The Surprising Science of Beneficial Stress with Dr. Sharon Bergquist

Dr. Sharon Burquist, welcome to Well Beyond 40.

It is an absolute pleasure being with you.

We have never talked about this before, so I am excited to unpack it. This idea— and great title for a book, The Stress Paradox— but the idea that, that not all stress is bad and that we might need some good stress. And so we're going to dig into that. How did you get into this subject?

So my background is I've spent the last 30 years in internal medicine, and I also do research centered around prevention and how to age healthy. And so a lot of the goal of the work I've done is to help people prevent disease and, and age well. And along the way in the research, I stumbled really across this whole idea that Stress is one of the most powerful ways that we can make our bodies healthier. And there's a lot of history behind how we understand stress today. And in the last 20 years, a lot of cellular and molecular biology that has enabled us to understand what stress is doing down to the level of our cells. And that is really my interest because I'm always looking for a unified way where we can make health simple and help people just do a few things that are striking at the heart of our foundation, ourselves. And ultimately, stress is that thing.

Well, so let's— because it sounds like we're really reframing stress, and I think when people think of stress, they only think of bad stress. So let's first start with what stress is.

Yeah. So stress is really Anything that throws your body out of balance, anything that challenges you, it could be psychological, it could be physiological. And like you said, we understand stress to be something that harms us. In fact, our group has actually published studies on how stress can lead to heart disease. But what the new science is showing us is that it is also equally true that stress, that the stress can strengthen and enrich us, and that we can use these good stressors to build resilience against the harmful stress. And that is really the paradox, that we need stress to build stress resilience, right? So it is counterintuitive. It is reframing our understanding. So our goal really now is is not to, quote, cure stress, get rid of it out of our lives. Our goal is to optimize it. And that has huge implications for our health, not just mental, but physical, how we age. So that's really what the new science is about. And that's what the book is about as well.

This is— I mean, it's— when you say it this way, it's so obvious because it's like, what do we do when we go to the gym?

Right.

Right.

You know, exactly.

So then it strikes me that it's really a balance. There's obviously some things that are bad stress, harmful, and there are things that could be good stress. But then, you know, even good stress, too much of a good thing becomes bad, right?

100%.

So a lot of it seems like it's about having the right amount of balance. And I like you said, it's not about having no stress because You know, I remember hearing, hearing this before and people talking about stress management. I'm like, what is stress management? It should be called stress balance, really, or creating the resilience. So you talked about good stressors. What would good stressors be then?

Yeah, so good stressors. So like you just said, there are a couple things that can differentiate good versus bad stress. So it's the kind of stress It's the intensity of the stress and the duration that we are exposed to the stress. But one of the key things that has been borne out from this new research is that we have historically thought of, you know, like you said, too much stress is so harmful. So if we can just bring that stress level down through meditation, mindfulness, we can avoid the harm of the harmful stress. But what we're really learning is that when we bring stress from that extreme to that mild moderate range, we don't just not harm, we actually take off. There's a Goldilocks zone which we call the hormetic zone based on the science of good stress called hormesis. Hormesis being from the Greek to excite. That when we're in this zone, we're actually strengthening. So it's not just finding that balance of getting less stress, but getting into that sweet spot where it is actually benefiting us. So the relationship— if you picture the St. Louis Arch, right? So in that middle Goldilocks zone is where that arch is at a peak, where our resilience is at its best. When we have too much or too little, that is what is making us vulnerable to so much of the mental and physical illnesses that we're seeing.

And so even if it's good stress, and I would think good stress would be— I mean, exercise is a great example. Too much good stress would take you out of the Goldilocks zone. How do you know? Because I would think for, you know, there's a lot of talk out there, especially online, about, you know, exercise and cortisol and blah blah. And I think Wow, we have maybe, I don't know, 20% of the people really hitting the exercise recommendations. Are we really concerned about over-exercising? Like, is that really our big challenge out there in the world right now? I don't think so, you know. But how would someone know whatever type of good stress it is? I'd love to unpack what those can be, but how do you hit the Goldilocks zone? How do you know how much is your right amount?

Yeah, a lot of it comes down to where you are, and you just have to hit a point where there's some discomfort, okay, some sense of challenge. You have to be a little bit out of your comfort zone but still feel safe and not overwhelmed. And for every person, that's going to be different. Like, to your point, if someone has never exercised, well, maybe doing a 5-pound weight can push them to that discomfort zone. If someone is an professional athlete, obviously it's higher. But every time we go through that, you lift the 5 pounds, recover, that stress recover, the recovery of course is when we're building so much of our resilience. And it's like lifting weights, right? Every person has to start where they're at and then work their way up and keep pushing themselves out of that comfort zone. So there's a lot of tuning into your body and getting a sense of how you felt after that stress exposure. You know, if you're invigorated, you feel energized, you hit that sweet spot. If you're fatigued and if you need to be in bed, you know, you've clearly overexerted yourself.

Are there tools, things like HRV, that can be helpful here, or do— or are they relevant or not?

Yes, you can definitely use, you know, some people like to track HRV. You can also use heart rate monitoring, however you want to track. Absolutely, with heart rate variability. So for anyone listening who may or may not be familiar, it's the beat-to-beat variation because our heart doesn't beat like a metronome. Between each beat, there's a slight bit of difference, and the higher that variability from beat to beat, It's a sign that our nervous system, the balance between our sympathetic and parasympathetic nervous system, is doing well. So we want a higher heart rate variability to show that your body's in a less stressed state. So you can track that day to day. I, I personally track mine, and it gives me a sense if this is a day to, you know, have a big workout or, you know, cut back. But to your point about what you said of, you know, we hear all this talk about worrying, did I overstress myself with this workout? And oh goodness, this high-intensity exercise elevated my cortisol. I think what gets lost in the conversation, and this is, I think, what you're alluding to, is that when we have a quick spike of stress, and it's brief and intermittent, that our bodies love it. We are wired for this. So if— and this is true of all the good stressors, they're brief and intermittent. So if your cortisol goes up during a high-intensity interval workout, and it will, and then it comes back down, what matters is not that transient increase in cortisol. What matters is what it does to your baseline level of cortisol. So when we go through cycles of peak, we are triggering adaptations through a stress response so that our basal cortisol level is lower. Just like you said with heart rate and blood pressure, right? We don't not exercise because it spikes our heart rate or raises our blood pressure because we know that it's going to bring our basal baseline blood pressure and heart rate down over time. So, I think we also have to not fear these transient spikes in cortisol. We are actually made for it, and that's how we stress our body enough so that our body becomes resilient to it. And the next time we encounter that stress, we are more resilient and we can handle more.

I'm so happy you said that because I hear so much on the internet about, "I spiked my cortisol," or, "I spiked my cortisol." I spiked my insulin, and I went, um, like, you could literally look at exercise and go, this is the stupidest thing to do. I'm going to spike my cortisol. I'm like, I was doing some resistance training to see how high I could get my blood sugar to go because I was pushing so hard. I got to 220 on my CGM because I was like killing myself, right? So you might spike your blood sugar. You might, like, you're gonna definitely have blood pressure crease on the outside. All this stuff looks terrible, but the adaptation is amazing. I do wonder though, especially with women, in looking at women versus men working out, some of the stuff that I've read recently says that women have trouble identifying how hard they can really push themselves, that their one rep max, they can generally push themselves more than, than they realize they can. And I just wonder if we might limit ourselves a bit. That's why I was like, what tools do we have here? Because I think quite often we could probably push ourselves a little bit more, but there's been so much fear-mongering out there about cortisol. Like, no, you want— you want to do this. You want to train your nervous system to be able to handle hard things and recover.

Yeah, absolutely. I think, you know, there's an element of trial and error with any health habit. You know, no health habit works for everyone, but there are certain things that work for most people. And what we're talking about are really the non-negotiables of our physiology. So, if we ask the question, what are the good stressors, right? So, the good stressors we're talking about here, we touched on intensity of exercise because it has unique changes in our physiology above and beyond moderate exercise. But other similar good stressors include phytochemicals in plants, and we can get back to why those—

yeah, that's been another one that's freaked people out.

I'm like, oh, absolutely, those are good toxins, and we can come around to that. Um, fasting in a way that I'm going to call normal eating, really in alignment with our circadian biology. Yay! Heat and cold exposure, and then good mental challenges and good emotional challenges. And we can certainly differentiate the good and the bad. But the reason these are good stressors is not by accident that we've randomly picked these 5 stressors. These trigger hormesis, or good stress, in our body because what they do is activate our cells and their stress responses. And our cells, essentially, when they get triggered, they can resist damage, oxidative damage, inflammation. They have repair mechanisms. We can repair DNA. We can repair repair protein. Our cells start to recycle damaged parts and old parts that are ready to be kind of cluffed over. And our cells actually recharge themselves through mitochondrial mechanisms where our life force, the mitochondria that are making our energy, get regenerated and we make better mitochondria. And these are built into our physiology because for over 2 million years our ancestors had these stressors built in their environment. And it's only been in the last 200 years that we've removed these natural stressors. And as a result, we are not activating our natural defenses against all these environmental exposures, against the factors that cause disease and are accelerating aging. So this lack of good stress has now become a huge risk factor for our health.

So you just mentioned, I want to, I would love to unpack each of these. And it's funny how they become like controversial, especially the plant chemicals, the HIIT versus moderate. Um, would you say then that the priority really is to do short bursts of intense exercise as contrasted with going out and doing like a jog?

Well, you need the jog to be able to do the high intensity, right? If you don't have a base of aerobic capacity, it's going to be really hard to get to that high intensity. So I think you're going to need some moderate intensity to be able to reach the high intensity. But if you only did the moderate intensity without the high intensity, I don't think you're gonna get the same stimulus to the adaptations. So there are unique benefits, and by that I'm referring to the fact that when we hit that certain intensity, like we talked about, our brain, our central nervous system gets an adaptation that we wouldn't otherwise with a moderate intensity. So with the HIIT, we're releasing growth hormone and testosterone, and the hormones that we're secreting are different, and that's what's causing our baseline cortisol to decrease. We're also stimulating mitophagy, which is a selective form of autophagy. And so essentially what we're doing is, as we hit that super high intensity, we are rapidly depleting our energy. And our cells have an energy sensor, AMPK, or AMP kinase, and that sensor tells our mitochondria that we need to make more. So mitochondrial biogenesis, the growth of new mitochondria, starts to occur, and it triggers mitophagy, where the old mitochondria are— that are damaged get removed. So essentially, we are creating clean energy in our body. Right, we are creating a renewable energy source, and all the mitochondria that are creating these emissions in the form of oxidative stress are being removed. So all the pollutants that are coming with these mitochondria are being cleaned up. So we're essentially making our body full of clean energy, and that stimulus of that rapid energy depletion is what really is this potent stimulus And we also know that just from moderate-intensity exercise, if we're trying to improve our aerobic capacity, our cardiorespiratory fitness, which is probably the single biggest predictor of our longevity.

It's the biggest one. Why are we not testing VO2 max? It's like crazy.

Yeah, well, we do in our practice and we can get to that, but I 100% agree that That is missing in medicine, and it is so critical. And 40% of people who do moderate-intensity exercise are non-responders to an increase in their cardiorespiratory fitness. We need to engage vigorous activity for that 40% of the population to be able to really push to the peaks of their cardiorespiratory fitness.

I, you know, I think back. So I'm an exercise physiologist, that's my training. And I think back to a client I had when I lived in Palm Springs, California. And I took her, she wanted to work out at the gym at the Desert Hospital's cardiovascular rehab center. So we go in there and they've got everybody in there walking on a treadmill 2 miles an hour. Now they've got an amazing weight room. No one's using. And then no one's really using it, like the treadmills, beyond just walking. So I have her doing little sprinting activity and then doing resistance training. And the funniest thing was then everybody else wanted to do it too. And, and the PTs were absolutely freaked out about this because they thought this would hurt them. I'm like, oh my gosh, come on. And I think the cool thing about high-intensity interval training is It's what's intense for you. So I would start people out— like, I have people walk, but then I'll start them right away because someone's high-intensity interval training might be getting up and down off out of a chair 10 times, and someone else's might be jumping onto the chair, you know. And it doesn't matter, it's as long as it's intense for you. So this is, this is fantastic, and I'm really excited this message is starting to get out there because I think for so long the old way of aging was slow down and take it easy and be gentle as you age. And I'm like, nope, that's not, that's not the way to age. The new way to age is to continue to challenge yourself. And I just wonder if so many of these statistics we have about what happens as we age, losing our muscle strength and power, is just because of the way we've approached aging, which is all wrong.

Yeah, the leading cause of disability in this country is disuse. So most people think it's arthritis. It is actually disuse, which is so profound because we can control the leading cause that is leading to so many people being handicapped.

That is the biggest— I just wrote this down— like, that is the biggest tweetable line. I guess it's no longer tweetable, it's exable. That is what a line that is. The leading cause of disability in the country is disuse. And, you know, you look at what, 50% of the population sedentary. The average amount of steps per day is 3,000 to 4,000 steps a day. Like, it is, it's, it's horrifying. And I feel like finally you look at all of these things, and if all we did was get people moving more, everything changes. Everything. Okay, so that's one of them. Let's, let's step into the landmine of toxic plants, those scary plants doing all those terrible things to people.

So again, let's go back to our relationship with plants and how we co-evolved, because I think that explains the toxins. So when our ancestors were hunter-gatherers, they had to subsist on whatever food they could find. And so as a survival strategy, they needed to be able to have as many different types of plant food as possible. So some were potentially poisonous, others may not have been. So our bodies over the 2 million years have developed ways to rapidly detoxify any toxin that is entering our body, and we ramp up our own antioxidant capability. And when we eat these stressed plants, um, and we'll get to why they're called toxins, but when we consume a plant chemical, a phytochemical, what it does is it activates our body's own ability to ramp up our antioxidant defenses. So In the last 50 years of nutrition research, we have come to think of antioxidants as something we eat in our food. And again, I do a lot of work around nutritional science, and I've been guilty of doing that. We call antioxidants kind of the, the skin, or, you know, in the colors of the rainbow, right? That's what makes this. And what we've come to realize is if you measured the actual amount of antioxidants that we are consuming, when we get them absorbed in our body, they are in these micromolar amounts. And the amount that we need to neutralize free radicals is actually more of a, like, a macro, macro, uh, uh, millimolar, macro amount. Um, and so there's this disconnect, right, between the micromolar and the macromolar amounts that we need. And what's really happening is when we consume the toxin, it's activating our body's own defenses. That toxin is signaling our cells to tell our DNA to get expressed differently, and we are ramping up our genes that have— that code for antioxidant genes and we're ramping up our detoxification enzymes. So the food is giving us what we need to build our defenses, and it's rapidly metabolizing that toxin. And we have come to need those toxins, which are the phytochemicals in plants, to really activate all of our defenses, right? That's how we co-evolved over time. So the question is, okay, why do plants make these phytochemicals? Why do they make the toxins in the first place? And the plants have no way of escaping predators, right? All plants can do is they can create these molecules, these toxins that are their phytochemicals, to deter us and any animal or anyone who wants to chomp on it, right? And so these toxins are essentially the phytochemicals that they make as a strategy to be like a natural pesticide. When we consume that toxin, it activates our stress response, and our bodies have developed ways again to rapidly detoxify them. But, but the key here is that if we want to have a strong antioxidant defense system and to detoxify so much of the environmental pollutants and now microplastics, etc., We have got to ramp up our body's own ability to be able to neutralize and essentially fend off the potential damage in our environment. So this is the good stress essentially balancing out the harmful stress that we're ubiquitous in our environment.

So I remember having this conversation. I think you probably know Dr. Jeff Bland, right? Yes, you know, and he has found this amazing Himalayan tartary buckwheat. He's actually now invested in, he's growing it, and it is one of those plants that people would have avoided before, and it's so rich in nutrients, it rejuvenates your immune system. And I was like, gosh, it's, it's like the poster child of this. So how did this get out there that, you know, we got so afraid of all of these things like, you know, lectins on down.

You know how these things—

I don't know.

Right. How these things happen. You know, honestly, JJ, I think what motivated me to actually write this book is we have to step away from what's culturally now, what is the expectation. We have to step back and say, what does our body need? How has our physiology adapted? And these are non-negotiables. This is 2 million years of how our bodies were designed to make us strong, help us thrive. And we have to go back to these basics. I mean, right now, 1 out of 10 people in this country actually consumes the recommended amount of fruits and vegetables. We have more disease and more mortality from people not getting enough of what they need from food than mortality attributed to the things that we're demonizing, like the sugar and the red meat. So the lack of these phytochemicals are the bigger risk factor, and by manyfold. Wow.

Like, you know what I love about this? One of the things one of my nutrition mentors taught me early on, he was like, add before you take away. And I remember when I used to see a lot of people one-on-one, they'd come in and they would have like emptied out their fridge and pantry the day before because they knew they were coming in to see me. Now when I say empty out, I mean empty out into their mouth, right? And I go, I'd go, you're going to be disappointed because I'm not taking anything away from you at the moment. Like right now I'm just going to focus on let's make sure you eat your protein and get that in first. Let's make sure you get your vegetables and your fruit. Because they'll just crowd the other stuff out. You know, it's like you'll be full. Imagine that. So I love that idea. I had no idea that 1 in 10 people are actually eating the fruits and veggies that they need. That's, that's wild. I know my statistics for exercise. So you combine that with the exercise stats and we are in a dismal, a dismal state here. And now again, we're going to move into the next piece of this. So you talked about what you're eating and adding in the fruits and veggies. And I love— I don't know if you've looked at Deanna Minich's work at all with the— oh, it's, it's so great. Um, you know, she's— she would be a great person to talk to about this because she did everything around the rainbow diet but really dug into the different colors of all the fruits and vegetables and why you need all these different things and how many to get in a week. And so You know, I got fired up when I heard it about, okay, I can get 30 different things in in a week. And actually, when you count spices, it's totally possible. I think I've gotten in 12 already today and I still have dinner. So it's completely possible to do, especially when you start to think about it. Now, beyond this is the whole fasting thing. And yeah, I have definitely got my ideas on this. I'd love to hear, because you already said something that sung to my heart about, eating during the, you know, I always call it eating by the clock, you know, eating during the normal circadian rhythm. And that's been my frustration with a lot of the fasting information out there. I'm like, you're finishing dinner at 9:00 at night, or you're eating one meal at like 8:00 at night. This is, this is, and then you're going to go to sleep.

Yeah, there, there are two parts to the optimal timing of meals. So one is, like you just said, it's the duration of eating. And when I'm using the term fasting, I think it's so important to define it because I'm not talking about a long fast. I'm talking about going a minimum of 12 hours, um, maybe a little bit more if someone has metabolic disease because the fasting can actually help um, improve your insulin resistance. So there are some benefits of going to 10 hours, but at a minimum, people need to restrict their eating to 12 hours. And the reasoning behind that is when we're eating, our body's in a buildup phase. When we go past that 12 hours and we metabolically switch fuel sources from the glucose to the ketones, our body switches to a breakdown mode. We need buildup and we need breakdown. If we are constantly in a buildup phase, so average person in America now eats over 15 hours, you know, from the time we wake up, start consuming calories until midnight snack right before bed, 15 hours. We are spending too much time in buildup. And if you look at the results of that, well, right now, this experiment isn't going well, right? We, Just announced very recently that 75% of America is now overweight or obese. We cannot spend the time we're spending in buildup. So what I'm talking about is balancing buildup with breakdown. And at a cellular level, what that is doing is when we're eating, we are in a growth phase. And when we make that metabolic switch to using ketones, ketones are signaling molecules. Signaling molecules are how messages get communicated through our body, and ketones signal these repair processes that we're talking about— that resistance against DNA damage, reducing our antioxidant strain, anti-inflammatory benefits, the autophagy. So we not only need growth, but we need time for repair. And if we don't give our bodies a minimum of 12 hours, ideally even a little to repair from all the daily damage that's occurring, we are not optimizing our bodies. Like, on any given day, there are 10,000 injuries to our DNA. One— that's every minute, there are 7 injuries to our DNA. If we are not using our body's innate ability to repair that through our DNA damage response, that cellular stress response, our risk of developing cancer and heart disease and so many chronic diseases starts to go up. So the time interval that we're eating gives our bodies that chance to do the repair functions, the housekeeping that it needs to do to keep us healthy and protect us.

And here's the reality. I don't know what it was like, you know, you're, you're younger than me, but when I was growing up, we had dinner around 6:30 every night, and, you know, I'd breakfast around 7:30 in the morning. So I had an easy 13-hour fast every day, right? You know, and that's just normal. Yes. You know, and on the weekends, maybe I would eat breakfast more around like 8:30 or 9. So you just normally ate within that smaller window. And then all of a sudden I remember, gosh, I'm trying to think how many years ago, I was driving somewhere and I saw a billboard that was advertising Taco Bell's fourth meal. And I go, "Fourth meal?" You know? And I think a lot of this came up when we decided that fat was evil and we were gonna eat all carbs. And all of a sudden you're hungry and you had to have the snack before bed. I remember reading diet books that were like, you wake up, eat immediately, And then make sure you have the snack before bed. And I'm like, what do we need the snack before bed for? Like, what are we doing? So it's super logical. And I do like the idea of compressing it a little bit more if you are working on your metabolic health, but not going to this OMAD craziness that I see. What about, in my house, we have a recovery room that has both an infrared and a fast heat sauna and a cold plunge. I have a love-hate relationship with that cold plunge. But what, what about the stress of heat and cold, the thermic stress?

Yeah, so very similar to the other stressors that we've talked about. When we are exposed to cold or heat, there are different adaptations that we start to trigger. So the cold, for example, if we jump in a cold plunge, From clinical studies that have been done on people in the past, there was a big 2000 study. It showed that, that cold exposure can spike your norepinephrine level by 530% and dopamine by 250%. So one of the key things there is it helps us stay motivated. It's very energizing. So there's a lot of mental health benefit. But the really cool thing for metabolic health is that the cold exposure— our body has to generate heat, right? It's a survival mechanism. And what it does is it activates brown fat. And brown fat, for people who are not familiar with it, is that we have different types of fat in our body. We have white fat, which is the kind we're probably more familiar with than we want. Brown fat stores energy— I'm sorry, white fat stores energy. Brown fat burns energy. It is our internal heating system. And when we expose ourselves to cold, we activate the brown fat. And if we do it on a continual basis, we can increase the volume of our brown fat.

And it apparently also helps, which would go along with this. It helps you lose visceral adipose tissue too, I'd imagine, because of some of this beiging of your—

It does. And so when we have to generate heat, the brown fat, after it uses its own fat stores, starts to use white fat for energy, right? So there's a molecular switch in our cells. That is activated by stress hormones. And that communicates inside the cell an uncoupling where instead of mitochondria producing energy, the mitochondria use, um, their fuel sources to start to produce heat. So essentially you're like lighting a match inside your brown fat and the firewood is the fat and the sugar. So It is potentially helpful for chronic disease. This is a very young science, and it seems that because we have so little brown fat in our body, that the contribution to it raising our metabolism or making a significant difference to our blood glucose or our lipids, at this point, it's, it's probably a relatively small amount, but it's hugely exciting because it's this avenue of how do we You know, now that we know this tissue exists, how do we use this as a mechanism to fight this epidemic of chronic disease?

How long does the dopamine and norepinephrine stay elevated? Do we know?

We know from this particular 2000 study, they rechecked up to an hour time point and it stayed elevated up to that time point. We don't have it measured out for a whole lot longer. We know that this is true of cold exposure and all these other stressors that we're talking about. The stress is short-lived. The adaptations and the benefits occur for hours to days after the stress exposure. So for example, with the cold exposure, interestingly enough, all these stress responses are very different than our fight-or-flight response. And, and we can talk about the variances, but when we are cold exposed, the stress is not being triggered by the same fear-based— that most of the psychological stressors are being triggered. It's being triggered by cold sensations hitting our peripheral nervous system, and that is causing a spike in norepinephrine. And Interestingly enough, cortisol doesn't really go up in cold exposure. And what's fascinating is with repeat cold exposure, this stress recovery, stress recovery, over a 4-week span, clinical studies are showing that basal cortisol goes down, right? So just like high-intensity interval training, this whole idea behind good stress is that short bursts with recovery repeated over time, right? When, you know, one time nothing helps you as a health habit, right? But anything that you make as a long-term thing that you adopt as a lifestyle change is helping your basal stress level. You are improving your resilience. And that's what we're doing. So the benefits really far outlast the exposure and the timescales over which a lot of the reconfiguring that happens in our body, um, in that recovery phase is clearly a much longer time interval.

Good to know. I do it— the challenge for me has been with cold exposure is making sure that I'm not, uh, interrupting muscle protein synthesis. And I know that's still kind of a question mark. So what I do is I get up in the morning by going to my fast heat sauna, and then I get into my cold plunge. We bumped the temperature up of the cold plunge a little bit after hearing Dr. Stacy Sims, because, you know, first my husband was cranking it down to 45, and I'm like, you know, horrible. So it's a little over— we kind of settled on 50 to 52. But that's how I do it, is I do it before I go and lift weights, not after I go lift weights. So seems to work well. I know you can also get into a cold shower, hit your chest with the cold water, and then Dave told me— Dave Asprey told me you could stick your face in ice water. So for those of you that don't have a cold plunge, that's— there are some other options out there. And then what about the, uh, the heat side of things?

Yeah, the, the heat side of things, similarly, you are triggering some chemicals in the brain. Um, again, norepinephrine goes up, reduces pain, gives us more pleasure. You're also triggering heat shock proteins, which at the cellular level are again triggering that repair in the body. And interestingly enough, because heat mimics exercise— not that I'm recommending it instead of But our heart rate goes up similar to moderate-intensity exercise, which is really profound. But as the heat raises our heart rate to get the blood to the periphery, so the blood wants to get near the skin surface so we can evaporate the heat. In that process, there are shear forces that are being exerted across the lining of our arteries, the endothelial lining. That shear stress on the cells in our arteries helps those cells make more nitric oxide, which is this incredible vasodilator. Nitric oxide makes our arteries wider, plumper. It helps the lining resist blood clotting. It has antiplatelet activity as well as anti-inflammatory activity. So when we are making the lining of our arteries with making our endothelial cells healthier, We are preventing heart disease about as far upstream as we possibly can, right? This is now at the level of even before cholesterol comes along, it won't stick to a very healthy endothelial lining. And we're actually making our heart cells— again, the cells are the foundation of our health, right? We have 30 trillion cells, and if we can keep ourselves healthy, that is really where disease starts. So, it's incredibly powerful with heat, right? So, there are now long-term studies coming out of Finland that people who have been doing sauna, if they've been doing it up to 4 to 7 times a week compared to a control group of only once a week, that risk of mortality is down by 50%. I mean, really profound risk of dementia is also you know, down by over 60%. So sauna, again, it has these unique benefits for disease prevention, and we are just not tapping into these good stressors as a way to be our healthiest selves and live these, you know, incredibly long, healthy lives. It sounds like you're set up. Huh? Yeah, I was gonna say, your home setup sounds like you are, um, gonna Go for the world record.

The challenge is I'm not home, so we travel like 70% of the time. So when I'm home, I do it every single day because then I'm like, like, you know, we leave next week and we'll basically be gone for 3 weeks. I'm like, oh, um, what was I going to say? Oh, so Finland, Sweden, I think Norway and Iceland are like 4 of the happiest, healthiest countries in the world, and I'm convinced especially after spending time in Iceland. That was amazing. And being at this incredible retreat hotel spa where we, we did sauna and steam and cold plunge, and then we were in the Blue Lagoon the whole time. There's 104— it was just amazing. But I am convinced that, that they— one of the big reasons that they have such longevity is because, uh, you know, cold and hot is just a way of their life. That's what they do. And it's so bizarre that it's like a luxury here. And the cool thing with these saunas, especially these small fast heat saunas, they're not expensive and they don't take up much room. I really think they should start to be a part of everybody's, you know, everybody's home should have a sauna.

And like what you said earlier, JJ Virgin, none of this has to be expensive. I mean, I'm a big fan of making Lifestyle change is very accessible and affordable for people. You can do a hot shower, do a hot bath, do a cold shower. It doesn't need fancy equipment. I think certainly you can control the temperature a lot more if you have the equipment, but start anywhere. I mean, we are in such thermonatural environments with air conditioning and heating that we have come so far from what our body really needs to thrive.

Yeah, I think of the Comfort Crisis that Michael— I'm forgetting his last name, but that was so fascinating. Yeah, I interviewed him. I'm like, oh my gosh, this is so fascinating. It's like, think about just even your metabolism not having to adapt at all. It's always set at 70 instead of having to deal with all of the stressors. Okay, so the final one, the mental challenge piece of it, is this— is things like, um, like crossword puzzles, or is it something more than this? Every time I open up my phone, I— for some— I don't know what happened, like maybe it's my age now, I keep getting sold this mahjong, mahjong, whatever thing is. I'm like, oh man, did I get on someone— she's over 60s— like list? What happened?

So it is far more than that, and this is the part that really excites me and, and to me resonates. We have to first say, okay, what are the types of stressors that make us think that we need to avoid stress? So the chronic stressors, the kinds that are harmful by their nature, are unpredictable and they're uncontrollable. Okay, so hearing your child has an illness, working with a boss that you have some tension with, right? These are the chronic stressors. They're uncontrollable, unpredictable. Good stressors, like you said, some can be a crossword puzzle, right? They can be a new skill, but what's really critical is that they have to happen in a safe environment. By nature, because these are deliberate choices, good stressors are ones we are choosing. They're going to be controllable, right, because we can decide how long and the duration. And the key is that they need to give us a sense of potential reward, but it's not guaranteed. Okay, that is what makes us release dopamine, and that is such a different biochemistry of a stress response than the harmful stress that we are used to, um, or that we identify stress with. Um, so the stressors to be good have to align with your belief system, with what is meaningful to you, and the pursuit of it has to really release these chemicals that are like dopamine, oxytocin if they're generative stressors. Like, that's— is the nature of the stressor changes the biochemical response to the stress. Right? So the key here is that not all stress is the fight or flight response that we think it is, right? That is only for life-threatening stress, like running out of a burning building. And whether we're humans or any animal life form, we all have that same stress response. But the stressors in our lives are not fight or flight life-threatening. The stressors that are pertinent to us are the daily stressors, like getting your child to practice on time, getting to work on time, public speaking. With these stressors, there's a ton of individual variability of how we perceive stress, our resilience to it, and the stress response is so complex. We release oxytocin, the tend and befriend, cuddle hormone. We release serotonin, the happy or calming hormone. We release dopamine, the reward hormone, depending on the nature of the stressor. So when we are picking stressors, like, um, for example, you know, I can talk about writing this book. That was a good stress. It was hard. It was challenging, right? But incredibly rewarding. And the trifecta of these hormones that get released in the process of that challenge, right? The oxytocin from sharing it with people, the reward from the dopamine, um, the fact that it's something that's meaningful. These hormones that I just mentioned, the serotonin, oxytocin, and the dopamine, these counteract cortisol. So not all stress is harmful. There's actually a protective effect. And what's really profound is that our body is part of that stress response. Releases neurosteroids. So along with cortisol from our adrenal glands, we're also releasing DHEA, we're releasing nerve growth factor. And after the exposure to the stressor is gone, for hours to days afterwards, our body is developing pathways in our brain across our synapses, the connection between our neurons, that are helping us remember how we handled that stress. So we are reconfiguring our brain from like a DSL network to like a 5G network. And when we do this over and over again, we build cognitive reserve, which in clinical studies can reduce the risk of dementia by 46%. So we are rewiring our brain to be a more creative brain, to be a brain that can handle future stressors better. And this process, which we call neuroplasticity, is essentially use it or lose it, right? That's the whole basis of good stress. When it's in our body and we're making ourselves resilient against disease, we refer to bioplasticity. In our brain, we refer to it as neuroplasticity. But you've got to use it to be able to uplevel your physiology.

What I'm hearing here, and it's like I'm writing all these notes over here, is This is, to me, everything you've just said, and maybe it's because I'm writing a book right now, all a longevity-focused book, and all of this is like the ultimate longevity protocol.

Yes. If you look at the hallmarks of aging, so there are 9 key hallmarks at a cellular level, which are the processes that we know are contributing to the aging process. Good stressors, the ones that we just talked about, phytochemicals, high-intensity exercise, eating in a circadian pattern, the hot, the cold, and these good emotional and mental challenges, they are actually slowing down these 9 hallmarks of aging, right? So these hallmarks we know are like genomic instability, our telomeres get shortened, The epigenetic changes are part of it. Loss of protein balance. We can go down each one, and every single one is being slowed by these good stressors. There is no more powerful form of longevity medicine than what we're talking about.

And every single thing you just said is absolutely approachable. There wasn't anything you said, and now you're going to need to buy an XYZ, or, you know, there's nothing like any of these things. There's really no barrier to entry, which is awesome. And I think the other thing that you have, because you have the book— when's the book out?

March 25th.

March 25th, The Stress Paradox. But you're also gifting our listeners a PDF. I think it's recipes. What is it?

Um, yeah, so the PDF we're gifting your listeners are 10 tests that aligned with what we just said that are super affordable, really easy to do. Some are home tests, but these are 10 tests, some you could do at home, some are lab, basic lab tests that are probably the best ways for you to gauge how you are doing in terms of health longevity. So it's an explanation of the tests, um, simple ways to do them. Some of them are home tests that you can do. And simple ways to access them. Um, so yeah, it's just a way, like you said, we need some objective measure to know if you're accomplishing your goals. So you can do a baseline, try good stressors, and then do, say, 6 months later, reevaluate your metabolic health, reevaluate your cardio— cardiorespiratory fitness, all in ways again that are so simple and accessible. Again, I'm in primary care. I feel like our country is going in the wrong direction. I feel like the solution— yeah, thank you. And I've had really a 30-year commitment to changing that within the healthcare system and incorporating these lifestyle, super simple things that we can all be doing to transform our lives. So yes, this is available. I, I free. Hopefully, uh, people will access it and benefit from it.

Please access this and benefit from it. I'm going to put it at jjvirgin.com/stressparadox, also the name of the book. And again, what I've seen from the book itself, because I got a galley copy of it, and now listening to you, is that you are all about doing things that are accessible. And I think that is so important. And the other thing that I really love— first of all, you have a beautiful way to explain complicated things into a very approachable, simple way, and that's genius. It's, it's really— that is a very highly developed skill. So yay for you on that. Um, so I love that piece of it, and I love the fact that this is— these are things that you can see a change in that when you do them, and they're really the majors. One of the things I see out there when you go online is people are majoring in the minors. They're fighting over, like, you know, almonds there, or spinach, you know, or Zone 2 versus HIIT. Like, they're majoring in the minors instead of just going, what are the biggest rocks that I could do right now that are going to directly impact my metabolic health and my quality of life and my longevity. And the fact that you have simple tests, some at home, some labs, that you can do these things for 6 months and see differences in that, that is like really putting your money where your mouth is, right? It's so good.

Oh, well, thank you. I, first of all, thank you for the, the compliment. And I have 2 clinical practices. I, um, I've used these protocols with my patients now for a long time. And the tests that are in the packet that people can access are ones that I've been doing with my patients. And I can tell you story after story of how people feel it has changed their life. And everything you just said, people are just missing the big picture, right, of we're so stuck in these marginal things that, you know, maybe we'll have a 5 or 10% difference on our aging trajectory or our health. But we're just stepping over these foundational pillars that ultimately we need for ourselves to be healthy, to have that solid foundation. And you can't go further upstream than making yourselves healthy. I mean, this is the future of medicine. It's all about cellular health. It's where all of our research is going. So 100, 100, 120% to this majoring in the minors. I think you said that beautifully.

Yes, let's not step— what is it, stepping over the, the dollars to pick up the dimes? Just go pick up the dollars, do the big rocks, and grab the lab, lab and at-home test so that you can really get a baseline. That is super important. What you measure and monitor, you can improve. Again, that will be at JJ Virgin jjvirgin.com/stressparadox and grab the book too. And thank you so much, appreciate you.

Sure, absolute pleasure. Thank you for the opportunity to talk about what I'm so passionate about. Thank you.