Why Getting Stronger Could Save Your Life with Dr. Kwadwo Kyeremanteng

Dr. KK. I know you want me to say your name like 3 times fast.

Maybe not. It could be great to see you, JJ.

It's been—

you too.

It was very fun hanging with you at Eudaimonia and, uh, doing the podcast with you. Your podcast, which is now— what's the name of your podcast now? You renamed it?

Yeah, Prevention Over Prescription JJ.

All right. So good. Because you are an ICU physician who's trying to get people to never see you. Mm-hmm. Yeah. What a great job proposition for you.

Yeah. I mean, a lot of people say like you're going to earn yourself out of a job, but honestly, when you see so many people, JJ, coming into hospital with preventable disease and you see the amount of suffering associated with landing in ICU. You really want to provide people with the tools to avoid seeing someone like myself.

How much of what you see, because I would imagine you see the broken leg, right? Or, you know, but how much of what you see is preventable?

Yeah, good question, JJ. Like, the examples are the ones that aren't preventable. We see a lot of car accidents, aneurysmal bleed, some, some cancers that are just due to bad luck. But I'd say we're talking close to 50% when it comes to metabolic disease. It's certainly in the realm of 33 to 50%. But from preventable disease, like from lifestyle choices, including smoking, it's significant. And I can't reinforce, JJ, how devastating it is to land in ICU. And when the patients land, when they, when we see our patients, it is usually a protracted, a long admission. You go, you have pain, you have suffering, you PTSD, anxiety. If you survive, you are a shell of what you once were because a lot of our patients aren't fit like yourself. They're not coming in with a great baseline. And so going through all this, functionally they're poor, and their families are involved in terms of trying to be there for their families, and so they're taking time off work, and so it is really a devastating event that could happen for a family. And so when you add it all up, plus my research area was in cost savings in healthcare, If you were landing in an intensive care unit, whether it's Canadian or in the US, that's on average at least $3,000 a day minimum. First day being like close to $8,000 to $10,000 depending on what you're admitted for. And so when you add it all up, it is so important to try and avoid landing in hospital, landing in ICU. So we are ultra passionate about giving people the tools to avoid getting sick.

Yeah, what you don't know about me is I actually spent 4 and a half months in the ICU with my son, so I know of what you speak. And, um, it was pretty amazing to see. And here's what was the craziest part of it. Now, you said something I'd never thought about before. Fortunately, when my son got hit by a car and ended up in the ICU at 16. He was in really good shape when he landed there because, you know, when you're in a coma and then recovering and on bed rest, because he literally couldn't walk because of some of the injuries, you lose a lot of muscle. I was cranking him with aminos and fish oil and all sorts of stuff. But the other part was I came in healthy too, because that level of stress for the caretakers is insane. In fact, I tested our adrenal health after the fact, and his looked pretty good. Mine was like trashed. I'm like, wow. Um, so you don't think about the fact that, you know, you want to be— you never know when these things are going to happen. And if you do have to go to the ICU, you actually want to go in as best shape as possible. But if you were in as best shape as possible, it sounds like half the ICU cases probably wouldn't even be happening, which is also like something we'd really want. There's always going to be a need for it, like, you know, saved my son, but what we don't want is it to be an unnecessary situation with diabetes or stroke or heart attack that could have been prevented. So when we walk down that path, and I know prevention is like the least sexy thing out there, it's just the hardest thing to sell, But we're going to sell it on this show because I know the people listening really care about quality of life and longevity. So what are some of the key things people could do to never have to see you in the ICU?

So first of all, JJ, just really sorry that you and your son had to go through that and your family had to go through all that. And you, I don't know if you remember this, but on the show you actually opened my eyes because of the peptide treatment that you mentioned in terms of treatment offers for your son. So you've really opened my eyes and now it's an aspect where I want to explore in terms of being able to provide better care for our ICU patients. So I just wanted to, first of all, highlight that. In terms of important elements, so I can't tell you how vital it is to be strong. Like we know already, like if Everyone on your show can— I'm sure has been an advocate of strength training and being strong going in. And I want to give you a quick story about a patient that I saw. He's a guy in his 70s, giving me permission to tell this story, and he had a— unfortunately had a cardiac arrest. He, he passed away for a period of time, but luckily his wife was a nurse, so gave him CPR right away. And in my line of work, if you're in your 70s and you have a Cardiac arrest, you die for a period of time. You do not come out. You don't leave hospital. You don't, we rarely see you survive. And because of this man's disposition, so he was a guy that went to the gym 5 days a week and had that resilience, like I call it body armor. He was physically, you could tell he went to the gym. Also was resilient mentally because you have that dedication, right, JJ? Like, right, going to the gym 5 days a week no matter how you feel. And he was a guy that was going at 5:30 in the morning. And long story short, he survived 3 months in that— in the ICU. He got home. He got to with his grandkids. He's not in a nursing home. And that was the power we saw of being strong, focusing on strength. It was such a motivator for not only the staff, but the patients around because he was walking on a ventilator. I want to repeat that, folks. On a ventilator, he was walking. Okay. Like that was the power of being strong. And I see this routinely and it's funny. People find this a bit odd for me to say sometimes, JJ, but in ICU it's actually quite hard to die. It's— the machines work very well that keep your lungs going, that keep your heart going, your kidneys. And what it ultimately comes down to is quality of life. And being strong will allow you to get back to that quality of life. Life. And this is why I, I mean, we all go to the gym for different reasons, but it's just an additional motivator in our house, JJ, to stay strong. Because when we have to go through that, that, that illness, when we have to go through that unfortunate scenario, we want to be ready. And one more story, and we could talk about other means afterwards, but Cindy Hooper, who unfortunately recently passed from pancreatic cancer, But she was diagnosed in 2013 and super active triathlete, goes to the gym on a regular basis. She ran or participated in an Ironman triathlon while on chemotherapy. As far as we know, is the only other— only person to ever do this. And that was the foundation of staying strong, to be able to do that. Survived so many years, over 10 years with pancreatic cancer because of that foundation, mental and physical. So lots of reasons, tools, but I just wanted to really highlight JJ, the importance of staying strong.

Well, and funny note, like we first saw each other at the gym. So, so we both, we both do what we say, but you know, you mentioned something important about being strong. Is the benefits go beyond just you're stronger physically. It's like when you do hard things, you can do hard things. And, you know, you talked about the guy with the ventilator. We started having Grant do stuff, and the physical therapists at the hospital like, oh, he can't do that. And so we literally got to take him on a day pass. We took him out to the hotel, to the condo I was renting swimming pool, which was an Olympic-sized pool, and videotaped him doing it because they wouldn't let him get in the pool. I'm like, watch this, you know, perfectly synchronized. So we would just kept pushing him on things more than they would let us do because I was like, you know, you're never better than when you're challenged and we've got to be able to face hard stuff. And I just love that this woman went and did this and just where people would use things as excuses. I always say that quite often that why you think you shouldn't do it is the actual why you should be doing it. The why not becomes the why. You know, and granted, she was probably killing off a ton of cancer cells when she was out there doing it.

Yeah, she honestly— I— this was one of those moments where when I'm at the gym or I don't feel like going to the gym, I would, I would often think of Cindy Hooper. I would think of her. And if Cindy was willing to do it and while on chemotherapy and radiation, I could do this.

Yeah. Quit your whining. No kidding. Okay, I have to ask you before we get on to more of the, like, actual health stuff, because I'm just curious about this because I know what happened with my son. Since you've been around people who have died and come back— and this is a total segue, like, this has totally got nothing to do with what we're talking about— but any near-death experience stuff that you've heard or seen?

You know, so I also work in palliative care, and I, so I'm around death and dying a lot and I've never heard from a patient of seeing the light or any kind of moment like that. But there are times, JJ, it's hard to describe that sometimes when you're in a room when a patient's actively dying or they pass, sometimes there's like a general feeling. It's hard to describe. Some people will say like it feels like a spirit is in the room or left the room or something. And I haven't experienced this with every patient or every circumstance, but sometimes there's just like a, feels like there may be a presence. And it's tough to quantify or to describe, but yeah, to answer your question directly though, I've never heard from a patient that I've been involved with that, you know, I saw the light or anything like that. But one thing I do see very frequently, JJ, that patients know when they're going to die, which is often a bit spooky because sometimes they'll look fine and they'll go to you like, Dr. K, like, I'm going to die tonight. And you, and as a young doc, you'll be like, oh no, you're fine, your vitals are good. Like, you know, things are fine. And that night they'll die, or the next day they'll die. It's— you see some fascinating things in this line of work.

When Grant was able to finally start talking again, he told us about the gray man. He told us about all the places he visited in the hospital when he was lying in the coma and described exact situations that he never would have known about, like where we were sitting, what we were wearing. I'm like, okay. And then he described the gray man, you know, being on the other side, what it was like being given the choice by the gray man and deciding to come back because he kept hearing— because I would sit and talk to him in the ICU. So I was like, there's definitely something, something more out there. That's all, uh, that's all I know because he says no space, no time,, and it's just beautiful. So let's go back over to the health stuff. So being strong, which— do you have any specific recommendations that you like to give patients? Do you get the opportunity to give patients these recommendations, or are you just like getting them out of the dire straits?

So JJ, this is one of the gifts that, uh, has come to me recently. So to answer you directly, no, my patients don't I don't get to have that conversation with patients most, most often. Often they're unconscious, often they're delirious and they're not aware of their surroundings. Occasionally I've had once a patient asked me about ketogenic diet. The patient was morbidly obese and I was so encouraged that they were willing to look at lifestyle modification, so I threw them a bunch of resources and because that was of interest. But the gift of the last few years, JJ, of being able to have platforms to advocate for some of this stuff has been an absolute blessing. I can't tell you. I mean, you know this because you live it, but how rewarding it is when someone comes to you and say, my mom now is no longer on diabetic medications. My mom now is like down 10 pounds and is physically stronger. So you could see her bicep like that. To me brings me so much joy because you're changing a complete trajectory of someone's life. And in the ICU, it's one-to-one, right? Where when we're doing right now is getting to thousands of people. And whether it's half a dozen, whether it's 100 of them that this lands with, it's so beautiful. It really is inspirational to me. So to get to your question, so I basically like to, when people, I get a chance to talk about this stuff either on our show or when people track me down, I like to really try and meet them where they're at. I think one of the things that is the most important thing when it comes to getting strong is personalize it. You know, some people are afraid to go to the gym because they're intimidated. So what are the bodyweight exercises that you can do? And I'm personally a believer of, you know, if you ask me what I think is the most effective 80/20 of getting strong and staying physically active, I'm a big fan of compound lifts. Like, I think there's a huge bang for your buck. You squat, you deadlift, you press, you hinge. There's such a— such beautiful exercises that, that in fact involve your whole body, right? And depending on what your goals are, like, I'm a big fan of 5x5, so, you know, just incrementally increasing that weight. So you're, you're aiming for 5 sets of 5 reps. As I've aged, I've actually, in terms of focusing on more high-intensity interval training involving weights, like I've, I, you know, we will do a Tabata workout with kettlebell, doing kettlebell swings, Tabata workout for hang cleans, like things like that. But the average person that comes to me, if they're serious about trying to really get strong and increase their lean muscle mass, push weight, compound movements, and you, you're always, in my opinion, going to get results.

I love compound movements, and I know they say, and it is true, that you can build the same amount of muscle doing a machine versus doing free weights, but it's different. In that your body, your nervous system, has to coordinate things very differently when you're kind of in the wild, which translates better to everyday life. And you named the ones that I really love, which are squats and deadlifts and presses. And you also mentioned 5x5. So for everybody listening, that would be like, let's say you're picking 5 different exercises, um, and I actually do it 5x5x5. I do 5 exercises, 5 sets, 5 reps. So it's the Fribble 5. But you could do it with 3 exercises. And basically, when you're working in that shorter rep range, you're going heavy and fast. And the heavy in that shorter range is really going to help develop strength because power development, strength development, muscle development, actually you can do them all at once. But if you're really focusing, strength is shorter sets. Power is just like you talked about doing high-intensity interval training, doing some, you you know, kettlebell swings and stuff like that. And by the way, I'm loving doing high-intensity interval training with functional moves because I feel like I kill two birds with one stone, like you talked about. It's awesome.

100%. And can I add one other thing too, JJ? Why I, I'm a big fan of compound lifts over machines? Yes, because most people, aside the ones in this room right now, their core is not where it needs be. And so when you do the compound lifts, if you're doing it well, you're engaging your core, so you're gonna prevent from that back pain from happening later on. And, you know, this is something that I wish I would have learned more as a young adult, to build that foundation, because I was a machine guy forever, and I'd see those body— like, the Olympic lifters do their thing and just kind of just keep a close eye but never really participate. But now, now I pretty much transitioned in my 40s, and now that back pain that I used to have is much better because you learn how to brace, you learn the need to have a strong core to be able to fulfill those lifts. And so that's, to me, one of the biggest advantages of doing those compound lifts. You're— if you're doing it right, your core is engaged the whole time. And that way, when you're used to that, you're protecting your body.

I love that. It's funny, I have the body divided into 4 parts, upper body pushing, upper body pulling, hip and thigh hinging, and power core. And I don't worry about core because core is in everything done correctly. And if you really think about it, if you used machines exclusively, you actually could get in more trouble. Yeah. You know, because you're protected. And in life, we're not protected. So I always say, if you have bad knees, you have a bad back, that's even more of a reason to do these things, not less. Whereas people tend to go, I can't do that because— and then you have that woman with pancreatic cancer running marathons. So yes, you can, is the answer, right? Well, what about the diet side of things? I'm getting— I'm tromping right down into religion now because diet is—

geez, you know, it's It's funny, you're right, JJ Virgin, this is religion, but there's some— once again, when people ask me, I try and give things on a personalized approach, but to me, the one that is non-negotiable as far as I'm concerned is protein is king or queen, whatever you want to call it. Like, protein is the most magical lever that we can be leaning into because Everything gets better when you focus on protein. Everything. Like your lean muscle mass is going to increase, therefore you are stronger, therefore you are improving your lean muscle, or your basal metabolic rate, 'cause your muscles love glucose and they're burning up those calories just by being bigger. You are more stabilizing your blood sugar, so for those prediabetics or diabetics, Here's the antidote, right? Like gaining that lean muscle mass because your increased protein intake, you are fuller, so you're not gonna want to crave those, those chips as much, or those Ritz crackers, or those high refined carbohydrates, because you're satisfied. You're less feeling a need to fill a gap. And so when you add it all up, the improved insulin resistance, the increased lean muscle mass, being fuller, it's just an amazing lever. Whether you are vegan, whether you are low carb, whether you are keto-focused, like this to me is the non-negotiable. This is the one that I think if you are serious about being healthier, this is where you got to lean into. And some of the other parts, I really think, can be individualized. Like, I'm a big fan of intermittent fasting. Like, I don't eat— or time-restricted eating, depending on how strict you want to be with your definitions. But I don't eat till noon, and I allow myself about 3,000 calories a day. And it allows me to just focus. Like, I don't have to think about the quantity of food. I just get to demolish my meals, and assuming they're high-quality meals, I just get to eat like a beast, and I love it. I love it. And so this is what— it's a good lever for some, not for all. Low-carb, I think it works for some, but once again, it's— I think it's individualized. Keto, my main issue with keto is that it's hard to sustain sustain. And any kind of nutrition approach to me has to be sustainable. And then the last one I'll mention is staying away from the middle of the food aisle, avoiding the processed food. And I know that's easier said than done, but I can't see how many— I can't tell you how many transformative, uh, transformations I've seen from people that have eliminated especially specific processed foods. I had a guy, a colleague, stop taking pop altogether, lost 30 pounds in no time.

It's amazing to me that people are still drinking soda. Like, this just completely— maybe I'm completely naive, but I just— I mean, obviously people are buying it, it's in the store, so, you know, but it's amazing. That's like one of the easiest things that you can do to improve your health, just don't have soda.

100%. I mean, I think— I mean, similar to other things, people are just addicted. It's addictive. Like many of the processed foods that we grew up on. Now, it's hard to believe to say that we grew up on processed foods.

Our ancestors— I was raised on Pop-Tarts and Captain Crunch.

Exactly. Like I was, you know, Honey Nut Cheerios, Frosted Flakes, Froot Loops. You know what I'm saying? Pudding, Jell-O pudding, like a— Yep. We were overly processed. And now I think we're really seeing, I don't know if we were gonna get into this a bit, JJ, but I can't tell you how exciting it is to see that people are really starting to question this stuff. Like what we're feeding ourselves, whether it's how things are hormone modified or, how, what these ultra-processed foods are actually doing to our, uh, our health mentally, physically. Like there seems to be almost like a revolution happening right now. And it totally excites me. I'm sorry if I'm digressing, but like, I think a change is coming.

I love it. So what's interesting, like you mentioned protein as this foundational piece, and then the other things to me are tools. And you might need to use keto temporarily for something or long-term for cancer. But you know, it's like you look at these things and go, I used keto when my son had the brain injury. You know, it's like you use some of these tools for what they're needed for, doesn't mean you're going to use them forever. Like, I see carnivore as a great food elimination diet, but not a forever diet. So there's all these tools out there you can use. The one I don't understand at all is this use of low protein for longevity. That one like completely flies in the face of everything. You know, like let's lose our muscle mass and live a long time. The two don't go together. So that one I don't like. I think you kind of were tipping your toe into something and I've sort of looked at this whole thing and go, I really am not interested in not being controversial anymore. And I don't understand how health is political. Like this is the weirdest part. But I'm very excited about the fact that we have this maha movement. I don't know why people think this needs to be political. What it's really saying is, hey, we need to look at what's in our food supply. We need to look at what's going on with our healthcare. And yes, we do. And our food supply, like, just looking at— and I'm assuming it's the same in Canada as the US, I don't know— but like, they're pointing out that there's all these foods in the United States that are outlawed in Europe. And they actually started to show like back in, you know, the '50s and '60s what the foods looked like. The fact they were in boxes or they were in cans or they were in glass jars. And now everything's in plastic and everything has been changed from, you know, from regular cane sugar to high fructose corn syrup, like just garbage all across the board. Is it the same in Canada?

Unfortunately it is. JJ Virgin. And I'm— I don't know if you were early to, to the game with this, but I'm, I'm considering myself late to the game to having this aha moment of this. There's, there seems to be a lot of reason to be concerned, and I'll put it that way. I, like, I, I did a show with a, a nutritionist from the UK, and they were talking about how exactly What you mentioned, there were some processed items that were banned in Europe that we're giving to our kids in their cereal and so forth. It's crazy. Like, have you ever— do you remember when you were a kid when you would, you would have, um, you buy a loaf of bread and I don't know how long it would take before it got moldy, but it wasn't very long, right? We've had bread in there in our house, it's like 3 weeks, 4 weeks, and there's not an even a glimmer of mold, I'm like, this is fishy. Yeah, you know, like there's something not right here. And what was fascinating about this interview with, with this, uh, dietitian is she was saying anecdotally— I, I don't have evidence to, to support this, so just keep it with a grain of salt— less asthma, less autoimmune disease, less gluten intolerance, kids less medicated. Like, there's something off. I'm just gonna say this. I've been saying this for a while, not as much publicly, but there's something off. Like, I went to a little kid's party, or sleepover, and 75% of the kids were medicated for ADHD. I'm like, there's something not right. We can't think to ourselves that, oh, we're better at diagnosing this, oh, we're, We're just more aware. Oh, like there's, there's something. I know it in my core, JJ, that there's something that we're doing to at a societal level that is not jiving. It can't just be our awareness. Right. And so I think this, this, this idea of really reevaluating how we're feeding each other and I'm a believer of food is medicine, man. Like it is. You mentioned ketogenic diets for cancer patients, ketogenic diet for mental health disturbances, for epilepsy.

Yeah. Well, they've been around. This has been around. I always love people going, it's a fad diet. I go, oh no, this has been around for like, what, hundreds if not thousands of years. People using this when they didn't have anything else for epilepsy. This is not a new one.

Exactly. And so for us to think of when we know there are therapeutic options around food, to think that eliminating or to think that our current food supply might be harming us is not a leap by any means.

It's an obvious conclusion. And I mean, okay, so ADHD, you could say, oh, we just didn't know it was there before. I think we would know if autism was there. Like that's a little more obvious. And clearly that has increased exponentially. So, you know, there are a variety of things, everything from the pans we cook in and, you know, the water supply and the food.

Like, it goes— microplastic stuff. Like, yep, I remember people talking about this ages ago and I thought they were a little woo-woo. There's a New England Journal of Medicine article, I think about 3 months ago showing there's microplastic. I believe it was in, in, in the reproductive organs, if I'm not mistaken. But it's like, that is wild.

Have you tested yours yet? No, we just tested our microplastic. So, you know, I mean, I think of the years. Well, first of all, when I, in the '80s, I had a Diet Coke problem. I still remember in my teenage years, my mom would not bring this into the house even though she fed me Pop-Tarts and Captain Crunch. She didn't believe in artificial sweeteners. So I would walk all the way down the hill to get Tab, to bring it all the way back up the hill, which is like, you know, a mile down, a mile up to get Tab, but with my allowance. But, um, you know, I went off to college and then afterwards I just was hooked on Diet Coke. I would buy liter, 2-liter bottles of Diet Coke. And then all that, when everyone switched to buying water— I still remember when we— no one carried a water bottle around, like no one ever did that. Now all of a sudden you have all these plastic water bottles and years of drinking out of plastic water bottles, thinking nothing about it, freezing them, you know, right? And then I'm always amazed when you have something at the store that says, you know, microwave ready, and it's in plastic, and you're like, what are you doing?

Like, it's crazy, honestly. It, um, and my mom, rest in peace, was always being a big component of why you putting that plastic in the microwave. You know, that ain't good for you. And like, as a kid, you're just like, relax, mom. Like, yeah, everyone's doing it.

But in hindsight, she, she had a lot of, uh, you know, moms are always right. That's pretty much the best way to think about it. But it is crazy. So we just did, uh, you know, Brian Johnson, who I Just think it's fascinating. Sent out a thing that he had a microplastics test. So I'm like, okay. And Tim and I weren't the lowest, but we were the second one up. And you know, then it's like, all right, now what? You know, we're doing all the things, but I think all I can tell is that sauna's gonna be one of the best things to do. I mean, would you, you wouldn't have a way of seeing microplastics in ICU and surgery and stuff, I'm assuming.

I mean, this is a, JJ, I'm just learning this for the first time that you're measuring it through blood work. Like, this is— I'm fascinated about this. And I am— I mean, I feel like right after this I'm going to have to go jump in the sauna. But I do think without— I mean, the evidence for the sauna and longevity is pretty solid. But I do wonder about Is that one of the added benefits? Like, clearly it sounds like you're a believer that, like, this detox phenomenon from, from sauna uses is, is part of the value in terms of longevity.

No question. And that's why we actually have two different types of saunas here. We have the one that heats fast, heats and heats up higher, and then we have the one by sunlight in the infrared so that we can do both. And I literally have just taken to working in the sauna because I'm just like, I think the more the better. Like, if you look at the healthiest countries, the thing they have in common— everyone's always trying to say it's, it's this, it's that. I just got off with Dr. Gundry and he was telling me like some of the things that they really have in common, which it's not a vegan diet, by the way, hint hint. But one of them is always like, you know, contrast therapy. They do hot and cold and they do a lot of sauna. Sauna to me makes a ton of sense.

I love it. I love it. It gives me more excuse to spend time in. Yes. Like we put a sauna in our crib about 4 years ago and it's been such a godsend because at this time in where I am at in Ottawa, I could point the camera out into the, in terms of the snowiness, but it's trying to think the conversion and, well, see, you can do heat and cold contrast.

You can do it easily. Just, yeah, you just go outside.

Like today, it's -9 Fahrenheit.

Oh yeah, geez.

Hence the turtleneck.

So I know, I'm sorry I'm in sleeveless here.

No, that's good. It gives me something to aspire to. Summer, spring is coming.

How do you see like turning this all around? I mean, you've got 50% of the people coming into the ICU You're, I would assume it would be kind of frustrating now knowing what you know to patch them up and send them on their way. Like, how do you see shifting all of this? Is there a way to do that?

That's a great question. I often ask some of our guests the same thing, JJ Virgin. And if you asked me 2 years ago, I would be a little bit more on the frustrated pessimistic side. Like, we're not really making any headway. But JJ Virgin, this is an exciting time to be in this landscape as far as I'm concerned, because people are thriving. I see it. They're thriving to get healthier. They're thriving to avoid using the acute care system. They see the benefits of trying to get healthy. And so I am encouraged. Not only because the public seems to be responding to a certain degree, but also young healthcare providers. I'm seeing more initiatives out of them. I interviewed a kid yesterday, he's in his third year of residency, that is evaluating the impact of exercise on mental health. And he's the first to say that the beauty of exercise is that you're killing multiple birds with one stone, like you're getting metabolically healthier, You are becoming more resilient. You are improving your mental health as a result of exercise. And this is— he's the future of our healthcare system. And so I think there's a momentum here. And what I'm trying to encourage all of us, including you, JJ, is like, do not slow down. This is the time that we— in fact, that we should be accelerating. We should be having more conversations. We— I'll give you an example of what I'm trying to do more of this year. I unfortunately had a friend of the family in his late fort— mid to late 40s pass away unexpectedly and suspect it was a heart attack. And to me, it was just another reminder that we need to get that word out there. We need to be promoting healthy we live in. So I'm— I was offering local businesses, uh, gonna be doing a presentation at a school on the importance of staying active and, and being healthy and why seeing someone like myself or my colleagues in the ICU is not a good thing. And I, I just think we need to put a little bit more of our foot on the gas right now, and I, I actually think it's going to pay off in evident. And this is leveraging social media, leveraging podcasts, leveraging AI and ways that people can make their lives easier, create those healthy habits. I really think this is the time that we get to, we get to push and people will respond.

So how would you leverage AI since you threw that provocative statement out there?

So There's several. Like, one of the things that we helped develop with our— with Guyatta is we have a food app. So you— it's basically a food coaching app. You take a picture of what you're eating, you're worried about this label, you take a picture and you get feedback. You say like, your, your, your goal is to get to 150 grams of protein. Uh, you— by the way, you should maybe think of replacing that, uh, that Yogurt with Greek yogurt, like giving that feedback to folks that really trying to encourage them to make healthier choices and to be able to track their macros using AI and giving little nudges. And to me, like, you already get this sometimes through your Apple Watch or whatever smart device you're using saying, hey, you know, you're You're on a streak of 6 workouts this week. One more and you got a perfect week. So how about we, how about we get you going? There's going to be the aspects that I think I'm not an expert on this yet, but I will be more in tune with this in terms of personalization and really getting a sense for what, what exercises, what foods do you best respond from. I think you're going to be able to get biofeedback from whatever wearable you might be wearing. You might be able to— by the time we're— I don't know, I'm gonna say in the next couple years, I believe you'll probably even get glucose feedback, like continuous glucose feedback on a wearable. And so like all these things, I think, where you're measuring, you're getting a feedback, that to me is where I think AI could help out. And I And the one last one too is sometimes just leveraging AI or whichever one you use as a coach. Like you could have conversations with your ChatGPT or your Claude saying like, you know, I've had a rough week, I'm thinking about making something, what do you think? And getting that feedback in terms of what would be an optimal choice. So I think, It's an exciting time overall with AI.

It is interesting. I have a longtime client, like off and on I've worked with this guy for probably 15 years. And the last couple years I was like, uh-oh, you need to power up your resistance training. You're getting sarcopenic. He'd always been more on the plant-based side of things. He just was doing more on the yoga, you know. I was like, you got to lift like way up your weight training. I contend that as we age, we've got to do more, not less. Like, people tend to taper off and take it easier. I'm like, oh no, no, needs to be just the opposite. Like, I'm working out harder now than I have in my 30s and 40s. And so we started doing all this stuff. I gave him all these things and had him tracking his food on his app. Well, he threw it all over into ChatGPT And he said, they redesigned my smoothie. So ChatGPT redesigned a smoothie to have the protein that I wanted him to have. It checked his meals and told him which modifications to do. I'm like, you kidding me? Told him like, if you wanna gain this much muscle, 'cause he is like, I wanna gain this much muscle under this time, what is it exactly I need to do? Gave it to him. I'm like, kind of blew me away. I've been using ChatGPT and Perplexity, but I didn't realize it could do that.

So, and it's only going to be able to do more, JJ. It's, I mean, I could talk your ear off on that, but it is exciting times.

So in terms of supplements, where do you see the big, you know, because I, again, I am a big fan of supplements. However, they are supplements, like diet first, then add supplements. I do not believe that you can get what you need from diet alone. So which are the big supplements? What are the gaps you see out there?

Yeah, great question. So I— so in terms of the ones that I think are no-brainers, vitamin D, especially being in a northern climate for us, being dark-skinned, I think that one's a no-brainer from my perspective when we're talking about immune health. Bone health. It just makes a lot of sense. It's cheap, it's available. It, to me, the— this is, this is probably the easiest one to, from, to, to convince folks on, I think, is the vitamin D supplementation. I also like, from a, a daily regular, uh, supplement, creatine.

I, I, yeah.

Yay! It's one of the— yeah. And thank you for the Shia team, by the way. Props to JJ Virgin, Mama Bear, Kathy Caramantang is a big fan of the Shia team.

Good. Gotta get these women taking creatine and not being afraid.

Yeah, I think it's interesting that I'm excited to see more of the creatine movement. It's, as many of your listeners have heard, one of the most safe well-studied supplements that you could take, increasing your lean muscle mass, your recovery, your strength, as we talked about. And then the mental health side and, and, um, uh, and mood. Like, there was a study recently that I saw on social media. I haven't dove into the paper, but it was supplement— it was creatine with cognitive behavioral therapy versus just cognitive behavioral therapy on its own, and those that took creatine had better results. And so you have the cognitive, the mental health side, and the, the physical attributes. Like, there's W's all over the place. And then in terms of other ones, I, I like the fish oil for the anti-inflammatory aspects, the reducing risk of dementia. I take, I personally take collagen for my joint health. Like it's not for my hair, my skin, even though it's, you know, it is pretty. But the, as I'm not getting younger, you get that. There's some pretty, pretty solid evidence to support like those that are having like early signs of osteoarthritis and so on. And so forth.

Well, think about, we used to do, like 100 years plus ago, we used to get a lot more bone broth into our diet. Like, I have a bone broth shake, but I'm not— oh, I'm not making bone broth at home.

You do a bone broth shake? So like, what do you put in it?

Well, so it's dehydrated beef peptides, basically bone broth. And so that I've spiked with additional amino acids because of course collagen is deficient. So that's what I do. So it's about 80% collagen. So I either do that and/or more collagen, but I agree with you, that's one I do every single— like all the stuff you're saying are all the things that I do. And you know, you think about our body makes vitamin D. I don't know about you, but I've never seen a vitamin D test that's in the ideal range of someone who is not supplementing. Ever. Never.

Yeah. I mean, I'm in a very different world, JJ, where Like, I don't see healthy people. So, but if you were to take— like, I don't know the actual numbers, but if you were to take a sample of everyone's vitamin D level in the ICU, it would be in its boots. Like, almost everybody— because we see a lot of chronic disease, and that's obviously associated with low vitamin D levels. So yeah, I If I saw a normal vitamin D level in the ICU, I might, I might have to do a one-handed cartwheel and be like, wow, this actually happened. And just to complete the list, JJ Virgin, the other one that I tend to take is two more: magnesium glycinate. We take that— I like to take it for sleep and stress reduction, so I take it before bed. And then The last one, whey protein. I do that. I don't do it every day. I do it when I don't feel like I'm going to meet my protein goals, or sometimes I like to take it after a workout to more likely achieve my increase in my lean muscle mass. But yeah, overall, those would be my heavy hitters.

And see, I think the— throw some whey and some collagen into that whey, and then you've got a two— one-two punch on that one. So yep, those are collagen, vitamin D, fish oil, magnesium, like, are my— and then of course Mitopure and NAD+ and Sinalytics. Those are my other ones that I take.

But I feel like I'm still learning. You're gonna have to come back on the show, by the way, to talk about some of this, like especially like the mitochondrial health, but, and the peptides. We talked, talked on it a little bit on, on the show, but I'm, the stuff I'm learning now is absolutely fascinating. Like the microdosing and autoimmune disease and—

Oh, you're down the rabbit hole. You need to have Dr. Tina Moore on your show too.

Tina Moore?

Oh yes. You want Tina? I'll connect you up. Um, she's really, really smart on how to microdose GLP-1s. It is gonna come out. Like, there has been the weirdest thing out in our world about these peptides and the backlash against them. And all I can figure, I'm gonna sound like a conspiracy theorist, but when you take these peptides, it can get you, and not at the dose they're recommending, at these low doses like Dr. Tina teaches, reduces inflammation, improves insulin sensitivity, has a whole host of benefits, autoimmune, cardiovascular, like they, I mean, it just goes, the list goes on and on. Brain function, which is why I started giving it to my son. And what I think is that it reduces polypharmacy. So that's probably why there's the little backlash, because all of a sudden you could put someone on one of these and they wouldn't need a statin, or, you know, their blood pressure meds, and like, you know, their diabetes meds. A lot of stuff could shift. So I think they're really interesting used in a very different format than the drug companies are doing. And there's so many more peptides out there, like PPC-157. And I mean, you're going to go down the rabbit hole. And I also found a great company for oral peptides that have some that really can help you build muscle called PeptiStrong.

So, oh man, we definitely got to talk.

Yeah, you're going to—

and can I ask you, JJ? I know it's your show, but you're saying you lift heavier these days, right? Like as you age, how are you finding recovery though? Because I'm finding myself like these nuance, these like nagging injuries that just seem to not go away as easy. I don't know if you're finding the same or how do you approach recovery?

So it's interesting. I had a brief moment in time where recovery was very challenged. And it was when I was going into perimenopause, my estrogen dropped. And actually, Dr. Wanda Wright talks about this. She was the first person to identify the muscular musculoskeletal syndrome of menopause. I just fortunately went into my dentist because my teeth were bleeding. He goes, oh, that's estrogen. So I started an estrogen patch and boom, I was recovering. So I have found with creatine— so I take my shea team product, I, I take 2 doses of that a day. I take collagen, I take a lot of protein, I do my fish oils, magnesium. I take that Mitopure by Timeline that helps you get stronger and helps you recover. I take NAD+, which is really great going in, and I do the Synalytix. And honestly, I'm not having any trouble recovering. And I literally— what I've really focused on in resistance training that I think has shifted over the years is I'm focusing a lot more on strength and power. So a lot of throwing, a lot of jumping, a lot of like hard stuff, pull-ups and, you know, deep squats. And stuff, which you'd listen and go, oh, okay, I've got bad knees. Well, I have a knee replacement, a hip replacement, and a broken foot, you know. So, you know, a broken— I mean, things from being this dummy in my early 20s and late teens doing things, sports I shouldn't have been doing, like acrobatics and ballet. But, um, you know, keeping strong has allowed me to be able to not have to have that knee replacement for 30 years. So I think that we've got to push ourselves more. I also think— find that I do heat. Heat post-exercise is anabolic, so getting in the sauna post-exercise can be great. Cold pre— you don't want to do cold too close after because it actually can block muscle protein synthesis. But I'll do a hot and cold contrast in in the morning before I go work out. And then here's my secret to helping me recover. So good sleep. And one day a week I do yoga, kicking and screaming. I take myself, I drive myself over to that yoga studio 'cause I do not like it at all. I do a hot yoga class and I think that really helps a ton.

Oh man, we're cut from the same cloth. JJ, I do the same thing. One hot yoga class. I also done this. Have you ever done fascial stretch therapy before?

No, is that like— I don't know what it is, so I don't know if I've done it.

Yeah, it's basically a professional that stretches you, like, oh yeah, and like just beyond the limits that you—

is it like PNF stretching? I used to do that when I was a trainer to my clients. Those poor people. I don't know what that is. It sounds, it sounds, uh, it's like where you actually— there's a way that you can trick the body to allow you to stretch deeper than you'd ever be able to stretch.

Oh, when you like put more pressure on that? Yes. Yeah, well, it's— I, I would say it is similar, actually. It is, it is similar. But, uh, yeah, my personal trainer introduced me to that and definitely got me being able to touch my toes again.

So it's nice. I also, we try to get a massage at least every other week. We try to do more like once a week. And I have this thing at home that also helps with recovery. It's gonna sound ridiculous. So we went to Seoul, Korea 2 summers ago and I was just blown away by them. First of all, I never saw one, one overweight person while I was there. Tim saw one. I didn't see any. Everyone was super active. Everyone was moving and walking. And we went to the gyms, and we— both hotels we were at had huge gyms connected to them, and everyone was wearing a uniform like a PE outfit. And there were all different ages there. There was like 20-year-olds all the way up to like 90-year-olds at the gym, which shocked me. And then they were— so they were doing all this stuff, and then They were sitting over and they had like what I always thought was the Figure Salon silliness thing, that band that goes around your hips that vibrates you. And we were laughing doing social media stuff, so we went, we'll go do that just to get some great social media pictures. Well, it felt so good. You can put on your hips, you can put on your shoulders, on your thighs. Like, this is the greatest thing ever. It's the ultimate lymph, you know, lymph mover. And so I bought one. They're like $150, and they're amazing. It's this thing, I mean, it looks like the old I Love Lucy figure salon thing, but it really is amazing for recovery and getting things moving again. So I think that plus sauna, and you're, you know, perfect.

Yeah, no, a lot of takeaways for me because, uh, yeah, I, I'm kind of recovering from my hip flexor injury right now, so I'm— it's front of mind.

Yeah, when you think about how you get injured, you get injured not— you know, people talk about tearing a muscle. Well, we micro-tear muscles when we work out, but where we're really getting injured is the muscle-tendon connection, right? And the tendon-bone connection. So what I always think about is, what do I need to do to get my— because, you know, when you're first starting to work out, it's your muscles and tendons learning to communicate, your central nervous system learning how to do those moves. So form is everything. And then after that, it's your, your connective tissue getting strong, and then it's your muscles. So you don't want to ever push it past what your connective tissue can do. So I kind of watch myself as I'm working out, and I use speed as when I'm starting to get to failure, you know, because if you're trying to push to failure, a lot of times you'll push in poor form. If you're using good form, you can tell when you start to get there because you just lose your speed. So I just use speed as that indicator. And then something I learned from Gabby Reece, and I thought that's the smartest thing I ever heard, is after she's done a hard workout and she's fatigued, she does balance work. Hmm. Because think about it, when are you going to get hurt? When is your balance going to be a problem? Not when you're like peppy, it's when you're wiped. So she does balance work when she's fatigued to really help her body too. And I think that has a lot of merit. So throw that into the mix because I need you— I know you need more things to do.

But it's, it's, it's, uh, that's gold though. Like, because it's stuff— it's, uh, the timing is good and it's something that we all need to work on in general.

Yeah. And it's just, it's just something quick you can do. Like, it doesn't take you know, like stand on one leg, close your eyes, you know, do a— I've been doing these things where I get kneel on the floor and then I get up and down, you know, my hands are up here or up here. I'm gonna start doing it with dumbbells. I haven't started that yet, but standing up and down that way.

Yeah, so you're winning the game, JJ Virgin.

There we go, we're both winning. And you're winning out there doing the good work keeping people out from seeing you, so we just We just got to get this message out far and wide. I appreciate that you are writing books and have a podcast. I know you have a book, it'll either be out or it's coming out. So we will make sure we put all of that in the show notes. Where are some of the places that people can follow you? I know you have your podcast. Again, the name is—

Prevention Over Prescription. You get— honestly, JJ, we're all over the place. Like if you go to drquaddrow.com, .ca. That's, uh, that's our natural website, and most of our information's on there.

And how do you spell— we'll put all this at, at jjvirgin.com, Dr. KK. Dr. KK. I'm making it super easy. The team at first spelled your name out. I go, you know what, I'm going to make it easy.

There you go. Yeah, yeah, um, yeah, Dr. D— sorry, drkwadwo.ca. We're everywhere on social media, @kwadcast. So K-W-A-D-C-A-S-T. We got our supplement brand, Guided Nutrition. We got a, as you mentioned, a book that's coming out. And we have also our first book on apologetic leadership. All on Amazon.

Are your supplements both in US and Canada or just in Canada?

Oh, you know, we're global, JJ. Global.

That is hard to do.

It is, but I mean, our number one clients are in Canada and the US, luckily.

Okay, it's great to have a place to send people in Canada because I was bringing, sending stuff in and the licensing and cost for every single product, I was like tearing my hair out.

Oh, it's not easy. It's not easy. But honestly, JJ Virgin, just If I could take a second, just thank you for the work you've been doing and having me on your show. You, my wife Kathy, is what got me onto JJ Virgin, and you've been an absolute inspiration. She's lifting heavier. She is on the chia team. She looks incredible, feels incredible, busy mom of 3, and I think a lot of that we have you to be grateful for. So I just, I'm in awe of JJ Virgin, the more I learn about you. And, uh, it's a real honor to be able to jump on your show.

Ah, thank you. I appreciate it.