My Back Is Degenerated (But I Have Zero Pain): Here Is My Daily Mobility Routine

In this episode of the Boundless Life Podcast, the biggest step you can take to reduce microplastics, how to get rid of back pain, what you need to know about heart scans, and a whole lot more. Good morning, good afternoon, good evening, wherever you are. I'm Ben Greenfield. Welcome to the show. This is a solo episode where I'll be diving into some news flashes and a few Q&As. My apologies if A, I sound a little congested, or B, if I look like a Smurf attacked my face. A, because I'm working on a pond renewal project right now in my yard. And as a part of that, I have aerator and I have a muck scraper and I have a couple big caterpillar tubes filtering about, I believe it's around 15,000 gallons of water per hour into a wetland filtration system. And I've started swimming in the pond and I'm pretty darn sure there's still some algal bloom in there because I turned some laps yesterday and I woke up this morning waking up my wife with my sneezing. So, not sick, just bloomed with algae. And then B, regarding these blue glasses on my face, I had a late night last night. I got up a little early this morning and these glasses are wakefulness-promoting glasses. They actually do the exact opposite of blue light blockers. They actually concentrate blue light. So, I've got these overhead podcasting lights. It's blasting me with a little bit more wakefulness-promoting light than I would normally get. These are made by Ra Optics, R-A Optics. They're called— I don't even know what they're called. We'll just call them the Wakey Wakeys. So anyways, today's shownotes are at BenGreenfieldLife.com/505, BenGreenfieldLife.com/505. Alright. Well, let's jump into today's topics. Plastics. Plastics. Obviously, Microplastics are a hot topic nowadays. People claim that you have a credit card's worth of plastic in your brains. That claim has been disproven. I've tackled that on another podcast. But we all, based on the fact that we live in an increasingly post-industrial plastic-infused environment, get a lot of exposure to plastics. And some of it does accumulate in the body and some of it does not all pass out via, say, the stool, which would be normally how Plastics would come out of the body, or the sweat, which would not be the normal way the plastics come out of the body because most plastics, including microplastics, are too large of a size to pass through the typical sweat gland. You lose a little bit via the sweat, most via the stool. So these plastic products that we get exposed to, they contain chemicals. These chemicals have names, phthalates, bisphenols. You've probably heard of these, and they can leach out of plastic during use, let's say plastic containers. So there was a recent 7-day trial and it was pretty interesting. What they did was they looked into what happens when you avoid various types of consumer products and what had the biggest effect on reducing microplastic exposure. So what they really wanted to look at was a few different groups. So they had group 1, and in that group, all the food had little to no plastic exposure. So this was the— Clean. My neighbor is the Ned Flanders of health group. They were super, super picky about their plastic because they were in an experiment where they had to be. Group 2 was similar to Group 1, but then they also had no use of plastic-based cookware or kitchenware. So they took things to an even greater extreme. Group 3 had no use of personal care products that would be associated with plastic exposure. The average toothpaste, shampoo, Lotion, et cetera, that is stored in plastic. And that's something important to know. Like, you know, your toothpaste maybe might be made out of products that don't include plastics in them, but then if it's stored in a plastic tube, well, guess what? It's getting exposed to plastic, all the more so if it was subjected to heat, say during shipping or in your bathroom cupboard or elsewhere. Same thing with shampoos, conditioners, lotions, et cetera. Group 4 was a combination of all interventions. And these folks took things to the extreme extreme, plastic-free diet, Plastic-free cookware, plastic-free kitchenware, plastic-free personal care products. They were the YouTube health influencer of plastic-free, like all the way to the max. And then group 5 was the control. This was your retard-maxing neighbor who literally does not give a crap about microplastics or plastics, doesn't even know about them, doesn't care. And they're literally just like chewing on Tupperware. So what did they find? Well, they found that bisphenol Phthalate levels were reduced in all of the groups compared to the control group. No surprises there. BPA was especially reduced in group 2, the group that was not using plastic-based cookware or kitchenware, suggesting that that's a pretty big source of BPA. The phthalate metabolite called monobutyl phthalate, that's a big one, that was reduced in all groups compared to the control group. And then another big phthalate, monobenzyl phthalate, that was mostly reduced in the group that had the diet with no plastic exposure and also the group that had the diet with no plastic exposure and was not using plastic-based cookware or kitchenware. All right. So before we dig into what these results actually mean, the question is always whether this is even clinically meaningful. Why are we talking about plastics? Do they actually Well, evidence certainly suggests that BPA, for example, one of the plastics measured in this study, does have adverse effects on health. There was one meta-analysis of a number of observational studies finding that, for example, higher urinary levels of BPA are associated with higher risk of type 2 diabetes, and not just that, but also obesity. And high blood pressure. Another 5-day randomized controlled trial in young adults also found that ingesting BPA, like from food sources, worsened insulin sensitivity, which probably suggests why BPA is associated with adverse metabolic effects in a number of studies. These phthalates that I mentioned, like the monobenzyl phthalate, these have also been associated with a higher risk of metabolic syndrome. Interestingly, the lion's share of the studies that I can find on plastic exposure show that the majority of the issues come down to insulin sensitivity and metabolic issues. You often hear people talking about estrogen stimulation, drop in testosterone, drop in fertility. For phthalates and BPA specifically though, it really looks like a big, big factor is what it does metabolically in terms of worsening insulin resistance. Well, if we come back and we look at this study, it appears that the lifestyle measures that matter the most in terms of reducing BPA and phthalate exposure are not getting exposed to it from the foods that you eat and not getting exposed to it from the packaging that is storing the foods that you eat or that the foods that you eat are being cooked in, right? So kitchenware, cookware, and the food that you put into your mouth and what that's stored in, those are the biggest things to control when it comes to plastic exposure. If you say from a budget standpoint or a logistical standpoint, can't pull out all the stops, like you can't do the toothpaste, shampoo, lotion thing, and the personal care products, just like the full overhaul of that and the plastic bags in the kitchen and all of this are things that you can avoid, at least pay attention to what is going into your mouth. Perhaps that's why a lot of the major products that are coming out right now for reducing microplastic accumulation are based on addressing the gut. One fascinating interview, and I'll link to it in the show notes, I just completed it a couple weeks ago, it's out already, was on sulforaphane and the ability of sulforaphane to potentially not only pull plastics and microplastics out of the gut, but out of the tissue. As a matter of fact, after that podcast, I started using sulforaphane before I go to bed at night. I'm using a product called Brock Elite. Brock Elite, it's like a really concentrated sulforaphane extract. And then, based on that study that they did, they actually just came out with a microplastic-specific product. I got a bottle of it in the mail yesterday. I didn't start it yet, but that's one thing that I'm doing. I'm sweating a lot and then I'm being super careful with what I eat and what my food is stored in. Glass, for example, most notably, and stainless steel. And then, I'm careful everywhere else that I can be careful. I am currently— so, I have an executive assistant who's actually helping me with this, but there is a website called grove.co. I'll link to that one in the shownotes. And, it has replacements for all the things that would be in your kitchen, in your bathroom, et cetera, if you want to just switch everything out. But, if you're going to start anywhere, start with anything that's going near what you're putting into your mouth, if that makes sense. Next up, back health is something that is near and dear to my heart. I'll tell you why shortly. But there was a recent analysis of what exercises or what physical activities affect the health of the spinal disc. They looked at running, cycling, swimming, weightlifting, and other explosive sports. Now, I'll get into that study momentarily, but first, you're going to hear a couple of times during this podcast about the results of an executive health screening that I recently did. I work with a company called Next Health, and I was down in LA for this screening. Had a blood analysis. I had what's called a CT angiography, a scan of my heart for plaque. I had a full-body MRI and a couple other evaluations. They also do things like VO2 max, grip strength, et cetera. So, I got the results of my full-body MRI back and it backed up Pun intended, what previous full-body MRIs have shown. I have mild to moderate degenerative changes in my cervical spine, especially what's called disc height loss and some arthropathy, which is basically arthritis in the spine. And, I also have mild to moderate— to moderative, another word I made up— mild to moderate degenerative changes in my lumbar spine, meaning I have a disc height loss, I have what's called a diffuse disc bulge, I have an annular fissure. I have neuroforaminal narrowing and arthritis basically from L1 down to S1. So, most of my low back. Now, here's the kicker. I am pain-free in my back unless I sit on an airplane without stretching for 4+ hours. I have specific things that I do to address my back health even though I have a really beat-up back. I mean, I spent 20 years doing Ironman triathlon and— bodybuilding, especially in the early years with probably less than stellar form and obstacle course racing. I was a competitive tennis player before that. And, I've really done a number on my back. So, after I explain this study to you, I'll tell you some of the things that I do for my back. But, beyond the full-body MRI, what got me thinking about this was this study. So, let's start here. Your spinal disc has 2 parts. You've got this tough outer ring of fibrous tissue and then this gel-like center that acts like a shock absorber between each vertebra. Now, the gel center is mostly water and what are called proteoglycans. These are large molecules that pull water in and hold it there. Interestingly, total rabbit hole, if you have a very, very, very low carbohydrate diet and are in a constant state of extreme carb restriction, you actually don't have enough glucose to produce a significant number of proteoglycans, and your joints can suffer if you're eating low, low carb. Interesting. I don't know if my strict ketosis that I followed for a few years may have affected the proteoglycan component of my discs, but it is something to think about. So long story short here is healthy discs will stay hydrated and plump, and degenerating discs will lose water. They'll flatten out, they'll get more fibrous and stiff. And that's what the researchers wanted to measure, like the physical state of the disc tissue itself when it comes to the activities that you do. So You can't just stick a needle in and biopsy the spine to check somebody's disc health. You need to use an MRI. And, there's a couple of different MRI scales that they use. One is basically a hydration meter for the disc. That's kind of a newer measurement. It looks at what's going on as far as the disc height, the disc volume because discs will physically shrink as they degenerate. So, an MRI can look at that. And then, there's kind of an older maybe more crude grading system. It's called the Furman scale, where a radiologist will look at a spine MRI and assign the disc a grade from 1 to 5. That's like healthy to severely degenerated. And it misses some of the finer changes that these continuous MRI measures can check. But what this study did was they actually wanted to use these MRI disc measures as the outcome And compare what kind of sports people participated in. Now, excuse me, this was observational, meaning they didn't take a group and say, hey, you run, and then another group and say, you swim, and another group and say, you bike. They instead just took over 4,000 people and looked into the type of physical activities that those people tended to engage in. And then they used an MRI, what's called a continuous MRI marker, to look at disc health. Disc hydration, basically. So what they found was that people who run, right, running really stood out. People who run regularly tended to have somewhat better hydrated, healthier looking discs on MRI compared to people who didn't run. Now, weightlifting, cycling, rowing, skiing, swimming, gymnastics, martial arts, CrossFit, yoga, and dance were also looked into. Here's what's important to know. None of those sports that I just listed led to worse outcomes for disc health. It's just that for some reason running led to better improvements in disc health, or at least it was correlated with better improvements in disc health. This I think is worth mentioning because I think a lot of people think that like impact-based running is bad for the spine. It might be that slight loading or impact that causes a kind of hormetic response in the disc somehow. to result in better disc health. It might be the impact that assists with cerebrospinal fluid movement up and down the spine. It could be some of the G-forces from running just assist with that a little bit more. But no matter which way you look at it, here's what you can say. Running isn't going to hurt your back when it comes to your disc health. Now, coming back to my full-body MRI, the fact that I have a super, pardon the expression, effed-up spine, cervical and lumbar spine, but don't have back pain, what do I actually do To achieve that? What is my no back pain protocol despite having a really messed up back? So here are a few of my go-to strategies. And what I'm going to do in the show notes over at BenGreenfieldLife/505 is I will include some helpful photos, videos, and links for you for each of these. So the first thing that I do is what is called Stu McGill's Big 3. Stu McGill is a well-known, probably the most well-known spine biomechanist. And, he has a trio of these core exercises. The first one is called the modified curl-up. The second one's called the side plank. The third one's called the bird dog. I do these every morning. I start off my morning with stretching and foam rolling anyways, but I always throw these in. So, the curl-up or what's called the modified curl-up, this is kind of similar crunch-ish. You lie on your back with one knee bent and one leg straight and you put your hands underneath your back's natural arch to kind of keep the back neutral. And then you just lift your head and shoulders an inch off the floor. You hold for 8 to 10 seconds and you lower. So you're not crunching up like a traditional sit-up. You're just kind of curling up just a little bit. And again, I'll put some videos in the show notes. The second one, the side plank, you've probably seen this before. You lie on your side, prop up on your forearm and either the side of your feet or for an easier version, the side of your knees. And then you just lift your hips so your body forms a straight line. You brace your core, You hold that for 8 to 10 seconds, and I do 5 of those per side. And then the bird dog, you may have seen this one before too. You start in a crawling position and then you reach with one arm forward and then you drive the opposite leg back, right? So, I'd reach forward with my right arm, I drive my left leg back, and you can hold that position for a little bit of an added challenge, again, for 8 to 10 seconds before switching sides. I also do 5 of those per side. That's not much. That takes me less than 5 minutes, but I do that every morning. And occasionally, if I'm in the sauna, I'll throw in a few extras. And so, Stu McGill's exact recommendations are a 5-3-1 pyramid. So, 5 repetitions of set 1 of each exercise, 3 repetitions of set 2 for each exercise, and 1 repetition of set 3 for each exercise. So, he's kind of going the 5-3-1 sequence. I kind of do 5-5-5 for each and just call it good. But anyway, so I do that just about every day. What else? I have an inversion table. I don't think you can see it behind me, but it's right here in the room. It's a Teeter inversion table. I hang from it for about 2 minutes every day. I mean, it's right in my office. It's not hard to do. Sometimes I'll hang from it for longer than that or a couple of times per day. That basically tractions the spine and kind of increases some of the spacing between the joints. The next thing that I do is I care for my hip flexor mobility. And my number one exercise for that, Is called the couch stretch. Go to the shownotes, I'll link to it. Super simple. I hold for about 60 seconds per side. I tend to do this one when I'm in the sauna or if I'm like, whatever, waiting for an airplane to take off. It's pretty simple. You're kind of trying to get your shin back up against the wall behind you and you're just pulling yourself up into a deep hip flexor stretch. Some of these ones are easier for you to just go to the shownotes and pull up the video and I'll put them all in there, my full protocol. But I do the couch stretch every day. I do a stretch called the Founder Stretch every day. So the Founder was taught to me by a guy named Dr. Eric Goodman, multi-time podcast guest, who's also been to my house, him and his compatriot, Jesse Salas. They came and taught my whole family their whole Founder routine. But the one that really stuck with me that I do every day, kind of an 80/20 guy, is the Founder Stretch. So that is a posterior chain strengthening And decompression movement. It was designed by Eric's company called Foundation Training. So, this one, again, video is pretty critical, but you're standing with your feet about 2 feet apart. You're pointing your toes inward a little bit. You're bending your knees slightly and kind of pushing your hips back behind you and your head out in the opposite direction. And then, you're lifting up your chest, putting your hands out in front of you, reaching your hands forward, forward, forward, Well, pushing your butt back, back, back, and taking these deep decompressive breaths. Audio doesn't do it justice. I highly recommend you just check out the video that I'll put in the show notes and listen to my podcast with them to learn more about the biomechanics of how it works. But basically, it wakes up dormant glutes. It kind of creates this interior muscular tension that decompresses the spine, and it teaches your body how to properly hinge and evenly distribute load throughout the body. So you're less likely to hurt yourself later on when you're, say, Weightlifting. A couple other things. Right now, I'm standing. I am working on a new studio. I might be sitting a little bit more in that studio. Even if I sit, I use a special chair called an Anthros. But most of the time, I stand or I use my walking treadmill. Walking is fantastic for the spine. You get good rotational movement. It's another thing Stu McGill recommends. I have a super plush soft treadmill that I use for walking. I often record podcasts on it as you may have seen. It's called the Walkolution. Walkolution. The Walkolution treadmill. So, huge fan of standing desk or treadmill desk instead of sitting in a chair. And when I do sit in a chair, I tend to use this one called the Anthros, which has just really good spine support and was built to be a highly biomechanically friendly chair. And then, the last thing is I created a YouTube video that shows all of the little foam roller tools and spinal treatment tools that I use in the morning for my morning stretching protocol. And I will link to that in the show notes if you go to BenGreenfieldLife.com/505. But a little teaser of that, for example, I have a PEMF mat and it is a really powerful one. Like, it puts out— like, there are certain PEMF companies like Pulse Centers, Hugo, Dr. William Pawluk makes a few also that you really like. They almost like shake your body. But if your spine is tight or your hips are tight and you lay on that thing and do some stretches on that thing, It is magical. It's incredible. I also have what I call the greatest stretch in the world in that video, which involves me lying on this stretching arching contraption that I got on Amazon. And then, I have an acupressure mat pulled on top of that. And, it is also incredible for decompressing the spine and also stretching the hip flexors. And, that one, I think of all the exercises in that video, That's the one that works the best. So, check that out. That video is called Stiff Joints? Try This 20-Minute Mobility Biohacking Protocol. I'll put it in the shownotes. And hopefully, that is helpful to those of you who have old man backs like me. Okay. So, we are going to go on and talk about the other part of my executive health screening that was also pretty interesting. So, The MRI is the one that I did for my spine. That's just a non-invasive imaging scan that uses magnets and radio waves to create detailed pictures of your organs and your tissue and your bone. It doesn't use radiation, just magnets. The other one does use radiation. It's called a coronary computed tomography angiography or a CCTA. You may have heard of this before. It's basically looking at your coronary arteries, your heart's blood vessels, to provide a little bit bit more detailed insight into your cardiovascular health. And if you're doing something similar to what I got, like there's one called a HeartFlow, one I did is called a Cleerly, the software that they run the scan through has special algorithms in it that can measure the exact volume and the location and even the composition of arterial plaque, which is kind of cool. So you can basically see, okay, is it stable? Is it unstable? Where does the plaque reside? It's like this comprehensive 3D map of your coronary arteries. So that's called a CT angiography. So the question that people sometimes ask is, well, how accurately does this predict my risk of a cardiovascular event versus the standard, let's say, LDL, HDL, blood pressure measurements that a doctor might use as a non-imaging-based tool? So the way you look at this is there's basically 2 ways to figure out whether you're headed for a heart attack. So the first is that you can estimate. You can take a handful of things about you that are relatively affordable and easy to collect, and you feed them into an equation, and the equation gives you back a percentage. So if your doctor has told you, for example, you have, I don't know, a 7% 10-year risk, they didn't necessarily do a scan of your heart, but they used an equation that looked at your paperwork and your lab results. And then the other way is to actually measure, like take a picture of the arteries using a CT scan and count how much disease is physically sitting in the wall of your arteries. So this new study that just came out put those 2 approaches head-to-head in over 6,000 people. So the first way to measure, like I mentioned, is this cardiovascular risk calculator. There's a few ways to do it. There's one called the, not to get too nerdy here, ASCVD pooled cohort equation. That takes into account your age, your sex, your race, your total cholesterol, your HDL, your systolic blood pressure, whether you're taking a blood pressure medication, whether you have diabetes, and whether you smoke. So 9 items. There's another score that doctors will use as a cardiovascular risk score. It's called the European version, SCORE-2. That uses age, sex, do you smoke or not, systolic blood pressure, and non-HDL cholesterol. And then there's a 3rd measurement, and that's the one they use in this recent study. It's called the ESC Risk Factor Weight Related Clinical Likelihood, or the RFCL for short. And that uses age, sex, and how many of 5 different risk factors that you have: family history of heart disease, smoking, dyslipidemia, which is like bad cholesterol, high blood pressure, and diabetes. And so these are just like yes/no questions, right? So if your LDL is 190, which is high, you get a point for dyslipidemia. If you have an LDL of, let's say, 140, like 50 points lower than that, well, that's also still considered high. So you would also get 1 point for dyslipidemia. Like, the equation would not tell 2 people apart who had an LDL of like 190 and 140. Same thing with blood pressure. Like, do you have high blood pressure or don't you? Not like, where do you lie on a spectrum? And these measurements also don't take into account some other factors that I think are important. Lp, probably the single most common inherited driver of early heart disease that you can measure in the blood. That affects, I think, 1 in 5 people, high Lp. ApoB, that counts the number of atherogenic particles in your blood, not just the cholesterol inside those particles, but the number of the particles. No measurement of that. They don't look at fitness, they don't look at calcium score, they don't look at the artery itself. So that's typically the type of thing that doctors are looking at. There's still some value to the cardiovascular risk calculator, But it is flawed in some ways in terms of its precision. So this study was called the CONFIRM-2 study. They had, like I mentioned, over 6,000 people, and all of those 6,000-plus people had had a coronary CT angiogram, that CT scan that I was just talking about. Pretty even split of men and women, and they followed them for about 4 years. And they ran every scan through an AI-driven quantitative CT analysis. That means that like the Cleerly scan, they cannot just tell, do you have calcium, but they can tell you where that calcium resides, if it's calcified, if it's non-calcified, right? Non-calcified is a softer, more inflammatory kind of calcium. Calcified plaque, a lot of times you'll see that in people like me who exercise a lot, who have wounded their heart through hefty exercise. But who still at least have some amount of stable plaque. So then they split these people into 4 groups by total plaque volume. They had a group with zero plaque, they had a group with some plaque up to what's called 250 cubic millimeters. That's how you measure plaque, up to 250 cubic millimeters. They had people at 250 to 750 cubic millimeters and over 750. So if you have zero plaque, you got pretty low risk. Up to 250 cubic millimeters, 2.5 times the risk. 250 to 750, 10 times the risk. And over 750 is 15.9 times the risk. So that's pretty hefty. But of course, these are what are called hazard ratios. So big multiple of a tiny number could still be a small number, right? So what would this look like as absolute events? Well, if you have zero plaque, you're basically under 1% of a cardiovascular risk event. If you had up to 250, cubic millimeters, you're between about 2.3% and 4.6%. 250 to 750, you're between 10.3% and 13.5%. And then over 750, you're between 16.7% and 19.8%. So basically, the more cubic millimeters of plaque that you have, that directly correlates with whether or not you're going to have a heart attack. And by the way, this is near and dear to my heart, haha, Because my plaque is based on my last score, about 400 cubic millimeters. A lot of it is not the soft non-calcified plaque, but because I have family history of cardiovascular disease and this is increasing, I'm actually very interested in the topic of reducing or regressing plaque. I was on an hour-long call with someone who's running a study on this right now that I'll be enrolling in, just looking into all of the different ways that one can reduce plaque. So this is certainly something that I will keep you posted on the podcast. So here's what you need to know. If your doctor is just measuring lipids, all that, let's say like your LDL is telling you, is what's circulating right now. It doesn't say anything about how many years the LDL has been circulating at that level, or even how efficiently your specific biology deposits lipid into an artery wall, or whether, say, you've been carrying elevated Lp since you were born. It's some kind of a recent environmental development, which is a little bit more rare. So you could have 2 people and they could have identical cholesterol, identical blood pressure, identical smoking history, and totally different arteries. I know there are some doctors and some medical professionals who feel that a CT angiography is an unnecessary and expensive medical procedure, but I think that if your blood lipids show any significant amounts of dyslipidemia and/or you have family history of cardiovascular disease, it's a good idea to get a CT angiography, a really good idea. So what this study showed basically is that Cardiovascular risk score aside, even if your cardiovascular risk score is high, if your total plaque volume is low, you have low risk for a heart attack. And if your cardiovascular risk score is low, but your plaque is high, as shown by a CT angiography, your risk of having a cardiovascular incident is still elevated, right? So I've preached this message on the podcast several times. And if you get one of these CT angiographies and you see 250 cubic millimeters or higher, As a score, that's the line where you want to get pretty aggressive. Pretty aggressive could mean, I'm not a doctor, don't take this as medical advice, but it could mean you're doing a low-dose statin combined with what is called a PCSK9 inhibitor. There is some evidence that they may, that may slow plaque progression or allow for a little bit of plaque regression. I cannot name any names right now for this study that I'm personally going to be enrolling in. Just stay tuned. But there's also some pretty good evidence that high-dose lumbrokinase and high-dose nattokinase from a specific source may also help to reduce this plaque or regress the plaque along with a certain form of cyclic dextrin. This would obviously be a little bit more of, I suppose you might call it, a natural, less of an allopathic traditional approach to managing plaque progression. But those are a couple examples. There's also what are called Nrf2 activators, which when combined with something like niacin may also have a pretty good effect on plaque progression. I worked with a company called VitaBoom a few years ago to develop a product called Heart Health. I will link to that in the show notes. I took it consistently for a while. And then I kind of lowered my intake of it when my lipids really normalized. And frankly, my lipids normalized, I went back in for my CT angiography, and guess what? My plaque had elevated even though my lipids had normalized, which comes right back to this study that I'm telling you about right now. Like, the lipids don't tell the whole story. And so now I'm going back into damage control. And now that would include looking into this high-dose lumbrokinase. And nattokinase and getting back on my heart health product. So now here's the good news. Here's the good news. Hopefully I didn't scare everybody. This is another recent study. It found that there is a highly protective thing that you can do if you have elevated plaque as shown on a CT angiography. This was at the University of Edinburgh. They used AI to examine hospital CT scans of 1,722 patients, mostly in their 50s, who were symptomatic. They had chest pain. The people with the greatest muscle density in their chest and backs were the least likely to have a heart attack or die in the decade after the scan. So, this was a long-term study. So, there's something about having good quality skeletal muscle, particularly combined with greater strength in the torso, that seems to be protective even if you're at a higher risk based on your CTN geography. So, the main muscles that they showed were important when it comes to this is the back muscles, the pecs, and what are called the intercostal muscles, which are the muscles between the ribs. So, this would mean, for example, elephant in the room, just pull-ups and push-ups, right? 2 of the best exercises you can do. Throw some rows in there, probably some overhead presses, and anything that stabilizes the torso like a planking-based exercise. And it's really interesting, more good quality muscle in those specific areas, kind of the torso and the upper body pushing and pulling muscles, reduces your risk of a heart attack even if you have high plaque. So this other study that I mentioned, they didn't really take into account, that I know of, upper body muscle, right? They were just looking at a cardiovascular risk calculator versus a plaque score. But that's really good to know, right? That's something highly protective that you can do. So, yet another reason to get on the exercise and muscle-building bandwagon. And again, I'm not a doctor. Don't take this as medical advice, but get your ass into the gym if you're not already. Do you want free access to comprehensive shownotes, my weekly roundup newsletter, cutting-edge research and articles, top recommendations from me for everything That you need to hack your life and a whole lot more, check out BenGreenfieldLife.com. It's all there, BenGreenfieldLife.com. 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