How to Achieve Optimal Health & Extend your Lifespan | Dr. Darshan Shah

20% of the information that makes 80% of the difference is not about what you should be eating. It's about eliminating ultra-processed food from your diet.

Stop something, start something, do less of something, or do more of something.

We're gonna learn in the next 20 to 30 years how to reprogram ourselves to age in reverse. Not just stop aging, but age in reverse.

This could save your life or the life of a loved one.

For every 10% of time that you spend over 4 hours sedentary adds 15% extra to your mortality rate.

This episode could really be on How not to die?

The number one thing you have to make sure is you don't have sleep apnea at night.

I stop breathing 250 times a night.

Even mild sleep apnea can lead to increased rates of metabolic disease.

Where's a good starting point?

Sleep, nutrition, and movement are really the Pareto principle of overall health.

Well, and this is what's beautiful about movement.

Again, it's free. Lifting weights every single day, if you can, at least 3 times a week, is gonna be massively impactful for your longevity.

What are the ones that are just foundational?

If there's one thing I could tell you that has moved the needle for 100% of my patients, it's—

Welcome back, Kwik Brains. This topic of today is one that I'm extremely passionate about, which is brain optimization, the science of, and also extending human longevity. Who doesn't want both those things? If you're in our community, these are really hot topics, and we're going to do a deep dive in this, and we have a very special guest with us. Today, a buddy of mine for quite a few years, Dr. Darshan Shah. He's a board-certified surgeon, amongst other things, done over 20,000 procedures. He's a very fast learner. He got his medical degree at the age of 21. He's an entrepreneur and the founder of Next Health. And this is a place that I go to, to enhance my human biology. Like everybody wants the extra edge, both physically and mentally. So it is one of the very first and largest clinics for health optimization and human longevity. So welcome to the show, buddy.

Thank you so much for having me. I'm so excited to talk to you.

I've been looking forward to this. I've been a patient and a client of Next Health for many years, probably one of the early ones. And you and I have had the opportunity to share stages multiple times. We're doing that again this week.

This weekend.

And I thought maybe give people some context with your breadth of experience and decades in the medical field and focused on I really like— people call it whether it's biohacking or human optimization. How did that happen?

Like for many of us, it happens through a personal journey and life struggles and life challenges, right? So I started my career off as a surgeon, surgeons, a surgeon working in trauma and then reconstructive surgery. And those surgeries sometimes take 12, 14, 16 hours a day. Being an entrepreneur, I also was working on growing a business, buying surgery centers, opening them, running them. So I found myself working 14 hours a day in surgery, and then another 14 hours a day afterwards trying to hire employees and, you know, do the payroll and manage the balance sheet. And ended up just working so hard for 20 years after graduating from medical school that I found myself in a really kind of an emergent state of health, an emergency to turn things around.

Mm-hmm.

I had an autoimmune disease. I was hypertensive, uncontrolled, metabolic syndrome, basically everything, every list listed disease on the CDC top 10 causes of death, I checked the boxes for all of them.

Wow.

Yeah, yeah, it was a really bad part of my life, a part of my life that, that I kind of felt shameful that I got to that point being a doctor. And that was also the same year was the birth of my son, 2013. And, you know, if you look at all the kind of charts on all-cause mortality with multiple diseases, I quickly realized I had a 50% chance of living long enough to see my son graduate graduate from high school or college.

Wow.

Yeah, and so, you know, stark realization, not a happy one, but, you know, I knew I had to change things. And being trained in Western medicine, even though Western medicine is incredible, like the surgeries that we would perform to save lives, just mind-blowing, but Western medicine is so good at treating trauma and disease after it's been diagnosed, and it's really horrible at turning those things around and also preventing them, sadly. I quickly realized that I needed to get an outside education, basically reeducate myself on the science of health, which is very different than the science of disease.

Hmm.

And so, that's kind of how the whole ball started rolling. Back in 2016, our friends, Sarah Gottfried, Mark Hyman, they all started talking about functional medicine and treating disease at its root cause. And, I dove really deep into that science, the science of root cause medicine, functional medicine, the science of exercise, sleep, nutrition. I became a nutritionist, I became a personal trainer myself.

Wow.

I got all the certifications, and I was able to turn my health around completely within the course of that year of learning. And so from there, I decided, you know, this is the kind of medicine I want to practice, this combo of Western medicine, functional medicine, also sleep, nutrition, exercise, and then this entire field of longevity science started emerging after that paper in Cell magazine about the 8 reasons that our cells age at a cellular level. And I saw this opportunity/excitement in that field where we're going to learn in the next 20 to 30 years how to reprogram ourselves to age in reverse, not just stop aging, but age in reverse. So I want to be there for that. I want to be there for that moment. And so that was another big reason that I decided to go into this field was I wanted to live long enough to get to that point where we are actually able to reverse aging, and it's coming soon. And, um, I decided to form a business around it, being the eternal entrepreneur. I quit surgery, started Next Health. And Next Health is basically a health optimization and longevity center, is what I call it. And it brings all these disciplines together under one roof so that you can not only turn around your health, but also participate in the latest kind of advancements in longevity science that are going to come.

Yeah, yeah. You mentioned the Causes of mortality, whether it's heart disease or cancer, and if this could be measurably prevented. I mean, this episode could really be on how not to die.

How not to die, right, exactly. And what people don't realize is so much incredible new things coming out, even in the last 6 months, some of the stuff that's happening that's now available to us that you really can— it's not like a hopeless situation once you get diagnosed with the disease. You can turn it around completely. And it's just so exciting right now. Yeah.

And this will be the medical disclaimer. This episode is not meant— it's educational purposes only, not meant to treat or diagnose any sort of disease. Obviously, talk to your health practitioner. Before we get into some of those tools, and because I know our community is hungry and they love to learn and tap new resources, how do you look at it then? Like, what's your framework for looking at optimal health?

Yeah, so, you know, I see probably 100 patients a month, and right now I'm still doing a lot of patient-to-patient interaction. And I love that because it really teaches me how I can teach people about how to kind of take all of the massive amount of information out there and distill it into what's actionable. And so I provide 2 frameworks. One is I call the Wellness Wheel. I divide your health up into 12 different and we take people through these 12 categories over time. So we start with the basics: sleep, nutrition, and exercise/movement. We then move on to how not to die, preventing cancer, metabolic disease, Alzheimer's, and heart attacks.

Mm-hmm.

And then we talk about functional medicine, and so that's things like hormone health, brain health. We talk about gut health as well, how to detoxify your intestines. system and emotional health. And then we move on to longevity as kind of like the end of that journey that we take over the year with our patients. So that's one framework I use. And the second framework I use is the Pareto principle. 20% of this information is going to move the needle for you 80%. And I tell people, don't get hung up on the details because you're going to get paralysis by overanalysis of whether you should eat blueberries or strawberries, you know, or what's the best, you know, neuro-enhancing supplement you could take right now. It's just, that's not going to get you the 80%. And most people don't know what's going to get you that 80%. So I really focus in on the Pareto principle. And then I also realize that every patient is different. You have to meet them where they are. Usually patients fall into one of 4 different categories, and I try to figure out where they are, and then we, we customize a plan for them at Next Health.

What are the 4 categories, if you would?

It's different for each one. So like, for each aspect, like for nutrition, you have people that are only eating junk food, right? And then you have the people that try to eat healthy most but they really don't have a great education on it. And so they're still going out to restaurants, they don't cook a lot at home. Then you have the people that are really like, you know, taking a deep dive more into the science, and they really are clean eaters, they call themselves. They really have their protein optimized. And then you have the biohackers that are like taking 50,000 supplements, you know, as well. And so you gotta find out where people fall into these categories.

Right.

And kind of get them back to what's really gonna help them utilizing their own biomarkers.

Okay, so let's look at that, the Pareto principle, the 20% that gives people the 80% of the results and the rewards. Where do you start with your clients or patients? What do you recommend?

Yeah.

I mean, and we'll also put the wheel— if people are watching on YouTube, we'll put the extended version of this conversation. We'll put the graphics there also as well. So make sure you subscribe there. And as always, we'll put links to everything we're talking about here in the show notes at jimkwik.com/notes. So people are bio-individual.

Right.

You wanna focus on the 20% that yields the mass reward in return for people's time, money, focus? I'm sure there's a lot of diagnostic tools.

Yes.

Okay. So it could add up, certainly, financial resources and time. What are the ones that are just foundational? Yes.

So it's a great question. And by the way, most of what's going to move the needle is free.

I love them.

Yeah, and so what I would tell you is that with nutrition, let's talk about nutrition first. It's an easy topic for us to cover. The 20% of the information that makes 80% of the difference is not about what you should be eating. It's about eliminating ultra-processed food from your diet.

What would be included in that?

So ultra-processed food is basically food that is created or manufactured in a factory that has a list of ingredients that is mixed in with chemicals to preserve it, to change the color, to make it smell different, et cetera. All of the— this giant food industry, what they've been serving us for the last 50 years, that's cheap, that's made from, you know, made in different countries and shipped over here in boxes. That's ultra-processed food. But what most people don't realize is that a lot of times, even though they're not eating those boxes of food with long lists of ingredients with chemicals they can't pronounce, they're still getting it in their day-to-day diet. And that's because they're getting it at restaurants. Restaurants buy this ultra-processed food and they put it there on your table. They're still getting it in some of the oils that they cook with, things like vegetable oils, seed oils that are mixed and bleached with chemicals. And they're still getting it in obviously fast food as well. And so people tend to forget that. And so if there's one thing I could tell you that has moved the needle for 100% of my patients, it's eliminating ultra-processed food from their diet. And so some people have no control over their diet and that's totally fine. But as long as you're not eating that ultra-processed food, you're automatically going to get healthier just focusing on real whole foods. And then after that, then we can kind of go into— once you get that off the table, then we can kind of start diving into what's the best dietary pattern for people. And on that note, what I tell people, the most researched diet is the Mediterranean diet. And that doesn't mean you have to go into just becoming a Greek food eater all the time. You know, you can, you can follow that pattern. And the pattern is super important because all they're doing in the Mediterranean diet is they're eating an a big amount of vegetables, they're eating an adequate amount of protein from meats, usually fish, and they're also eating some good well-selected fats, things like extra virgin olive oil, avocados, nuts, etc. And that opens up a giant amount of different— I use diets in quotes, I don't like the word diet, I think it's a lifestyle that you need to adhere to, but that opens up a lot of different things. It opens up paleo, it opens up like That's how the Japanese eat. It's a blueprint diet. All these kind of diets that people try to talk about and really adhere to, really it's just following that pattern that's super healthy. So that's kind of where I try to gear most people towards. And look, a lot of people love the keto diet, a lot of people love the carnivore diet. And I use those sometimes as interventions, but I just don't think that they're good long-term dietary protocols. And then And after that, what we do—

And it's not just what you eat. It's how you eat. It's when you eat. It's who you're eating with. A lot of people are eating while they're stressed or working and they're not getting that parasympathetic rest and digest. Yeah, our listeners know this, but there are 4 needle movers you could do for behavior. You can either stop something, start something, do less of something, or do more of something. So, as you're listening to this episode, filter through that lens. What can I stop? What can I start? What can I do? What can I do less of? What can I do more of? And those are the little choices we can make and those little by little add up to a whole lot.

Exactly, absolutely.

So I love starting— yeah, it's great that we start with the food that we intake and what not to do and what you can do and what you can add. That's some flexibility and some freedom and things can be delicious and nutritious.

Absolutely, absolutely. I mean, how much delicious food is out there that is absolutely nutritious that once you start changing how your brain interacts and you start, like you said, making small changes over time, you really get used to it. And then this, it takes time. People have to give themselves time. People have to learn how to form new habits. And we've changed so many people's, so many patients of ours' health completely just by focusing on these big rocks. You know?

Yeah.

We all know the story about the jar. The teacher puts the big rocks in first and then the pebbles later. We start adding the pebbles over time after that.

I love that. All right, so now we covered food as part of the 20%. What else would fall in that bucket?

So when we talk about exercise, I always, you know, people always ask me like, what kind of exercise should I do? Strength training, VO2 max? And we always take it a big step back. And I ask people, how much time do you spend sitting at work all day? Right? It's really the Pareto principle there is sedentary behavior is what's killing you. And I don't care how much time, even if you go to the gym every day for 2 hours, if you're sedentary 8 hours a day, that's what's really affecting your biology at a cellular level. And so we try to give people tools to cut out sedentary behavior. There's immense amounts of research that show that for every 10% of time that you spend over 4 hours sedentary adds 15% extra to your mortality rate, okay?

Wow.

Yeah, it's a massive correlation between sedentary behavior and mortality. So the solution there that we give people that works extremely well is to take what's called an exercise snack. Have you heard about exercise snacks? Yeah, so every 45 minutes, take 5 minutes where you just get up, walk around, you maybe do some jumping jacks, maybe do some pushups. As long as you're moving every 45 minutes, that counteracts that sedentary behavior completely.

It's like a little brain break. And it also follows the Pomodoro technique that we teach, that there's a dip in your focus, your mental energy, your endurance, you know, after 30, 45 minutes. So it's a perfect time. Primacy and recency is for our memory students out there to boost your retention. But it's a wonderful way to reset yourself, like a little pit stop.

Right, and there's one more benefit to it. Your cortisol, so when you're, people have a lot of stress when they're working. So every 45 minutes, if you take a break, it cuts out that cortisol release from your adrenal glands. And so what happens with cortisol is if you stay stressed for a long time, your adrenal glands reset to a higher baseline of cortisol secretion. And that keeps happening over and over and over again, the more time you stay, in a stressful situation. And we know chronic cortisol release leads to all of the chronic diseases, right? So if you take that 45-minute, 5-minute break, you will cut off that cortisol secretion, allowing it to reset back to a lower baseline. And so that's massively impactful to your health as well.

All right, so people are taking these, these, these, these snacks to be able to re-energize. We call them brain breaks to be able to move, Maybe do some breathing. A lot of people are just fatigued because of their posture and they're not— sometimes when they're in fight or flight, they're not getting that deep diaphragmatic breath. Maybe hydrating.

Exactly.

Beautiful. And then, so setting it something simple. And this is what's beautiful about movement. Again, it's free.

Yeah.

Right? That's something that— and as your body moves, your brain grooves, which is an added benefit. You personally set a timer for 45 minutes?

I do. So I actually used to use an egg timer. for a long time. And then I downloaded this app called Flow on my Mac. I think it's available for Windows as well, where it just shuts off your screen in 45 minutes. If you're in the middle of something, you can ask it for 5 more minutes, but it'll just shut off your screen. And man, it's such a game changer.

Amazing. Okay, so we talked about food, we talked about movement. What else would fall underneath Pareto principle?

Yeah, so with sleep, I say the Pareto principle there is be before you start wearing your blue-blocking glasses and you start doing all these sleep supplements, the number one thing you have to make sure is you don't have sleep apnea at night. A lot of people suffer from sleep apnea. We're actually finding sleep apnea in over 70% of our patients that come to Next Health, believe it or not.

Wow.

Yeah, and even like mild sleep apnea, people don't realize they have it, but even mild sleep apnea can lead to increased rates of metabolic disease. And so you really want to treat that in whatever way possible.

Yeah, I talk about this in Limitless about my sleep. I have severe sleep apnea, so I stop breathing 250 times a night. Each episode is at least 10 seconds, so it's kind of waking up. And I, you know, CPAP device, dental devices, I had a surgery down the road here at UCLA. They took out my tonsils, my uvula, my soft palate to create more airflow, 'cause it was definitely obstructive. But they could go see a doctor, they could do a home study, they could do a home sleep study.

Yeah, exactly. So you don't need to go to a sleep lab anymore. There are some great sleep studies available at home, at least for initial screening, where you just wear a little pulse oximeter and a wristband. And we get some great data from that on our patients. And if you are snoring, you are waking up gasping for air, or you get tired within an hour of waking up, Or if your significant other tells you that, you know, you're waking up gasping for air and you're snoring so loud, I would highly suggest getting tested for sleep apnea. Because as you know, you know, suffering from this, it's— it can be— it can be really, really disruptive to your overall health, your life. You just have to live in brain fog all the time, and it's— it's necessary to get it treated. And there are different ways of getting it treated, like you mentioned a lot of them. There's one more surgery available, by the way, which is a pacemaking Electrode they can put in your throat that actually opens up your throat when you're breathing in. And so those types of things are available now.

Okay, it's nice to know there's options. Just your favorite outside of, let's say people are good with the sleep apnea, do you have one kind of go-to sleep tip for yourself?

Yeah, absolutely. So, you know, with sleep, you have to fix your sleep environment and your sleep routine. And so there's different things you can do in your sleep environment, which is make it as close to a cold, dark cave as possible that like our ancestors slept in. And with your routine, my favorite thing on that, which I'll highlight for you, is I tell people your routine actually starts the moment you wake up. That's when your sleep routine starts. And what you need to do is when you wake up, as soon as it turns light outside, go outside, physically go outside and expose yourself to the outside environment and to the low-level sun or the light in your eyes from the sun. If you can at all do that, it's an incredible way to set your circadian rhythm for the rest of the day so that, you know, your melatonin secretion starts 14 hours later, your cortisol release is regulated all day long. It makes a huge difference. And what we normally do— what do we do when we wake up? We get up, we go to the bathroom, we turn on the bright white lights, and we start our day off in this huge white light environment. And that actually is kind of disruptive to our sleep patterns. 14 hours later.

So yeah, and devices and everything. Absolutely. Again, no, there's no cost. I mean, we're gonna go through some of the tools also and procedures, therapies yet that you have at Next Health. But the foundational stuff is—

Yeah, we haven't spent a dime yet.

Right. And it's not— it's low, low financial cost, if anything, and also low time investment. Right. Like, I mean, how much, how much light do you need? How much— what's the minimum dose there, you think?

I usually say spend about 5 minutes outside. Yeah, so I have my coffee outside in the morning. Yeah.

And even if it's hazy or foggy, you still get the benefit.

It still works, right?

As long as it's not inside, even if there's sunlight, the windows probably filter out some of the spectrum of light.

It does, yeah. So, you know, you want to open your windows if you can't go outside. Say you live in like the 50th floor of a building, it's just not possible. But, you know, I have a place in New York I go and I still make it a point to make a cup of coffee, go downstairs, go outside.

It makes a difference.

It does make a huge difference. Even like the— even if it's a little bit chilly outside, Which is always— and that's what our caveman ancestors were used to. They woke up, it's a little cold outside. That temperature also helps to set your circadian rhythm as well.

Okay, perfect. So we talked about food, we talked about movement, and sleep. Is that complete, or is there anything else you would add for this?

I mean, there's a lot in each one of these categories. You know, then we start kind of filling our jar with the medium-sized pebbles. So with like nutrition, we are Huge believers in the continuous glucose monitor for about 6 to 8 weeks for most people, not forever, just enough time to learn about how your body's regulating glucose. It's incredibly important for brain health especially.

And what are those glucose spikes? Or when we're talking about insulin resistance, what's that doing physiologically that's impeding people's peace and productivity performance?

Yeah, absolutely. So the more glucose spikes you have, the more you are trending towards insulin resistance because every glucose spike is an insulin spike. When there's too many insulin spikes, your cells start saying, why do you keep trying to feed me when I don't need to be fed? Insulin resistance is what leads to— it's like the baseline of all the other metabolic diseases, but in the near term, before you even get diagnosed with a disease, it can cause a severe amount of brain fog, it slows neuronal action potentials, it can do in your heart, it can actually weaken your heart muscle. There's a lot of different problems with it. with insulin. Insulin—

Weight gain.

I mean, absolutely. Weight gain, fat gain is basically a baseline for almost all diseases, causes fat deposition in your liver. So yes, you want to control that as much as possible. You want to keep your insulin levels as regulated as possible, which means minimizing the amount of glucose spikes that you have during the day. Now, for people that don't have a continuous glucose monitor, you can still use the same techniques to minimize glucose spikes. So there's things like Putting the carbohydrates at the end of your meal instead of at the beginning of the meal.

So like vegetables and proteins, fats, and then end with starches and sugars.

Exactly, end with starches and sugars.

So it's not just what you eat, it's the sequence or the syntax, the order in which you eat it.

Exactly, because the fiber from the vegetables will prevent the absorption of glucose in your intestinal wall. Secondly, the protein will fill you up, so you just eat less of it. And then the other tips that we usually give people is don't snack, try to snack as minimally as possible. There's this whole food industry that revolves around snacking, and that's just so they can sell you more food. We're not supposed to be snacking, you know? And finally, I tell people, definitely go for a walk after every single one of your meals.

That's it. Even if it's a 5-minute walk, it keeps your glucose curve Because yeah, with the muscles that absorb and then it mitigates that spike, which is so very important.

Yep, your metabolism lives in your muscles. And so if your muscles are active, you're going to be metabolically active.

Fantastic. I love that. Anything else that would fall under this 20%? I know it's 20% for each of these, this is the thing that moves the needle and then there's 20% in each category, which could be hours of conversation.

Yeah, I would say also just to touch real quick on the exercise category, one of the things I, that a lot of people think they realize, but intuitively they don't do, is they don't have adequate amounts of strength training in their exercise protocol.

Okay.

Yeah, so I have, you know, you have 4 categories of people once again. You have the people that don't exercise at all, that are sedentary. You have people that are like gym rats that do only strength training. Then you have people that are like on the treadmill all the time. And then you have people that have a good variety. And that variety is what's key. You got to be able to, Especially as you age, you have to have an adequate amount of strength training and cardio training to really make sure that you stay mobile and you maintain your VO2 max, you maintain your strength over time. Because once again, your muscles is what's going to strengthen your bones. People that have sarcopenia have osteopenia.

That's right.

And those are the people that get frail as we tend to age past the age of 70 or 80. Lifting weights every single day if you can, at least 3 times a week, formally lifting weights for 45 minutes is going to be massively impactful for your longevity.

And the strength and resistance training also, you get the dopamine, the serotonin, the endorphins, you get the BDNF, the brain-derived neurotrophic factors, you know, so, so very important. And I love what you said. It's just not just doing it 3 times a week or for 2 hours a day. It's doing something throughout the day.

Exactly.

Getting in that and then until it becomes more of a habit.

Right, right.

You know, I start craving it after a while, especially in, you know, in my 50s. It's something that I just, you know, movement is so key because, you know, and the number one reason, you know, obviously it's a brain show. The number one reason you have a brain is to control our movement.

Yes.

You know, it's not just a mind-body connection. There's a body-mind connection that using your body in different ways could stimulate your brain in fantastic ways.

Absolutely.

Fantastic.

Well said.

Anything else that falls underneath there? Again, we talk about food and nutrition, sleep, movement and exercise. Anything else that should be on people's radar? And then we'll go into the tools and resources, therapies.

Right, right. So I would say in those, in the basics category, that's probably, you know, we've covered the big bases over there. We're big believers in a concept called becoming the CEO of your own health. And we We really encourage people to start watching their own biomarkers. So we give people a set of like 10 biomarkers that they should be following, which are blood tests, but also a few more they should follow at home, specifically with skeletal muscle and body fat.

Okay.

And so we have all of our patients purchase a bioimpedance scale. And, you know, there's controversy around how accurate they are. There's some that are more accurate than others, but it's really about watching the trend line. You want to watch your skeletal muscle muscle mass get to a level that is good for your age and you want it to stay there, or you want to keep improving it. Same thing with your body fat. And so I think everyone should be watching these. The scales now, you know, your typical bathroom scale just weighs you is garbage. I think you want to get something that can give you some trend lines, that is a good app that you can track these biomarkers with. And so that's, that's a big piece of what we talk about.

So what would you say are the most important things that people, those biomarkers that The, the biggest difference that are like foundational. Are you ready to activate your competitive advantage and achieve unparalleled success in your personal, professional, and your financial life? Welcome to the Limitless Learner Virtual Summit on August 5th, 6th, and 7th. By registering for and attending this free 3-day virtual event, you'll learn how to double your brainpower, to double your earnings, and maximize your free time. Just go to thelimitlesslearner.com to secure your free spot.

Yes, the foundational biomarkers are getting the skeletal muscle mass and the body fat. That's 1 and 2. 3rd is your blood pressure, especially after you turn 30 years old. You want to make sure you have a blood pressure cuff, you're checking your blood pressure at least once a quarter. In the correct way. The blood pressure most people get at their doctor's office is garbage. The person doing it is stressed, they're rushed, you're rushed, you're stressed, white coat syndrome. You need to do it at home.

3 separate readings. During certain times of the day.

Yes, yes. First thing you do in the morning after you're relaxed a little bit. And you do it 3 times in the sitting position with the cuff at the right position. And you take the average of that. Because high blood pressure is known as a silent killer. And it's one of the things that a lot of people are ignoring Because they just assume their doctor is checking it once a year for them and most people don't check it enough.

And I guarantee you somebody listening right now that takes action on this, this could save your life or the life of a loved one. This is why these conversations, even though people have heard some of this stuff before, if it creates an impetus for them to act and do something about it, they could get information and data that could— right in time.

Absolutely, right in time. And I can tell you, a lot of people are so hyper-focused on their cholesterol levels for heart disease But heart disease is really a combination of 3 things working against you together. One is cholesterol, but that's the last thing. The first 2 things are high blood pressure causing damage to your arterial walls, and thirdly is inflammation as well. And so these— high blood pressure is easily detected 10 to 20 years before it becomes a problem.

Wow.

And in fact, it has to be tightly controlled. It has to be 130 over 80, under 130 over 80. on the systolic and the diastolic, because for every 10 points increase you have over that, you have a 15% increased chance of mortality. So for people trying to get their blood pressure under control and you're noticing it's 138/85, you do need to do something to get your blood pressure under control even at that level.

Anything else that you want people to be— in order to be able to manage it, we've all heard that you have to be able to measure it, Right. What else are you looking for with patients or with family members?

Yeah, on the biomarkers, I empower people with at least 5 or 6 blood tests that you need to know. Anytime I walk up to you in the street, hey Jim, what's your hemoglobin A1c? You should be able to tell me that number. So hemoglobin A1c, hs-CRP, which is a measure of inflammation. We like making sure people also know their ApoB level, which is kind of a combo of all of your bad cholesterols. We like people to know their vitamin D level is one of the most important micronutrients out there, which also functions as a hormone. And after you turn 35 or so, you should start watching your hormone levels, your testosterone, estrogen levels as well. And so those are the— those are just kind of big picture.

Where's the person that's listening to this, where do they get these tests? And then once they get the data, It has to inform some kind of change of behavior. I know you do this at your clinic for those, because it's kind of concierge care. Where can they get the tests? And then how can they— they're not qualified necessarily, most people, to take that data and make changes.

So what I would say is for simple things like this, there's a few things on this testing. So anyone can get these tests from their doctor. They just have to list them out and say, doctor, I want you to get these tests. And if your doctor doesn't order them for you, it's time to find a doctor that will.

And it's hard to find even a doctor, you know, because in my personal experience, and mine's not like everybody's, but for most of my life going to a doctor, it's a very short period of time and we never have a conversation about sleep and diet, the things we're talking about right now, movement and exercise.

Right.

You know, and, you know, these tests, you know, before I learned about this, it was just something that was— I was a little like in the dark about.

Absolutely, absolutely. And, and this is the whole concept of becoming the CEO of your own health, because as a CEO with a business, you would never look at your KPIs once a year with a consultant that doesn't even show them to you. It only tells you when you're now losing money, right?

Yeah.

You're watching these things trend over time. You raise alarm bells when things are not in the optimal range, not when they're abnormal. You raise it when things are not optimized, right? And so you really want to get yourself educated on these biomarkers and what they mean, why they're important, what's the optimal range and what you can do about them. And so I have a lot of content online that I give people for free. I give people a free spreadsheet as well that they can use to track these and it'll give you all the information and what to do if things are headed in the wrong direction. And once again, this is all free stuff and if your doctor orders these blood tests for you, your insurance should cover them. For sure. If he or she doesn't order them for you or you just don't have access, there are many places online now that you can self-order these as well.

Okay, and we'll put links— your team could provide us with links that we'll put in the show notes for people to access this as well as the links to your clinic and everything else.

Right, yeah, you can get all the blood tests you need with a simple finger stick now and send it in the mail. And you can get the results back in a week laid out for you.

And what I like about everything you're saying is very measurable. Just like when people go through our programs, you can measure someone's reading speed, their reading comprehension. You can measure their memory before and after for names, faces, you know, numbers, whatever we're presenting. What about— you can measure people's activity, their sleep, their latency, their REM, their deep, their HRV. Is that something that you're tracking also as well?

We do, we do encourage people to do some sort of sleep, HRV, activity tracking for a period of time, especially when we're gathering data and we're trying to make changes. Now, once again, every patient is different, you have to meet them where they're at. There's some people that look at the numbers and they get almost more stressed, they're not sleeping well. And there's some people that want to track forever. I find most people are somewhere in the middle where they will track for a certain amount of time, they get things optimized, and then they'll retrack when things when they think things are moving in the wrong direction. That's my middle group. But then, and then I have the biohackers that have 4 different devices on at the same time that are tracking and comparing notes from each one. And so, you know, I try to be realistic on how much tracking is number one, affordable, mentally tolerable, and what they really are going to do with the data as well.

Sure.

And I would just really encourage people out there to not be blind that there are excellent tracking modalities out there for all of these markers now.

Yeah, and going back to being the CEO of your own health, you know, the CEO is going to look at those numbers, right? And then see if you have this whatever glass of wine before you go to sleep, if it changes your numbers. And, you know, I think even with children you could do that. They have a piece of cake and you check in with them and just see how they feel. As opposed to telling them, don't do this. And it's very experiential.

I have a patient that, you know, absolutely thought he was sleeping incredibly well. He's like, I'm the best sleeper on the planet. I wake up so energized every morning. And so we just said, that's great, but let's just check how much deep sleep, how much REM sleep you're getting. And so he's like, I don't need to do that. I don't need to do that. But so I just bought him a little pad that goes under your mattress that's made by Withings. It's like $50. We found out he was getting zero deep sleep because he was waking up 10 times during the night. And he had no idea, but he ended up having sleep apnea as well. And so people don't realize that the data can be very helpful, even though—

To trust, but also verify.

Right. Trust and verify.

I like that. All right. So we talked about the foundational things. What, I mean, you have a big menu.

Yeah.

Of things that people could do that goes— the acronym I use is MEDS-RX. You know, M is meditation, E is exercise, D is diet, S is sleep, and R is relationships.

Right.

Right, for longevity and happiness. But that X is like the extras.

Yes.

Right. And so what are the needle movers there? Because when I— and I— when I'm in a city that has, you know, one of your clinics, You know, from personal experience, I spend a good amount of time there just kind of getting everything set up to be able to perform the way I need to be able to perform. What's kind of your go-to? I know it's different for everybody because everyone has different needs and has different starting point.

So yeah, we always start off, you know, if your basics aren't optimized, there's no use doing any of this stuff. So we get those optimized and then we move on to— then we have all kind of like these technologies on site at Next Step. So I'm going to give you kind of what we do at Next Health, but I'll also give you the free version that people can do at home as well.

All right.

So at Next Health, we have what we call the Longevity Circuit, and that's where people come in for a couple of hours and they will first do a sauna session for 45 minutes, and then they will go into a cryotherapy chamber, and then the chamber somewhere between 2.5 to 3.5 minutes. Then we have an LED light bed, which has 20,000 LED lights. that near-infrared lights.

And going back to the heat and the cold, what are a couple of benefits there just to remind people?

Absolutely. So, you know, heat therapy, specifically sauna therapy, we have massive studies out of Finland that show that they can improve your longevity, decrease your risk of heart disease, decrease your risk of neurodegenerative disease.

And almost all cases of mortality.

And all-cause mortality, exactly, all-cause mortality. And so we know there's an effect there. It's probably mediated through heat shock proteins, through detoxification from sweating, et cetera, right? And so I'm a big believer in sauna therapy. I wasn't for a very long time.

What's your protocol? I mean, how many times a week?

Yeah, so I try to do it at least once a week in this protocol where I either go to NexHealth, I actually have it at home as well, where I do 40 minutes in the sauna, then a cold plunge, 40 minutes in a sauna, cold plunge, and then one last time. So, I try to do that 3 times in a row. I'm sorry, not 40 minutes, 20 minutes, 3 minutes, 20 minutes, 3 minutes, 20 minutes, 3 minutes. That's my protocol. And then, whenever I have a chance, if I go into Next Health, I'll just do this kind of longevity circuit, do all those things together.

And the cold, the benefits from the— whether it's a cold shower or cryotherapy or a cold plunge, what are some of the benefits?

Endorphin release for your brain. IGF boost afterwards, growth factor boost. There's also the kind of the shock to your system that brings all the blood into your central organs and then pushes it all back out. So that incredible kind of rush of blood to your central organs is incredibly detoxifying. So lots of benefits from that.

Yeah. And then how you feel after— I mean, during is one thing, but how you feel afterwards and also So the idea that we could do— it's reminding ourselves, it's evidence that we could do difficult things. We can do hard things when we need to. But the feeling I get after, for hours after, is just— I can't replicate that with hardly anything.

And the sleep improvement even the night of is just mind-blowing.

That's astonishing. All right, so we talked about heat, cold. What else is part of this longevity?

Light, the near-infrared light as well, which increases nitric oxide production from your from your cells, which decreases high blood pressure, number one, but also improves your mitochondrial health as well. So that's extremely important. The health of our mitochondria is basically our health. If we don't have energy, none of our cells can do what they need to be doing, right? And so we need to make sure our mitochondria are healthy. And so that's very helpful for mitochondrial health is to do some sort of LED therapy. But people can get the same benefit if you don't have access to LED light bed, just going out into the sun. It gives you the same types of benefits as well, exposing yourself to sunlight.

Yeah, or a cold shower. Exactly, cold shower. Or perhaps some ice at the hotel. I always get like a— because obviously I don't have cryotherapy machine.

Do you do that? Are you one of those people that empty out the ice machine?

I do. I apologize to anyone who's looking for ice. But I do rounds. I take off a pillowcase and I just walk down the hall, fill it up. I do that 5 times for the tub and I'm good to go. But that's how I start. I like to start my day that way.

Yeah, yeah, yeah. Me as well.

Fantastic. Any other therapies you want to highlight?

Yeah, so, you know, we also do things like hyperbaric oxygen therapy. Hyperbaric oxygen, I trained at the Mayo Clinic in Minnesota. We used to use hyperbaric oxygen back when I trained, you know, many moons ago, 30 years ago.

Which is pressurized.

Pressurized oxygen at a higher concentration, right? We used to use it to heal wounds for people that had just had strokes, to heal their brain, for people that had near drowning, to heal their brain, to refoster connections.

It was a big part of my recovery from my, um, my TBI.

Right, right, exactly. TBI. And so just bringing that out kind of more into the wellness world for people to utilize has been very popular and I think extremely beneficial. I use hyperbaric oxygen once a week if I can.

Okay.

From around. Um, that's one of those things that, you know, you have to find a specialized center that really knows what they're doing. Um, second, and then after that, we also do ozone therapy, for example. Ozone therapy is a therapy where we expose your blood to ozone, and that is detoxifying. It kills basically bacteria, fungi, viruses, and also detoxifies your blood as well. So those are some of the therapies that we do. And then we have some more advanced level therapies for people really seeking—

Maybe we can mention a few because we have those same 4 categories of people that listen to it. And some people are like cutting edge and want to know the latest.

So you want to know the pinnacle of biohacking? So it's an exciting world right now in longevity technology. And so we're finding that a lot of technologies that have been available to us for a long time acute care settings, like in the hospital, are actually beneficial for longevity. And so one of them is something called therapeutic plasma exchange, where we actually used to use this for autoimmune crises, where people would end up in the ICU because having a massive autoimmune crisis, and we had to remove all the immune complexes from their blood, like instantaneously, or else they would basically die from this. And what we found is that the that same removal of plasma, using it for people that are suffering, for example, Alzheimer's disease. We can actually slow the rate of Alzheimer's because we're removing the protein complexes that are in the blood, the inflammation, inflammatory cytokines that are in the blood as well. And so these inflammatory cytokines, when you remove them completely and you rid your blood of them, you actually slow the aging process as well. There's a lot research coming out around this. So what therapeutic plasma exchange does, it's about a 3-hour treatment. We sit you down with an IV in one arm.

Mm-hmm.

We remove the blood completely. We put it through a specialized machine that allows us to spin it down and separate the plasma from the blood cells, and then we put the blood cells back into you. Okay? So that separated plasma fraction we discarded. That's where all the bad stuff, I say, lives. And we're doing this basically like 100 cc of blood at a time, 250 cc's of blood at a time. So you don't really feel anything, you're just kind of laying there for about 3 hours and it's done. And you see this giant bag of plasma that's usually kind of dark and murky. Also cholesterol particles are removed, etc. It's used a lot for people, like I said, in autoimmune crises. It's also used to slow cognitive decline. It's also used for people that have certain high cholesterol syndromes like familial hypercholesterolemia. anemia, Lp, but it can also be used for general longevity purposes. And we're really excited about that technology. I think we're going to see a lot more research around that being a great kind of bridge to some of these other therapeutics that are potentially coming down the line in the next 10 years. We pair that a lot with IV stem cells as well.

Okay.

I think that's also something that, you know, obviously we can't say can treat any particular disease, but I feel that there's massive benefits for removing— for reducing inflammation, for potentially also many applications as well.

Okay. And you also have a whole menu of IV therapy.

Yep. NAD, NR IV as well now, which is coming out very soon, which I'm really excited about. Yeah, yeah, it's all part of our makeup.

A lot of people are hearing about NAD+. What is it and why is it important?

NAD+ is something that's made in every single one of our cells. It's a precursor that your mitochondria use to produce ATP. ATP is the energy that every cell needs to perform all its functions. So unfortunately, as we age, or if we are working out really hard, or we are sick, or we're traveling, our NAD stores get depleted. And so doing NAD both as a supplement or IV is replenishing that substrate your mitochondria needs to create energy. And so that's basically why everyone needs NAD.

Yeah.

Now, obviously, you know, humans have lived for centuries without NAD supplements and NR IV, But we kind of live in one of the most toxic and stressful environments we've ever lived in as humans. And so now we see this chronic depletion of NAD that's occurring in our lives and getting those back up to normal levels gives ourselves a fighting chance. Okay.

So we covered a lot in this conversation. It was like a mini masterclass, if you will, on brain health and longevity sciences. What would you recommend our listeners, our viewers right now? Where should they— where's a good starting point? It's always kind of people, as you mentioned, paralysis analysis. Maybe they feel overloaded or overwhelmed. But what are some of the simple actions you would recommend to listeners?

I would say get your basics right if you're in that category of patients that has not done that yet. So the things we talked about with sleep, nutrition, and movement, are really the Pareto principle of overall health, because those 3 things is really the 20% of health you need to focus on to create an 80% result on everything else. I always talk about, you know, the wellness wheel is kind of like a flywheel. A flywheel is when you put a certain amount of energy onto one part of the wheel, it makes the entire wheel turn faster and faster and faster. And so that's where you want to apply the most energy. Now, say you've pretty much got that down. I would really start focusing in on learning about your biomarkers, becoming the CEO of your own health, and purchasing a couple of the items that we talked about: a bioimpedance scale, a blood pressure cuff, and maybe some blood tests. And then seeing kind of where there's gaps, and then focusing in on those gaps. You know, we're all so blessed now with the internet that we can do a lot of research on our own. But also, you have to be careful where you get your information from.

Sure, sure.

Right? Um, there's a few books that I love, um, that I buy for my patients sometimes. Um, one of them is yours, of course. I sent you a picture of my son reading your book, my 10-year-old son.

That put a big smile on our team's face. What other books do you recommend?

Yes, um, I love, um, Dr. Hyman's book Food. Uh, it's a master class in food. Um, Food: What the Heck Should I Eat? Um, I love the book by Jesse Insoupe about controlling your glucose. I think that's a fantastic book. You know, all of our friends have written such incredible books and there's so much great information out there, especially for people that feel like they will suffer or are suffering as a loved one suffering from a disease process. Like Dale Bredesen's book on the end of Alzheimer's is one of my favorites as well. If you feel that that's something in your family history that you want to avoid, I'd highly recommend reading that book for sure. So those are a few of my favorites. I have on my website, I have all my favorites. People can look up kind of my reading list.

And, um, and also your social media. I mean, it comes up early on my feed. Oh good. You have these, these daily clips, you know, with, you know, these powerful gems and treasures.

Thank you.

So where can people connect with you? Um, Next Health, social media?

So my, um, Social media handles @darshanshawmd. That's on all the platforms. My website is drshaw.com. My— if you want, if you're in New York or in LA, you can go to next-health.com and come visit us. We're opening all over the country and world now in the next year or so with our franchising that we're doing. And that's probably the 3 top spots to find me. And, you know, I'm always I'm always doing podcasts with incredible people like you. So just search my name on podcasts.

I love it.

Yeah.

So I encourage everybody as a reminder, you know, I hope this conversation is a reminder that you are the pilot of your health. You're not the passenger. You know, you are the CEO. And we can make these small little choices that can make a big difference for ourselves, for our family, for our team. I would challenge everyone right now to take a simple action. Take a screenshot of wherever you're consuming this. And post it, and tag Dr. Shah, tag myself so we get to see it, and share one thing you either learned or you're going to apply in the upcoming days, weeks to be able to get to that next level of health that you desire and that you really deserve. And make sure you also if you want the extended version of this conversation, which is longer, we always put twenty minutes. We put snippets of the audio on the audio platforms like iTunes and Spotify, Pandora, so on, but the extended version always goes on our YouTube. So join 1.5 million subscribers there, leave comments with your feedback and your suggestions. And Arshad, thank you so much again for coming, not only coming on the show, but the great work that you do.

Thank you.

And thank you also for your care for my brain and my body.

Fantastic. So this is a lot of fun. Thank you so much.

Absolutely. We'll see everybody in the next episode. Until then, uh, be limitless.