have hepatitis B, they're at risk for liver cancer. If they have hepatitis B and they consume some of these foods with aflatoxin, the risk shoots up.

Well, you can just drink a bunch of coffee with your peanuts, right?

Yeah, that's the key.

You know, what I understand is that there are certain peanuts that are grown in dry, arid climates, like Maranatha peanut butter or Arrowhead Mills peanut butter, which are actually aflatoxin free because they're grown in these dry, arid areas.

Yeah.

And that's generally what I look for. I don't, I don't do, as I try to do, more raw almond butter or raw walnut butter than I do peanut butter. But when I do peanut butter, I'll look for a brand like, like the Maranatha or the Arrowhead Mills to, to ensure I'm, I'm not getting, you know, peanuts that have, have mold or fungus on them. But that's interesting that these, these two research studies.

But by the way, peanut butter has not been shown to have health benefits.

Peanut butter compared to peanuts, has been shown to not have seen health benefits.

Yes. Not to my knowledge. I don't know.

What about peanut butter that's made from just peanuts?

I don't know if it's tried. Last time I looked at it, it said no, it's similar to, you know, if you have fruits, it lowers the risk of type 2 diabetes. If you drink a lot of fruit juices, it increases the risk. Now, probably that's because it's not pure fruit juice. It's not that you and I took that mango or that orange and crushed it and used the pulp and put it in the glass. They're putting preservatives, they're putting sugar, they're putting other stuff.

Yeah, I mean, I could totally understand if the peanut butter has hydrogenated oils and sugar and stuff added to it. But I mean, if it's peanut butter with just peanuts, I guess the only thing I could think of is that it's very, very easy to over consume and perhaps reach a lot of diminishing returns with any type of nut butter. I tell people, yeah, you know, think of nuts the same way you would eat nuts in the wild if you had to shell them. You know, anybody who's gotten a bunch of of nuts in the shell and you keep those on your kitchen counter around Christmas time. It's a pain in the butt to have to eat nuts. And so when I, when I eat almonds, I think, okay, how many of these almonds would I eat if I had to shell them? And honestly, it's not much more than like a small handful. And I think that that's a kind of a more natural way to, to consume nuts just so you don't overeat, you know.

You know, I happen to like pistachios and you know, you have to crack the shell and I carry it in my car. I'm a little hungry. I'm going to a meeting. They may serve lunch at the meeting. They're probably going to serve an unhealthy lunch. You know What? I'll have 10, 15 of those pistachios.

Which are great for the microbiome, by the way. Pistachios.

Yeah, yeah. And the, the other thing that I think it's worth the listeners to know is that please don't drink diet drinks.

You mean, you mean, you mean diet drinks with, with artificial sweeteners and stuff like that?

Yeah, yeah, yeah. You're gonna have a Coke, Have a Coke, have half a Coke. Okay. Get 60, 70 calories.

Is that because of the effect of artificial sweeteners on the microbiome?

It does, yeah. It affects the microbiome and actually glucose intolerance is worse with artificial sweeteners.

Yeah, yeah, I've seen, I've seen the same thing. Aside from stevia, stevia appears to be relatively safe in most studies. Yeah, unless it's thethe truvia version of it produced, I believe by the Coca Cola companythere's a lot of other additives in that form of stevia, but like good raw organic stevia seems to be somewhat safe. So you alsoso, you talk about coffee, you talk about vitamin D, you talk about nuts, you also talk about meditation. And I specifically think it's fascinating what the effect of meditation is on anti aging and telomere length. Can you get into, into what exactly happens to ourselves when we meditate?

Yeah. So, you know, for centuries people have meditated and found subjectively that they're happier, they feel experience more bliss, they're more creative, they have better interpersonal relationships. Now the science is catching up. What else does it do? These are all subjective. What about objective things? Elizabeth Blackburn, brilliant Australian scientist working in California, got the Nobel Prize in medicine or physiology with two other colleagues about six years ago. And she discovered and described what are called telomeres and the enzyme called telomerase. So at the end of my shoelace, there's a piece of plastic. At the end of our chromosomes, there are these pieces. They're called telomeres. And it turns out that the length of the telomeres correlates with cellular aging. And it's easy to imagine who would have lower cellular aging. So it turns out these are victims of horrific trauma, mothers of chronically disabled children, and caregivers of people with dementia. Right. The person with dementia is clueless, and they may innocently ask a question. The person, the loved one, taking care of them is dying. I heard a story about President Ronald Reagan. He had left the White House, and somebody had given him a replica of the White House. And one day, he's sitting in the parlor and he's looking at it, and he turns to Mrs. Reagan, to Nancy Reagan, he says, what is this? I think it has some meaning for me, but what is his structure? He did not recognize the White House, but he's just saying it. And meanwhile, she's dying. She was sobbing. So these three categories of people have shortened telomeres, and it may relate to as much as 10 years in lifespan. This is speculation. Who has longer telomeres? People who exercise. People possibly on the Mediterranean diet. And again, we don't know what component of the Mediterranean diet. Is it the olive oil? Is it the nuts? Is it the fish? And then people who meditate. And within four or six weeks of meditating, you start to see increase in telomere length and telomeres.

What kind of meditation did they use in these studies that showed that meditation affects your telomere length?

You know, I'd have to go back and look at the study, but I think it was transcendental meditation.

Interesting. Yeah, we. We did. We did a podcast with a guy on transcendental meditation a few weeks ago. And that, I mean, it seems in terms of research that. That, you know, it's kind of like Kundalini Yoga. Like, as a form of yoga, that seems to give a ton of benefits compared to other forms of yoga. It seems, from what I've seen, because I've looked. I've looked a lot in a meditation that TM appears to be the one that gives the most. The most benefits, which is why, you know, if I meditate, I do tm. If I do yoga, I do Kundalini. But that's interesting. That's interesting. In terms of telomeres.

Yeah. So I wake up every morning at 4, 4:30, and I meditate for 30 minutes, then I'm at a coffee place having my coffee at 6:15.

Now, what about the effect of meditation on the. On the gut?

I don't know. That would be another thing. What happens to the gut microbiome? What happens to gastric acid secretion? What happens to GI motility? There are some studies that people with irritable bowel syndrome benefit from tm. I think there's a lot of confusion. Meditation is very different than mindfulness. And tm, I think, is one of the easiest. You know, you're taught a mantra by a certified teacher. You get thoughts. How do you come back to the mantra and just do it twice a day? And even though we experience a lot of bliss and happiness, the real reason is to accrue the benefits and activity, which is why do it first thing in the morning. And then if you have time, do it at 4, 4:35, even if you do it for 10 minutes. And I was saying you should meditate once a day, and if you don't have time to do that, you should meditate twice a day.

Specifically, when it comes to meditation versus mindfulness, I think in the book you have a section where you talk about mindfulness and how it can affect things like constipation and irritable bowel. What exactly is that? And what would be an example of mindfulness and how it would affect the gut?

So mindfulness is to be. To sort of live in the moment and to be aware of what's going on. Mindfulness means that when you're going to sit down for lunch, you look at the food, you're mindful of what you're going to consume, you're going to be mindful of how you're going to chew it, you're going to be mindful of whether you're going to have coffee after that. But there's an effort involved in mindfulness, and it's become very, very popular. But my personal feeling is meditation is far, much easier. It's like taking the right angle to dive at the deep end of the swimming pool from the springboard, and boom, you go into the water, there's no splash. You have this wonderful dive, and then you emerge refreshed.

So basically what it comes down to is transcendental meditation or something like that for decreasing the rate at which telomeres shortening. And then mindfulness, being aware, taking lots of bites, chewing your food, looking at the texture, the color, et cetera, to reduce the potential for irritable bowel or constipation or Something like that from a meal. Okay, got it. So a few other quick, quick kind of rapid fire questions for you here. First of all, in terms of coffee, do you have a favorite coffee that you drink? Like a favorite source, favorite method of preparation?

I happen to like tall Americano. That's the size I get. Yeah. And now as I. Even before I walk into the particular shop I go, they're already making it nice. They can see me parking in the car.

Do you add cream or sugar or you just do tall Americano? Black.

I have it black. You know, I simplify it. You know, I want cream and then I have to worry about calories. I want whole milk, then I want them to steam it because I don't want them to lower the temperature of my coffee, man.

After my own heart. Except I'm black.

Yeah, I just make it simple, right?

Yeah, exactly. I just do black coffee. And then typically most coffee shops don't have decaf brewed, so I'll order decaf Americano or decaf pour over. Okay. What about your favorite, your favorite source of vitamin D?

So I actually don't rely on the foods. And there is a website called Vitamin D3World and you can go and order a ton of vitamin D. And they're very, very tiny and they can come in different concentrations. 2000, 4000, 5000. And it's pretty inexpensive. So last time I ordered it was maybe six months ago. And I got two or three of those bottles and you said it's a vitamin D drop. A vitamin D3 world. No, they're very tiny capsules.

Okay, vitamin D3 capsules. Do you take vitamin K along with it to prevent the calcification effect of excess vitamin D?

No, no, That's a very good question, but I don't.

Okay, yeah, I take liquid vitamin D. At least in the winter I take it. I don't, I don't take it at all in the summer. But I take liquid vitamin D, but It's got vitamin K2 in it. I use this stuff from a company called, called Exos. Because I actually, if I get a multivitamin and I look at the label of the multivitamin and it's got very, very low amounts of vitamin D, I will assume it's not a good multivitamin. You know, if it's got like 200 international units of vitamin D, they obviously haven't done the research on vitamin D, but I also will not use that multivitamin if they also haven't included vitamin K. Because again, it becomes obvious to me that, that whoever's manufacturing that multivitamin doesn't understand the importance of packaging vitamin K with, with vitamin D. So I, I use the droplets like that or else I'll look for a multivitamin that actually has vitamin D3 plus vitamin K2.

You know, surprisingly, Ben, I've talked to a bunch of my hematology colleagues and they know very little about vitamin K2.

That's crazy.

That's like the medical profession needs to be educated about that.

Absolutely, I agree.

I'm glad you mentioned it. Yeah.

Okay. Two other questions because wewe've got coffee, we've got vitamin D, we talked about meditation but also exercise is one of the things that you talk about in your book. So favorite workout, what's your go to workout?

My, you know, so I happen to have been, I have coined a medical term and the medical term I've coined is boomeritis. Yeah, boomeritis, Baby boomers coming of age and creating a huge income for the orthopedic surgeons. So I'm 65 years of age. When I was young I ran marathons, I did pole vault, I played cricket. When I came to this country I used to play tennis in India. I became a total tennis nut. I would tennis court at home with a ball machine and I would play six hours, eight hours of singles and doubles on a weekend, both days. And now I'm the recipient of two titanium hips, both left and right. Five weeks ago I had a double laminectomy on my back. It doesn't stop me. I still play golf and I travel. I've been to 106 countries and I give 100 to 150 talks a year. But the back pain had become so severe, unrelenting, that I finally went in and saw this amazing neurosurgeon and in 1 hour and 40 minutes he did a double laminectomy. I didn't do a fusion so my leg muscles have atrophied. It's amazing what happens in two weeks. And I'm now I have a Fitbit of course and I'm doing about 4,000 steps each day and I'm slowly increasing it. I'm going on a 10 day vacation plus giving two talks at Oxford next Thursday. And when I come back I'm getting a personal trainer and I'm going to learn how to walk properly because I was little hunched over, the back pain and I have to flare my shoulders stand more erect. I'll probably do some hydrotherapy in the swimming pool.

Yeah.

You know all those things.

The biggest Tip I can give you is you need to read this book called True to Form. It's by a physician or a chiropractic doc actually named Dr. Eric Goodman. And it is the program that I give to any of my clients who have low back pain. I've now converted my entire morning routine to do the exact exercises in this book. It essentially turns on your glutes, decompresses your spine, and I'll have people follow it for four weeks and their back pain just disappears. But the cool thing is that it's really good for athletes, too, because it activates your glutes. So it's called True to Form. I'm gonna do an article about it soon on Ben Greenfield's.

Yeah, yeah, I'll Google it right away and order it. True to Form.

True to Form. All right, last question about your habits. Your favorite nut. What did you say your favorite nut was? Pistachios.

You Pretty much pistachios. But I'll also have peanuts. You know, and the old Indian style is sometimes my wife will roast half of them and add a little bit of lime and some onions, and it's. It's a wonderful snack.

Roasted peanuts with lime and onions.

Yeah, just before the single malt scotch.

Nice. I like it. I like it. You are a man after my heart. Okay, so one last question.

I want to meet you, Ben. Where have you been?

Yeah, I'm way out in Washington state, other side of the country.

Okay. One of these.

Yeah.

Okay, good.

I'll actually be out at Princeton in October speaking at an endurance symposium over there. So maybe I'll swing. Swing over to Harvard on my Ivy League tour. You have a lot of stuff in here in terms of these five things that people can do. If people just need a simple way to remember all of this. Do you have any tips?

Yeah, I think. Here's a good, easy way to remember. On a wonderful, good sunny day, go for a brisk walk or a short run to your favorite coffee shop, Java shop. Don't put sunblock. Now you've got the benefit of the exercise, the vitamin D and the coffee. Don't go nuts remembering this. And before you go for that run, meditate. Now you got all five.

Don't go nuts remembering this. I see what you did there.

Yeah.

Nice.

And before you go, meditate.

That's a morning routine I could do. I like it. Yeah.

Cool.

Well, Dr. Chopper, this is fascinating. And if anybody's listening in, I took notes on everything from the mighty Mouse research to the elephant and weasel poop, coffee and beyond. If you go to BenGreenfieldFitness.com Big Five, that's BenGreenfieldFitness.com big the number five. I'll put a link to Dr. Chopper's book in there as well. So check that out. I highly recommend giving it a read, especially if you want to delve into the nitty gritty research behind some of the stuff that we talked about. Because, because there is a staggering number of studies. We're not just pulling this stuff out of our butts. And oh, by the way, speaking of which, I'll link to the coffee enemas too.

Yeah.

Okay. So doctor, sorry, one second.

Quickly tell me the name of that book again.

It's called I'll link to it in the show notes as well for people, but it's called True to Form. True to Form.

True to Form. Okay.

Yeah, it's definitely worth a read. It's super simple. It's got all the photos in there. You do one thing Monday, Wednesday, Friday, another thing, Tuesday, Thursday, Saturday. And it takes like 10 minutes in the morning. Really easy.

Awesome.

Well, cool. Well, thanks. Thanks for coming on the show, Dr. Chopra. I really appreciate it. Really appreciate your time and you know.

A ton of stuff. I'm so impressed and I learned a lot on the show with our conversations.

I'm an idiot. I'm an idiot savant. I know a ton of stuff about, about fitness and nutrition, but so go to BenGreenfieldFitness.com Big Five, check out the show notes. And until next time, this is Ben Greenfield with Dr. Chopra signing out. Have a healthy week.

You've been listening to the Ben Greenfield Fitness podcast. Go to BenGreenfieldFitness.com for even more cutting edge fitness and performance advice.

Sam.