How to run healthy and strong with Dr. Cucuzzella (2:24 marathoner)

The heart rate's a marker of what's happening metabolically, physiologically, how we're accessing fuel, how we're teaching our body to use fat for fuel. I mean, that's what Mark Allen was doing before they really understood fully, you know, fat max, these terms like what pace are you going where you're burning the most fat per fuel, and that's actually your sweet spot. You know, what is the fastest you can go when you're actually optimizing your fat burning? Because then you got the big log on the fire. As soon as you go a little harder than that, now you're burning matches. You know, but it's pretty subtle. You might not feel it, but now we've got a lot more objective measures.

Welcome to another episode of The Extra Mileage Show, number 58, with Dr. Marco Gisella, round number 2. Before we dive in, I would like to thank Element for sponsoring this episode. Element is a delicious sugar-free drink mix that has everything that you need and nothing that you don't. I drink it in the morning, it— mix it in my water, and it tastes delicious. The orange is my favorite flavor. Increasing my electrolyte intake has made a noticeable difference in my energy levels. I no longer have brain fog, and the quality of my sleep actually improves. Sometimes after hard workouts, especially on hot days, I would get headaches, and this really no longer happens. Electrolyte deficiencies are common, especially among athletes, and I think many people don't realize this. LMNT can help prevent and eliminate headaches, muscle cramps, fatigue, sleeplessness, and other common symptoms. It is a science-based electrolyte rate of sodium, potassium, and magnesium, which helps make you feel great all day. Also, they have a no BS, no questions asked return policy. So if you don't like the product, like, you can buy it, you can try it for an unlimited amount of time. If you don't like it, they will give you your money back. You don't even need to return the box. That is how confident they that you will love it. Go to drinklmnt.com/flow to get a free sample pack of 8 flavors with your first box. That is drinklmnt.com/flow. See also the link in the description. Today's guest is Dr. Mark Guggezella. He ran the Boston Marathon 25 times and he has a personal best time of 2:24 in the marathon. For 30 years, he has run a sub- 3-hour marathon. He's also a doctor and a professor of family medicine at Western Virginia University School of Medicine. Dr. Mark Guzella is also a lieutenant colonel in the Air Force Reserves, designing programs to reduce running injuries in military personnel. For all the podcast listeners, do know that every episode is available as a video on YouTube. And for all the YouTube viewers, know that every episode is also available as a podcast. So if you want to listen to it on your run or if you want to watch it, just so you know that that is available. I hope you enjoy my conversation with Dr. Mark Gugosella.

Dr. Mark Gugosella, thank you so much for coming back on the podcast. It's been 4 years already. Can you believe it?

Yeah, yeah. My pleasure, Floris. Been looking forward to chatting with you for a while and been following all the good stuff you're doing. So yeah, let's share the love.

No, absolutely. And it's been fascinating to see how much has happened over the last 4 years. And I think one thing I found quite eye-opening was how much more awareness there is for low heart rate training. And recently you sent me a presentation deck from a presentation you gave, and even there, just seeing all of the different resources that are available right now, like, how have you seen that over the years, like the low heart rate training awareness becoming more mainstream?

Yeah, it's a good question. And I think, yeah, mainstream because now people have heart rate monitors. But, you know, when I gave a couple presentations on this topic of aerobic development and, you know, what some people affectionately call like zone 2 training, like what is that? You know, so back in the early days of like Arthur Lydiard, they would just go out on conversational runs. You know, so for those listening, Arthur Lydiard coached like 12 Olympic medalists. Multiple gold medalists. And he didn't have any exercise physiology background. You know, he was a milkman who started running and he got into running coaching by rehabbing cardiac patients. You know, so, and around, so he was the coach of like Peter Snell, one of 3 Olympic gold medals in the 800, 1500. So those are considered, you know, pretty lighting matches, short, short anaerobic type events, but they require a huge aerobic development to be able to perform in those 800, 1,500 meters. But before he did that, he was involved with rehabbing cardiac patients where in the US, I'm a physician. So in the US in the 1960s, well, if you have a heart attack, you know, you just need to rest, right? You must rest the body. Bill Bowerman, you know, that's a long story, but he went over there to take his elite runners from University of Oregon. So Bill Bowerman founded that little shoe company called Nike, but was 10th Mountain Division soldier, Flores. And so, you know, he had a lot of pride, but he decided to go bring his team to New Zealand to learn what Arthur Lydiard was doing. There weren't podcasts then, so for the internet. So if you wanted to know what a coach was doing, you had to actually go over there and spend some time with them. There was no other way of disseminating information. But so he shows up there and he sees this little group gathered under a tree and they were going to go for a jog. You know, that word hadn't even been invented. You know, maybe it'd be like the word woke in 1970. None of us would know what that means or gaslighting these new words. So jogging was like that. The word jogging didn't— or aerobics, you know, that was Ken Cooper, you know, 1968. So he joins that group and to see what they were doing and he gets dropped he's being bullied, you know, going up the first hill by a cardiac patient. So, you know, he's asking Lydia, you know, what are these guys doing? He says, well, that's my cardiac group. They're just going for a jog. Just show up with them every day. So he shows up, you know, starts walking up the hills, but then ultimately, you know, is able to jog for 30 minutes. And that was the goal for the cardiac patients was to be able to jog for 30 minutes. And then ultimately some of them went on to run marathons, but that was that baseline health was being able to jog comfortably for 30 minutes. So they didn't have heart rate monitors, but they used to call it New Zealand fartlek. So we know this term fartlek is play, just play, don't be too structured. But he knew that most cardiac patients were type A. So the version of fartlek Lydia taught the cardiac patients was a different version, was to be happy and conversational. So that was the fartlek, that's play, it's fun, it's enjoyable, and that's the way back to health. So then you've had Phil Maffetone and many of of Phil's disciples. So in the 1980s when heart rate monitors were probably about the size of this big water bottle. So he was playing and Phil is like Yoda. I've had the privilege of working with him, teaching courses with him, and going back to the early days of this. So he knew that the people that were type A, like most endurance athletes, they need some type of objective marker. You know, it'd be like, ultimately, it's like that heads-up display on your car. You know, we want to be able to see things ourselves and intuit it, but some people actually need, you know, you're going, you know, on your windshield, right? Like a Formula One car, it's going to say 62 miles an hour. So they need that objective marker until they actually truly understand it and feel it.. And so, you know, he started working with people like Mark Allen, you know, and he had lost 6 Ironman triathlons, was about to quit. And anyone can read his story or listen to any of his podcasts, you know, and he shares his story. He's like, he was about to quit. And then he goes out to the desert to find this guy, you know, it's like Yoda. And he says, Mark, just slow down, trust me. And you don't question it. It's like you go to the master and he says, do this. And you come back in 6 months, right? And you don't question it. But then he went on to win 6 Ironman triathlons. Most people remember him for that, but they don't remember that he lost 6 Ironman triathlons to this guy named Dave Scott. So those were kind of the early days of it. But, but now, you know, you look at like any, like, uh, Dan Plews, you know, so I think, you know, anyone who listens to your show, just go to EndureIQ, you know, it's his website and his blogs, you know, so you, you take, you know, like the, the, the perfect Renaissance person for all of this would be the athlete scientist and the coach, right? So how do you combine all of these things, you know, and be able to disseminate information that's palatable for, you know, the average, you know, recreational runner, you know, like us, we're mere mortals, right? So, you know, he's working with the best of the best, you know, so he was age group Ironman. He still holds the age group Ironman record, like 8:20. But, you know, he's published about 100 scientific papers on, you know, heart rate training, timing of nutrients, right? Low carbohydrate diets, you know, the right food at the right time, you know, being able to adapt your body to use fat for fuel. So I think the heart rate training, now we're actually understanding that the heart rate's a marker of what's happening metabolically, physiologically, how we're accessing fuel, how we're teaching our body to use fat for fuel. I mean, that's what Mark Allen was doing before they really understood fully, you know, fat max, these terms like what pace are you going where you're burning the most fat per fuel? And that's actually your sweet spot. You know, what is the fastest you can go when you're actually optimizing your fat burning? Because then you got the big log on the fire. As soon as you go a little harder than that, now you're burning matches. You know, but it's pretty subtle. You might not feel it. But now we've got a lot more objective measures. Steven Seiler. So anyone can listen to Steven Seiler.

Yeah, we had him on the podcast as well.

Yeah. He was writing about this stuff. You know, he's an expat now in Norway because he married a Norwegian, but he was studying, you know, the world-class athletes, you know, in multiple sports in the, probably starting in the '90s, you know, and he developed, you know, I think they kind of made up the term. I don't know if he first called it polarized training, but he just witnessed what they were doing. And so they did a lot of easy training, but then, you know, certainly they had to do some hard stuff, but without the easy stuff. So the majority of training for us, these, whether it was a cross-country skier, speed skater, most of it was this zone 1, zone 2, conversational pace, you know, below.

He has an incredible YouTube channel as well where he dives into much deeper.

Yeah, I love listening to him.

Oh, absolutely. I love the part too that he brought out a TED Talk that has more than a million views and just breaks down in simple terms. Because sometimes I feel some of this data that gets put out there, it goes over the heads of a lot of people. And when you would mention to a recreational runner, yeah, just do this, this, this, this, this, it like goes in one ear and it goes out another. But if it's very simplified, like the way he presents it as well, the way I've heard you present it and other people, it's, it's much more easier to follow along. And like, yes, there might still be some some further personalization or some further tweaking as we improve in our running and as we like aerobically improve further. But yeah, sometimes we overcomplicate things too, I think.

Exactly. Keep things as simple as possible, but not one bit simpler. Yeah. His TED Talk, anyone can, you probably, you could throw a link on. Yeah. But, um, you know what he is doing and people like Inigo San Millán, you know, so you bring what are the best in the world doing, but you know, you and I really don't care, right? Cause we're just mere mortals trying to stay healthy, raise our families. And not get heart disease. But how can you take what we've learned from the best in the world and apply it to us? Or, you know, I see sick people. You know, if you look at how we do medicine compared to how, like, that car you're driving out there in your driveway is technology based on a Formula One car, right? So Toyota, if it's a Toyota, it's— they've taken what they, they've learned from the best-performing vehicle and putting it into your car. So you've utilized that technology and brought it down to drive to your grocery store. But what we do in medicine is actually the opposite. We take broken people and compare them to sedentary people as the gold standard. So we never fully understand what is that perfect human, how does that person operate, that gold standard, and how can we apply that to a patient with diabetes? To try to help them get healthier because different rules apply, you know, on how you need to exercise a diabetes patient versus Eliud Kipchoge, you know, like who can tolerate high intensity and what happens at a, at a cellular level that you can easily understand that a patient, an athlete, you know, just anyone wanting to be healthy can bring into their life. But most of it, actually, the common thread is you slow down, right? Like you start there and you, and Then you figure out, you know, okay, how much intensity later can your body handle, you know, structurally and physiologically, you know? So, okay, the load, you know, plyometrics, there's a lot of structural load to that, but then the metabolic demands, you know, what energy systems are you using?

Definitely wanna come back, come back to that point you just made earlier about like the people being compared to sedentary people versus optimal. Cuz I do wanna talk later on a little bit about blood work work and for athletes and whatnot. First though, sticking with the low heart rate training for a little bit, we still see some people that are new to low heart rate training starting out with this approach, and they might not right away start seeing that they become faster at the same heart rate. Do you have any recommendations when people are starting out with low heart rate training, some of the things that they can experience, and even if they're not improving some ways to troubleshoot this.

Yes, I think some of it is, so how do we actually pick the heart rate? So unless they've actually been to an exercise lab, which is probably 1% of people, you know, we're all wired a little bit differently. So, you know, a good marker that you're in the right zone, so to speak. So, you know, we breathe in oxygen and we breathe out carbon dioxide. So glucose, when we're burning glucose, we make more carbon dioxide. When we're burning fat, we make less.. And in the lab, they call that a respiratory exchange ratio. As you go from off the couch to all-out sprint, you know, you're ideally using fat for fuel, you know, when you're at easy efforts, but then you gotta, you know, put on the gas and you're burning glucose. So everyone has a speed where, okay, you and I are going for a jog, Floris, and you, you're 40 and I'm 56. So at a certain pace, you now would be like still chatting away and I would be, so I'm out even if my heart rate is saying.

I actually doubt that. It's probably going to be the other way around.

I've seen your running times. Now at 56:40, maybe flip that 15 years before. But, but so my perception of effort there by an objective marker, my respiratory rate. So I'm still a bit too hard. But there's other things going on in people's lives, right? So, okay, I'm sleep deprived. I'm working night shifts. I'm stressed about this or that. Something's going on in my family. So if your body's— I'm still eating a crappy diet. So it's not just— we can't reduce— because really what you're trying to do is create a healthy human specimen. And Steve Silos talked about that. And he had a beautiful interview. It wasn't an interview. They did kind of a report by just looking at all of Molly Seidel's training and her philosophies. And she said this, you got to be healthy first. You got to be healthy first. So, you know, her nutrition wasn't healthy. Her training was overloaded. You know, it doesn't matter like what your heart rate, you're already overloaded right there and you're going to break. So, you know, on her foundation, you should listen to that one. It's like, yeah, she's running twice a day, all of it mellow other than like 3 key workouts a week. You know, but she's figured out that's, you know, she's higher volume runner, which someone else may not respond to higher volume. Everyone responds a little bit different depending on our muscle fiber types, but everyone needs to, you and I can give some general guidelines, but then the individual out there, you know, has to look for how they're, that's why working with a coach or an advisor, something's not working for you. There's usually something that that person hasn't sorted out. And that's like as clinicians, that's what we do in medical practice, right? So, or else we'd be replaceable by an AI box. People are humans with a lot of things going on in their lives. So it might not, they might be at the right heart rate, but something else is going on that's making them not feel good. They could have another medical condition. What if they're just horribly anemic because of something going on medically and they're like, I'm not responding to this heart rate training. Their thyroid's off. Something— they really have something medical happening to them that they don't know. So there's other— when people come in, you know, have this complaint medically to me, you know, we're checking all the boxes. Let's check this box, this box, hormonal situation, endocrine function, sleep, stress, your training. Oh, I'm training for an Ironman with 2 full-time jobs and 4 kids. Okay. It's probably not gonna work. So, but I'm doing it all zone 2, but I sleep 4 hours a night, you know, get up to swim at 4 in the morning. So I know I kind of went on there, Floris, but I think it's a complicated question when someone say, what's not working for me? Like, what is it?

We need to drill that down. I think you're spot on there. There indeed often seems two areas you can take that with. One is, is your heart rate training zone correct? And like identifying that part. And then on the other end, are you sleeping enough? Are you recovering enough? Is your nutrition on point? Like all of these other things, because very often I do see people taking a formula like 180-H and right away be like, oh, this is not working for me. Or like, but then when you start looking at the 4 hours of sleep a night, like actually, if you start sleeping more, it could be working for you instead of right away adding a +10 or +15 or like any of these other things. I think you made another good point earlier of the talk test, even with Arthur Lydiard, where it was just even before any of the formulas, it was just being able to have a conversation the right way. Because yeah, it's only 1% of the athletes does a lab test with the lactate testing and like it's a bit more complicated, but there's a lot of other ways you can get to certain data points from there on, even seeing how the body responds to that and looking at all the other areas under your hood. It's like, it's a bigger picture instead of of only looking at the running component or only looking at the one thing there.

So yeah, yeah, fascinating person I listened to, Flores. He spoke at University of Virginia. They have a running medicine conference every year, and this was probably like 8 years ago, was Frank Shorter. If you're listening, so Frank Shorter won gold medal in 1972 and a silver in '76 to a dude who was doped, so we'll give him 2 gold. At least I'll give him 2 gold. He deserves 2 gold medals. But he had a 17-year— he described his training, you know, and it was sports med stuff. But, you know, like, he's obviously like the patriarch of running in America, if not the world. But he just— he had a 17-year career where he was hardly hurt and he was at top of his game for about 17 years. It's a long, long time. But he said he knew this to be true. He didn't— he was self-coached and he didn't have a physiology degree. He was a lawyer. But he said, the more I did the hard running, the more I needed to do the easier stuff. And he did a 20-mile run every weekend, every year, all year long, right? He just knew that he needed to do that. But he said the harder he did the hard stuff, the more he needed to do the easy stuff. And, and as we explained, like what happens with acidity, without that, you know, that huge base he had, he couldn't do that hard stuff. And he'd share these stories. He says, yeah, some people would show up. They had these group runs in Boulder. It's like him and De Costello, some of these early guys, and they would show up for the group run and they would be able to run with Frank Shorter. And they're like, oh man, I'm like hot stuff. I'm running with Frank. It was an easy day. He's just jogging along. But that's because he had to do that. And they'd ask him, Frank, can I run with you tomorrow? And he's like, sure, show up at the track. Different story., you know, doing 1,000-meter repeats at 60-second quarters, right? And you'd make it about 100 meters before you go, oh, I think, oh, shoot, my hammy's bothering me today. You know, I'll call it. But like, yeah, that we just learn physiology by what works for people. And it's more easy stuff, right? I've never heard the story of any athlete who has had a long career hammer themselves year after year, right? They have— even looking at countries that develop athletes, you know, so the countries that really focus on high intensity, they have these one-and-done athletes, right? They, they have one Olympic cycle, then they're done. And then these folks that keep— the Kenyans for like Kipchoge, right? People that keep coming back year after year, they call it the Kenyan shuffle. They're easy days. They run like easy. And it's just the way it is. So I think, you know, until someone proves otherwise, you know, what humans do that works, then as scientists, we have to figure out what are they doing that we can apply down to the mere mortals. You know, so Steven Seiler, the talk of his TED Talks is something like his TED Talk is like what we have learned from the best to apply to normal people. That's what we really want. That's why you do your show. Like, how can we? Yeah. Apply this to normal people without masseuses and, you know, afternoon naps and all that good stuff.

Without the luxury of being able to nap for hours.

Or just call it a day.

Give me a break. That part is still possible. Yeah. Let's talk about lactate shuttle for a little bit because this is kind of an extension of some of the things you've mentioned over here.

But can you break that down in simple terms? Yeah, in simple terms. So when I was, you know, early track days, you know, and early medical school, right? So like when you ran hard, you developed lactic acid, right? Like probably everyone who's, I'm 56, you know, coach, you know, you're building up lactic acid and then, you know, and then no kidding in medicine, you know, we measure lactate in our septic patients, sick ICU patients, because it's a marker of hypoxia., and it's a marker of mitochondrial dysfunction. So when, when lactate is up, the, the system is more acidic. So the basics, you know, written on the back of a napkin for exercise physiology. So we've got 3 fuel sources that our bodies can use for energy, and it's all happening in the mitochondria. So we have billions and billions of mitochondria in our body. Our heart's probably the most, and brain are the most rich in mitochondria., and these need to produce energy. And so we can put fat into these mitochondria. That's a more sluggish process, multiple enzymes involved, a little more oxygen involved to do that. That's why you got to be going a little slower, more patient to tap into the fat, you know. So it's kind of like a series of gears. Glucose is like you gotta climb up the hill, hit the gears, you're using glucose right away. Now glucose has a couple different pathways right away. Glucose shuttles to this other byproduct called pyruvate and makes lactate. This is the anaerobic system without oxygen, and this is not happening in the mitochondria. This process is happening in what's called the cytosol of the cell. If you were to pull up a model of a cell, you've got the energy factories, the mitochondria. This is where the magic happens. But if we need energy really quick, and you can do it without using the mitochondria, so you can produce a couple ATP You know, whereas fat can produce about 120 or 150 ATP. So the— but you get— you can get the ATP right away in the glucose path, but you produce what's called lactate. And that lactate is necessary when you break down glucose, and that lactate produces acidity. It just travels with acidity. The more lactate, the more acidic the environment is. And ultimately, that acidity is what makes your brain and your muscles say No bueno, I'm done. Now that glucose, in the presence of oxygen, that pyruvate can get into the mitochondria, and it's called aerobic activity. But you're using glucose, but you're not really producing the lactate. Not as efficient as the fat. But when you kind of ramp up the speed a little bit too high to allow oxygen to do its job, you're producing this lactate. Now that lactate can have a couple fates. So the unfit metabolically sick patient, that lactate cannot get back into the mitochondria. There's no— the mitochondria are dysfunctional. We produce acidity. And my patients who have diabetes type 2, they produce lactate getting off the couch. We put them— I do exercise testing here 3 days a week at my hospital. At like stage 1 of a stress test, they're already, already gassed. They're already getting acidic. Now, the fit athlete, so these, this lactate is mostly produced by what are called the type 2. These are more your fast twitch power fibers. The type 1 fibers, these slower twitch fibers, they love fat. They don't use glucose quite as much and they don't produce the lactate quite as much. So when you're kind of getting into that pace, maybe a tempo run where you're breathing a little harder, Right, you are, and you're tapping into those faster twitch fibers producing some lactate. But kind of as Frank Shorter discovered, if you have a really robust type 1 fiber system, slow twitch fiber system, what happens is you got this magic shuttle, like a little shuttle bus, that can take that lactate and bring it back into the mitochondria as another energy source. And all roads lead to what's called acetyl-CoA for the nerds out there. So this lactate can now become a fuel. So it's like, wow, this thing that we thought was a toxic byproduct is a fuel. So that's why people that are massively aerobically fit can do interval training, right? Because you can go do, you know, 8 quarters on the track, but you recover, right? So you build up the acidity, right? We've all done that. But wait, now like in a minute, your heart rate's back down. You're fine. You can hit it again.. But if you didn't build that type, and that's, that's happening in the type 1 fiber. So you're building up the acidity in the type 2s, but all of that easy training builds the type 1. So you're building this massive base of type 1 fibers that can buffer. So you kind of have to earn the right to do interval training. So without, that's what shorter lineage runners discovered. If they didn't do all of that, you know, all the cross-country skiers in Norway, right? They do 80 to 90% of their Kilian Jornet. You had him on the show, right? He's a massive fat burner. He eats a lot of carbohydrate. Carbohydrates, but he's, he can burn fat for fuel because he goes out on 6-hour runs without eating, and he's mostly in zone 1. And when you, when you look at an elite athlete, their zone 1 is like our zone 5, right? So he's, he's technically physiologically like, like not even fat maxing, right? He's just out for a walk, but he's running like an 8-minute mile up a mountain, you know, at an effort you and I would be gassed. But, yeah. So, the bigger the base, the higher the peak. So, without the base, you're like Pisa, right? You don't want to be like Pisa, big pyramid. As Siler says, training is you're baking the cake and racing is eating the cake. So, you're building this base to be able to buffer that acidity.. And that holds true in any rowing, cycling. Look at the best Tour de France riders, right? They've got this massive— they're not even producing lactate, you know, to any degree that would cause any discomfort until they're like at 300 watts. And if you're a cyclist, you know that, like, holy shit, right? Yeah. It's like all out. But these guys are having a conversation. But that's— and they're not on low carb diets or they built this metabolic machinery that they can use fat for fuel because the type 1 fibers use fat for fuel, whether you're, you know, eating more or less carbohydrates is, you know, you can shift it a little bit, but it's more about the training that's doing that necessarily than what your habitual diet is. The habitual diet can move it.

But I hope that makes sense in plain language. Yeah. So, so, so once again, to summarize, low heart rate training is very important to build that pace that is even going to be beneficial at a higher intensity.

Yeah. Then you can do the mile race or the 5K, right? Or the, you know, we started teaching this for the military mile and a half run. So the people, they were convinced because it was the high intensity culture. Well, I got to run a mile and a half. I need to run it fast. So I have to train fast. But no, the opposite was true that, you know, because that really is at what we would call that, that lactate threshold where we're not able to buffer the lactate where ultimately you're starting to get acidic and you shut down, right? You're not— it's not because you're out of fuel, it's only a mile and a half. You get enough acidity where you're just like, I'm done. But so to raise that, that level, you have to raise that first level, you know, so that you push it up. And it's hard to convince, you know, military people who are Type A that to get fast on your mile and a half You got to run slow because that's why they're in the military, right? They're like, you know, I'm going to go harder than this dude, David Goggins type approach, you know? Yeah. I love listening to the dude, but, you know, will break the average citizen. Yeah.

Even though he does do a lot of talking, conversational, everyday pace running, but yeah, then there's the other element again over there too.

Yeah.

No, no, I love listening to the guy. He's awesome. He's sick.

Same here.

You definitely got a lot of people off, off the couch.

Yes.

For myself, what I've noticed, kind of in line with what you were just saying, is I did two lactate tests at a lab about 15 months apart, and I did a lot of low heart rate training in between. So the, the whole lactate is that signaling molecule as well, where it tells your body you're in pain, you've got to shut it off. And so the first time when I did the lactate test at about 7.8 or 8, I felt like, all right, I'm done with this test. Yeah, that's pretty high.

Too uncomfortable.

The next time I was able to push it to 14.9. And like just that difference over there, like, yes, I trained more, but it was also a lot of low-intensity training. I also became more comfortable with discomfort, I think, with just being able to push that that, that max further to the right too, the discomfort I was able to hold there.

So that's your max. I'd be curious to see, so say it's a run test and you're on a treadmill, you know, like a 7-minute mile, 6:30 mile, 6-minute mile, you know, the fitter you are, the less lactate will show at the higher speed because you're able to shuttle clear it. Absolutely. Curious to see if that moved what we will call to the right, meaning Absolutely. It did. It stayed at like 2 millimoles of lactate, which is still very comfortable aerobic. You know, where, where do you start to, where does the line curve start to go up? Because that's the, so you want to train before you see that curve start to go up. That's your point. That's where you want to kind of stay a little bit to the other side of that. And that's a good 2.0, 1.9 over. Yeah. And everybody's a little bit different. I mean, it's practically, you know, most— are you breathing comfortably or are you not breathing comfortably? And I think most people know that without the test. But the tests are fascinating. You know, I've been in the lab multiple times getting these tests and I love being a human subject as you do too because you learn the physiology because it makes it real. And then you see train different for a year and you see eat different and see, okay, let's see what happens.

In my exercise test. Yeah, and now these tools are becoming more and more accessible too. It's even the tools of like, ah, some athletes start to buy their own lactate meters and you don't— yeah, you can go to a lab, but there's also people who are starting to train themselves, or even like the continuous glucose meters or some of these other things that are becoming more accessible to a wider audience.

So yeah, and as long as you have good— I think people like that heads-up display. I think sometimes if you're, you know, without really knowledge of what these things mean. You know, I remember listening to something and they were talking about, you know, the Ironman triathletes have limitless income, you know, and certainly the Norwegians who win everything, you know, they've got a whole science around lactate. But then you have all the age groupers now, you know, in the middle of these races checking their ear for lactate. I honestly don't think we need to be going there. Just all day, just go out and and rides, you know. Yeah. But, you know, it's, you know, they're working on, you know, like I've got a continuous glucose monitor in my arm, but there, you know, no kidding, in 5 years we'll have continuous lactate meters. You know, we'll have all kinds of other things that I think will help. And the technology that is expensive now, right? Like this little monitor on my arm, you know, you can $75 for a month. Yeah. Yeah. That one as well. But every patient I have with diabetes, I offer it to them. Because they learn about their diabetes. Oh wow, when I exercise it goes down, when I eat a bagel it goes up. Like they learn and then maybe they don't need it anymore. But that, you know, just like my phone or like a little heart rate monitor, you know, they used to be, you know, this is my favorite one here in my pocket. This is just that little OH1. I'm not, you know, endorsing any products or, you know, have any conflicts of interest or anything, but I find that like This is old school, actually. This thing's like 8 years old, but the wrist ones I have, it seems to be like all over the place. You know, maybe it's just, you know, I'm lean and it's just, it's cold, but they, you know, it just loses signal. But this little one here, which cost like $50, you know, just sits tighter, you know, to my forearm or my bicep.

And you prefer that one over like a chest heart rate strap?

Yeah, I'd It's just a pain in the ass to put on the chest thing. Most people have worn those. It's just like, yeah, it gets sweaty and gnarly. This thing I just slide onto my forearm and it picks up and it's perfect without putting the chest strap. But I think find something that's accurate, works easy, and don't necessarily look at it real time all the time. Just maybe just go for a run and then download the data later. And see, oh wow, that was good. So then you can start to get your brain in the game, learn something. Oh wow, that felt easy. And heat is going to affect it. Other things affect it. So it doesn't mean that you weren't really in that right zone. If it's 90 degrees and humid and you're at a conversational pace, no kidding, your heart rate's going to be higher because you're delivering blood to your circulation to cool your body. So that doesn't necessarily mean that you weren't in the right zone that day because environmental factors are going to shift that without it being a negative thing.

So don't get too tied to the data. Would you not recommend people slowing down a bit more on hotter days though? Oh gosh, yes.

Because their bodies are automatically going to be working hard.

Your heart rate will be higher. Yeah, it's a bit of a fine line there, right? Because you also want to watch out that you're not pushing it as hard as on really cool days where typically you see yourself—

conversational on hot days, but you'll find even conversational, your heart rate's going to be higher at the same, like, perceived effort. You know, they call them like the Borg scale, you know, am I, where am I on a 1 to 10 or 1 to 20? So it's going to feel like the same perceived effort, which should be, you know, low, comfortable, but your heart rate might be 10 beats higher, you know, in a warm day. Sometimes even the time of day, you know, depending on your stress level, caffeine load, you know, you may be a little, you know, a little lower in the morning time than later in the day when you just have more stuff on your mind. Heart rate just might be just a little bit higher, but learn your pattern just like you have a glucose monitor on floor. So you probably see what your pattern is, which is going to be different than my baseline pattern. So there's not a perfect pattern. Well, I want to be like Mark's pattern or Flores's. I want to be the pattern I am when I feel good. I wake up tomorrow and I feel like running, right? If you don't feel like running, something's going on, right? Like you're overtrained, underslept, but you should. You probably wake up every day and like, I feel like you need to. I mean, most days, Flores, do you feel like, like I feel good, right?

I feel like, oh, for sure. This morning at 6 o'clock, I was awake at 5 AM and then at 6 o'clock I woke up my daughter and I was like, come on, let's run. And she's like, no. And I know, like, as soon as she was out, she was all excited. But yeah, she wanted to turn around for one more second, but she just needed a little kick into the butt.

And then once we were running, she had like a super blast of a time right there. Wow.

Your daughter goes out and runs at 6 in the morning?

Before school. It keeps you alert. It's good for her brain as long as she wants to.

To do that. Gosh. Yeah, no, she's normally good. Like, yeah, it was, uh, it was one of those. Oh, that's cool. Um, one part I want to talk briefly about was blood work for athletes, because I think sometimes athletes are out there, they're training consistent, they're doing a good job with movement throughout the day. Sometimes they might actually eat quite well, or think they eat quite well, Yet they might experience certain deficiencies. Like last week, a friend of mine did a, did a blood test and he found out he was very low on vitamin D levels and he was low on magnesium. And he noticed something was off in his body. He just had low energy. So he ended up going and doing that. Like, what are some things that you see sometimes among athletes?

Yeah. Like with blood work? Yeah, the basics. A lot can get misinterpreted with blood work and there's a lot of charlatanism online about you know, $800 blood panels with stool samples looking at this and that. We're going to tell you what to eat, some personalized stuff. So there, there probably is a little bit of truth in that with a lot of marketing hype. But like, it's just like training, you know, the fundamentals are the fundamentals, and then you can get into the weeds and nuance. But so, so for example, common things we see, you know, in people, whether they— no matter what their nutritional strategy is is vitamin D deficiency. So vitamin D, even though it says a vitamin, is not a vitamin we really get from our food. If we get it from the sun, and you know, no kid— I take vitamin D year-round. I go to work, right? I run at 6 in the morning, so I take vitamin D and I check it once a year. And for me, I need to take about 5,000 units a day just to maintain normal vitamin D because I'm not running at lunch without a shirt on. So if you're in any part of the world where you're not out in the sun, get your vitamin D checked. And it's not your fault if it's low. It's just you are not in the sun. So now we can look at specific things I see in different types of nutrition strategies. So B12 is actually pretty common, and B12 is an animal product. So if you're out there listening and you are, you know, fully vegetarian, fully vegan, not getting any animal products, you got to supplement B12. B12, right? So I mean, people can live like that, they can thrive eating just vegan vegetarian diets, but they got to supplement, right? Because it's missing things. So B12 for sure. So if you're minimal animal product, for whatever reason you've chosen to do that, get a B12 level. And if it's low, and you can certainly continue to eat the way you're eating, but you got to supplement it. And the— what we see in the lab panels for us too is this bell curve, and they call it normal range. So there's normal range and optimal range. So they may say vitamin B12, like it starts at about 200 is in this bell curve normal range, but that's not optimal. So we want to be kind of more— I forget the nanograms per mil or something, but you want to be about 500 on B12. So I mean, if you're someone who's on the more carnivore side, you probably are fine, right? So I've never seen anyone who's just, you know, eating a lot of animal products be low on B12 because you're getting a ton, like eggs and meat and fish, get a ton of B12. With that stuff. But if you're not having that stuff, get a B12. And iron would be a similar vein. So iron, there's two types of iron. There's heme iron, which travels kind of in the red blood cells. So red meat is the rich source of what's called heme iron. And heme iron is the most bioavailable, meaning our bodies utilize it. So if I buy a box of bran flakes and it says 100% daily iron, no kidding, half of that's in my shit the next day. So it's not bioavailable, you know. That's like You don't. It's bound up with the fiber. But if I have ribeye, that is bioavailable iron. So if you minimize red meat, you know, for whatever reason you minimize, maybe it's just a cost thing. It's expensive to eat red meat, right? It's cheaper to get chicken, you know. Um, so if you're minimizing red meat, get what's called a ferritin, which is a measure of your iron stores. Very, you know, $20 test. Um, a blood count will also— so people will become iron deficient before they become anemic. I mean, I think it's fine people that are under really stressful lives get a baseline thyroid function, you know, a TSH test. But, you know, like measuring magnesium on a blood test measures serum magnesium, not what's called like the red blood cell magnesium content. So we're measuring more kind of serum than an actual— the active component of the magnesium. So you can get misled So magnesium, again, really rich in animal products and like the dark green leafy veg. So magnesium is something I think is inexpensive to supplement, you know, that take a little magnesium every night, you know. But if you're eating like a super nutrient-dense way of eating, right, you're eating plants and animals, right? That's in our DNA. So if you're eating good quality plants and animals, you're eating like everything you need, right? You don't— supplements are what you you would need if your diet is deficient in something or you're losing something. But you can get now, like, through sites like, you know, Ulta Labs and Own Your Labs. So you can go and order your own, you know, if you have a health coach, good advice. And it's a lot less— I order all my labs, you know, just, you know, on the internet, go to a LabCorp draw site because, you know, it's inexpensive and it's transparent. Like, okay, I want a vitamin D, it's $15. Right? You go to your doctors and they order a vitamin D and you get this bill 2 months later, it was $250. And you're like, wait, how did— because, you know, many, probably many of you out there, oh, I want to go to my doc and get some labs done. And you get what you think are these basic labs and there's like this $800 lab bill. And you're like, wait, that was just like a blood count and a thyroid test, a vitamin D. So, you know, you have to be a little bit of a wise consumer. But, you know, outside of those things, you know, if you have a specific family or medical, you know, I think a lipid panel You know, so that's your basic cholesterol panel. Cholesterol is not the problem. It's, it's an, it's an abnormal lipid panel with high triglyceride and a low HDL tells us your body's heading toward diabetes. So that ratio is the heart risk. So someone has high triglycerides, low HDL, you know, that's something to pay attention to. But that's fixed by your diet mostly. But you need a good clinician to try to sort that out. High LDL, which we you know, shouldn't and used to call bad cholesterol. So HDL is what people refer to as good cholesterol, but really there's no such thing. The cholesterol is the same, it's how it's packaged. So LDL is just packaged differently than HDL. It's all the same cholesterol, it's how it's packaged. So this LDL has confused people for generations. So LDL, you know, could be good. You can have these big LDLs where you could have small LDLs with the same LDL number. Now, if you have completely normal coronary arteries and a test that's $99, which is probably better than any lab test, is called a coronary artery calcium. You know, so if you're a middle-aged male or woman and you just want to know, gosh, do I have any plaque on my arteries? $99, right? Zoom, it's like a mammogram of the heart. And if, so I'm 56 and knock on wood, my score is zero. I don't have any plaque on my arteries. And I feel fortunate because my father had his first bypass at 35. Oh, wow. Genes load the gun, but lifestyle fires the trigger. So whatever his trigger was back then, everybody smoked, right? So, and he had a lot of stress because he had me as a kid. So, and 3 brothers just like me, which were all like ADD before meds, right? We were just like destructive neighborhood vagrants, right? Always getting into trouble. So it's just now, but whatever it was. But so, you know, I want my cholesterol to be high because it's part of every cell. So I really don't care. My HDL is like super high, but my LDL is also high. But if I had a bunch of stents in my heart, I would want to lower my LDL. So, so again, it's all relevant. We don't just lower cholesterol just because we have high cholesterol, take this med. It's very nuanced and You should always have a conversation with your clinicians. We should never put you on a medicine. So, Flores, your cholesterol was high, and if you leave— if you go into an office and I— and your doctor says, Flores, I'm going to put you on a statin, I'm going to put you on this med, just like that, like, no, we want to have a conversation about that. So I'm sure most of your listeners, because they're on podcasts, you know, you, you're in that world where I want to know, like, you explain to me as my N of 1, what does this mean? Don't just put me on a pill because healthy people don't need medicines unless there's something specific. So I think, you know, I'm trying to think if I'm missing any basic labs for health performance, but those are gonna be, you know, thyroid, blood count, lipid panel for your heart disease risk, B12 if you're not eating a lot of animal products, vitamin D if you're not in LA.

The red blood cell count is an interesting one too sometimes with athletes running higher volume. And that's one part too that I've noticed, some athletes just have been much lower red blood cell count. And I've heard certain, like, certain conversations there of like, ah, when you stamp a lot on, or like when you make a lot of steps on the ground, that you can actually like damage some of your red blood cells.

They call that March Himawa. Analysis. So again, if you have a low-ish, you know, there's a bell curve, right? So everyone fits somewhere on that as your normal. So if you're kind of low on a blood count, and for those listening, that's a CBC, hemoglobin, hematocrit. So say it's 38 or something for hematocrit, which would be on the low end. Now that could be completely normal and well, or you could be, all right, you might be bordering on anemia there. So check an iron store. Because if your iron stores are low, say you're a menstruating female, right? So you're losing blood every month, you know, just because of your physiology, and you're running on hard surfaces and you're tired and your blood counts low. Check your iron stores, because if that was because of the blood loss, your iron stores are going to be like gone before you start dipping into your blood count. But if your iron stores are all fine and I look back at your labs and you had that same level 10 years ago, That's like your eyes are blue, right? So it's your eyes were blue then, your eyes are blue now. And well, that's weird. Only 20% of the population have blue eyes. So it must be a medical problem or something. No, it's just the way you are. And same as like total cholesterol. If someone tells me their total cholesterol, it's like them telling me their eye color.

It's like, I don't, it doesn't mean anything at all unless we get more information about that. Yeah, I just want to add one last comment about this. In our Personal Best Running coaching program, sometimes we notice something is not clicking with an athlete. One of the checkpoints sometimes too is like more towards the end, but it's like, when is the last time you saw a doctor for an annual physical? When is the last blood work you've done? And even recently, someone went to the doctor, got his blood work done, and noticed thyroid function was off and just there knowing certain things and at least having a conversation with the doctor about it versus flying blind and not thinking about that part.

Sometimes it can bring things to the table that we just don't think about as athletes. Yeah, 100%. Yeah. So if you have, I mean, so I'm a 56-year-old male and if I was tired and my blood count was low, okay, well I'm of the age that I'd need to be screened for colon cancer. Answer. It's running too much, not enough. You know, I'll share, you know, maybe this. So I was 18 years old at University of Virginia running track. And like, I'm feeling like shit, Floris. Like, I'm tired all the time. You know, like, what's going on? You know, I just can't keep up in workouts. And I was hurt. Like, we're all hurt. This hurts, that hurts. So they gave us, you know, ibuprofen, aspirin in the trainer's room. And we're just kids, right? I don't know what that is. So my roommate like looks at me, my stomach's starting to hurt too. I asked my roommate about like, I'm not feeling good. And he says, you know, you look about the color of that wall, you know, it's a white wall. So I mean, dudes don't go to doctors, certainly students, college students. So his dad was a pharmacist. So he gets on the phone with his dad and he's like, yeah, my roommate doesn't look good. He looks kind of pale. And so his dad threw my roommate, is he taking any medicines? And I said, well, no, but I have this stuff they give me in the trainer's room, you know, I don't know, look at the bottle, aspirins or something. He's like, oh my gosh, you better go down to the student health. And they draw a blood count. And my hemoglobin was 6 and my hematocrit was 18. So that's like less than half of the, I'm going to track practice. And then they, you know, I get admitted to the hospital the same day, you know, because I had, you know, multiple ulcers and bleeds in my stomach. You know, but the type A people can compensate, right? Because they're just, And then I think it's a training problem, or maybe I'm not sleeping. But here, you know, my problem's medical. So if you're not feeling good, you know, talk to your coach about what that's going on. But if there's something that really isn't feeling right, right, I'm a little more short of breath, right? You're a middle-aged male. You could be having angina. So this is what I do in my job is like, I want to clear the medical, and then we'll talk about your training. And it doesn't take— but that's find someone you can trust because, you know, if you're 25, probably a little different. But if you're You know, a lot of people discover New Florist, or, you know, they're, they're getting their second religion, right? They're like, later in life, you know, semi-retired, you know, doctor told me to exercise, you know, medical problem, right? So these are people starting at a non-well baseline, and we want to help get them healthy first and then get them fit on top of that.

Yeah, yeah, yeah. I want to talk briefly about Running Forum because this is something that that you're passionate about, I'm passionate about. And I just found out actually through Mick, our mutual friend Mick, that we both have Laurens van Lingen in common too. Yes, he's amazing.

Yeah, he's like—

it's funny because I'm seeing— yeah, I will.

Like, he's—

I'm seeing him tomorrow. Like, I'd go to Laurens, like, for— so he's a physical therapist, but he is also a running form coach and like, I mean, he's a movement specialist.

He wears many, many different hats indeed. But yeah, I get emails and texts, you know, him, Mick and I, like he's always, and he's such a giving person. So he's always got something that he's thinking here, like at another level, but he can bring it down. But enjoy your visit with Lawrence.

Yeah, no, he'll sort some things out for you. No kidding. He always does every, every time. And I think just from a recovery perspective as well, even for athletes, we have talked about recovery is possible in a lot of variety of different ways, but even from time to time, seeing a physical therapist or seeing a chiropractor and identifying, especially once you start running higher training volume, like, ah, where are areas that you have some weakness or tightness, or what are some of these areas that you can work on? I think it's it's very beneficial. And every time I walk away from him, I just feel like a different human again.

It's pretty fascinating. That's what we do. I own a running store and, you know, I can't do movement or gait analysis in my clinic, my medical clinic, you know, between, you know, 4 walls and can't even get someone to squat in there because there's not enough room. But, you know, Lawrence is also a fan. So I think one of the things that really helps, like if you don't have access to a movement guru, is, you know, we have the TrueForm runners, a motorless treadmill, because it's kind of the lie detector. If you can't make that motorless treadmill go effortlessly, you got some— it's like going to the driving range with a blade club, an old-school club. You know, if you can learn to hit the 3-iron blade straight down the middle every time, your movement pattern is dialed in. Now you can break out the Big Bertha club, right? So a motorless treadmill, if you're near a West Virginia, or, you know, I'm about an hour from DC, come out to our store, you know, and we put people through a static movement analysis, stability, mobility, and then we put them on the treadmill. And, you know, almost to a T, you know exactly what someone's going to do on the treadmill based on their movement analysis. Because if they can't extend, if their hip flexors are tight, they cannot get out of gear 1 because they can't use their glutes, right? So you can predict it completely. And then we don't fix the gait per se, we fix the restriction. Now, some people it's neurologic, right? They just don't know how to use their glutes, but they got plenty of mobility. So, we want to sort out, is this a hardware issue, meaning you're just stuck, or is it a software issue, meaning I just need to learn the movement? And so, find someone who can help you with that, and is it hardware or software, and just try to optimize, you know, get good at running slow before you run fast. You know, like run slow perfectly. That's where minimal shoes come in too, because you really learn, you know, how to dampen your impact and use your springs when you run barefoot minimal, and then put on the springier shoes to race, but you've dialed in the form. You know, Kipchoge wears those fancy shoes to run 1:59, but no kidding, how many miles of barefoot and minimal running did he do even before someone lined him up for a race. You know, all these guys, they ran to school gravel road barefoot. Like, they have perfect movement. Then you can put a shoe on any shoe. They'll run like any shoe you want, right? They'll be good to go.

Yeah. Good luck tomorrow with Lawrence. Oh yeah, those are all— I've probably seen them 10 times already. I'll definitely, definitely end up recording doing a show with him. And like, a lot of this goes back to running relaxed, about breathing patterns. Like, there's a lot of like exciting topics to dive in further over there. One question though about running form here is how much should we try to alter our running form? Like, when we're going out there, like, some people naturally have a better running form than others. Like, some people, like, body types are different, and some people are taller, some people are shorter, some people have higher— how much should we try to focus on fixing our running form and how much of that should come natural?

Yes, I think there's probably 3 categories to put people in. Okay, so you have someone walk into my store and they just want to run, right? They've been walking and they want to run. Okay, so we're going to take their shoes off and just get them to feel what relaxed jogging is, right? It's not even much faster than a walk. So I just want them to feel springy and relaxed, right? And I'll take their shoes off, you know. So for them, that's— I just want you to feel what running is, right? Running is a spring motion, you know. And just get them to learn how to just feel landing soft, relax, breathe through your nose, you know. So that's like teaching some of the— like how to ski, right? Like, here, let's just keep— let's try to prevent you from hurting yourself or being in pain doing this. So that's one group. And then you have a group that has an injury, right? Because, okay, you got an injury. Okay, well, let's dissect what that is. Are you just running too much? You know, okay, you got this weak tight, you know, or it could be biomechanics. So if someone has an injury, you know, it's rarely the shoes. You know, if you go to a running shoe, you just need new shoes and they'll fix your injury. And I think you're like, that's good for selling shoes. And I own a shoe store and I'm not interested in you getting new shoes when you're hurt. I wanna help you, you know, teach you how to run barefoot and we sell shoes. So it's probably not a good business model. You know, so that's a reason to look at adjusting someone's form if that's analyzed in the context of everything in that history. And then maybe performance, right? So, okay, I wanna, you know, so I'm sure like, you know, you read about how the, you know, eternally damned Alberto Salazar, you know, at Port Oregon Project, you know, There was an article, I think it was in The New Yorker, where they're, you know, like, these guys need to improve by 1%, right? So of course they're going to try all the illegal stuff, what they can get away with. But yeah, just arm— like, yeah, they're just looking, okay, can we improve efficiency? You know, but at a cost, right? So, well, okay, I think this is better form, but maybe they get hurt. Now, if you're otherwise well, you're loving your running every day, you're not hurt, you know, and you're mostly in zone 2, right? You're just happy, who the hell cares? Like, you're fine. I would not be interested unless they came to me and said, I wanna run a little faster. But that person, like, whatever they're doing is good, right? Just because you can't tell from a video if they have good or bad running form because it doesn't tell us forces. Now, on the extremes, you have someone lands in a checkmark position, legs straight out, you know, ankle dorsiflexed, Boom. You know, okay, probably suboptimal for efficiency, but there are plenty of people who look pretty wonky. But if they're actually like, you put them on the motorless treadmill, like that's the lie detector. Because if they can make that motorless treadmill go gear 1, gear 2, gear 3 effortlessly without thinking, you know, wherever they're holding their hands or they're moving pretty darn good, you know, even if they might land on. So you can touch gently on your heel. And roll, right? That's, that's totally fine. You're not impacting. So the whole thing about forefoot, rearfoot strike has no relevance into who's moving efficiently. You know, the best runners actually, when they look at their gait, you would think that, uh, okay, so, so how much variability do you have in your gait pattern? The recreational versus the elite. Who do you think has more variability in their gait pattern?

The recreational or the elite?

You would think the recreational. Yeah, but no, it's the elite. Because yeah, they just have their brain, they have a lot of different strategies. Yeah, yeah, yeah. If you watch, you know, video, and I've shown this in lectures, you know, mile 9 of the Boston Marathon, the lead pack, right? They're all 2:06 marathoners. Wait, they're landing on their heel, all of them. But then mile 25, the ones who are still in the race, Right? The ones, the money's on the line, they're up on the ball of their feet, right? Because they need that little extra preload spring because now they're running 4:30 pace. That's interesting. Yeah.

Because what's the goal at mile 9? Chill, right? Yeah, sure.

Oh, like at that point, hold back. Yeah, hold back. Just stay, like, stay out of trouble. Use as little energy. So they're just touching it. They're not heel striking. They just touch and roll. Meb, right? Watch Meb. He's just rolling along the ground. Wait, he's heel striking. Wait, he just won the Boston Marathon. So he must be doing something right. But then when the money's on the line, you know, most, not all, most will get up a little like track runners, get up a little more on the ball of their feet. You know, when you gotta like, you're trying to drop somebody, but mile 9, you know, they're not trying to drop someone. They'd be gone by mile 13 off the back of the pack. But just, yeah, they're, and you're probably doing this too, Forrest. You're like, I'm a little tight here. You're just like, like, let me just change this a little bit. And you're just instinctively, ball of foot, heel, you're just rolling along, trying to recruit, use my glute a little more, get a little tall. You're just constantly adjusting to the terrain a little bit, but keeping it smooth, relaxed, breathe through your nose.

That part also for racing, I see so many times we tend to like lift up our shoulders when we get tight and like tense. And then, like, to run faster, just relax more, especially in those later stages of a race when we start to tense up.

That's a big one. Yeah, how do I usually— like, you know, when I was doing the road marathons, I'd write a little something, you know, on my finger. You know, I'd write something like PB or, you know, posture, breathing, relax. You know, something that's your cue. Oh, I feel like crap now. You're like, heads down. This sucks, right? You're tall. Posture, breathing, rhythm, relax. It was PBR. Posture, breathing, rhythm, relax. Posture, breathing, get your rhythm back, relax. And then you can get out of the bad space. But have some little cue. You write it on your finger. I would actually run races and I would have— I wouldn't wear a watch to run marathons. I don't like watches. I'd just put a little smile on my wrist. You feel like shit, right? I don't want to be like, oh shit, my Garmin says I'm slowing down. No, I see the smile. I love that. What's he say? Finish every workout with a smile. You interviewed him, right? Like, yeah, that exudes. Yeah, it was a wonderful interview.

Thank you though for doing that. Yeah, no, I was, I was very honored. Yeah, to share his knowledge over there. But yeah, he's, he's, he's smiling even in the pain cave. And that's the thing, when you are in stages of a race that it is discomfort. And even if you force yourself to smile, it's sometimes you feel better just because of that. Absolutely. I want to be respectful over here. I have 2 more questions. One is about the— actually, 3 more questions. There's the blue zones where people live the longest, or like regions, areas where people live the longest. Based on cultural habits, food habits. Like, one key component from this is stress management and community. Is there any thoughts that you have to share about stress management and community, high level? Because I know you're, you're very busy from your end. You wear a lot of different hats, but I also see you're actively involved in the community through your running store, through like organizing different events and whatnot.

Can you share some high-level thoughts here? Yeah, yeah. And I mean, everything we, we know about this is called observational research, right? You look at cohorts of people who live long and well. You can't do what's called a randomized trial where we're going to— for us, we're going to give you a nice community, they're going to love you and hug you, you're going to feel like you give to that community, and we're going to take this other group and make you depressed and lonely, and let's see who lives longer. So I do not want to— IRBs, like, an IRB is an Institutional Review Board. They would never pass that. But we know that when people could look up— it looked up— probably the most powerful database is called the Harvard Longitudinal Study of Aging. The Blue Zones is not a study, it's a book by a National Geographic, you know, writer explorer. But it hits a lot of the things that we get in this Harvard Longitudinal Study of Aging. So loneliness kills. So when people are lonely— and Vivek Murthy, who's a Surgeon General, I think former Surgeon General, Wrote a whole book on that. Like loneliness, there's something about loneliness that's really toxic, right? That probably sends off different signals, neurochemicals. So being lonely, no good, no bueno. Having a purpose. So these people in this Harvard Longitudinal Study of Aging, so one of the most important markers of who's still alive is people that have some purpose, right? So like the people that have purpose never like really retire, right? They're always doing something. And we can't really measure that objectively, but that comes out strong. It's way more important than what your cholesterol is, your genetic makeup. So we know that's real, and we just know that's real. And there's no downside to that. So, and whatever that is, you know, it could be your church community. We know that people have a tight church community, they do better. They get the social support, they get the emotional support, they have purpose. So giving back, right? When people give, right? Like when people give to charity and they give it anonymously, we know that has, you know, whether that's of yourself or your finances, when people truly give without expecting anything as recourse from, you know, they're not doing that for their own benefit. They're doing that just to do that. That has this amazing effect on people's health. You know, and we don't see that a lot now in modern culture. It's kind of everyone is thinking is, you know, capitalistic society. We're kind of doing that. And all these other societies, right? There's no nursing homes in these quote blue zones, right? Because, you know, the grandma is still at the head of the table, right? Even though she may not be the one cooking and doing as much stuff, she is still the most important person in that table. And with, and like, it's just the way it is, right? So, so that, that's like super important. You know, when, when people are removed from their home and placed in care homes, we know that that doesn't do good things for people's So yes, it's real. Have purpose, you know, give back, you know, to your community, you know, and people, you know, get more than they give when they do that. So yeah, that's about the— but you can look up the science of loneliness and people have written books about that. Yeah. I mean, they're studying like PET scans and brainwaves about like all kinds, but like, don't be lonely.

Absolutely. And, and that part too, like I see you're actively giving back through a variety of different ways. Like even you being here on the podcast, like this is purely you sharing your knowledge from over the years and it's helping people. And same from my end, like we're not in here for like financial gains, it's really us wanting to share and like do good in the world. Free clinics almost every weekend. And that brings so much for And that can be in a variety of different ways. It doesn't have to be like hosting a podcast. That can be like even the smallest act of kindness can make it— can make a positive impact there.

Absolutely.

So that's big. Where can people find out about your book, about your store? Where can people find out more about it? Because before we actually answer that, I highly recommend this book, um, Run for Your Life. Mark has written it. Or Dr. Gugosella, sorry, has written this, has written this a few years ago, and it has an incredible amount of information, like an extension from what we had just talked about, about heart rate training, about nutrition, about running form, about injury prevention. So this book, I've read it several times.

I can highly recommend it. Where can people find this? Yeah, it's anywhere where books are sold, as they say. I have a website, runforyourlifebook.com, and we have a number of videos on there. So, you know, we've done a lot with running form drills and running form videos. So, you know, that stuff that you can't get from a book is on the website for the book. But yeah, pick it up. It's in paperback now too. Come out to our store. So if you live anywhere near Baltimore or DC, so we're in the eastern part of West Virginia, tworiverstreads.com is our store. We have the motorless treadmills in there. You know, we do clinics almost every weekend. Just walk in, you got an injury, you want us to film you, you know, and I'd be glad to chat and work with you. So that's a good resource. And when I'm not there, my staff are amazingly trained and they're not just going to put a pair of shoes on you because it feels nice and cushiony. They'll look at your feet. We try to fix people's feet in the store. Yeah, there's, that, those be, I have a website, Dr. Mark's Desk, which links to all those things.

Drmarksdesk.com. A few members of our running coaching program have gone into your store and have either met with you or your staff. And all I hear is very positive stories from the expertise that you guys have in the store. And I have yet, I've yet to make it over to your way to West Virginia or even 1,000 miles away. But then again, like, I would love to go over that way and check out the store one day, or even—

Come to our races. Freedomrun.org is our races. So I direct two races, one in the spring, Harpers Ferry Half Marathon, and in the fall we have one called Freedom Run. These are like old school races through national parks, mix road and trail. You know, very— they're not going to be your PR races, but they're experiences.

In amazing places.

For sure.

Good community. That's that community feel. You're getting community right there. A lot of volunteers. Good, good.

If you hear me and want to volunteer for a race, call me up.

Absolutely. Absolutely. I need volunteers. Good opportunity to help and meet Dr. Margot Guzella. Last question here. A lot of listeners runners here are looking to improve their running and overall health.

Do you have any closing thoughts over here for them? Actually, I mean, it's basic, you know, eat, eat like a human, you know, eat real food, you know, move gently and easily without pain, you know, to fit it and then fit it into your life. You know, running shouldn't, you know, when you come back from a run, you should feel better. This should add to your day, not be like another chore. So you should always, if you finish your run and you feel better than when you left stiff going out the door. I mean, you and me, probably 100%, right? Like, I run in the morning, I'm a little stiff, but I've never not felt better at the end of a run than when I went out the door. So if the opposite is happening to you, you're doing something wrong. You should always feel better when you come back, and you should wake up tomorrow, you know, maybe it's a day you just don't have time, but you should always feel, oh man, I could run today, right? I feel good, I could run today. And if you really don't feel like running, something's wrong either in your health or your running or your life or your mood. So you should always, because running is such a powerful mood enhancer. We know that by the hard science, right? All the, so something, if running isn't making you happy, something is really jacked up in your life somewhere. Talk to someone who can help you, right? Because this could be like one of many things, you know, you really need someone who can like medically and even spiritually a little bit, you know, We're not a bunch of parts.

For sure.

Thank you so much for sharing your insights. Amazing job on that sub-3 while chatting with your phone.

I guess you were holding your phone. Yeah, it was the GoPro. That was a fun one. No, I appreciate that. Next time you're in San Diego for the low-carb conference, let's definitely go for a run. I will come out there and look forward to some miles with you.

Yeah, look forward to it.

Have a great early afternoon for you. Yeah, for sure. You too.

We'll talk soon.

All right.

Thank you. All right, brother.

Bye.

Thank you for listening. What was your favorite lesson, takeaway, or quote from this episode? Please let me know in the comments. I will be giving away a book that is Dr. Mark Gugoselli's Run for Your Life book that he has written to one of the comments in the YouTube channel. Also, right now Element is offering a free sample pack with any order of their electrolyte drink mix. That is something that I've been drinking for several years now. That is 8 single serving packets free with any Element order. This is a great way to try all 8 flavors. You can get this at drinklmnt.com/flow. That is D-R-I-N-K-L-M-N-T dot com slash flow. See also the link in my description. Also, if you're looking for any help in your training and racing journey, check out the Personal Best Running coaching program that I've developed. Several other PB Program coaches are a part of, and you can find that at pbprogram.com. Thank you for listening and have fun out there on your runs.