Monitoring Heart Rate Variability: A Key to Longevity

Welcome to the Living to 100 Club Podcast.

Well, hello to everyone joining us today on our podcast. You're listening to one of our Successful Aging episodes this month on the Living to 100 Club, and I'm your host, Joseph Casciani. Each week, our conversations educate and inspire, helping you get the best out of all the years we're given, regardless of what obstacles come our way. You can learn, learn more about my club at our website Be sure to take a look at my new training and activities manual, Better, Longer, and Happier: A Guide to Aging with Purpose and Positivity. This is a series of 12 modules in a card deck format developed for activities directors at senior living communities. The goal is to engage senior residents in activities that are challenging and foster a positive mindset. You'll find these at our website, livingto100.club/blh. Now on to our program today. On our Living to 100 Club podcast, we invite Dr. Torquil Ferro to discuss the value of monitoring our heart rate variability. Dr. Ferro's latest bestselling book, The Pulse Cure, focuses on the strategies to staying healthy and how to use a smartwatch or other wearable device to monitor heart rate variability. We discussed the now well-known strategies for longevity, including nutrition, exercise, reduced alcohol consumption and stress levels, hydration, and cold water immersion. According to Dr. Farrow, 9 out of 10 diseases are associated with and detectable by abnormal heart rate. Therefore, by monitoring our own heart rates, we can take proactive preventive steps to return to healthy baselines. First, a little background. Dr. Torkel-Ferro is a general practitioner and emergency physician, documentary filmmaker, author, and photographer. In 1996, he was one of the first Norwegian medics to work for Doctors Without Borders when he worked in war-torn Angola. Over a 25-year career as a freelance doctor, he's worked all over Norway, has had tens of thousands of consultations, and gained a unique picture of the diseases that plague us. He's learned that the cause is most often found in the stresses of our lifestyle, in the stresses that our lifestyles place on our bodies. Dr. Ferra is also an award-winning photographer, author of The Camera Cure, and has made documentaries about his pilgrimages to Nidarø and Santiago de Compostela. An inveterate traveler, he's made his way by bicycle, motorbike, kayak, boat, and car through over 80 countries and speaks 8 languages. He lives in Oslo with his wife and 2 children. The Pulse Cure, his latest book, has spent 58 weeks on the bestseller list and has been sold to 5 languages: Swedish, Danish, Dutch, Polish, and World English. Dr. Farrow believes that the book's appeal lies in the fact that many people experience the immediate effects of the Pulse Cure. Dr. Farrow, welcome to our program today.

Thank you for having me on. So it's a good title for your show, you know, living to 100. So that was exactly what I wanted as well when I made a big change in my lifestyle because my father, he died at 73. Uh, and, um, then I took a look at myself and I saw that if I continue living like this and doing all the possible mistakes in the book I've written, then I will live, not live much longer than that. And sure, I really want to live to 100 and live a rich, vibrant life as well. So, yeah, so, uh, yeah, so the book is all about how to do that and how to use modern technology to to aid us in the process. Yeah.

So you've had a, a wide-ranging career. You've worked in many different areas as a physician and also photographer and author and traveler. How did you come upon the Pulse Cure? Tell us a little bit about the background there.

Yeah, that was actually while I was traveling. I was sailing with my own boat and the family in an island close to Tahiti called Moorea, and I was in a hammock. I remember because I was reading the book from, uh, Bessel van der Kolk, called The Body Keeps the Score. And that was 5 years ago. And that was the first time I had ever heard about the concept of heart rate variability, which is a measure of the state of our autonomic nervous system and of our physiology in general. So it was actually at the travel. And then I came home and I realized that in the new technology, in the smartwatches and in the Oura Rings and different modern devices, you can actually track the heart rate variability and as a window into our own function. And for me as a doctor, it's been a revelation to, to see how I could use that, because in the beginning I was just interested in my own readings. I did not have a plan to make a book. That was just later when my publisher asked me if, if, if this was material for a book, and it was. So initially it was just me wanting to Yeah, to improve my health. Uh, yeah, to, to live to be 100. Yeah.

And you researched enough to learn and understand that the heart rate variability does give clues to what's going on in the body, right? Can you explain that?

Yeah.

What do we detect?

Is it good or bad? The heart rate— yeah, the heart rate variability, uh, is the variation between heartbeats. So, if you have a well-regulated nervous system, then when you breathe in, then the heart rate will go up a little bit because there's more oxygen in the lungs. And when you breathe out, your heart rate will slow down just a little bit, just measured in milliseconds, because there's less oxygen in the lungs. So, the heart will save a little bit of energy this way. But if you are in the stress state, then your ancient neurological system will interpret it that your life is at stake and you have to use all your forces, including when there is less oxygen in the lungs. So then the heart will beat at a very steady pace, like a clock, like a watch. So if you are in a relaxed state, variation between heartbeats. If you're in the stress state, no variation between the heartbeats. And of course, there's a sliding scale in between here. And the watches can pick this up. And through artificial intelligence and all the millions of users that they have, they can interpret the signals they get and, you know, give you some algorithms and then tell you what is your state both in the moment and throughout the 24 hours, you know, day and night. So, and as a doctor, I know that the physiological strain in our systems makes us sick. Poor sleep, poor diet, you know, too little or too much exercise, too much stress, you know, alcohol, a lot of things affect these stress levels and just being very busy and hectic lives, you know. So once you get this system in order, improve the sleep, improve your ability to rest, to meditate and so on, then you improve your overall hormonal balance and your autonomic nervous system. So you get more surplus of energy in the moment, you feel more refreshed in the morning. And also, and you can Google almost any disease, cancer, heart disease, dementia, Alzheimer's, Parkinson, all of the diseases that, that prevents us from living to 100.

Mm-hmm.

You can Google that and add heart rate variability and you, you will find lots of research.

Yeah.

Because this is a metric that is easy to get in, in research because of the availability of ECG monitors and the smartwatches and so on.

Mm-hmm.

So it's, it's an incredibly important metric and the most the, the best part of it is that you have it on your wrist yourself. So it's like a speedometer of your own physiology, and you have the speedometer on your wrist, you know. So it's not like in the, in the healthcare system, you know, the, the strategy is waiting until we get sick, and then the doctor has all the results, and you are in the hands of the doctor. So, so, uh, your, your future, your health depends on how good is your doctor, how good is your healthcare insurance, you know. But with these watches and rings and so on, you get the control. You get to take charge of your own health.

Yeah. Yeah. That's so important as we talked. Just that immediate feedback helps us to make more informed decisions. But I know when we spoke earlier, I had this question. I'd like to ask it again so our listeners can benefit. Does the, let's say, the high stress pattern or poor sleep or, you know, unhealthy diet, do they get different readings? Does the variability change from one unhealthy aspect to another? I mean, can we tell that one variability is due to stress and a different related heart rate variability is due to poor sleep, or is it just all on and off?

It's, yeah, it, it, it'll all affect the heart rate variability. Mm-hmm. So like, for example, if, if you have had a day where you have done a lecture, you have eaten a, a big dinner at McDonald's, and then after that you came home and you had 3 glasses of wine and then you just slept for 4 hours. Okay, then everything will affect heart rate variability. So, so what you have to do is you have to isolate each one of them. So maybe one evening you take 3 glasses of wine, you know, and the other evening you can check out what, what does a meal at McDonald's with, with french fries and so on do to your, your health state. So it's kind of some detective work involved. Mm-hmm. And that is what I had to do in the beginning because in the beginning I used ECG device and, and I had to do all the detective work myself because there was no guidebook to tell me. I had to, to find out everything and isolate everything because this is actually the world's first guidebook on how to use these wearables and, and relate it to the different lifestyle strategies that are healthy for us.

Yeah.

So because that, that is the, the kind of good part is that whatever that we know is good is measurable in the heart rate variability. Which makes it easier to motivate yourself when you see the effect of it. And of course, to demotivate yourself, you know, to avoid having the late meal and avoid having the 2 glasses of wine, you know, like every day that I used to do. So, so it's, and that is why it has been so successful in Norway. And now it has actually been on the bestseller list for 6 to 7 weeks. Um, because it works, because people can feel the effect immediately. Just after a week or two, they see that, okay, this, this measurements tells me something about my being that, that helps me getting healthier.

Mhm. Yeah, years ago, I remember when biofeedback was developed and how important that was to giving some immediate feedback to an individual about their breathing or stress level or brain activity. So this is really a very sophisticated form of biofeedback that gives us that information about our heart rate. So why are we, um, you know, why are we so, um, so bad at recognizing our own stress level or our own impaired sleep or our own poor diet? I mean, we need this kind of concrete feedback, but why don't we— why don't we understand it before we have to wear the watch?

That's because we are not equipped to do that. We don't have a sense for our inner state, or we have a sense of it, but it's very poor. So if you feel stressed, if you feel bad, it has been going on for a long time, or it is really too much. Because our senses have been developed through millions of years, you know, out on the savannah, even from before we became human beings. And all the dangers that threatened our survival came from the outside. It was other animals, snakes, it was food that was with bacteria in it, it was other enemies attacking us. So we have a very good sense of sight, we can differentiate between 100 different shades of green, for example. We can smell, you know, something at a long distance. We can hear a bird singing far away. But the sense of our own heart rate, for example, whether you now have 60 heartbeats a minute or 80 heartbeats a minute, I would not be able to tell. I can't feel that, and particularly not as I'm living my life, you know, conversing with others and being you know, having my attention other places and on myself. So what these watches really do is that they keep track of the heart rate, and the heart rate will tell you the load on your system. So if there is something stressing you, it will immediately be seen in the heart rate variability. So it will be seen in the heart rate as well. But the heart rate variability is like watching your heart rate with a magnifying glass. It's a bit more accurate. And more useful than just the heart rate in itself.

Yeah.

So it kind of replaces, it kind of replaces a sense that we never needed to develop because it's only in the recent years that it's our inner state that is making trouble for us and keeping us from living to 100.

Yeah. Yeah. The threats are internal now and not external. Maybe 1,000 years from now we'd get better at detecting detect some of these abnormalities, just like we could detect the threats that were external. Maybe we can eventually learn. Right now we need this.

So it may be in 1,000 years, but, but until then, you know, we need, we need help.

Buy the Garmin watch.

Yeah.

So, how, maybe just a little more specifically, how would, say, lack of sleep affect our heart rate? What do we detect?

Yeah, lack of sleep stresses our whole system. So it will also— I've been also using a CGM, a continuous glucose monitor. And if I get up and I've slept poorly, my blood sugar will rise. You know, it will be a stress on the body. And whatever you do the day after a night of poor sleep, you will have to you know, muster forces kind of artificially that you don't have at your disposal in the moment. You have to really, you know, pull yourself together and make— to strain yourself more. And it is visible in the stress level. So if I have a certain activity after a poor night's sleep, I can see that my heart rate is is, uh, is faster than another day with good sleep. So, um, you can see that the day after a good night's sleep, you can, you can work kind of at the much more easier than after a poor night's sleep.

Yeah. So the stress level goes down, we get more rested, and it shows up in our heart rate. Yeah. Yeah. So, um, What about, we talked about problems with, you know, lifestyle changes and diet and exercise and social activity. And you mentioned that one other factor is really important as a way to reduce inflammation is cold water immersion. Kind of skipping a little bit here, but how does cold water immersion improve our circulation or reduce inflammation?

The cold water will— we think that it's because in the really old days then at the savanna, you know, 10,000 years ago, 40,000 years ago, we at night, it was cold and at night was the time of the day that the body really had the processes of restoration, of recovery. So, it's kind of a— the cold is kind of a signal to the body to dampen the inflammation in the body. And this is why also the athletes, they use cold water immersion, cold showers after an exercise, after training, to keep down the inflammation that this training will affect on their bodies. So, they can train more to put inflammation down. And we can also use that, you know, put in a cold shower. So after the normal shower, you can have maybe 2 minutes of cold showers, you know, every day. And you can see it on your watches because, and that is nice because it's always painful even now, you know, I've done it for like a couple of years. It's always uncomfortable when you switch the shower onto the really cold. But when you see on your watch that for maybe 2 or 3 hours afterwards, it calms you down. And you also feel it. You feel more alert, you feel more calm at the same time. And the fact that I can see it on the watch, it motivates me even though it's a certain pain involved in those 2 minutes.

Yeah, a little reward for experiencing that discomfort.

And it does not really have to be that cold. Even if you go out into the sea in California, where you are, and it's probably, it would be maybe 68 degrees in the water, 68, 70. Even that is enough to cool down. But you may have to stay there in the water for like 10 minutes or so. And if you get out of the water, you can also try not to dry off with a towel, just let it air dry, and that will also cool down the body, and you will see it on your device. So, so that's a good thing. And that is what, you know, we used to laugh, you know, at least in Norway, particularly with women, you know, for many years they have been out in the icy cold water, you know, among the ice lakes swimming. And we have kind of been laughing at them, you know, like they're crazy. But they turned out to be right.

There's a reason for it.

There is an effect of it. And particularly the cold is good for inflammation. So if you have arthritis or joint pain, often the most effective things to relieve that is the cold.

Well, yeah, I've seen the athletes in the ice baths. I mean, they sit in the tub that's filled with ice water. So I can understand that. That's just a newer— I think that's one of these additions to our list of lifestyle improvements, things that really help us to stay healthy. And cold water immersion, I'll, you know, I think that's an important addition. That's good to know. So would you say the, these watches or the monitors can really detect risks for, did you say 9 out of 10 conditions? Chronic diseases? Yeah, chronic disease conditions.

Yeah, heart rate variability, uh, is, um, associated with 9 out of the 10 most deadliest diseases in the, in the US, and then probably all over the Western world. So that would be like cancer, uh, heart disease, uh, stroke, kidney failure, uh, dementia, Parkinson's, um, depression.

Yeah.

Wow. Many of those things actually. The, the one, the one that is not connected to heart rate variability is road accidents. So, um, uh, that is not connected to it. Like trauma will be probably both on the cause side of it and the consequence side of it. Because if you have a low heart rate variability, um, that will be because your immune system is strained, it has a load, it does not work properly. And then when you get the disease, like cancer or heart disease, it will be an extra load on the system and further worsening the effect. So it's kind of a positive feedback downward spiral, so to speak. Sure. And this is why And you can Google, you know, heart rate variability and cancer, and you will see that it will, will show the, the risk of getting cancer. And if you get cancer, it will show the prognosis. And if you get cured of the cancer, then it will show the risk of having a coming back again. So it will be related to all these diseases. And actually, some people, if they see that they are doing everything in the book, in the Pulse Cure, to improve their system, and it's still a lot of stress in their systems, some have actually gone to the doctor and found out that it was cancer that caused it, actually. So, but the most common thing, if you if you find out that you have a lot of stress in your system, um, that you cannot seem to mitigate, it's often a food intolerance that is the problem for gluten, for, for milk, for whatever food, uh, source. So, um, that's, that's the most common.

Yeah. So it's detecting all of these abnormal functions or systems in the body and it doesn't do the head injury or trauma, like you said, because that's not— I mean, it may be a cause of death.

It's like a fever. You know, it's like, it's like if you come to me and you have a fever, I have to find out what causes the fever. It can be an infection in your kidney. It can be sinusitis. It can be pneumonia. It can be a urinary tract infection and so on. So you have, I have to do the detective work to find out where does this infection come from. The, the fever is just a sign that there is an infection and the low heart rate variability just shows that something is stressing your system. It, it will not tell you what it is. You have to do that job yourself kind of. So, and, and this is also, this is also a, a fun, interesting kind of job. So a lot of the success of the, this, the Pulse Cure and the whole thing about it is that it's kind of a gamification of yourself, of your own health. And doing the detective work to find out what works for you and what does not work for you is interesting and fun. You know, of course, for some people it's not fun when you see that it's really hard.

Sure.

For a lot of people, it's really hard to get out of it. But it kind of shows the reality of it.

So, uh, yeah, yeah, and it, it puts us in the driver's seat, so to speak. I mean, we're, we're now responsible for understanding, doing that detective work and figuring out what it is. And then maybe with the medical counsel advice, we find out what to do about it. But, uh, we're in the driver's seat, not, not just the, not just the doctor anymore. That's how I think about this. Yeah. So it's, uh, been wildly successful, your book. The Pulse Cure. It's not available yet in the US, or it is?

It's available mid-May. It's already available as an ebook and as an audiobook, but the paperback version of it, it's 14th of May. It will be out as a normal book and available in all the bookstores, maybe not in the shelves, but in all the online stores and so on. It will be able to get it.

Yeah. Okay. Yeah. Well, congratulations on so many successes. That's great.

Yeah. Thank you. It's been a—

yeah. What kind of devices do you recommend that we wear that gives us, you know, a good heart rate variability measure?

Yeah, I must say that the best one is the Garmin watches, which is a US product, US watch that has bought a Finnish physiological company's algorithms. So the success is not the watch in itself, but that they have been smart enough to buy Firstbeat Analytics and implement their algorithms into their watches. So, and that is what has made it so easy to see what happens throughout the day. So you can like push a button and you can see your stress level in the moment, which is very useful because you can first feel how am I feeling right now? And then you can check, okay, the stress level is like this. And then, you know, you actually get to know yourself better this way. You actually start getting more sense of your stress levels through that. Sure. And of course, you will get a report in the morning, you know, how have you slept, you know, have you is the recovery good enough throughout the night and so on. And yeah, but you have lots of other choices as well. You have the Oura Ring, which is another Finnish product. You have the Whoop Band, which is an American product. And probably an Apple Watch is also useful. And so there's an app called Athletic, you know, a combination between athlete and Analytic Athletic. That is quite good also. So, so, yeah, so the, so almost all the different smartwatches will show heart rate variability in some fashion. So, yeah.

And are you, do you use your smartphone to read the results or you can read the results right off the watch?

Yeah. Yeah. Both.

Yeah.

Well, so, so you can read it from the watch.. But of course you, you can get it even more easily understood with the graphics on the phone. You know, you can, you can go in and, and magnify, you know, it's, it's easier on the phone.

Mm-hmm.

But you can also get a lot of results straight on your, on your watch.

Yeah.

Mm-hmm.

And can you say what a reasonably priced Garmin watch is? I mean, not, not the best, but not something so low entry level.

Yeah. The very most reasonable ones, they will be like VivoSmart 5, which would cost you probably $100, maybe a little bit more. But if you want more out of it, you need the segment from maybe $300 that have heart rate variability that you can see the heart, the HRV during the night. And those watches start, I think, from $300. And then of course, if you are exercising and you you really want a good assessment of your exercise training, then you need to go up to the maybe $500 segment and more expensive. So they have a wide range and they also have a range for, you know, sports watches but also very female-oriented, you know, that looks more elegant also. So because actually most of the people interested in this are women. You'd maybe think it was men, because it's a technological thing. But at least in Norway, I think 80% of the users or the ones that contact me, the buyers of the book and so on, that's women. Because they have more problems with stress-related diseases, autoimmune diseases and So they, and they are more health conscious than men for, for some reason, you know, men are not. So usually it's the, the, the wives that, you know, push the guy to the doctor. So, and it's probably like this in, in this field as well.

Yeah. We want to do it on our own, I think. Not, not to rely on others. Yeah. Okay.

Yeah.

So that's a, that's a big difference, 80%, but it is what it is. Uh, you have a, a masterclass on the Pulse Cure. Tell us, tell us about that.

Yeah, we, we have a website called thepalskure.com, uh, which is a social community in Norway. There are like 4,000 Norwegian members of the community because it's, it's almost like Facebook. We have made it ourselves, but it's that you can post, for example, a question. You can show the, the algorithms from, you know, the last week or the last day or whatever you you have a question about, and you will get answers either from me or from, from the other members there. So, and this way we find out a lot of new information, you know. People are trying this and that and finding out how to solve a certain challenge, you know. If they see— so if one person experiences some kind of stress, you know, during the night, for example, or the early morning, and they post on these curves, and then they will get answers from people with suggestions. So, have you tried this? You know, this worked for me, you know, and so on. And there are workshops there, and there are video lectures that we have. We have a blog there. So, because there are really not so many places to find information, you know, of course, the Whoop, the Whoop podcast, you know, the Whoop band, they are very active. So they have a very good podcast and they also have a very good blog. So you could read a lot there. But there is not so much information about how to use these wearables and particularly Garmin. So I think it's a very useful website to go and get your, find your answers.

Yeah. ThePulseCure.com.

Yeah, ThePulseCure.com.

All right, that's a great resource. Videos, workshops, blogs, and also to submit question. And I guess to submit, um, some breakthroughs or insights people might have learned about, um, their heart rate variability that nobody else knew, and they share that too. So not just questions. Yeah, great, great. Okay, uh, looks like we're out of time for today, Dr. Farrell. But before we wrap up, I just want to remind our listeners to visit my website, livingto100.club, sign up for my email list, and download a free copy of my 9 Tips to Make Living Longer Enjoyable. And if you're affiliated with a senior living setting, be sure to look for my new training manual and activity guide, Better, Longer, and Happier. Dr. Farrow, any final thoughts or anything you'd like to share with the audience?

Yeah, I would like to say, because earlier, we doctors thought that, okay, if you past 70 years old, you know, it didn't matter much what you were doing. You know, you could, you know, just relax, you know, sit on the sofa and drink wine, you know, do whatever. But now we know that it's even more important to have a healthy lifestyle, you know, after you are 70 and even older. So it's actually the most important age to do these things, to do your part to be able to live to 100 and staying healthy on the way. And yeah, being able to enjoy your life and get the maximum out of your life. You know, that is my aim and that is what I want to teach others as well.

Yeah. Well, thank you. I'm so glad you shared that. That's a really important message. And we are, we do have more control than we think, right? I mean, earlier generations never knew how much control we have over our longevity. And, and you're, you're validating that same, same finding that we do have control and it's not too late to start in our 70s.

Yeah.

Yeah.

Yeah. Great.

Great. Well, thank you for being a guest on our program and thanks to all of our listeners for tuning in. Hope to see you next time. Mm-hmm.

Thank you.

You're welcome.