Joe Rogan Experience #1108 - Peter Attia

four three two one hello Peter hello Joe what's going on man hold ah you were just telling me something that what is one of the most ridiculous things I've ever heard that you swam from Maui to lanai right and you're the only humans to ever do that I'm told I was the first person to swim from Maui to lanai and back the one way is a pretty famous swim race that's done every year you're the first person to do it the round go back dude why'd you do that how long you got when I was a boy they told me I couldn't do it what made you want to do that it's a ridiculous proposition so I got into I decided in this case sounds silly I read a book in January of 2004 about this woman named penny Dean who still to this day holds the record for the fastest crossing of the Catalina channel so swimming from Catalina Island to San Pedro or I read to you typically swim to point point Vicente and she had done it in like seven hours and 20 minutes and I was like that's amazing I was that as a crow flies it's 21 miles with the currents it's a little longer and I was like you know I really want to do this but I got to learn how to swim first that's that's three miles an hour swimming she is a phenom penny Dean had a stroke rate of 90 strokes per minute which I mean now that might not mean anything to someone who doesn't swim but like to turn to have a hand hit the water every you know third of it 2/3 of a second is a remarkable thing yeah I can't hold the cadence of that for a hundred yards Wow and she did it for 20 miles yeah what a beast she's out of control yeah there's certain people like that man that freaked me out I think I think marathon swimming might be one sport where if you just look at the numbers I think women are better than men hmm well there's that woman who swam from Cuba to the United States right she was the first person and she didn't she do it like at a fairly advanced age yeah I mean she's of course got an amazing pedigree of swimming and this wasn't her first rodeo right right right why why do you think women are better than men at that I mean those of us that I'm not a member of this community anymore but when I was it was one of our favorite topics of discussion I think thing opportunities are ideas that were put forth were higher pain tolerance something about being you know evolving to be able to give birth mmm just means they can tolerate pain a lot higher I think another thing I've heard is buoyancy you know women are naturally gonna have more body fat which provides insulation when you do these swims you're not allowed any wetsuits or AIDS of any sort so shorts you're like you're in a speedo and on a single latex cap and that's it and so if you can have a little and and so I think women's hips because they're gonna have more fat on their hips they it corrects one of the big buoyancy issues that we have in swimming mmm we didn't evolve to swim we're horrible at it naturally because we swim like this we drag our hips through the water mhm and if you think about the importance of aerodynamics and most of the things that we think about whether it be archery or racecar driving or cycling you know in water it's that much more important because the density of water is you know thousands of times greater than air so swimming is just a hundred percent about avoiding drag Wow so well that totally makes sense I just have been fascinated forever with people that are capable of pushing their brain to do things that other people just don't think are possible like a you know Bigfoot 200 race or any of those things but the swim one is particularly crazy because you can't stop right right like if you're running an ultra marathon you just want to sit down for a couple minutes and just take a break you can do that but if you're swimming there's no I've got it you could tread water is about as good as it gets but you can't touch the boat or the kayaker it's an immediate disqualification Oh God that's so crazy man that is such a Wow so you heard about this woman doing it and that's when I read this book and I was like I really want to do this at the time I was I was actually in my residency in Baltimore and I was like you know I really want to do this and I kinda have to learn how to swim to do it so I started taking swimming lessons and then that mean to make a very long story short basically by about the summer of 2005 I entered my first swim race which was a two mile swim race in Lake Reston Virginia and I did it I was like oh my god I just swam two miles in the open water you know it was hard but I was like okay that's the proof of concept now you just got to figure out how to make it 20 25 miles and so I just you know went completely psycho and ratcheted up the training and and then in October of 2005 I did my first Catalina swim wow that's got to be a pretty good feeling though when you're done that you are capable pushing yourself to what most people think is an impossible distance yeah I thought I mean people you asked a moment ago why do you do this I would say that in life velocity means very little acceleration means everything so what do I mean by that right like if you're going 650 miles an hour in an airplane you don't actually feel it mm-hmm you only feel when speed changes right so I've always had this theory that emotionally that's also true like happiness is only interesting when it's juxtaposed with sadness and so the feeling of crawling on the shore after you've been swimming for 12 to 14 hours is amazing but what makes it especially amazing is that six hours earlier you thought you were gonna die so you start these swims in the middle of the night to avoid the shipping traffic so that first swim boat drops you off at Catalina Island it's midnight that's a darkness you can't imagine like you can't even see LA from Catalina you have to swim for six hours before you even see the lights of Los Angeles really yeah what do you see the stars and the phospho like bioluminescent organisms in the water whoa which is incredible and that's worth the price of admission so every time your hand comes through the water you're pulling and ripping these little things and you're seeing the sparks and you can't tell where the water ends in the sky starts in other words the Stars and the bioluminescence looks like one cylinder so for the first few hours that's cool but then you know my first swim the water was incredibly rough I had only swim in the ocean for two weeks before the swim I did all my training in a swimming pool so in a lake on the East Coast so now I like I wasn't used to how to keep the salt water out of my mouth right so then I was like puking my guts out and then my if while you were swimming yeah you got yeah yeah how does that work you just stop and puke and then keep swimming Wow and then but then my tongue started to get really swollen from the saltwater because again as I would learn later on I would go on to do many more of these swims but what I learned is the importance of spitting the water out of your mouth very quickly so in a in a freshwater pool or lake you get away with more but in the ocean you swallow that saltwater you're gonna get sick as hell so all this stuff's going on so by 5:00 in the morning you've been swimming for five hours you're getting cold you're I mean you know frankly just physiologically like your cortisol levels are at an eighth or you're just you feel horrible it's like it's a really bad feeling and you're not even halfway there and it's like you don't know if you can do it and blah blah blah well if six hours later you're now crawling out of the water feeling like you've done this amazing thing that that's emotional acceleration that's like the greatest contrast I know you said I mean I've never experienced that but I was explaining the other day to a friend of mine about this camping trip that we went on in Montana I went it was like 9 degrees outside it was freezing cold we stayed out there for five six days and then when we finally got to a hotel room I took a shower and it was the most amazing shower experience tread life and that's a small right now but you take a shower every day and it's a big deal yeah when you do it in that setting or or think about the the meal you've had if you've been fast similar situation yet we're starving or lost at sea yeah yeah yeah I can't imagine that's a so now that you've done how many of these have you done these crazy you swim races or swim I mean calls them several yeah they're usually these major major ones are not racist you you're you're on your own you have to you go to the Federation that oversees that body of water and you say hey I want to do this and then you you know you go through all the channels to do it like they have to have an observer there and they you follow these officials so that you can be registered as someone who's actually completed it right and someone's there to make sure you didn't you know you did it correctly I don't know I've probably done all in probably like a dozen of these but probably like six of them really long ones what's the longest well I that's a good question what does the Maui one was twenty miles there and back so forty miles total no it's a the Maui channel is a 10-mile channel so round-trip is twenty the bigger question is time in the water because you rarely get to swim these in a straight line so the Maui lanai one I wanted to go Maui lanai Molokai Maui to do the triangle mhm and that would have been thirty miles as a crow flies but we just you know boat captain wasn't willing to do it at night because the tiger sharks and during the daytime we couldn't physiologically figure out how one could suffer against those the wind because the wind gets so brutal in the middle of the day so even the one that I did which was just the there and back I ended up swimming for twelve hours because on the the first way crossing where there was no wind it took me four hours and then it took eight hours to get back because I was swimming like the hypotenuse of a triangle right like currents going this way so I had to swim this way just to go in a straight line and I still kid I almost missed Maui Jesus prayer so I almost got swept out to Molokai just because the current was about 1.7 knots which is about as fast as I can swim maybe two knots that is a ridiculous thing man why are you doing this this is maniacal well I don't do it anymore I mean it was certainly it was an amazing season of my life but I think once my daughter was born which was ten years ago this summer that's when I I only probably did two of these after she was born because then the training just got so I just you got to live in the water if you want to do this sport like you got a including the winter you know like you know even in San Diego where I live it's still you know fifty five degrees in the water and you're gonna spend three four hours a day in the water freezing you know it's just so that was like you know I just don't have the the drive to spend twenty five hours a week swimming what was the what was going on in San Diego when that guy got bit in half by a shark couple years back they were training for something yeah that's a funny you remember that that was May of 2008 I remember that like it was yesterday so at the time I lived in San Francisco and this is actually just before I swam the Maui thing now that I think about it that was 10 years ago I swam the Maui thing in June of oh six a June of oh eight so I'm doing all my training in a swimming pool up in San Francisco because I don't want to acclimate to very cold water I actually want to be in warm water but I needed one long ocean swim of like 14 or 15 miles as my like last training swim so I came down to San Diego to do it and just by bad luck I came down a few days after that guy was killed now this was a guy I didn't know him but he was a triathlete training with a triathlon group that they would go out and swim every morning and I know the beach exactly where it happened in Solana Beach and unfortunately like most people who get attacked by great whites they have a very they always attack the same way which is below and behind stealth bite up and and then they retreat so they're trying to basically injure the prey so that their prey exsanguinate sand then they take off and then they wait till you bleed out so they never saw the shark but you could tell from the bite marks it was I actually had a friend who was on the beach and saw him when he came out and he was basically dead when he got to shore he had he had bled to death the problem is though in this case the shark had bit him and cut through his femoral arteries and veins and the saltwater prevents you from having any hemostasis so it exacerbates the blood loss so that's generally how folks perish when they're great when out of the water you know a bunch of other swimmers came to his rescue and luckily that commotion prevents the Sharks from wanting they come back so three days later I go out and I'm swimming at that Beach because I swam from my training swim was La Hoya up to Solana Beach and back and I got to tell you like three days after a guy dies where you're swimming it is it was about one of the most mentally challenging training swims to be like because you can't see like the water at that part of the beach is so murky you know and you're only a couple hundred yards offshore that like you can barely see your hands when you're swimming and so you're just thinking is this the day I'm not interested in that Jay I can't see why yeah there's just something about sharks - I mean they're to me one of the most terrifying things but it's first of all we're so inept in the water I mean even a person like you is a great swimmer yeah we're joke yeah what we are in comparison to what they are it's just you're you're throwing yourself into the world of a super predator and to know that one just jacked a person just a few days before and you're out there swimming around yeah although I will say this you know when it's all said and done all of the close encounters I've had probably the scariest moment I've ever had in the water was doing a swim from Santa Rosa to Santa Barbara so Santa Rosa Island which is the second for this North Channel Island you got Santa Miguel Santa Rosa Santa Cruz and Anacapa represent the top four Channel Islands so we did this November swim it was a nighttime thing against woman from Santa Rosa Island to Santa Barbara and at about 5:00 in the morning maybe 6:00 in the morning you're just starting to get enough light where you can see and you're out there so you really have amazing visibility and I look down probably 40 feet and I see this enormous thing swimming like this which is how sharks swim and I see the dorsal fin in the position that freaks me out and the tails this way but all of that is shark right and I like you know like lift up out of the water kind of hyperventilate for a second and I'm thinking to myself all right you got to make a judgment call here if that's really a great white you probably ought to get out of the water but if you the moment you are out of the water that's it the swim is over like you just spent like months doing this like it's one so then I convinced myself and I think I'm right I think it was a dolphin on its side because a dolphin on its side would its fin would get tail fin would be the same way and it could swim that way so in the end I just kept swimming but I mean that scared the out of me well they have seen quite a few of them off the coast of Malibu there's tons there's no question that like they're there they are way more plentiful than we realize and all you do is talk to the fishermen like the fishermen will tell you they're like you like off Coronado I mean it's like there's non-stop great whites really oh yeah why are you freaking me out Peter the good news is they see us all the time and most the time they realize we're not what they want yeah they want seals yeah that whenever they attack us they're making a mistake now is there a like a suit you can wear like a kevlar suit to protect protects you from getting bitten in half no but this is so funny you bring this up I became obsessed with this thing called the UH what was it called Christ you you put the thing on your ankle like you had like a little velcro thing you'd wrap it on your ankle on had a tail like this long you know like four foot long thing and it was charged and it sends out an electrical impulse that disturbs the out of the Sharks the Sharks nose is an organ that senses electricity so when a shark like that it could be pitch black it could be soot water and make still scope you you know from hundreds of yards away based on the electrical activity of your heart and that organ is their nose so this little thing I forgot what it was called like the shark taser or some it puts out a signal that like tases them and they don't want to get within like oh there it is James a cop here the world's first shark deterrent bans called the shark bans worn on the wrist or ankle I don't know I thought it had a different name but because the one that I was gonna get and did a ton of research into had a really long tail hanging off it and that became the problem he's his patented magnetic technology to repel sharks so the tail was a problem because of the drag no because it would sound silly but it would come up and zap you in the nuts it's like so it became unbearable to practice swimming in this thing like every 37 seconds you'd get zapped by the tail and I was just like as I like how it says reduce the risk oh yeah hey can I get some numbers please see reduce by how much by one seven or statistically and then it also is a leash for your surfboard too you can use one of those to trap it to your strap it to your ankle yeah no it's gonna come to me like in an hour I'll remember what this silly thing was Jamie will probably find it off of Catalina I know it's one of the best shark fishing places in the world I have a friend of mine who told me that if you think about like wild places on earth that are just overrun with predators and terrifying like predator prey activity Catalina Island is one of the top spots in the world I was like what are you talking about he's like I'm telling you man the shark fishing off Catalina Island is insane and then I watched a television show just you know synchronicity a couple days later and it was these guys shark fishing off of Catalina I was like what in the I could have never guessed they're catching Makos mostly yeah and and it's actually my recollection because we swam around Catalina once as well the backside is way more aggressive than the front the side that faces the Pacific side they'd rather that's right yeah there's way morning so I think that's exactly where they were yeah it looked pretty nuts I mean they were bringing in these 15-foot sharks I was like what the these are just floating around out there you know it's uh I mean I guess of course they are right I mean it's a there's a lot of fish out there as well so I'm sure the Catalina is amazing pretty crazy it was I die I'd swum to it I'd swum from it I'd swim around that I'd done another thing and I'd never stepped foot on it except at the beginning rend of a swim until five years ago I went there for a vacation like actually just went to Avalon for you know three days I'm like it's not a place I could live it's a little you know too quiet but for three or four days it was amazing I think people hunt on Catalina they've got huge Buffalo there is that what it is yeah so apparently there was a movie that was made there back in the 20s or something like that just let a bunch of Buffalo well they had a bunch of Buffalo yet for the movie and I guess they never liked the corral totally overrun with Buffalo well there was one of the Channel Islands that they had actually turned into a bow hunting destination like they had brought in a bunch of deer I think they brought in stags and a bunch of weird exotic and they put him on this island I think they even had elk and then biologists just weren't having it they're like this is just so out of whack yeah and those so they had them eradicated and the way they do that is it's pretty gruesome they just gunned down from the air and just leave the bodies yeah they just decided that they were did invasive species regardless of how ya Leah below might have been to people that wanted to go there and eat them you know they just decided just for the ecosystem alone just there's no predators there and they weren't gonna turn the island the Wild Kingdom and bring wolves or something in there yeah it would be pretty goddamn crazy imagine if there was an island you go and they just had wolves and elk running around on an island cuz well that's it I'm surprised that wood got them all down at least say make it open season for hunting or something like that they could have been productive well out it they that's an interesting perspective so biologists look at it in terms of the entire ecosystem right they look at in terms of the play ants the amount of waste fecal waste that these animals are leaving behind the fact they're literally eating everything that they can on the Scion they're not supposed to be there and then they're competing with whatever things are native to that island and probably I mean if you got a thousand pound elk it's not supposed to be on the Island this thing's just eating everything it can and they don't they don't have a winter either so it's just like the whole like they're just not supposed to be there the Channel Islands themselves are kind of amazing I mean most people know of Catalina but you know there's eight of them and now two of them you can't step foot on I think it's allowed to know San Clemente and San Nicholas there are military bases oh so we tried to do a swim from San Nicolas back to Los Angeles this is a real a swim because it's like an 85 mile swim and I spent like six months researching it speaking to a bunch of naval officers I was like hey is there any way we can because you officially do have to start a swim you have to be able to touch dry land and be out of the water and they're like yeah you can't come on the island so in the end what we decided was we were just gonna do a stealth landing you know by the time they came down and screamed at us and shot it as we'd have been off the island but then we got to the island now the other big thing of its and nick is that's real shark territory because that's where the elephant seals live and so when we got out there we literally could not get to shore because of the elephant seals like we're 200 yards off San Nick and you know this after had taken a full two days to get out there I mean this place is really hard to get to because the water is brutal and you're not in a huge boat and yeah you're looking at like thousand-pound elephant seals that are just like licking their chops looking at you trying to get in the water what would they do with you I I didn't want to find out but they're not predatory I mean I don't think I know I mean I think they're aggressive as hell did you see that video of the little girl that's sitting on a dock and a seal jumps up and grabs her in the ass and pulls her into the water gerrae see that Jaime yeah and I didn't think that seals ever did something like that before I don't know I did see a special once about how dolphins could be kind of aggressive with each other like they could harm you know they could leave this this seal is sitting there and this girl hmm the sea line actually look at this it comes up and they think that's secret so cute yeah but it I think it was probably looking for a handout and these people weren't giving it to her oh and then she turns her butter yeah that I bet I'd be right back fill that puddle with lead your kid oh yeah yeah they jumped up fast yeah they're predators I mean things yeah you know they're not eating plants in the water they're eating fish and you know whatever they can get ahold of they probably birds and stuff too they're probably used to scooping things up but I bet that what that's from is them getting too acclimated to people PR feeding them remember yeah there's a they have an issue in Boulder where Boulder is your bin Colorado yeah yeah beautiful right gorgeous super liberal like as progressive as it gets right you've been in San Francisco Oh have I think Boulder is right up there but there's less people in there you know everyone's real healthy and active and hiking and stuff like that they don't allow hunting for mountain goats on the weekends because there's so many people hiking and going that they don't want people killing these mountain goats in front of them because people freak out even though they have decided that they have to control the population and kill a certain number of them but so many people go out there that these things aren't scared of people so it's created this really weird situation where if you are hunting them you're you're almost hunting something that's domesticated people feed them Cheetos so much so that a friend of mine was talking about it that he was up there with his daughter his daughter opened up a bag of cheetos and the goat walked right to a wild goat lives out in the woods walked right up to his daughter and they laughs and she opened up the bag of cheetos and put it and he stuffed his head in the bag of cheetos he knew what to do and he's he's in this guy who was talking about this is a hunter and he's like this goat has like cheeto dust all over its face like it's the craziest thing its face is all red with cheeto dust and it's sitting there chewing these cheat like it's done it before yeah and it's just that that goat had diabetes I think probably eventually right yeah I was in Costa Rica there's another similar situation and we were staying at this Four Seasons out there and the monkeys have got very customed to people being there and so they come by and they hang out and they look trying to get things from you and my daughter opened up a package Oreos and the monkey just jumped onto this little ledge like a couple feet away from her and uh and my wife was like I really don't think it's a good idea that we feed this thing Oreos and I said wow you know it's probably gonna get eaten by a crocodile anyway I mean it's poisoning it is that what you're thinking it's not gonna eat this every day it's not gonna be a normal part of its diet but we hand the monkey and Oreo it pops open the Oreo and starts chewing on the frosting like a little kid and then we're like oh this little probably gets these things every week right so begs the question does he know how to do that because he's watched some human do it or are we innately wired to do that with Oreos whoo I think he knows how to do it because someone's giving him Oreos so many times then he knows that the good stuff the good stuff the middle they should just sell that piece I think that's only good because you can you can contrast it with it comes back to the contrast exactly I think you're right I think you're really right I think it was just pure middle it'd be pretty gross yeah if they probably sold pure middle nobody would buy it but if they sold those black cookies by themselves no one buy those a gross things either biscuits is it worse cookies like those could once you eat the white stuff you're like all right I'll eat this stupid ass black cookie it's the Sun caustic a cold cookie here it is there's a little monkey doing it look they grabbed her from you and then just love or it looks look at them open immediately open it up and start chewing that white stuff yeah crazy we had um there's a thing that is called the quwata Mundi have you ever heard of those it's uh it's related to the raccoon it's this weird animal that lives mostly in Central and South America and it has a northern range that extends into Arizona all the way up into Mesa I think like it gets into the areas where it gets cold but Arizona I think is the only state in the US that has it but it's this weird-looking monkey raccoon thing that is so domesticated that we gave it some grapes here it is we gave it some grapes and this little there it is I mean look at that weird little thing it came and sat we had like a little patio area in the hotel room and it came and sat down with us and so calm that it's sat and went underneath one of the chairs and took a nap after we gave it some grapes like what we're hanging around my daughters are running around making noise and this thing's just chilling it's like a pet it was a total pet it was a total pet yeah there they are they're cool man weird-looking things people eat them apparently apparently they hunt them in Arizona yeah I mean after seeing this it's just like I don't think I can hunt that I'd have to be pretty hungry to eat one of those they're so cute a little face weird little animal men really interesting yeah our relationship with animals is very odd when they get into close proximity yeah yeah we've got a wicked coyote problem in San Diego and at least in the part I live in and you know just one of those things once we got rid of mountain lions because nobody wants mountain lions around the Coyotes run amok is that what it is I think I mean that's not gonna front of mine about this the other day actually and he was saying that there's probably only like in our neighborhood there's probably only like two mountain lions left and the the Coyotes just they've exploded there there's so many of them around like and it doesn't really bother me that much I mean I actually kind of like listening to them howl but you know if you if they get into your chicken coop yeah I had one killed chickens just a few weeks ago yeah yeah I have that video of a dead chickens such a bummer man we chased it away it was on the roof of the chicken coop the way they jump is so stunning like they're so graceful like I've never seen anything that moves like that in the wild the way a coyote does they there's a six-foot fence it's on the ground it jumps to the top of the six-foot fence almost like it's it's under different gravity rules than us and touches the top of the fence and then boom it's on the top of the chicken coop I mean in like a second I haven't seen that that would be yeah it's crazy I have video of one of them jumping my fence I caught one of them with a chicken in his mouth jump in the fence jump to six-foot fence with a chicken in his mouth just jump boy touch the top of the fence with his front paws back paws went over right behind it and was gone it's crazy but you know look they we need them we need them to kill the rabbits and the rats and if we didn't we'd have a giant like here's what I tell my daughter cuz she she like gets all stressed out there's coyotes and her walking around our house and I was like well first of all they're pretty skittish of us and boy they keep those rodents under control they really do you need them for that but there's a coyote problem across the country they're the only animal that's in every single state in every single city now in every single city there's there's coyotes in Manhattan good luck I'm not bullshitting Oh in the park they found them in the park they found them in the Bronx they found them in abandoned buildings yeah there's a great book I read called coyote America by a past guest of the podcast named Dan Flores he's a wildlife historian so it's fascinating they're a really really unusual animal in that when you shoot one they yell out here's this whisset sky Odie's in new york city look at this in New York City dude in New York City New York City Police Department coyote running down the street yeah unbeliev they're everywhere man they have they have a real problem with them in Chicago I thought I could escape them when I'm in New York no you can't escape them anywhere they're in all 50 states now they've completely extended their range and the reason why they extended their range is because we we went after them we hunted them down you know they were able to eradicate wolves and the way they were able to eradicate wolves is they would kill the Alpha and then they would take an animal like a horse they would shoot it and then they would fill it up with strychnine and so then they would rub the Alpha the body of the Alpha all over this this carcass of the horse and then the other wolves would come and smell that the Alpha had been there and then they would eat the wolf or eat the horse rather and die and so they were able to do this and essentially use this method Plus shooting them and things like that to eradicate them from the West because of ranchers and cattle farmers they've never even been able to do that with coyotes when you shoot a coyote if they do roll call like when you hear them yelling if one of them is missing it sends the females it sends some sort of a signal where their bodies produce more pups so if one's missing instead of having like three pups you'll have six so you make more coyotes when you kill them and they extend the range when you persecute them they just extend their range it's their crazy animal they are wicked smart man they've been chewing at the roof of my chicken coop trying to get in I came outside the other night my dog I have I have three dogs but one of them is a golden retriever and that dog has zero instincts I mean it's it is just a it's a little human it's like it's like it's a little marshmallow it's just a yeah so he's fun no good running with his stuff he's great dog sweetheart of a dog great pet but like he's like what's going on over there there's a coyote on the roof dude what do you mean what's going on over there they're literally chewing the shingles off the reader job outside got one job to do you know Bart he's not interested he's just going he's only a year old too but he's just curious you know it's uh it's it's very weird living in proximity with all these things because where I live you know we have a lot of hawks a lot of owls a lot of coyotes and occasionally a mountain lion and I've seen I saw cat once which is pretty interesting I've never seen one of those they're weird-looking so weird looking thing to see one of a friend of mine I put it up on Instagram see if you find it it's old it's an old one on Instagram a friend of mine had a coyote or a bobcat break into her chicken coop and kill every one of her chickens and the coyote there it is look at that freaky bitch how did you find it so quick you're an animal Jaime's a bobcat he's got the best searching skills of all time but look at that that's in my friends chicken coop he's a bunch of murdered chickens scattered around it you're the look in that thing's face yeah that that look is you yeah that look is you lady yeah it killed you chickens why do you have them outside whoo yeah crazy man so how do you know Jacko this is how we got connected yeah yeah UPS at home so John I was like prepare to get your brain blown out I'm gonna send my friend over ice all right let's do it so I met Jocko through one of my really close friends a guy named Kirk parsley who's a also a Navy SEAL a former SEAL and Kirk said hey you got to meet my friend Jacques basically it's just like you guys use got to meet Jocko just have to experience Jocko that was basically it was like a ride yeah so so I met Jocko we obviously connected pretty quickly and then I think oh this was before Jacko's book had come his first first book had come out and I said I got to introduce you to one of my best friends that's got Tim Ferriss who I'm obviously you know Tim and because Tim's always looking for you know a great guest on a podcast and so I called Tim and I said look you got to just trust me on this one sight unseen just have Jocko come to San Francisco next week just I don't need to say anything else it will be worth it and I luckily I had enough credit in the bank with Tim I've done it I've been successful on enough sight-unseen recommendations but I think the Jocko was the best one ever because he called me after he called me while Jocko was still there and he's like yeah that was pretty intense yeah I sent him an email after the Podcast might that's one of the best podcasts I've ever heard in my life and I made a post about it Chako responded to the post and then I got Jocko on and then I and Tim convinced Jocko to do his own podcast yeah and now it's huge I mean his podcast I get text messages all the time from people thanking me for telling them to listen to it and then I get tweets from people thanking me for talking Jocko into doing it because it's just this that just just there's outliers in this world you know in in everything there's outliers in athletics who's out but in when it comes to like discipline and motivation and just just when you look at someone who's just undeniable like jock was one of those guys he's just undeniable he's a specimen he's definitely off the graph yeah I'd met him a long time ago when he was training with Dean Lister and Dean was fighting in the UFC mm-hm I remember meeting them I'm like what's that guy's deal they've got a whole lot of going on behind their eyes like okay guys seen some stuff you know yeah I'll tell you that's very funny Jocko story I don't think I guess I can tell the story in public it's pretty funny so Jocko is in New York just after his book came out and you know this and I was like look I want to do see someone like my my buddies who run hedge funds here because some a lot of what Jacko does is they you know he and his partner like they consult with guys like this doing leadership stuff and so we went up to the offices of one of my friends who has this very famous hedge fund and his office is like on the 50th floor on Park and it's looking it's like a beautiful view down Park and we're just sitting there in his office just shooting the and I forget how it came up but somehow we were just talking about like like how good is a sniper like what does it actually take and and then of course we're we're talking very specifically about I can't believe I'm blanking on his name Chris the Bradley Cooper played him in yeah Chris Kyle we're talking is because Chris Kyle had been part of Jacko's team I forget which SEAL team maybe it was he when he was SEAL team two but um in fact I think Jacko said he goes you know yeah Chris was a part of my team for more of his kills than any of his other kills and so then we were like like what sets him apart I mean obviously any Navy SEAL sniper has got to be amazing but Chris took it to another level what what was it and he and he said okay let me show you what it was so he said as we walked us over to the window and he goes okay you see that guy in that hat over there like about a mile down the you know you could basically see because of like a pink hat or something I said yeah he goes okay if you're a sniper you got to be able to lay down not move and put your eye up against this thing and like look out at him and you can't though if you ever take your eye off that you're gonna lose the sight so you got to be able to stay in that position and I'm moving to it he goes and I forgot the number was but Jaco said the average Navy SEAL sniper can stay in that position without moving I glued to the site for X number of minutes and I forget what the number was maybe was like 15 minutes he's like Chris could do that for two hours he could lay in that position not moving and not taking his eye off that thing with one eye shut for hours and he you know he's just like he just had a different he just had a different gear and it was just an amazing I mean I mean those are some of my favorite moments with Jaco is when he like can tell you something that is like like they're like maybe three people in the world that would understand why that matters you know sniping is fat is really fascinating right because just sharp shooting just being able to shoot something at a distance and long distance shooting is it's it's a big sport I mean for in terms of target shooting I mean there's guys that are out there they're shooting 1,500 yards and doing it competitively that's a crazy digit it's amazing it's a crazy distance but when you think about it you got a rifle it's on a rest you're sitting you're either on a bench or you're prone whatever it is you're lying down most of the time this is all it is it's this with your finger pull pull pull pull pull boom some people are way better at that just think of that coordinating your vision getting the reticle set on the target yeah pulling that and without movement the outliers are the people who can do that and you've got to think like when you when you break down physical movements right like you watching gymnastics routine the Olympics like holy and it flips and the land and they stick and it's incredible but now break it down to just the movement of your trigger finger pull pull pull pull pull bang no movement you know I mean it's I'm sure you've shot guns but it's hard to like if you shoot pistols and you have dummy rounds you know like a lot of people they mix in dummy round so that they find out they're jerking the trigger yeah and when you see like I was watching a video with Tim Kennedy and Tim Kennedy was a shooting at the range and he's he's pulling bang bang bang and it goes click and he goes woo look at that trigger control like it cuz it was he put the way he pulled it right it didn't go off target it didn't move it was it there was no punch to it you know but you you got a practice for ever just to be able to do that just to not anticipate the recoil of the gun and yank and move and twitch and just controlling the mind I mean it's a fascinating thing to me that's just just pulling this one finger you would think anybody could do that I can show you how to do that right you know like like I've had friends that say they want to go hunting you know I want to go hunting you know what would I do where do I get a boat I'm like slow down let's get your rifle because I could teach you how to shoot a rifle we could we could get someone we could sight in your rifle we'll go to the range I'll cite it in in a hundred yards get you a good accurate rifle and then all you have to do is kind of keep it together a rifle we get into a hundred yards of a wild pig you're gonna be able to kill this thing or 100% you got years before you're gonna be able to shoot that thing with a bow I mean years first what it is and the bow is like my wife said this to me a while ago she of all the things you do she's like archery seems to be the only one where even if you don't have a good day you're still happy like if I if I if I'm on the racetrack and I'm driving a race car or if I'm you know swimming or whatever and I just have a bad day like I don't I'm just not firing on all cylinders like it you know it just kind of pisses me off right there's something about archery where even if I'm not having a good day like maybe it's an extension of what you're talking about with the trigger finger so for me I got an artery because of Tim and the story that the thing that he told me which obviously for yeah the thing that he told me that immediately made me be like I want to do this it was just anything that requires that much perfection just seems great and he was like yeah you don't take a shot unless you can kill the animal like you know and so like you might take one shot in two days like it's got to be a kill shot and the kill shots got to look like XY and Z and I was like oh that's like you got to be dialed in so it was this idea of back tension you know it was sort of like wow if you're taking a perfect shot like it's all in the rhomboids you know it's all back here and you've got to be able to do as you said you've got to completely be able to eliminate any anticipation any of this business and you know and so I think that I I think of archery for me is almost like a meditation like if you like I'm talking in the way like Sam Harris would talk about sort of consciousness and the way you are so hyper aware of what you're doing that yes you can daydream and your mind can wander but if you actually start to imagine the sensations of every part of archery in many ways it feels like meditating so I think that's why I'm just like you know and I never really thought about it with shooting a rifle so I don't have much experience with guns but I'm guessing it's it's very similar but as you said like the the the difference between the good and the great and that is less obvious you know at a distance yeah I think offhand shooting a rifle and shooting a bow I bet I bet armed just as accurate at 60 yards as the average person is not a sniper but the average person with a rifle you can be pretty accurate you know you can't off a bet so there's there's some similarities there's like there's a similarity to having the you have to have perfect technique you have to have the right stance you have to make sure that you know everything's locked in and your your structure is correct but I agree with you that I think it's some sort of a meditation I also think there's something to hitting a target that is in our DNA that's connected to hunting that's connected to survival that's connected to I mean the thousands of years that people through arrows and what did that what does that thing called what's that thing called the day yeah as I say it atlatl right yeah yeah yeah that's like an advanced spear throwing thing and then archery and just I think when a person would hit a deer they knew their tribe was going to eat right so there's this like charge and you get a small amount of that juice when you hit a target yeah no I'm sure there's I'm if there's got to be dopamine that's being secreted whenever we do that it's the greatest feeling in the world yeah doesn't it it shouldn't make sense like when you're looking at someone doing it you're like what do you give a if that arrow goes in there it doesn't make a sense like why does it make somebody there's a Sat like Jamie laughs at me because I'll hit the bull's eye from 45 yards and I'm like yes it's like you get this little whoa you get a little little burst man I just like the whole experience even the sound so sometimes like when my veins get holes in them like sometimes you put a broad head through or you put like a field tip through another one and now obviously sometimes if you trash the vein the arrow doesn't work but like usually just a single hole in a vein will produce a sound that is the greatest sound you've ever heard when that arrow leaves the whistle yeah yeah love it so the album with certain broadheads certain vented broad heads they whistle it was how much they give the end all the heads yeah yeah so that whole experience of like the perfect release you know even when you surprise yourself like I've been switched over to this Carter evolution release sure about back tension release it's the it's the most pure back tension it's better than the honey because the honey you could still cheat a little bit you know if you were getting lazy you could you wish list exactly right the evolution there is no cheating right you can't you it's yeah so you can surprise yourself with a shot mm-hmm yeah so there's no anticipation yeah yeah you can't explain this to people who don't do it notice that now you can't they're like what are you rambling about boring the out of me I have tried to explain this to people you don't know what I'm talking about I was trying to explain it to Alexander Gustafsson he was in here the other day and he's a hunter too and he but he only hunts in Sweden you can't bow hunt it's not legal oh and he wanted to learn how to shoot a bow and so I was explaining that I put my finger on this trigger my finger sits on the trigger I use a card or two I use a first choice that's the name of the reason I go my finger my thumb is on the trigger but I never squeeze it yep the squeezing is all done with my back as I pull then it got just goes off and look you can see his head was like why but you just do that right just do that you know it's so counterintuitive but once I got into it Tim actually sent me this book on back tension and then I just devoured it I mean it was sort of like the reading the penny Deen book you know is Tim doing this a lot now not as much as he should be but trying to hunt with it yeah Tim Tim o hunt and I actually got it so far I know he's hot yeah only with rifles no no he's hunt he he goes he's been on bow hunting trips that's in fact what got me into it cuz about two years ago he was getting ready to go to a trip do a five-day trip in Colorado and he called me and said hey I want to talk with you about like some training and some nutrition to like get ready for this is gonna be kind of an extreme whole deal you know you're at altitude you're running around like crazy you got to be able to like mm-hmm like sprint and then be totally relaxed and so he's like you know can you help me think about how to train and what the nutrition would be and and I said okay but tell me more about what the demands are and the more he told me the more I was like why am I not doing this freaking awesome so that's so and he's got an awesome video of this he took but I mean probably he only took one shot and like the whole five-day trip it was a perfect kill what did he tell it was a huge bird and I can't even remember what a word yeah yeah I was like a bird on the ground like some huge ass bird but it wasn't a turkey it was like I remember what it was but the shot he was like you know it was one of those things where it was like because it you know like all my practice is on stationary targets right so it's a totally new dimension when it's like the things doing this so it was flying it was it was like kind of like either running on the ground or about to fly or something anybody hit it in motion I mean it was a great shot that's crazy yeah yeah that would be Big Bird in North America did he shoot a eagle yeah I was reading something about the goose problem about how the goose population has exploded because of farmlands and that they literally don't they don't know what to do with the the certain population of different kinds of geese that are flying into this country from Canada it's funny you say this I was in Toronto three weeks ago which is where I'm from and though I don't go off and and we were I was with my brother and we were up taking the kids to some place and sure enough like we're walking from like one area to the other and these geese come up and they kind of start posturing and I'm thinking what the and my brothers like movin like yeah clearly one of us is near one of their eggs sounds like what he's like oh yeah yeah he goes these are the most aggressive creatures and they're big yeah they're pretty big so I was like fair enough let's just keep walking don't make eye contact they're big but you can cook them so them get out of here goddamn keys yeah there's a there's a there's a certain type of geese that they call rib eye in the sky because they have a delicious red meat to them what is that called which god damn it but they're very plentiful in Texas yeah they hunt them in Texas and they they litter what's the meat like is it marbled it looks like a ribeye it's crazy sandhill crane thank you sandhill crane that's what it is is there anything you don't know he's a wizard with the ghoul seriously with Google everyone is a wizard but Jamie's an extra wizard he's really he's a ninja yeah but that is what they call them so it's it's actually a common phrase because it I've had friends that say it might be the most delicious meat in the world I mean it tastes like a like a like a Wagyu ribeye mm-hmm and it's flying around and you could shoot like 10 a day crazy like my friends that hunt these things and you know they're fine they're mostly in Texas I don't know where they are but my friends who've hunted them hunted them in Texas I mean I'm sure they fly all across the country but yeah it's a crane it's not a goose yeah I've never been I've only been bird hunting twice I went once with Anthony Bourdain first TV show we hunted pheasants and he shot one and then we cooked it and ate it that was fun I shot at one and missed and I shot a turkey once which is pretty interesting wild turkeys very good very delicious but you know it's um when I like mammals I like eating mammals I prefer I prefer red meat I think it's just better for you I think it's more nutritious it's more exhilarating there's something about the the meat itself just it tastes better no I haven't met too many foods I don't like really use it and eat it well with the kind of exercise that you do I'm sure you you almost have a voracious appetite I mean I do but nothing like what I used to mean I I fast pretty much every day I mean doing 16 hours what are you doing um depends so when I'm in I split my time between New York and California when I'm in New York it's absolutely one meal a day no ifs ands or buts because it's just the schedule is such that you know I'm seeing patients in the morning and afternoon and I don't want to do I don't want to waste time to eat what do you doctrine that's a good question I mean I trained as a surgeon and did cancer surgery but I my practice is based on longevity so it's sort of how do you apply nutrition exercise sleep stress management Endocrinology lipid ology supplements hormones all that stuff like how do you engineer how to make somebody live longer is my clinical interest so yeah so in New York I eat one meal a day so it's basically like a 22-hour fasting window and then I'm feeding within a two-hour window Wow when I'm here it's about this well I mean yesterday and today it's the same like you know today is just been kind of a busy day you know I won't eat till dinner tonight but my short fast would be 16 hours where I would eat a short fit that would be a short fast long one for me really dude you got to get in touch with your evolutionary so I had this discussion with a friend this morning cuz he was saying to me he can't do 16 hours he's a you just told no but I said you got to understand if our ancestors couldn't function when they were hungry we wouldn't be here so it's not just that starvation a short term adaptation to starvation is is necessary is probably beneficial in other words you know during these short periods of deprivation of food you know we get just a little bit more epinephrine and norepinephrine we just get a little bit sharper a little bit better I I can't even I can't even remember what it's like to eat three meals a day it's been so long really yeah I mean I've been doing crazy for ten years nutritional wise like I mean I spent three years in ketosis where it was just until one day I was in ketosis for three years lots of fasting but I think intermittent fasting or time restricted feeding probably at least five years and what a for people listening what are the benefits of that well I mean if we're gonna be a really technical we have to be clear that I think a lot of the benefits are overstated and a lot of the benefits are things that we've only studied in animals so there's a guy named Sachin panda at the Salk Institute in San Diego who's I think one of the world's experts on time restricted feeding but you know for example a 16 hour fast in a mouse produces unbelievable results if you take a group of you know certain types of mice or strains of rats or other rodents and you in a 24-hour period deprive them of any nutrient for 16 hours but then for 8 hours let them eat whatever hell they want they can't gain weight so and and and the reason we think is that it once you give a long enough period of time when the animal can ramp up it's like the enzymes in the liver that are responsible for fat oxidation I mean they just basically become fat burnt I hate that term fat burning machine it's so overused but that's bad they basically just become unbelievably efficient at metabolizing fat so we have to be careful that when we extrapolate that because you and I have a very different metabolism in a mouse like a 16 hour fast to a mouse is much longer than it is to us so I don't know if those benefits would extend also it's not entirely clear the time restricted feeding will produce the longevity benefit that we see in other sort of fasting or fasting mimicking types of diets so for me what it comes down to is I mean honestly it's just an easier way it gives me a much more Liberty with what I eat during my feeding window I don't have to be nearly as restrictive when I'm feeding if I have that period off it's just just in terms of like my physiologic response secondly there's a convenience thing like I kind of hate being tethered to eat mmm I like knowing that if I get into a pinch like I don't have to eat right now if I'm sitting on the airplane and they're serving dog I don't have to eat I can wait another five hours until I eat I also just feel much more steady in my energy levels I I kind of vaguely remember like 10 years ago when I was kind of like eating a normal diet how I always had this lull in energy after lunch like there is the post lunch pre dinner I just don't feel good like not that I feel bad but like I'm not sharp I'm not in my a-game and I don't even remember that feels like anymore which is not to say I feel great all the time but I definitely don't have that vacillating energy level yeah I've said that to people when I eliminated most carbs from my diet you know and I have a friend of mine who talked to his trainer about that his trainers like you're crazy eat bread eat pasta don't listen him like no don't listen to him like just just google it that stuff's terrible for you if you want to eat carbohydrates get it from fruits you know get it from some natural sources but just if you have a trainer that's telling you to eat bread get a new trainer because it's just it's not what you need it's nothing wrong with eating if you want to occasionally and in small doses but when I eliminated most that stuff from my diet I felt the exact same thing I felt that midday nap desire go away and they're just the fog enos about like you at the end of the day like oh god I'm tired and then I'd have to drink a cup of coffee to get ramped back up again and this is like never-ending cycle of having this insulin spike and then this crash and that is that's from carbohydrates it's from refined carbohydrates and you know having too much sugar in your body and everybody does it it's like all right so this will be funny for your so google my name and just put like peter attea fat and you know you're gonna see a picture of me when I was a swimmer cuz all this time we were talking about me swimming you're assuming like I'm a fit dude I was fit but fat dude fit but a fit but totally fat and this was a meeting Oh non-stop carbs look there there I am see on the left there well I wouldn't say you were fat I would say you got you got a little paunch on ya I don't know wait wait there's another picture after I swim across Lake Tahoe go to that that one right there yeah go got there fella yeah but it's also you're sitting down suck it in for a picture on Instagram might look okay no I I was definitely you know probably what maybe thirty pounds heavier Wow but but bought you know body fat was much greater and what were you eating oh I mean I probably went three three or four bottles of power eight a day because you know raining all day and you know every post workout was a carb refeed and so you're in sort of this vicious glycogen dependent state yeah and people that it's it's crazy that there's so many folks out there that are living their life that don't even understand that this is a process they're going through they just think this is eating and exercise this is what happens but it's not your body live you shut up cut that off push it away enter into completely different food source just change the way you you eat your body will change and that that just that concept the people that sounds like horseshit it sounds like what are you saying you you're with you offering some miracle cure your office no I'm saying you will change the dimension of life that you operate in it will change because you won't be the same person you won't like who you are is dependent upon a lot of things but one of them is how much energy you have how you feel what are you crashing if you change the way you eat you change the energy you have you change the way you feel it'll change your behavior will change your choices it'll change your ambitions it'll change your potential I mean there's so many things that will change but there's an interesting question which I've I spend some time thinking about and I've sort of accepted the fact that we might not know the answer which is when I was growing up I was exercising like crazy not as much as I was when I was swimming but I mean sorry more than I was when I was swimming but I ate like I had the world's worst diet growing up so I would eat breakfast was a bowl of like a box of cereal so I'd take like one of these Tupperware bowls it was this big and fill it with a full box so each day I would have just a box of cocoa puffs or whatever I would start the day and then lunch was a full loaf of bread which would seven sandwiches plus a plate of fries plus a big tub of like like a two liter jug of orange juice but I was training six hours a day right so I would you know run ten miles in the morning in the gym you know boxing like it was you know you know what that shit's like I mean it's ridiculously energy expending but the point is I had a hard time holding my weight and I was a middleweight 160 walked around at 158 who walks around below their fight weight so you know my waist was 28 inches I was probably four-and-a-half percent body fat and I was eating anything and everything you could put in front of me and then something happened in medical school where that just stopped and I wasn't even eating as badly at the time but all of a sudden the metabolic adaptation just vanished and you know I mean I wish someone could study this meaning you would have to take a group of individuals and do muscle and fat biopsies over their course of their life or at least during this window when we think this is happening and I think for many of my patients or just even friends like it seems that this happens kind of in your 30s if you're a guy for women it it's it's harder for me to tell because I think pregnancy can interfere with this so sometimes we get a bit of a skewed answer but if I had to hypothesize I think that we go from having a lot of lipoprotein lipase on muscle cells and not much on fat cells to the reverse so when I was 16 and invincible my muscles had a lot of this enzyme LPL on it that could just absolutely take whatever I was throwing at them and turn it into energy for the muscle whereas when that LPL exists on a fat cell you're basically just gonna store more fat and now why that would happen over time I mean we could guess reasons but I'd love to know if that's the case because I still can't really figure out like why is it today I am so carbohydrate sensitive when there was a day when I could eat you know I was probably eating seven or eight thousand calories a day of which 80% were probably carbohydrates when I was growing up and was lean and mean did you experience a crash at all in the like post afternoon crash post lunch crash it's a good question back then I don't think I did that much back in the day which would also speak to the idea of better fuel partitioning feel partitioning meaning this sort of technical term for where your body knows to go to excess energy you know are you going to glycogen are you going to the fat and then where are you storing energy so I suspect that was just better at fuel partitioning as a kid which I'm sure most of us were anyway it's kind of of course the real question the reason we care about this is like what could you do about it right like what you know for example like that's probably one of the reasons why testosterone as testosterone goes down you're gonna get fatter all things equal and part of the reason is testosterone up-regulates LPL and hormone-sensitive lipase and all these other enzymes in the direction of making you leaner versus fatter so but that kiii i just don't think that that's enough of it you know i think there's something else that's going on that's triggering that decline so for you at this twenty two hour window of not eating what do you think the benefits are other than your energy and slight spikes in norepinephrine and some other hormones well I don't think there's sufficient evidence at this point in time that time restricted feeding is going to impact my longevity so I think that's the big claim and it's the big claim is think what is the claim what are they saying oh I mean I think the claim would be that fasting mimicry which could be you know like what's a Valter Longo talks about where you do a 5-day hypo caloric diet of 750 to a thousand calories a day for five days followed by 25 days of ad libitum feeding meaning eat whatever the hell you want in terms of total caloric content you know the claim is well that's going to enhance longevity and or you know doing a sixteen eight or 18 six is going to enhance lifespan so just to take a step back I am only aware of three things that have universally extended lifespan across all model organisms so if you think of like all eukaryotes right if you go from yeast to worms to flies to mammals the only things that uniformly extend life or almost uniformly is caloric restriction and/or dietary restriction so total reduction in calories during the lifetime and or reduction of certain subsets of those calories so there's a super famous experiment that was done actually if anyone's interested I wrote about it it's on my blog somewhere but it's basically this the best experiment ever done in caloric restriction was between monkeys and there was a group at the NIH and a group at the University of Wisconsin and it was like a nineteen year experiment or something like that so you could really study the impact of caloric restriction over these things and that experiment showed us that caloric restriction extended lifespan if you had a really shitty diet and it did not extend lifespan if you had a really good diet hmmm counterintuitive but it also spoke to the idea that dietary restriction probably mattered so in other words if you're eating a regular diet of McDonald's every day and then we put your counterpart eating 70% of McDonald's every day that's going to move the needle but in the Wisconsin and in the NIH experiment when you took the monkeys that were eating kind of it wasn't their natural food but it was less horrible food the caloric restriction did not extend lifespan so that threw a wrench and everyone's understanding of caloric restriction and there are certain strains of mice that also don't seem to be enhanced in terms of lifespan meaning just time on on earth but for the most part nutrient deprivation pretty ubiquitously extends life the second thing that uniformly extends life across this is a drug called rapamycin which is kind of like my favorite drug in the whole world I mean meaning it's like I think it's the most important drug in in terms of this space not necessarily because it's a drug that we'll all be taking though I do believe that is the case but more importantly because of what it's taught us about the nutrient sensing pathway and its target which is this protein called tor the target of rapamycin or mTOR as you've probably heard of it as a mechanistic target of rapamycin and rapamycin inhibits that now it's a bit complicated because there's two variants of it there's something called mTOR complex one and mTOR complex two and if you take rapamycin day in and day out every day which for example transplant patients do it's an immune suppressant that doesn't seem to really extend lifespan but if you take it in a pulsatile way you selectively get this M torque one inhibition without the M torque two inhibition that seems to produce longevity big-time and how does that work how would you take it selectively well this is sort of one of my main clinical interests because I obviously I'm waiting for the day when I can start taking it and ultimately you know feel that it's safe enough that I could give it to patients if I'm extrapolating from all of the best data out there so that's looking at the work that's come out of a guy named David Sabatini's lab David's a guy at MIT he's a professor he's actually the guy that when he was a medical student doing his PhD in 1994 actually discovered how rapamycin works in mammals he's actually a guy that coined mechanistic target of rapamycin M torque as a name and so now whatever we are almost 25 years later you know he's still running the powerhouse lab that understands it so if you look at all of the literature that's coming out of their lab coupled with a guy named Matt K Berlin at the University of Washington who's doing rapamycin studies and dogs along with the work done by someone named Joan Manik who was at the time at Novartis is now at a company called restore bio and a few other people my intuition is that somewhere between two to six milligrams every five to seven days is probably the sweet spot but you know am i confident enough in that to say that we should all be taking it not yet there's a couple things that like I want to be able to measure before we do that but you know in the animal data this stuff's remarkable if you look at Matt Carolyn's dog data it's remarkable like what well so for so you own a dog you know this right I mean if you if you look at outside of euthanasia or accidents how do dogs die they basically die of cancer and heart and and and they get dilated cardiomyopathy so it's a different type of heart disease and humans get they don't get atherosclerosis they get heart failure their hearts just get too too too big and their rejection fraction which is the amount of blood the percentage of blood that leaves the ventricular chamber with every contraction that is that number goes down bad things happen now to put that in perspective you and I sitting here a couple of normal fit dudes we probably have a resting ejection fraction of 60% and if like we went out there and like killed it and worked out as hard as we could at peak we might get that up to 80 85 percent ejection fraction so once the ejection fraction gets below 30 percent you know a person starts to become very symptomatic well Matt took these dogs that had low ejection fractions to begin with and I forget what the exact number was but it might have been like below 40 percent or below 30 percent put them on rapamycin for 12 weeks and in just 12 weeks saw an absolute 10% improvement so not it didn't that means that's not going from 30 to 33 that's going from 30 to 40 % EF improvement in other words this is hard to measure in effect in 12 weeks of a drug and certainly you're not gonna be able to measure a longevity impact over that so much of the study that's being done with this is looking at surrogate markers that we assume would portend longevity so Matt's work focusing on the ejection fraction mannix work was focused on immune response which weekend was so this was the turning point for me this was like December of 2014 was like when everything in my professional world shifted in terms of my interest towards like rapamycin is the thing I want to know everything about because when I was a surgical resident you know we used to give rapamycin out like it was cotton candy to all the transplant patients it was an amazing drug that revolutionized transplant physiology because it had far fewer side effects than massive doses of prednisone and things that we used to have to give patients now you could give them much less prednisone and you could give them rapamycin or cousins of rapamycin like fk506 and what you're doing with that stuff is you're suppressing the immune system so the body doesn't reject the organ exactly now when you do that does that leave them susceptible to illness or disease yeah would that be the case with rapamycin in person taking it for longevity that's the million-dollar question and so I think in - so in a moment I want I'll tell you the story of how rapamycin came to be because I think it's the most interesting story in biology certainly in the last 2530 years but when it was approved in 1999 by the FDA it was for this indication it was an immune suppressant it was ten years before anybody figured out that oh wait this could also extend life and there and you had this paradox which was wait a minute how can an immune suppressant extend life I mean everybody acknowledges that immunity is a cork you know element of Health and so in December of 2014 I feel like it was like almost Christmas Day I remember thinking this is like the best present I've ever got Man X group published this paper which they did in a group of about 320 65 year olds ish so they put them into four groups there's a placebo group there was a group that got and it wasn't actually rapamycin it was ever ever limas which is an analogue of rep mice especially the same drug so there's a group that got one milligram every single day five milligrams once a week 20 milligrams once a week they did this for something like 8 to 12 weeks and then they washed out meaning they got nothing for 8 to 12 weeks and then they were hit with a flu vaccine and then the scientists measured the immune response doing these really complicated assays where you look at t-cell function so relative to the placebo act paradoxically all groups and I said paradoxically because even the group that got one milligram once a day all saw an increase in immunity which is a good thing but the five-and-twenty group saw an even bigger response the people who just got 5 once a week or 20 once a week so on even bigger responds but the group that took 20 once a week had more side effects and the biggest side effect of rapamycin acutely is these awful awful mouth sores called Aptos ulcers they're nasty they're brutal I used to get them all the time just from I think sleep deprivation or anything you know something that was weakening my immune system so it's an internal sore not like a cold sore no no it's like you canker so it's a really nasty type of canker sore yeah so okay once I had one so bad that I was like this is when I was in residency and I was like it was just driving me nuts so I went to the o R and I got a bunch of lidocaine which is a local anesthetic and I went into the call room and I just grabbed my tongue and just injected like lidocaine in it just when I did that somebody walked in and I've got like blood dripping down from my mouth and I've got a needle in my mouth and they're like and I'm like no no no it's not what you think it's not what you think I swear it's lidocaine they're like dude oh we're going to help you know who our support groups for people like you lidocaine is disgusting I had my deviated septum fixed and they shoved the lidocaine up there you know it's it's it's harsh stuff and the rest of the day I just felt like shaky and just weird and then I realized oh this is like a almost like a cocaine type thing like it's you know you know why we have lidocaine because of cocaine yeah yeah that's a guy named William Stewart Halsted who was so near and dear to my heart because he was the original he was the founding surgeon at Johns Hopkins and one of the original four horsemen so the four main physicians that basically have shaped medicine in this country all started out at Hopkins Osler in medicine Hopkins in surgery and two other guys Walsh and I'm blinkin Kelly was the third one and he basically figured out because you got to remember like there was a day when surgery was staggeringly barbaric like prior to ether surgery was like alright can you hold him down like gagging getting drunk gag them and like we're gonna do our thing alright yeah it's just crazy so god I used to know all of this I don't remember any of the exact dates anymore but it was like kind of like mid-1800s to late 1800s when up at Massachusetts General Hospital I forget the name of who it was but someone basically came up with ether so ether became the first form of anesthetic but you know you were sort of knocking people out well it was you know fast forward probably 20-30 years when Halsted figured out that this thing called cocaine could provide local anesthetic so he began experimenting with like crazy and of course in the process became like patently addicted to it so you have this entire generation of surgeons at Hopkins from that early era that were completely Koch addicted so Halsted in all of his first generation of residents and then of course from that we got lidocaine bupivacaine all of these things that don't have the same properties but to this day cocaine is still used and most people don't realize it but cocaine is a schedule 2 drug meaning it actually has a medical application unlike heroin which is Schedule one in the DEA and marijuana that's right but but cocaine is schedule 2 and it is still used in some ENT surgery because it has some favorable properties over even lidocaine and bupivacaine for nasal surgery did you know that they still use coca leaves for flavor in coca-cola they actually extract the cocaine from it use the coca leaves and the cocaine goes to medical for I don't know I had cocoa tea for my first time this summer like real cocoa the latte but like brought up from Monte Monte to cocoa that's what it is oh yeah it's great I could not get enough of that stuff you can't shut the up on it though that's it's a weird sort of hi it's a very strange thing it's very talkative sort of hi I thought it was just everything about it was like just the leaves you ever done that like in Peru or no no I've never done neither but apparently it's really interesting like the it's like a coffee sort of a thing and it's got flavonoids it's actually yeah yeah it's actually probably healthy for you I just love plants in general yeah but what it's we think of the coca leaves as producing cocaine cocaine we think of as inherently negative but the leaf itself like if you just don't extract it it's actually really good well that's the thing I mean I and that you know even like thinking about the difference between eating fruit versus eating Oreos yeah like yeah like nature is pretty good at regulating how fast this stuff so in the case of fruit like how quickly does fructose hit your liver mm-hmm there's a sort of governor built into it if you're putting raspberries like could you get non-alcoholic fatty liver disease from eating enough raspberries yeah probably but it's like you're crazy yeah you got it you need to become a full time job or you can just drink a giant gallon of orange juice every day all right if that would do it I would do it yeah cuz we most people think of fresh-squeezed orange juice as being oh you're eating healthy yeah look at you over there were you fresh squeezed are you juicing as totally healthy super healthy meanwhile you're just drinking a big old glass of sugar you literally your body doesn't know the difference being down to coca-cola very little difference between the two well which Coca Cola's got some other stuff in there caffeine but other than that yeah just the sugar itself yeah your liver would have a hard time telling the difference so crazy most people would think a glass of orange juice at breakfast is a healthy choice now glasses should have a mountain Dew yeah might get more done so this the dosage of 1 5 and then 20 so so that that study I remember reading that and think okay if so if you looked at that study you realize if you're gonna be in the placebo the one-a-day the five once a week or the twenty once a week the five once a week was the way to go that says you've got sweet spot that's right you got all the benefit of twenty more benefit than one and the fewest side-effects and how long is this study that was an eight-week intervention with an eight-week washout was enough to see the enhanced immunity do you think that a longer-term study is necessary to see like whatever body adapts yeah absolutely I mean all this stuff is in its infancy now my my schtick is so so right now rapamycin is off patent right so the drug was approved in 99 by the FDA but this is after an unbelievable amazing story of like how you know this drug almost got lost forever like you know so there's no economic incentive for a company to you know figure out how to do this thing with rapamycin and even everolimus I think ultimately Novartis and I'm saying this with no actual knowledge other than just my own speculation but I suspect Novartis was like well you know we're not gonna play this game just with everolimus and that's I think why it probably spun into this other company restore bio to sort of combine it with other agents but at an end of one level what I'm kind of interested in doing is you know using myself as a guinea pig to start to measure the benefits of it because my hypothesis is three things have to be true if rapamycin is working now I could be wrong but but this is my hypothesis and this is what I test with with with with other scientists is if you were taking rapamycin at the right dose so assume you're not getting all the nasty side effects you're not getting the mouth sores and stuff like that three things have to get better one your glucose metabolism should at least get no worse but potentially better I suspect it's a function of where you start so there is one doctor in New York who has like a rapamycin practice I think he's in he's in the Bronx actually and I've talked to him a bunch and when he when he started it himself he said like the improvements were remarkable just in terms of glucose metabolism but I think he was starting at a pretty bad spot but if you or I took it we might not notice much getting better but we definitely should not get worse so that's easy to measure clinically you do as an oral glucose tolerance test would give you that answer but two things should get significantly better the first is immune function should get better not worse there is no clinical way to measure that but we do know how to measure it I mean when I was doing my postdoc it was in an immunology lab like I know how to do that assay I just don't have like a million dollars worth of equipment to measure it what is the difference in the dosage even in the high end at 20 versus which would give someone if they got a kidney transplant yeah yeah typical transplant dose would have been like 2 3 milligrams every day okay so it's quite a bit different it is and it's different on two levels because you know when you're giving it every day at a lower dose you still still end up producing tissue levels that might even be comparable to where that person was getting with the spike of 20 mm-hmm and in general this isn't always true but in general in pharmacology side effects are the result of certain side effects are the result of the Nader dose and certain side effects as a result of the peak dose so with every drug you kind of have to understand this a little bit but going back to this rapamycin thing the third thing that has to be true in my opinion I could be full of but I think the third thing that has to be true if you're taking the right dose is you need to see an uptick in a toff adji and so just as if what does that mean at Apogee is this process where the body cells start eating themselves so it's kind of like a programmed cell death although technically we reserved that term for something called apoptosis but when you're fasting what's why would fasting produce a benefit and I think the most logical explanation is enhanced etaf adji so the body basically has to prioritize in the absence of nutrients the underperforming cells are basically told eat yourself and you know we can recycle some of your components maybe this mitochondria is worth saving this Golgi apparatus is worth saving and then we selectively when we refeed repopulate the better cells and in many ways I think rapamycin can do that in a pill so the problem is we don't have a blood test to measure at otha G so in in the in the lab when you measure at otha G you need muscle biopsies or they typically even just sacrifice the animals this has become a very hot area so the Nobel Prize in medicine and physiology was awarded for the genetic basically the elucidation of the genetic regulation of etaf AG in actually was 2016 so it's very recent bout a year and a half ago this is what the Nobel Prize was awarded for but what I'm hoping is that we can develop a signature for a toughie G with a blood test so I believe that you should be able to look at someone's blood and look at all of the you know metabolomics all of the small molecules all of the proteome and there should be a signature it should look different from the way we look when we're you know fasted or bred it's already fully fed otherwise would you just take a sample of the muscle tissue like punch something out yeah and and I'm I mean I'm willing to do it all and I probably will we're just trying to get what's called an IRB an institutional review board so to do these kinds of studies in humans even if I'm the only subject and it's just like I don't care what you do to me kind of thing we still have to get an IRB so we're working on getting an N of one IRB so that we can take muscle biopsies fat biopsies for me blood tests and then start to actually look for that signature would it vary and where you got it from like would you want you know isn't yeah more than one muscle group it's a very good question I don't know the answer hmm I probably have to talk to people who have a lot of experience doing this with animals but it it actually wouldn't surprise me like if I were gonna do it I would just start in the legs because the muscles in the legs tend to be the harbinger of what's going on in the body so for example one of the first signs of diabetes like a decade before you get diabetes one thing that if you're actually doing this kind of testing in people it you'll notice glucose like insulin resistance and the muscles of the legs hmm so once the legs start to get insulin resistant you're on a glide path to bad things happening I'm fascinated by legs first of all from years of martial arts but also because over the last year so I've been doing a lot of running and it's one of the only muscle groups that I to work out everyday I can I can run hills everyday and I'm not sore like that that's not even possible for any other group I mean I can kind of do that with boxing you can hit the bag and but as far as like running hills is essentially like plyometrics like you're pushing your entire weight up and then you're catching with the other leg and pushing it up yeah you can't do that with you can't benchpress everyday your arms will fall off I mean there's probably someone out there doing it that's proving me wrong but there's nothing like the amount of endurance that you have in your life but it could just be an adaptation that you've had as well I mean when I was a competitive cyclist I mean there were definitely days when I would especially when we did like multi-day events like there were days when it's just like you're beaten down yeah you're gonna learn in the first ten minutes like everybody else is riding together you're riding alone the fatigue level though is significantly different than it different than it would be if you were doing something with your arms every day you can definitely recruit more that's probably part of it right it's like more tissue I think you have more options like you can you know especially if you really have good proprioception but for example like if you're dead lifting you know I actually think if you so you know how you have like the positive and negative motion concentric eccentric motion of a weight if you're willing to do away with the negative you can lift heavy every single day so there's this guy named Riley Oh un-freakin'-believable dude I've seen people doing that you know I saw their Eagle Val on his Instagram the other day was doing deadlifts and just dropping the weight and I was like that seems weird to me so when I was a cyclist this was my training and it was all put together by this guy named Ryan Flaherty who actually introduced that was another one of my sight unseen introductions to Tim for a podcast it's a great podcast with Ryan Flaherty on and he's I call him the Guru of speed he this is a guy who like single-handedly I shouldn't say single-handedly I mean he's on the shoulders of many other people who have done great work but but has really done an amazing job of figuring out how to make people run fast and it's a very long story and I mean he does such a great job on the podcast go into it but but for the purpose of this discussion one of our interests was hey could we translate everything you've learned about sprinting into cycling and his biggest observation was the following if he took a hundred runners and lined him up and knew like before they ran knew how how hard they could hit a force plate treadmill he could predict the order in which they'd finish the race so a force plate treadmill as its name suggests a treadmill but it's a special treadmill where it measures the force that you hit and that the higher that number divided by your body weight that became what he described as mass specific force that number if you rank order it is the order in which people would finish the run so it kind of makes sense if you think about it right the harder you can hit the ground relative to your own weight the higher you go and the higher you go the longer you travel with each stride so Usain Bolt has the highest ever force plate measurement calculation and it's I forget what his ratio is I want to say he's like 6.9 or seven times more force than his bodyweight every time he hits you freaking staggering Wow so then Ryan's once he figured all this stuff out his next question this is when he was working at USA track his next question was could you train this in other words like okay if Joe runs a you know 4.9 40 and we want to get that down to a four five can that be done and it turned out the answer was categorically yes you have to do two things you have to get stronger and you have to get lighter so how do you do that and that's when he came up with this idea of we do hex bar deadlifts we lift really heavy so you're only doing 5s for is 3s or twos never more than five reps and so you'll do five sets every single day and you'll pick it so some days it'll be five sets of three some days it's five sets of five whatever it is and you're and they're very well prescribed like you know at what percentage of your one rep max you're doing these at in its up drop up drop up drop so you're never getting the actin myosin filament to tear past because that's what's happening in the negative is the actin and the the actin is coming de myosin and that is creating a micro tear in the muscle and that's what the muscle rebuilt that's why we get larger when we lift weights but when you drop it you you unload the muscle when you're relaxing it so the muscles not going to get bigger so you're getting all the benefits all the strength which is primarily around the type 2b muscle fiber and without the without the size so anyway went well when I asked Ryan hey could we do this in cycling we did this experiment which was he kind of came up this was for me and two other guys who were very good cyclists like I was like I'm a popper but these guys were like cat1 cat2 collegiate cyclers but but cyclists but they were like my training partners so we did this thing where we did the same routine that he had the sprinters doing and it's a bit more complicated than I've described because you're also juxtaposing the positive-only with something called a post activation potentiation which you may have already experienced this but I don't have you've ever tried to do plyometrics after deadlifting but it seems counterintuitive that you'd be able to do more but you can really yeah it has to be a heavy deadlifts of numbers or in terms of distance like more in terms of vertical really so your highest like plyometric jump is going to come after you've done like you know three sets of three at you know ninety five percent of your one rep max and three sets of three dropping or using eccentric no definitely no eccentric absolutely yeah huh Wow and so we would superset the plyometrics with the deadlifts and you would do this every day and so Ryan you know here he runs a training camp where he has typically the top ten college prospects every year just before the NFL Combine come down and I mean the changes he makes in their time like Johnny Manziel was one of them so obviously Johnny Manziel has obviously you know not panned out in the pros but most people kind of forget how good an athlete he was and when he showed up to camp I forget what his time was but I want to say it was about I don't you could probably look at this stuff for me you know it was three tenths slower than what he ultimately ran at the combine and he I think he had the fastest or second fastest quarterback time at the combine after just 12 weeks of doing this Wow I mean it was unbelievable lievable how fast he can get these guys to run i saw something the other day that I'd never seen before it's an eccentric bike it changes back and forth heard of this thing the second person that tell me about this I think I saw it yesterday in fact now that I think about it it was eccentric and concentric but it alternates yeah yeah and it looked really weird it forces movement and you're resisting the movement see if you can find that Jamie it's like an eccentric I forget what it's called but uh like someone sent me this like hey this thing's amazing I was like its bike the you talking about look different than that the one I saw was also different look it was a Rick that's like a recumbent yeah yeah that's what I saw - yeah eccentric yeah you're spelling it wrong oh it says just centric okay huh eccentric exercise bike try that but it's the thing is it alternated between eccentric and concentric it wasn't just hmm the one with the red and the top row looks like it what is that Pediatric Trauma no kids well whatever I wish I had saved it because I was like I'm never buying this but you know it just looked interesting it's like there's always these new methods of stimulating the body and tricking it into doing things and I guess that's essentially what a lot of people the way a lot of people think of intermittent fasting you're kind of stimulating the body you're hacking it you're tricking it you know and I wonder you know one of the things that Ryan and I talked about was could we ever adopt his training system to swimming hmm and in running and cycling it's primarily gonna be quads hams glutes have to be the muscles that do it which any row things we were talking about like you really got to be able to get the lats fired but how do you get the lats to fire at such a weight and then without having to do the negative as well so we just couldn't really kind of figure out how to do it and and there so we adapted part of his technique to swimming which was the actual training routine meaning so one of the big misconceptions if you're trying to go fast is that you need to still train slow but the reality of it is like you know if you're trying to run a marathon at you know call it a pace of 215 you know world-class marathon runner there's not a lot of benefit to be spending much time running at a pace slower than that if anything you want to be running slightly faster that's you know whom ebiz the American marathoner who won the Boston Marathon three years ago no so amazing marathoner he's the I think he's the only person to have won the New York Marathon the Boston Marathon and to have won an Olympic medal in marathon he won a silver medal in the 2004 Athens Games but when he won the Boston Marathon he was like 38 years old which in marathon parlance is like he might as well be a hundred and he had not really had a great race in the previous few years so he had been effectively written off in the sport and Ryan actually helped train him and all they did was apply this principle of sprinting into marathon running which was all right Matt if you want to win the Boston Marathon you need to be able to travel like four inches further with every step you take taking the same number of steps at the same cadence that you currently run and they you know Ryan did the math and said that means your force number has to go from where it is now which I think was one point seven meaning he could only deadlift one point seven times his body weight you have to get that up to like two point six or something and so when meb trained for the boston marathon he was focusing heavily on these deadlifts and doing much shorter faster runs and you know I mean if you watch the video of his boston marathon when it's incredible like you know he just takes off and like leaves everybody behind him and they're like yeah there's no way he'll be able to keep that up will let him go and they couldn't rein him in Wow do you think that someone's gonna be able to break two but that's the big we were just talking about the other day some guy got really closed would you say he hit Jamie like 206 or something I think someone's gone closer to that giant didn't that guy in Germany last year go even closer I think it was 202 or something along those lines and you think that this sort of method is what they're using so I don't know if I'm allowed to talk specifically don't worry no one's listening so so short answer is yes I think this can be done everything has to be perfect right meaning you have to have the perfect athlete trained to peak at the right time you need the right humidity like everything has to fire on all cylinders but just as there was nothing physiologically special about a four-minute mile when roger bannister broke it it was more of a psychological barrier you know I'm not suggesting for a moment that this will be easy but you know we're gonna get there I mean like this can happen that is incredible if you think about how fast you're running to run 26 miles in two hours is staggering I don't think people understand like what uh I mean I was never a great runner I could I was about a 250 marathon 255 marathon when I was a boxer but never trained as a runner like it was just I just ran so much and I was pretty fast but like when I think about how hard I would have to run to bust out a 250 to 255 and to think like was there any chance I could have ever got that down to a 230 it's a that is such an enormous change in pace yeah it's it's I I don't know that I ever could have done that regardless of all the training tricks in the world and what kind of diet of those guys following well I know med personally I can't speak to what the other guys do but I think a lot of those guys are frankly in the state of where I was when they were younger meaning like I they can probably get away with a lot more if you look at the physics of most of these guys they're they're perfectly built like I'm talking elite level I'm not talking about like anyone who go runs a marathon but if you're talking about like the people who are gonna win the marathons they are basically all engine and then chassis in the right place that's basically all they come down to right I mean they are enormous cardiovascular system very strong quads hams glutes and then everything else is very tiny when you say enormous like is literally the size of their lawn you actually look at well I mean it's all relative but when you look at their frame there thorax is gonna be larger and is it expanded because of the training I think so I mean it's you never know cause and effect sometimes you could argue Mike maybe these guys were maybe the people who are drawn to those sports are the ones that are you know or are drawn to be elite in those sports already had a genetic predisposition that's sort of my feeling is it's another difference with Lance Armstrong like doesn't he have a very large heart I don't know I think what Lance had that was pretty unique even amongst the world's best which is what he competed with of course I think his lactate threshold was a lot higher than most people genetically yeah and then of course in a in again you know I mean I know it's such a controversial topic although my view is I think that every single cyclist at least from 1991 until 2011 was on highly highly you know augmented programs so you know that Lance won seven of those years in the in that context just tells me that he was you know training harder and being more specific to the race I mean what people don't understand is like I mean Lance only peaked for one race a year like everything that that team US Postal did was geared for that one race and also when you really look at how much doping they did it well she wasn't that much like you know when they were blood transfusing it might have been two units over the course of a race and I'm not saying that that wouldn't help it would help a lot but that's nothing compared to what people were doing just a few years before Lance came along so Lance won I think his first one in 99 the guy who won before that in 98 was Marco Pantani before that was again in beyond ORAC in 97 and before that was gonna be Horne Reese Bjorn Reese's nickname was mr. 60 because his hematocrit was always over 60 that's frickin static how that guy didn't die of a stroke I don't know is that from EPO yeah Lance never had a crit over 50 to my knowledge they would basically always titrate with Ipoh and or hemoglobin up to 50 which was the trigger so you know but but I think and again I I've never I don't know Lance also I certainly don't know anything about him beyond like the little bits that I have read over time but I do think his lactate tolerance was remarkable meaning you know we measure lactate in athletes swimmers and cyclists when they're you know trying to figure out what their performance is and as far as I can tell there are seem to be these two phenotypes there's the one phenotype where people can tolerate staggeringly high amounts of lactate and and again it's not lactate per se that is causing the pain that you're experiencing it's the hydrogen ion that accompanies the lactate so lactic acid the acid part of that is the hydrogen ion and that's actually what's poisoning the muscle and preventing the muscle from having this effortless actin-myosin act you know contract release etcetera but we use lactate as a proxy because where lactate is high the hydrogen ion is high and there are some people who can just tolerate like incredible doses I used to work with Olympic swimmers and I mean there were just a couple of these guys like they could actually be standing with a lactate of 24 I mean when I was competing if I had a lactate above 16 or 17 I couldn't be standing like that was just too much pain like I was on the floor if I was over 17 I was puking and and I saw dudes that could stand there at 24 in fact I one of my good friends he won a gold and a silver medal in the Sydney Olympics and retired from swimming in 2004 then came back to swim masters so and was like he actually was trying to make a comeback to make the 2012 Olympic team and when he was training for that like I would poke him between races and I saw him get out of a 400 into the individual medley race which is the hardest swim race of them all the 400 IM is i mean you might as well just shoot yourself it's so painful he got out of that had a lactate of eighteen two minutes later not two minutes later maybe seven mins later jumped on the blocks and won a hundred breast race you know came out with a lactate of 21 that kind of thing so there are those guys and then I think at the other end of the spectrum the word on the street is guys like Michael Phelps or at the opposite end of that where they are so efficient at shuttling lactic acid out of the cell back to the liver where this thing called the Cori cycle actually terns lactate back into glucose that they never have high levels of lactate now again all of this is sort of work you know speculation because I don't I think they were very hush-hush about Phelps's numbers but I heard from reliable and reasonable sources that he would rarely have a lactate above eight point zero including when he's breaking World Records whoa which for me at eight point zero like I'm smoking and joking like that's fine but for you know he was so efficient at getting rid of it that yeah he could you know set the world record in the 400 I am and have a lactate of eight again I don't know if this is true but but I've there's certainly a plausible mechanism by which it could be well it's fascinating that this could potentially all be engineered right that like through use of CRISPR or something else you could take all these various facets of performance enhancing modalities extend a person's ability in so many different ways and create a super person yeah of course it's interesting right once you start genetically doing it but does it become cheating in the same way like would we would we does it if you have someone like Phelps who has this genetic predisposition to getting rid of lactose lactate and you take someone like me probably has none of that and you know you juice me up to his level is that cheating I mean I don't know I mean those are the questions I mean this is why people like Daniel Coyle who are so critical of Lance Armstrong say because because on the one hand you'll have camps that say look it's the great equalizer like why don't we just let everybody dopes and it's a steroid argument with them amazed well well and and frankly it's more my argument but I have a different reason for arguing that way which is I think having done these sports and nowhere near at the high level that those guys do it I just know how destructive they are like the Tour de France is the most unhealthy thing on the face of the earth I've heard that it's healthier to do two Tour de France on steroids than it is to do it off sterile abso-fucking-lutely [Music] when those guys finish the Tour de France they are osteopenic I mean their bone density has eroded their muscle they have lost so much muscle mass I mean it is a devastating grueling event now nothing's going to completely ameliorate that but like if we think that like watching these guys kill themselves riding six hours a day hitting peak thresholds of you know six watts per kilogram if we think there's anything physiologically reasonable about that we're out to lunch but is that the point I mean isn't that the point is that you can push your mind to do something your body absolutely doesn't want to do so you should be rewarded for for that you know you and and these guys are in a league of their own I mean professional cyclists are some of the toughest athletes out there I mean obviously every athlete at the peak of their game is remarkable and and no disrespect to like the best running back in the NFL but like you can't even compare that to what a guy does for workload for sure yeah for just the pain like the absolute sheer discomfort and the physiologic torture and the duration of it and all these other things well you see it in their faces too those guys like when they retired they look like they're 10 years older than they are yeah yeah yeah I mean they've lost all of the fat a lot of them you know they just if you don't have fat in your face I mean you age yeah matically they just look exhausted too I mean it looks like it's just drained them like they've forced to live 30 years inside of ten yeah so it's like what if we just say guess what everybody's allowed to use whatever amounts of EPO blood testosterone to be at the 80th percentile of what we consider normal so everybody's allowed to walk around with a hemoglobin of 14.7 or up to 14.7 or 50 would cheat that right wouldn't they I mean if you allow people to use but but I also think like the the testing on this stuff is so like it's so JV now there was this idea called the biological passport that was introduced many years ago which basically said look we're gonna develop a signature for every person and now if you deviate much from your signature we'll that'll be the trigger and the argument again by certain people I think Daniel Coyle argued this a lot in one of his books that he wrote ripping apart lance was the reason it's that the reason doping is unfair because the everybody does that argument doesn't hold water is because if you're a person who naturally lives at a hematocrit of 47 you're only getting a slight improvement going from 47 to 50 if you're a person who naturally lives at 43 you going from 43 to 50 you get a much bigger advance to which I say yeah but that's true on a relative basis but an absolute level if everybody's walking around with a hematocrit of 48 to 50 they still have the same oxygen carrying capacity it does level the playing field the concern though isn't oh I would believe the concern is you don't want people to think that the only way to do this sport is to take drugs well absolutely and it's also worth putting in in mind that and this is sort of my pet peeve with this whole drug and sport thing is like I mean personally I don't really give a I mean I just have bigger things I care about then like how many steroids Barry Bonds took to hit all those home runs but what really does chapped my ass is when people don't actually understand how steroids work right like it bugs the out of me when people assume that if you take steroids you will have you know you will hit that many you know homeruns or you will run this fast or lift this much the only thing that steroid is doing is enabling you to recover faster from the brutal work that it takes to actually do those things so you know all the eat if I if I shot myself full of EPO I mean you've probably seen Icarus right mm-hmm I mean I thought that was I thought he did it I thought but Brian I'm folk yeah I thought prideful did a really good job of showing like I mean and he was a pretty good responder to the EPO I think he did growth hormone testosterone an EPO I mean you saw in the end of the day he finished worse the second year round because but his bike ran out exactly that's my point you see like people don't realize like one little thing makes all the difference from a performance standpoint yeah he probably would have done a little bit better but it's not because the drugs were in him per se it's because the drugs that were in him allowed to train more so the reason he was a fitter Rider the second year was because his watts per kilo were hired because of how much more he trained the drugs enabled him to train that much harder yeah that's what it does it allows you to train harder so you recover better so you have more output correct but we don't want young kids to think that the only way to do this is start taking steroids and up your endocrine system and that's no of course not but we also want to keep in mind like see it almost requires like a broader discussion which is like why do we care well we care in combat sports because it allows you to inflict more damage oh no no no I'm saying like why would why do why it let's just say I'm not a professional athlete okay why do I actually care how fast I run or how fast I ride or any of these other things well because you want to brag about it okay so maybe your weight right so maybe therein lies the problem I mean I mean I you know when I stopped cycling competitively I think a big part of it was I just realized that performance and longevity stopped being collinear they started to become somewhat orthogonal they started to deviate in other words the things that I was doing that were enhancing my performance and I'm not even talking about drugs I'm just talking training wise it seemed to come at the expense of what I believed was gonna make me live longer so specifically the the thing I cared most about was cardiovascular health now the incidence of atrial fibrillation in highly trained athletes is ten times higher than that of non athletes so like that's a little counterintuitive right yeah why would people who have such amazingly fit cardiovascular systems have ten times the risk of this horrible condition called atrial fibrillation which yeah many people have it but not young you're not supposed to have that when you're 40 and it's usually associated with cardiovascular disease and yet people are you know showing up with these I mean I have four patients who have had to get ablations for atrial fibrillation what is an ablation an ablation is a procedure where they stick a catheter up through the femoral artery or in the vein and then they burn pieces of the heart specifically around the pulmonary veins and they basically are trying to burn away and create or remove the ability of the electrical system to move in this way so it was basically happening with with this type of athletes heart is when your heart is constantly being exposed to that high stretch high ejection fraction load you're basically stretching out the electrical system because the electrical system of the heart runs within its muscles so as you stretch it out a certain group of people and we don't know why certain people are no uncertain or not but they just developed this this dysrhythmia so you're soldering the motherboard as it were yeah yeah you can effectively think of that right you're like creating new like lines to block the the connection whoa that's crazy yes think about it someone said once and I don't know if it's true maybe you would be able to have some insight there that there's a concept that your entire life you have a certain amount of heartbeats does that make sense oh no of course I've heard it many times I don't know if that's correct that's scary yeah I don't I don't I don't tend to agree with that because I you can't compare one beat to the other I mean you you can't you know it's hard for me to say that you know an 80 to 90% ejection fraction beat under incredible load is the same as the beat that I'm you know like it is beat per beat the same as the beat I experience when I'm sleeping and my heart's rating you know my hurts medium 40 beats per minute I think maybe there's a directional truth to that but I I feel like when you're talking about human longevity it's a game of inches and that is like something that's probably directionally true within a mile now when you're talking about human longevity and you you know and you're thinking about all these different things that you could do to extend how much of that is supplementation and do you supplement like are you are you a person who takes colloidal minerals or are you a person that is interested in antioxidants like what what do you do in terms of that so I my view on longevity is it's just it's the hardest problem there is and so you got to have every like I'm agnostic about what the approach is so I want to understand everything that you can do with respect to you know food drugs supplements hormones and to be clear the only difference between a drug and a supplement is ones regulated and one is not but you know I have patients that'll say things like oh you know doctor I don't want to take that drug I'd rather do it naturally can I do it and it's sort of like well okay you you don't want to take a statin but you do want to take red yeast rice well they both inhibit hmg-coa reductase the end that catalyzes the first step of cholesterol synthesis you're willing to take one that you buy in a drugstore that's totally unregulated and you're not willing to buy the one that comes from a drug company where the FDA has their foot up the ass of the company making it to make sure it's perfect that just strikes me as a false equivalence so I only say that to just say like I think everything should be on the table and then the question should be how do you decide what to do so there are absolutely a bunch of supplements that I take but I don't have kind of a one-size-fits-all approach to it because I think you've got to be able to kind of measure what's going on in a person get a baseline and figure it out so you know I mean my guess is you've had a million people on the show that can talk your ears off about you know which people which people should take methylated vitamins versus which shouldn't and if you have this MTHFR mutation versus this one should you be taking this versus that yeah I think all those things are valid some of the stuff that I find even more interesting is actually a lot less sexy and I don't have a good answer for it but you know looking at for example vitamin D levels so you know you see a huge disparity in the vitamin D levels people have and it begs the question do all people run effectively at the same vitamin D level and is that a function of not just their own individual like how much Sun they're getting but more importantly like potentially genetically where they're from so I'm starting to feel like people who have northern European blood might actually run better at a lower vitamin D level than people like me who you know come from places near the equator where maybe I just evolved to see more sunlight and have more vitamin D what's your ancestry my parents are both from Egypt Oh interesting so in the range like when you look at a laboratory test when you check somebody's vitamin D like the range that's offered is thirty to a hundred is optimal I'm saying range yeah I'm like that's that's probably not the range you know so I personally think the range is probably forty to sixty but I also measure something called parathyroid hormone that allows me to further titrate that range and stuff like that well when you're talking about this it's really obvious really clear that there's so much data to go through that it's we're learning this and that this is it's I don't want to say it's at its infant see but if we look back a thousand years now we will most certainly say your understanding of this science is at its infancy yeah for sure I mean the issue is how do you make sense of a problem or how do you try to solve a problem which is unsolvable and and the reason I say that is the following you know you you have what I call kind of the medicine 1.0 world which was I define that as everything that took place before Francis Bacon you can probably tell me when that was I'm gonna guess Francis Bacon is like 1652 1670 or something like that but that was basically the first person to come along and codify the scientific method so anything that came along before the scientific method may have been correct meaning there were things that were certainly done back then that proved helpful but they weren't grounded in a principle of science in other words you know even a blind squirrel is gonna find nuts sometimes and then we basically through you know following the Khadaffi you know the the the elucidation of a scientific method the development of statistics to actually make sense of data we then got into the sweet spot where I think we are now which is medicine 2.0 and to me medicine 2.0 is really good at solving problems that are amenable to relatively short simple clinical trials and there has been no better example than in this space than infectious diseases so like if you think about the unbelievable improvement in human longevity that has come from antibiotics antiviral therapy for HIV I mean remember 30 years ago HIV was a lethal leap no questions asked lethal condition today it's a chronic disease for virtually every patient with HIV it's a chronic disease today meaning you will die with HIV not from HIV and that is that's almost hard to fathom when you consider how shitty we are at addressing other chronic diseases like heart disease cancer Alzheimer's disease so the problem is if you want to know the answer should I eat this way or that way should I exercise this way or that way should I take this drug or that drug or this supplement or that supplement to live longer we can never know the answer in humans because there is no clinical trial that can answer that question and we can do that experiment in everything that's not human but we've already learned the hard way that what happens in not humans doesn't necessarily extrapolate to humans and we can do things to be slicker about it you know when you study rhesus monkeys for 20 years it's certainly more interesting than studying mice for one year but in the end you know there's still animals in captivity they're still not in the same environment and all these things so my view on this topic is the only way to go to this kind of Medicine 3.0 is you've got to have kind of a strategy around how you think about it and so in many ways that's that's if that's what I spend most of my time dealing with is what is a strategy for longevity that becomes a scaffolding upon which you anchor every new piece of data because I mean I know things today from a data standpoint I didn't know 10 years ago and to your point even in five years we'll look back at stuff we're doing today and thank God we have more data is that still the right thing to do and so that strategy to me is is sort of fundamentally based on three bodies of literature and the first is is like what did we learn from centenarians so the people who naturally live to a hundred they have the advantage or that body of literature has the advantage of being based on humans it has the disadvantage of it not being experimental so we you know like we don't know like what cause and effect was and then secondly if you look at all of the animal literature or nonhuman literature where you can actually do the experiments what's common there and then if you look at the underlying molecular mechanisms so if you feel like if you tie those three together you come up with a general scaffolding for what it means to live longer and live healthier then we can try to look at one thing at a time and say hey vitamin D a Ornette antioxidant yay or nay so when you're it's it's got to be very time consuming for you I have a research team I mean that's when I started this practice about three years ago I realized like I was losing the battle my ability to sit and read scientific papers was like shrinking yeah so I hired an analyst you know he had worked with me in the past he was amazing I brought him over full-time to do this then another one then I mean now I have four full-time analysts and I mean as this practice grows and or you know whatever I have the revenue to justify it like I'll have ten analysts one day in this practice and even that's not enough I mean approximately 100,000 papers are published every month on PubMed Jesus Christ so I forget I did the math on that once I think it's like three papers a minute it's pretty stunning when you think about the amount of human achievement that we've experienced just in our lifetime in that regard like how many people are working on understanding just the mechanisms of the human body and this data is just piling up as we speak yeah but the problem is the signal-to-noise ratio is almost zero so I would say conservatively 90% if not 99% of that is completely useless really absolutely actually wrote about this once so when a paper comes out if it is never cited again meaning for the remainder of time no one ever even goes back to reference that paper you could probably make the case that that paper is not relevant and if you then further strip out auto citations meaning the only time it's ever cited is when the author then goes back in cites his or her own paper something like 70 or 80 percent of patient of papers never get cited outside of an auto citation again is this because they're not relevant or does it possible to get lost lost in the shuffle like some of them might be probably possible but I would bet it is much much more the former than the latter and then on top of it a lot of stuff comes out and then years later you realize it was wrong you know or it was and that's more often the case that it was wrong through an honest mistake than wrong through a dishonest mistake but there's still a lot of wrong through dishonest mistake stuffs coming out there as well so how much of this data is forcing you or causing you to alter your own patterns well we we believe internally that probably 100 papers a month enter the literature that are relevant to what we do meaning I mean some of the literature that comes out like you know the Rheumatology literature might be relevant to them but that's not what I think that's crazy 1/3 a day yeah yeah so that's why when I say I want 10 analysts you see why yeah it's like it's you got it because first of all it's finding those papers too so how do you do that like well we subscribe to a whole bunch of services that basically pre-filter a bunch of for us and then we have a system where we go about kind of pulling that stuff so you get those three a day and then they bring them to you how do you have the time now so yeah that's the thing it's funny you say that I was like literally as I was driving here today I was talking to a buddy of mine and I was like dude I'm the bottleneck and I hate it like I'm now the bottleneck because the analysts are now churning out stuff faster than I can even provide ancillary feedback because my job is like you know you know you hire great people who are smarter than you and like you just guide them you just point them in the right direction so what we mostly do is create programs where we're going out and looking for new knowledge so for example one of the questions that is tormenting me right now because I still don't know the answer is is there any benefit to taking human growth hormone from a longevity perspective there's clearly a performance benefit growth hormone is probably the single most abused drug in all of sports there's no question about that but is there a way to take it where it makes you live longer I've never prescribed growth hormone to a patient because frankly I'm not yet confident that I know the answer to that question but I feel like it's worth knowing right because I can certainly make at elia logic for why growth hormone could be helpful but I can also make a theological argument for why it could be harmful and so like many things your knee-jerk reaction to something can often be wrong and my knee-jerk reaction to growth hormone has historically been causes cancer because why well growth hormone tells your liver to make IGF insulin like growth factor and you know 2/3 of tumors seem to thrive on IGF so ostensibly you would think well growth hormone can't be right but then one of my analyst Bob Caplan pointed out to me a year ago he's like you know Peter I've been thinking about this and he's like given how ubiquitous growth hormone is in sports and how long it's been ubiquitous in sport like I mean this was the drug that turned around us Olympic athletes in the late 70s early 80s he's like where's the body count like where are all of these people dying of cancer from all these years of staggering growth hormone use I don't really see it when we went back and looked at literature I mean we found that the data on growth hormone and igf-1 is people have made it out to be in fact there's a I mean I could draw it actually for you not that anyone won't necessarily see this but at least you'll see what I'm talking about if this is percentile so higher and this is IGF level right so okay IDF level most people are listening to this oh actually it's really talking about that before yeah so the overall mortality curve for IGF and growth hormone is like a J curve meaning low IGFs really high mortality yes as you go from about the 70th or 80th percentile up to the 90th percentile there's a slight increase in mortality but this is not what you would think of like you would sort of if you were just reading the headlines you would think it looks like this right so you there's a sweet spot not only that if you this is overall mortality what if you parse this out by disease well that's when it gets really interesting so cancers curve looks like this very similar yes but Alzheimer's curve looks like this heart disease curve looks like this so describe that to people that are list well so what that means is so for example Alzheimer's disease and heart disease have an almost monotonic reduction in risk as IGF gets higher and higher and higher it's only cancer that seems to have that uptick where risk starts to actually rise once you cross past the call at 70th percentile and so when you integrate all of these curves together that's why you see this slight uptick now again this is epidemiology so one has to take this with a grain of salt but this is to me when I saw this graph which Bob put together I don't know while ago like wait a minute this doesn't jive with my preconceived notion of like growth hormone is bad this warrants way further exploration and so what that basically turned into is now an enormous internal project that will take us probably a year to complete and will constantly be updated like we did this already with testosterone two years ago we put together like a 40 page white paper on the topic and then at least once every two weeks it gets updated every time a new paper comes out basically asking the question like is testosterone replacement beneficial or harmful and under what situations should it be considered versus not and again the goal is to do this unemotionally and that's hard to do because for reasons I'm not entirely clear on basically everyone's kind of just emotional about this stuff well they're emotional about steroids because of all the press about Barry Bonds and you know all the different baseball players well I think that is is it a cheating is it the cheating aspect of it 100% yeah yeah I think that's exactly what it is I think people consider taking any kind of hormone whether it's growth hormone or testosterone as cheating even if you're talking about older people that take it like I was uh looking at one of those ads you know they have those ads for hormone replacement this is really old-looking oh yeah geoffery life I think that his name doctor life jacked means fucking's got a full six out-of-control like a gorilla and my friend was like god that can't be healthy I'm like what the are you talking about look at him I go what do you think a seven year old dude is supposed to look like they're supposed to be knocking on death's door that guy looks like he could his way through a building full of teenage girls you know he's like I shouldn't say teenager 20 year old 21 or 19 he looks like a man who's really fit and healthy with an old guy's head yeah he's weird and I was like you know if it's not healthy then what is it if that's not healthy look all he's gonna die cancer he's gonna die of a heart attack he's gonna die period if you look at his head how much time would you give him I gave you a if I gave you a bet okay we have a million-dollar bet give you an over/under of 10 years how many how many years you're gonna give this guy you're gonna give him 20 you give them 3 wait you're moving the over-under you said I'd had only had a 10 year window on that right you get you get a take over Buffett I'll take over on the 10 year okay well how many years you give them impossible to know if my allowed to talk to him first no no clue did you look at that magazine right no no I can't because I got when I was family history I mean honestly of course your parents will drown me more about how long you'll live and what you look but 70 in America is basically death's door no I think today well so this is a complicated question actually which is actually prompts another analysis it's in the ten year range yeah no so it depends how you ask the question so the question is what is the average life expectancy of a man and a woman today in the United States and I I mean someone's gonna correct me so I feel like it doesn't matter what I say I think it's 79 and 81 respectively for a man and a woman today but the more interesting question is this one which is what year were you born 67 okay so in 1967 what was the annual life expectancy or the average life expectancy of a man and a woman and we could look that up but I'm guessing it would have been let's see life expectancy has been going up at 0.3 to 0.6 percent per year we could back out that kegger and let's just say for shits and giggles like the number was 60 69 or 73 or something like that I promise you you were gonna live long what was it 67 67 all right yeah so do what I take the bet that you're gonna live longer than 67 even though that was the median life expectancy the year you were born hell yeah I'll take that all day long and so what we're actually putting this isn't just a dumb analysis weird I don't even know why we're doing this sometimes we just do dumb that has no bearing but what I want to do is create a graph of actual life expectancy as realised versus projected life expectancy in the year of birth my hypothesis is that is always a positive number what I want to know is what's the derivative on it is it increasing or decreasing so I think that science is accelerating our longevity and that that's one of my proof points is that we are constantly under estimating how long we can live now on the other end of that spectrum I am NOT one of these futurists who thinks like there's immortality out there you know I would be if right now I could sign a piece of paper that would say Peter are you willing to commit to a lifespan right now so you're willing to acknowledge that if there's some major breakthrough you'll miss out on it but I guarantee you this duration like what would you take right now if I said Joe you can be a hundred and and be fully functional at 100 so when you're a hundred then I could run and huh yeah you're gonna be like you're gonna be like a fit 60 year old at a hundred so you're still working out you're still shooting pretty good yeah would you take it nope in other words you're willing to bet by the time we get there yeah because when it's over it's over anyway yeah yeah so I mean to me I think most people have a greater sense of confidence about where technology goes now that I think they're really only been a handful of step function changes in longevity so you know the reduction of infant mortality was huge like once we actually figured out how the to deliver babies and not kill moms like that was a big deal that had a step function improvement in human longevity the next one was really sanitation like once we figured out that like don't where you drink a huge improvement in human mortality hilarious it's amazing present I think that for granted now right and then the third one was basically germ theory you know starting with Lister and going all the way to Fleming when we figured out like you know if you if you cut open a cadaver and then go and deliver a baby that's bad because there were these microscopic things that none of us anticipate right we haven't had a step function improvement in mortality in nearly a hundred years so what's next now I think there are a couple of potentials for that but what I don't know is if like they're gonna happen in my lifetime in your a lifetime but I want to buy the optionality to stick around for it hmm by doing all this incremental little it will use three plus papers a day the options or increasing its it just seems to me that it's there's a trend right the trend is as you as you're saying there is an increase of longevity but it's not a huge increase right but our understanding of the human body is just that's that seems to be pretty radically improving it's especially in terms of nutrition nutritional absorption the mechanisms behind nutrition on some level yet on some level I still feel like we're in the dark ages well because you recognize the potential or you know well no because I think question and I think I'm just humbled by how hard it is to actually take care of people like I think so I was about I'm about as good or responder as you're going to have to carbohydrate reduction so doing something as simple as just not eating carbs and not eating sugar like completely changed my health I mean at 40 if you compare the 40-year old me to the 30-year old me like the 40-year old is like literally twice as healthy as the 30-year old me and that was through something as simple conceptually simple as making this radical dietary shift and by what standards are you saying that you're twice as healthy at 40 then 30 how will you know 45 and but what what is the I mean again I'm speaking a bit so like what would be my lipid levels what would be my triglyceride levels how much body fat do I have what's my vo2 max like by all of those metrics like everything was just so much better at 40 I mean and and and so I just but yet I've seen a lot of patients where you take the carbs out of their diet doesn't matter you know you you you that you you make them fast you do this you know the other thing you just can't fix some of the underlying metabolic problems like what kind of problems no I think some people are just so insulin resistant that it becomes really hard to fix them without doing draconian stuff I mean I have one patient who is really now I think going to in many ways become the poster child for he's definitely the toughest case I've ever had and why he's such an amazing guy is he was actually able to do something that's really hard to do which is stick do something with complete blind faith in me even when it didn't feel good even when I knew it would take a long time to see the results so he he's probably five foot eight ways to thirty-five at the start so five eight to thirty five metabolic syndrome huge amount of fatty liver disease not the typical patient in my practice most of my patients are kind of young healthy people who want to like you know want this immortality thing but this is someone who doesn't fit that description probably seventy years old unlike you know for drugs for blood pressure test very heavy for a seven-year-old yeah it is yeah yeah oh and his and he just had a hip replacement he basically couldn't walk you know everything was and we had tried carbohydrate restricting him before it just didn't work and part of it was I don't know how he just it was hard for him to stick to it and Baba so I just said to him look man I want to try something completely extreme and I want to try it for six months every five days heard me every month you're gonna spend the first five days eating 500 calories a day of a ketogenic diet and it's basically just gonna be like vegetables oil like it's you're basically doing a bunch of salad and then for the next 25 days you're gonna do a time restricted ketogenic diet where you're only gonna eat in that eight hour window and then you're gonna repeat that every month for six months and he was like I won't be able to do it and I was like I know I know it seems crazy I think you will be able to do it because remember all that time that you're not eating your body's gonna have to start eating itself and so you'll be alright and the rhyme giving you a grossly oversimplified version of what we did but it was much more complicated than that there's a bunch of other stuff that we had to do to manage it as well well I mean he just sent me I mean we were in touch all the way along so it was clear that this was working but it was just kind of amazing to get a picture from him two weeks ago as we just passed that six-month mark he weighs a buck 75 whoa that's 60 pounds in six months holy his liver this is and that's interesting but not nearly as interesting to me as the fact that his transaminases which are the enzymes that the liver makes in response to how fad is accumulating you know normal is like less than 40 he was like in the hundreds and you know the ultrasound showed it was just a bunch of fat and he doesn't drink alcohol so we knew it was fatty liver non-alcoholic fatty liver disease you know now he's in the 20s and 30s blood his previous diet was he eating just to say he wasn't a particularly junk food you know it wasn't a junky guy the problem is he was metabolically broken so I'll come back to why I felt like this was a necessary intervention despite how draconian it was he's on a treadmill 30 minutes a day now he couldn't walk before I mean you take 60 pounds off a treadmill you mean walking she walks on a treadmill now yeah yeah briskly once you get the yeah it's the hip replacement yeah so it's just it's basically reprogrammed him and and and so the reason I have occasionally pulled that trick out although it hasn't always worked is based on this case study I read that's very famous I'm sure some I might there's gotta be someone in this show who's talked about it but it was um the paper was published in either the early 70s or late 60s but it was the longest ever medically supervised fast so it was this guy who weighed somewhere between 325 and 400 pounds he did a 382 day inpatient medical fast where he had only water and minerals at the end of that something like 382 days he was down from call it 402 a buck 65 this paper was published seven years later he weighed like a buck 70 about 75 the crazy thing about fat guy is his skin shrank - yeah so he didn't have that problem that a lot of people have when they lose a lot of weight where they have all this extra skin his skin went along with his body yeah and I wonder if that's just a note of genetic elasticity exactly I would like to know I would like to know if he had stretch marks when it shrank you know you know it's funny I've never tried to figure out like what ever came of that patient I can't imagine he'd be alive now though I know he was young at the time but the part that interested me was that he didn't regain all the weight 70 years later right that suggested that there was a like it was a reprogram well he got the blue screen of death on the computer he did the hard reset he got to be a new person again because I'm not of the camp that thinks like that guy got to be 400 pounds just because he was a glutton and a sloth like something fundamentally broke in that dude and what broke was he basically lost the ability to partition fuel correctly hmm now could food play a role on that absolutely certainly if you eat enough that can happen but I think it's more complicated than that I think it could be epigenetic if not outright genetic there probably more epigenetic and so I'm interested in this idea of how do you reset people and again this is all kind of long-winded way of saying like one of the advantages of practicing medicine is you get to you you say humble because every or every time you think you're smart and you're like I got this shift figured out like you don't mmm there's like some patient who's got a problem that you can't figure out and it just you know drives you nuts but you realize like I mean even just today I was talking to a friend of mine he's not a patient but I mean my god he's just going through like this devastating health situation he's been he has seen every doctor he's been to Mass General he's been to Stanford he's been to Hopkins he's been to the best hospitals in this country they can't come close to figure out what's wrong with this guy and so as bad as that is for him I think that level of humility is actually good for the profession it's good to what is going on with him they can't figure he's having these horrible neurologic symptoms where he gets these fasciculations and muscle weakness and obviously the big concern about six months ago when this started was he was presenting like he had Lou Gehrig's disease mmm which you know obviously is about as bad a fate as you can have luckily that has been ruled out and they've done a million muscle biopsies and all these other things but they don't know what's going on has he altered his diet he's taking no no we don't know what's going on it is certainly far outside of my area of expertise I mean what we talked about today was look man all we really need to be doing is fixing your symptoms at this point in other words there's understanding what's causing this and then managing the symptoms around it I think the smartest people in the country have figured out they have no goddamn clue what's going on let's now figure out how to manage your symptoms your energy levels your mood all these things what is was he done for that well I told him today I was like look I'm gonna send you a kit we're going to do certain blood tests on you and a certain urine test on you and I want to just figure out what's going on with your for hormone system just basically for hormone systems that play a pretty big role in how we feel and adjusting those doesn't I'm not convinced it necessarily makes you live longer but it can certainly make you live better so I want to kind of understand I suspect he's not firing on all cylinders on that dimension whether it's a result of whatever is going on that nobody can figure out or not but I'd rather focus on something that I think we can fix hmm yeah the the change in diet thing with that guy where he went and fasted for 360 plus days what did he eat when he got back on food great question I do not know the answer now it might be that that just I don't recall that being in the paper but if it wasn't I don't know if anybody did the follow-up but that's to me that's the interesting question so you got to feel amazing like he got his life back right like and my recollection is he was a young man he was in his late 20s I think yeah I believe I remember that as well I think um I would like to find out what he's eating now to keep his weight at the same level I mean he must just be so thankful first of all he might be like I mean I have friends that are pretty overweight and one that died pretty recently who was really big and he just had this feeling when he would meet people I mean he talked about a little bit he was just obese it was just this thing where you're just oh look at this enormous fat guy and then to go from that to oh there's a guy there's a normal guy yeah it's just a guy it's 168 pound I normal no difference between I gotta tell ya I know we loved it we loved to beat up on fat people mm-hmm we loved to turn it into a character defect but I gotta tell you virtually every fat person that I know or that I've taken care of they are not disproportionately eating more than their peers in some cases yes but not unbalanced that the problem is that they simply do everything incorrectly metabolically hmm you know so their body is functioning incorrectly yeah and it's you know and there's a genetic component I think there are dietary exacerbations I think certainly not extra sizing makes things worse so there are lots of predisposing factors but at the end of the day what's happening is when you and I eat like let's let's take a meal that that like if you had pancakes bacon and scrambled eggs that would be like a really good mix of I'd be 1/3 carbs a third protein a third fat so that's like a ton of nutrient right if you or I ate that yeah it probably wouldn't be that good for us but like we you know let's say we just finished a workout or something like we're going to partition such that that glycogen will first and foremost go to replace the muscle and liver stores of glycogen because we have bigger muscles and our muscles are more insulin sensitive we can actually disproportionately put more glycogen into our muscles into the leg muscles because you'll have done that run up the hills right and and then furthermore when we want to recruit energy again we'll have the ability to actually go back and get fat ass but you know in other words break down fat at lower ATP demands then necessarily always going to glycogen so in other words we partition fuel in a smarter way and these patients I mean you can measure this clinically using something called re R and of course doing other blood tests like they just they just they can't break down their own fat so their body is essentially broken in that regard and that can be fixed with with diet it's a hard problem because the way I explain it to people is and I'm so clinically I'm not interested in weight loss right I mean that's just not I'm much more interested in longevity and yes sometimes weight loss comes with that but I like if I ever get stuck doing you know weight loss like I'm doing the wrong thing for my interest but the way I say to people when they want to lose weight is look you don't want to lose weight you want to lose fat let's let's be very clear on our semantics it weight is irrelevant right unless you're a cyclist or some athlete for whom the actual scale means something but for for people like us it's you want to lose fat not weight and then when you say you want to lose fat what does that mean in English well do you want fewer fat cells or do you want each fat cell to be smaller those are totally different questions if you want fewer fat cells have liposuction but we know that that doesn't fix you metabolically so if you want fewer if you want to be less fat you have to have smaller fat cells now a fat cell conceptually has two inputs and one output so now I say let's reframe the question you got a room with a hundred people in it you want fewer people in the room what has to happen more people have to leave the room then enter the room so similarly if you have a fat cell and you want it to be less fat you got to get more fat out of it than enters it and the fat that exits the cell exits via a process called lipolysis and the inputs to a fat cell are something called de novo lipogenesis which is turning carbohydrates into fat and aureus tariff occation which is turning fat like in a free fatty acid into a triglyceride back into a fat cell each of those three Doors is controlled by hormones and so the purpose of nutrition mm-hmm or fasting or exercise or drugs or hormones or all these things is to manipulate those hormones in the direction of what I call negative fat flux or what would be referred to in the literature as fat balanced negative fat balanced and the hormones that drive that are many insulin hormone sensitive lipase testosterone estrogen cortisol being the five most important in my opinion maybe someone will disagree with that but I think those are the five that rule the roost and so you know how do you manipulate those well insulin seems to be the most important of the five and there's no better way to lower insulin than to not eat so the first thing that happened to that dude who went 382 days without anything but water and minerals is he basically had very low insulin levels in fact once he got into raging ketosis which he got into by about day 7 his insulin came up only to prevent him from going into ketoacidosis which was what would happen if he had no insulin response in other words if he was a type 1 diabetic he would have died of ketoacidosis because he wouldn't have had the insulin to regulate the uptick of ketones but if you were I did this because we have a normal pancreas we would actually make just enough insulin to suppress ketogenesis and keep that beta-hydroxybutyrate level in the you know kind of in the neighborhood of probably seven or eight millimolar as opposed to getting north of 12 to 15 which is when you get into trouble so you know how do you manipulate insulin nutrition is the first way if you can fast the next best thing is to reduce carbohydrates carbohydrates obviously are the most insula Zdenek of food although protein can be quite insula genic as well it has a different response and then that's when you start to think about these other things you know I've seen patients where they just can't lose weight and I watch what they're doing and they're doing everything right but they just can't lose weight but then you notice their cortisol levels through the roof it's hard to get rid of fat when you have hot lots of cortisol cortisol is a very anabolic hormone too fat and a very catabolic hormone to muscle which is the exact opposite of what we want testosterone of course is the exact opposite testosterone is catabolic to fat but anabolic to muscle and then of course you know women have a harder time because once women go through menopause they lose all the estrogen and all the testosterone and so now they lose to hormones that play a very important role in regulating this so for these people that are having the issue with cortisol levels that's exacerbated by stress right yes so stress actually exacerbates your weight gain absolutely oh that's interesting yeah literally eat the same die and gain more weight because of stress absolutely Wow again hormones are what's driving fuel partitioning you know you're responsible for what you put in your mouth but in many ways at that point like the hormones take over and decide where it's going wow that's fast and now you yourself what what's your diet like I mean you told me you only once a day but yeah I'm one one meal a day or sometimes two meals a day how many calories you take in you know nowhere near what I used to I just don't train that much anymore I mean I kind of lift three days a week and then I I ride like a stationary bike like a peloton or I prefer this thing called a wahoo kicker where you actually put your bike on it so I'll do that three or four times a week I would guess when I sit down to throw down it's probably 3,000 calories a lot in one meal huh yeah although the problem is I'm a pig like I'm kind of disgust like I can eat a lot it's it's gross like I gross people out it's pretty like four feet I only eat 3,000 and calories in a sitting is like tame really yeah yeah no I have an eating disorder really I mean I sort of I I think I have disordered eating yeah III I'm seems like you just enjoy it because you do it once a day no under any circumstance like I I stress eat I I do get a dope like I don't get a dopamine high from gambling or you know alcohol like I don't like those things are not things that I can abuse like when I'm really in a shitty place in life like I i soothe and punish myself with food a lot of people do so you can relate and as a thin man you know when you're talking to people that are large and I have the same issue it's gotta know it's time and I completely understand what these people are going through at least in as much as what they as that is the physiologic desire for it I mean obviously they will experience something even worse because there's the like I can like look I don't have abs on I don't have veins in my abs anymore I used to when I was in a ketogenic diet you know seven percent body fat I was completely ripped I'm not ripped anymore you know relative to that that kind of bugs me but like nobody really knows that I mean nobody really gives a so I can still like look like a super healthy dude a super lean dude even if I'm not but oh my god like when when shits going wrong like I want to eat some of the worst foods that have ever been created why is that instinct there why is the instinct that when you're not feeling like for me it's tired like if I'm tired like if I'm coming home from a gig and it's two o'clock in the morning it's very difficult for me to drive past when zzzz you know I want to go to when Dino that could be that could be accorded that could be an adrenal issue so a lot of times we'll see when people either turn to sugar or salt in times of fatigue a lot of times it can be a you know they don't have the right level of free cortisol at that moment in time I've always feel it's a willpower issue because if I could just get home I'll cook something healthy and then I have victory yeah cuz if I get home I know I've got healthy food at home I eat something really good and it's just as good but there's something about also there's like you doing you know he shouldn't do there's a little weird little charge there yeah that's interesting I mean I guess it's different for different people I think for me if I'm really gonna be brutally honest about it I think it's that I like I sometimes just want to punish myself and I'm like you know like eating bad food is like when you're bad you eat bad foods you give yourself a cheat day you know I don't not really I mean I think these days and you know you've got kids so you know what I mean cheat days just present themselves often enough where other reasons and unfortunately I think for me that cheat meals are a lot of times cleaning up the kids plate or something like that you know like like I mean the funny thing is I just I really don't know why just like shitty food like I like macaroni cheese I just forget their macaroni and cheese I gotta eat it my kids asked me to make them peanut butter and jelly the other day and they don't each is really good it's a fantasy with a glass of milk they don't eat the crust so I'm like well these crusts shouldn't go oh god these kids in Africa that should eat that bro so I ate the crud and I thought about all the bread with peanut butter and jelly I ate in those crusts I basically had a sandwich it's like I'm pretending that I'm just eating a little crying a lot I'm worse than you dude you know what I would have done in that situation I would've been like okay well I would have started by saying there's not enough peanut butter and jam on these crusts to like I don't have the right ratio so I would have like got the peanut butter in the gym and dip the crust in there and like and then I would probably made us anyway I'm just happy that it didn't need a sandwich I'm of my own as well as the crusts because I probably could once you once the gates are open yeah once I'm out there making spaghetti and meatballs like all right let's get some ice cream in this mix too you know let's I'm already off so what do you what do you eat like when you sit down for these three thousand calorie meals so if I'm in control of the meal which I usually am and I'm super boring dude so it's I like to have a salad in a bowl that's larger than my head so I always refer to that as a manly bowl that's the definition of a manly bowl so it's got to be like a staggering amount of salad and my salad is the same every freaking day it's romaine lettuce it's you know tomatoes mushrooms cucumbers carrots and then the dressing is just extra virgin olive oil freshly squeezed lemon salt and pepper it's a pretty bland salad in that sense but I mean I can eat that all day every day and then it's a serving of protein and I usually cycle through salmon pork steak you know get some gamey meat like whatever I just sort of cycle through that and then I usually have some sort of starchy vegetable to go with it so potato rice you know lately the last couple of weeks I've been skipping the starch and just mainlining extra salad and extra protein but you know or but but that's insane that's when I'm in San Diego where I have control over what I eat more in New York I never eat in my apartment like I just never cook so I always go out and there it's a little less regulated so I mean I just love Indian food I love Persian food I love food that unfortunately is you know got more carbs in it than I'm probably suited for but I try to modify so like last week I had this Bob who's actually one of my my head analysts he lives in Boston he came down to New York for a couple days we were doing some work and we went out for he loves Indian and I live in Ian's so we went out for Indian fun night and who we hadn't eaten all day so we ordered I think seven or eight entrees and the waiters like you know uh you guys know you ordered seven or eight entrees right we're like yeah we got it we got it we're good and so you know we sort of skipped the naan or maybe had one naan to split instead of normally I would have had like four nuns it only had one bowl of rice but still a lot of carbs it is yeah naan bread is insane yeah luckily Bob ate more of it than I did and he's way more jacked than me so he can get away with eating way more naan than me but yeah that night I mean also those sauces are like so fatty like I'm sure that was a four thousand calorie throwdown mmm the other thing I'm pretty good about is when I'm done I'm done so that's the other thing about time restricted feeding that I think I get away with more because like when I go back to my apartment I will rarely have another bite and when I wake up in the morning it's like black coffee you know I'm not sneaking little in throughout the day like whereas if I'm not fasting it's just too easy for me to just like oh yes like in my office like I shared my office in New York I share with another doctor who it's his office actually I kind of sublet an office there but like I've never seen more in my life like then the stuff patients bring for him to eat and patients bring him food doctor of course were they trying to torture him for torturing them I don't know maybe but it's like you know our drug reps will bring stuff by or something like this is like there's an endless barrage of bad food but it's like good bad food delicious like if they were bringing like Oreos that actually wouldn't tempt me despite the monkey home-cooked brownie yeah exactly like they go I forget the name of God I can't remember the name of some of these bakeries up there but but yeah there's like some ridiculous that shows up and every once in a while like I'm like okay the fast is breaking at four o'clock today give me one of those scones but as long as you do it with moderation you think you're okay yeah except that my motto in life is moderation is the only thing worth doing in moderation so the problem is once I start like it's usually the wheels come off the bus pretty quick do you try to mitigate that with exercise like do you say that I went off the rails okay so let's hit the gym and Gauhar it's less that it's usually I anticipated and so like so okay so last week a buddy of mine went to see the David Bowie exhibit did you see it by the way the Brooklyn no are you a Bowie fan at all yeah oh dude it's there till mid June or December Oakland yeah it's at the Brooklyn Museum it is Brooklyn a couple of weeks ago but I was only there for two days for the UFC you know how to show out there so probably the best shows I've ever seen in my only yeah unbelievable actually I didn't realize it but like it closed at 11:00 p.m. and they just didn't have the heart to tell me so I was there till midnight before they finally came in like escorted me out of the building they're like sir we closed an hour ago I was like damn sorry man so what is it it's like an exhibit of all of his art all of his music all of and it's like it's done you know when you go to museums and they put the headphones on you and you like push the button to hear the thing it doesn't work that way like whatever you stand near you get the music associated with that plus or minus a narrative as necess sorry huh but it was like I've never liked they I think they had every one of his costumes Wow it was it was epic so anyway that night I knew we were gonna go out for a killer dinner before in Brooklyn before we went to the show and so normally I exercise in the morning but that day I was like look I will your muscles will be a little bit more insulin sensitive if you can exercise about 30 minutes before you eat that's probably about the sweet spot so if I were to ride at like 8:00 in the morning and then not eat until 7:00 at night like I mean I would still eventually get the glycogen there but it wouldn't be quite as easy it would require a little bit more insulin so in that case I just modified my day and was like you know made my schedule such that I could ride at 5:00 p.m. in anticipation of that and I also wrote a little longer and a little harder just you know like let's really crush this session so that you know I can go and enjoy dinner a little bit more well it sounds like you enjoy a lot of things you have a lot going on you've got your medical practice you have I mean all these different things you participated in as far as athletics boxing and swimming and cycling what jazz is you up now like what do you like how do you you obviously have a mind that requires a lot of stimulation like what what keeps you going I mean I think I think this longevity thing is the perfect culmination of all of my previous lives in terms of professional lives so I mean I used to be an engineer and then I you know went into surgery and then I left that and went into management consulting and like was 100 like had nothing to do with medicine for several years I've just worked in credit risk modeling and so in many ways like when you combine medicine with engineering with risk management that is what longevity is all about like if you want to take the practitioners you know the roll-up-your-sleeves approach that that's what it is so I think that scratch is that itch but that I think for me like I have to be sort of mastering something so that's where archery and racecar driving today become just total obsessions and like when we were talking earlier it's like yeah I mean I don't know that I'll ever go hunt because I don't know that I want to spend three days you taking ten shots when I could be spending you know three days taking 300 shots in my backyard like in the end I think what I really just obsess over is trying to get better at something and the nice thing when you start things late in life like I didn't get my racing license until three years ago and I've only picked up archery two years ago or maybe a year ago like when you suck so much like the opportunity to get better is awesome so I think the bigger it for me is not intellectual I think it's like tinkering it's like figuring out how to do better yeah I said I share a similar interest in things I suck at and that's what one of the things that was so compelling to me about archery when did you start 2013 I think I bought well I bought a bow before that but I didn't really use it 2013 I think is right when I got pretty serious about it you had John Dudley on your show once didn't you yeah a couple times - I wasn't I mean that shot through the handle of the kettlebell yeah was that a hundred yards I think was a little more but yeah yeah that is that's one of my favorite things in the world he's helped me a lot he's a remarkable archery coach and just a great person to just great I once saw an Instagram him and Jaco in the like they bumped into each other in an airport and so like I saw Jaco like two days later we had coffee one day to be clear Jocko had tea I had coffee jack was a tea guy but I was like dude I can't believe you know John Dudley goes I don't know him he just grabbed me in the airport and I was like dude I would have business shot do I want to see this he did it with a lighted not yet he had a little people don't have any idea how crazy this is they cannot fathom what he just did yeah I've seen him do he's a gun dealers he's a bad when it comes to archery that's for sure and he's helped me tremendous where does he live he lives in Iowa he moved to Iowa so he can kill big giant deer because he literally bought a farm in a giant chunk of land and raises it for he has he does do some farming but essentially what he does is raises deer it doesn't raise him like it's no but there's no fence right makes it very make it favorable for them to be there he has food plots that he grows and I mean I hunted on this place a couple years ago it's amazing it's it's an incredible place he loves it I just I remember when I bought my bow like I just sort of you know went into the arch like performance archery in San Diego's like the place to go right yeah went in there and was like okay here's what I want to do there like why I'm like just want to do it like okay great and then I remember when I you know got all my kit and my setup in there like all right you got to go to knock on like you got to just watch this dude's videos and yeah now he's literally the best and in terms of like the average person who's interested in it he's got a great podcast about it knock on podcast but he gets so geeky and technical in his descriptions and his understanding of it and he constantly obsesses about form and structure and you know archery to me my history is a martial artist it really it jives with me it makes sense because you could do you could muscle things and do them wrong and develop bad habits and you'll never reach your full potential or you could do things correctly and be very very disciplined and focused and understand the what why you're doing something and then really actually reach your full potential this isn't really no other way and with archery specifically it's so satisfying like as we were saying before when you do pull it off and you know you do execute that perfect shot with your rhomboids and the hand goes over the back shoulder and you watch that arrow shunk go right into that bull's eye like yes I have my daughter come out and do the slow-mo shot of me from behind I've got like a hundred of these dumb things on my phone and it's just like I can watch them all day and it's like did I do it did I do it nope not there right yeah look No sweet a lot of it is elbow position to the height of the elbow the elbow has to be in line with the arrow you know and sometimes people are pulling but they're pulling and their elbows up here instead of way back here yeah you know I I think that's an interesting point about certain things right so so to me the other thing I like about archery and and racecar driving is you have to learn some emotional discipline no you can't get pissed off and work your way through either of those things yeah you can sort of get pissed off on the bike and it can actually charge you which is not to say that cycling doesn't have technique in it but it plays a much smaller role and in the end the Gherkin out trumpet but you can't go your way out of a shitty shot and you cannot in a car if you start getting pissed you're done now you're absolutely done the same thing to be said for a lot of things I think pool is one of them yeah it's a big one Golf yeah I don't do but yeah you know listen Peter we just did three hours believe it or not I don't believe that it's 2:30 huh that crazy this place is a time warp it really is but I really appreciate this conversation man was really fun so thanks man thank you if people want to get a whole deal on Twitter give me your Twitter address your website and all that stuff yeah Peter Tia md80 T ia ia all right thanks man that was awesome [Music]

Channel: PowerfulJRE

Views: 2,341,387

Rating: 4.791625 out of 5

Keywords: Joe Rogan Experience, podcast, JRE #1108, 1108, Joe Rogan, Peter Attia, comedy, comedian, jokes, stand up, funny, laugh, mma, UFC, Ultimate Fighting Championship

Id: gP1NA5f4LfE

Length: 171min 39sec (10299 seconds)

Published: Tue Apr 24 2018

Reddit Comments

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[u/HotSauceMmm]

For those of you who were deterred from listening because of the negative comments, let me tell you that this podcast held my attention the entire time, and piqued my interest in topics that, before, I knew nothing about.

This guy's knowledge and easy-to-understand explanations of complex theories spanning a multitude of subjects kept me wired during my entire run.

He was not trying to sell anything. He was not trying to direct you anywhere.

This was an in-depth discussion of medical and sports-related science that will take multiple listens to fully grasp.

To the neckbeard Rogan-trolls who downtalked this guy, its you who really ruin this subreddit, especially for the people who actually appreciate this type of material.

If you haven't listened yet, I urge you to do so. Very informative. Extremely in-depth scientifically.

When the negative people on this subreddit show me their marathon swimming record, as well as their medical degree, then I'll take you seriously.

10/10 will be listening again.

edit: word choice

[u/hawkwurd]

Why is everyone calling him a "snake oil salesman?" Dude literally wasn't trying to sell anything. Hell, he wasn't really even planting his flag on any zealous dietary principles or anything like that. He's just a well-educated engineer/Johns Hopkins surgeon/endurance athlete who was discussing his experiences and research.

I get it if you wanna call someone like Aubrey Marcus a snake oil salesman, that makes sense to me. That dude literally has a company that sells weird supplements. Wouldn't say the same about this gentleman.

[u/stalinBballin]

Joe "A coyote ate my chicken" Rogan.

[u/jerseystrong201]

Wolves and elk on an island. Joe's paradise. All that's missing is Cam in a bikini and he's in heaven.

[u/sknick_]

I was listening (not watching) when Attia said that HGH could cause increased incidence of cancer & TRT could cause heart disease, basically implying both could shorten life span. I was just saying to myself "ooooh" that has to be hitting home with Rogan right about now.

[u/TroutDaddy]

I've been doing this diet for the last two months where I eat less calories than I burn in a day, try to avoid refined sugar and eat a wide variety of fresh fruits and vegetables in addition to lean meats like chicken, turkey and fish. I've lost fifteen pounds so far, but the diet doesn't have a cool name and no snakeoil salesman convinced me to do it. Maybe I should try the diet that makes you feel like shit and can cause heart problems if you don't get it just right.

[u/xavijo]

YOUR BODY DOES NOT KNOW THE DIFFERENCE BETWEEN A GLASS OF ORANGE JUICE AND A GLASS OF COKE

[u/JoshuaKevinPerry]

So, I can no longer start at the beginning of the show after it goes live, anyone else have that issue?